Denis Dronjics third blog entry from his epic journey..(click..)

Our Voices 1st Workshop from Our Voices Project on Vimeo.

This is a quick look at the first Our Voices Project which took place the week of May 18th-24th, 2009. Photographer Hunter Barnes and artist Jason Rosenstock took cameras, printers, scanners and computers to the town of Lapwai, Idaho on the Nez Perce reservation and conducted a ten day workshop with teens there. Black and white 35mm photography, scanning, printing were taught as well as digital video shooting and editing. The students were asked to tell stories of their daily lives on the reservation through these mediums. All the equipment was left for the students to use and they have produced amazing work, which will be posted soon!

Dame Silvia Cartwright

Dame Silvia Cartwright. Patron of Rose Charities New Zealand, visits the Rose Charities Cambodia Eye Clinic. Please click to read the article from Stratford Press

Left to right: Mike Webber IRose Charities NZ), Dr Hang Vra (Rose Charities Cambodia) Dame Silvia, Mrs Natalia Hang, Mr Bun (Rose Charities Cambodia)

Rose Charities NZ Trustee, Mike Webber, hosted a visit by Dame Silvia Cartwright to Rose Charities Eye Clinic in Cambodia.

The New Zealand judge and former Governor-General Dame Silvia is one of five trial judges for the Cambodia War Crimes Tribunal and has been based in Phnom Penh since last July. She is also a Patron of Rose Charities NZ along with Lady June Hillary.

Mike said that Dame Silvia spent 40 minutes at the clinic on Anzac Day aftershe had attended Anzac day events at the Australian Embassy.

“She was most impressed with what we are doing for the people of Cambodia. Dame Silvia is a charming and friendly person, who put all at ease very quickly, and was able to ask the staff all manner of questions regarding their work. As a non-medical person she was fascinated by the pre-op preparations for cataract surgery that took place whilst she was there. She was given a tour of the tour complex, with explanation of what was done in each area,” he said.

Mike spent seven days in Cambodia. In the past the trips have been up to two weeks long, but he said the visits are now shorter because they are fine tuning the operation at Rose Clinic and spending more time planning for the future.
Whilst there he took the opportunity to visit the school where the second intake
of refractionist nurses is in training. Cambodian National Refraction Training
Project has been established by the ICEE and Mike was one of the people instrumental in having this set-up.

“This group I saw in training was at Ang Doung Hospital in Phnom Penh. ICEE have had a huge input into this project, and have set up new offices in Phnom Penh where examinations and optometrical services will be carried out. There is input also from the Fred Hollows Foundation, and their person on the ground, Horm Piseth, is the Cambodian Overseer of selection and training for this course. Main input form ICEE Sydney comes from Gerd Schlenther,
Research and Programs Manager, Asia-Pacific, and Dr May Ho, Project Manager, South East Asia who supervises the design and implementation of the training programme.

“There are seven nurses in the intake and they come from all over Cambodia. Once trained they return to their provinces and undertake the work they are trained for and refer people to the clinic when necessary.”

The 2007 Durban Declaration on Refractive Error and Service Development recognises that the greatest contribution to a severe worldwide shortage of refractive error services is the limited number of trained personnel, a need that is most pronounced in poor and marginalized communities in Cambodia.

The establishment of a National Refraction Training Centre in Phnom Penh and the delivery of refraction training by local personnel have been identified as the most effective means to address the shortage of refraction personnel in Cambodia.

The ophthalmic community in Cambodia is new and emerging. For example, in 2007, optometric services were provided by only 19 refractionists with no national refraction training available in the country.

RANZCO has also been successful in setting up a training course for Cambodian Ophthalmology, which requires four years of internship, and there are currently nine interns on this course. Visiting lecturers are supplied by RANZCO, and some other occasional lecturers brought in from Europe, Thailand, and the U.S.A per courtesy of PBL and the Health Ministry.

In December last year Rose Charities celebrated its 10th year in existence.

International Secretary for Rose Charities said the organization is about people helping people.

^{“10 years has seen a huge amount happening. Wonderfully it has happened in ways which really follow the Rose principals of ground level, person to person, 'human scale' initiatives. Everyone - organiser, donor, and recipient all benefit. Rose Charities is coming of age, but not, I am pleased to say, by adding layers of bureaucracy and rigid administration. Rose Charities remains what it always has been, and must always be; simply people helping people,” he said.}

^{Mike said the eye clinic in Phnom Penh is well on its way to be self-sustaining but he’ll continue to visit from time to time to help fine-tune its activities. Over the past five years other kiwis have been involved in supporting this project. David Sabiston, now retired as a Trustee,
has made four visits. Christchurch optometrist and Rose Charities Trustee John
Veale has made three visits, and Ken and Penny Adams visited last year.}

Walking to Santiago for Rose Charities...
www.justgiving.com/denis-dronjic
The never ending road! By: Denis Dronjic

I’m not speaking of the Road to Santiago I am so anxiously waiting to begin on May 13th, I am speaking of the road we choose for ourselves; the road that brings us to our destination, only to realize, once we arrive at our destination, that the destination has always been within us during the journey.

Here I am, once again, counting down the hours before the start to the new expedition. I must say, it’s a mighty coincidence that I am starting on my Santiago expedition on the same day I set off on my ‘Pedal for the Medal’ expedition I did two years before, in ‘07. It was on May 13th, 2007 I set off from Nanaimo, British Columbia, to cycle my road bike 3,000 km to San Diego, California, to help raise money for Rose Charities. It was during this expedition when I was first introduced to my never ending road.

So here it goes…. On May 13th, 2009, I’ll be starting my walk on the Road to Santiago. I had originally learned of this 860 km road through Northern Spain , from one of Paulo Coelho’s books. Paulo Coelho is a Brazilian author whom is recognized throughout the world for some of the most amazing mystical stories written. He completed this road himself and praised it a number of times in his books; that is how I came to learn of this Christian walk.

The 30+ days it took me to cycle the west coast is nowhere near the 45 - 60+ days I am predicting will take me to complete the walk to Santiago . I know, I know! I should be able to walk more the 30 km per day and get this done in less than a month. If you are rushing to get things done, sure, a person could complete it faster, if that’s what they desire. But even if I wanted to rush - which I don’t - I can’t!! I am starting the walk on my one year anniversary from the day I almost lost my legs and my life.

On May 13th, 2008, I was crushed by a car! I was riding my motorcycle when I lost control of my rear tire – due to rain and inexperience-- and since I was not able to regain balance I had to dislodge my motorcycle, only to hit the pavement and slide underneath an approaching vehicle.

The collision with the vehicle was so severe that I was thought to be dead by all the bystanders since they literally had to lift the car off my body with their bare hands. After I was revived back to life, I was rushed to hospital in critical condition. A dislocated hip like I was dancing salsa on a deserted island hanging of the coast of Spain; broken right femur; broken right head of tibia, connecting into my right knee; broken right and left fibula; broken left tibia (open fracture with more the 3 cm of bone missing); broken left ankle; broken scapula; and last but not least, like all of this wasn’t enough-- internal bleeding and swelling in the frontal lobe of my brain. Besides the road rash, I think that is the complete list of the injuries I sustained in this horrific accident.

Now don’t be shocked, it sounds worse than it really is. If you were to see me today, you wouldn’t even know I went through this. Besides a few hidden scars and limping when I walk, I function like this was nothing more than a bad dream. I mean, physically I am not what I use to be, and I might never be again, but this hasn’t stopped me from chasing my dreams on this never ending road. And that’s what this walk is: a journey, a journey to the destination called Santiago. A journey for all the children and families that don't have a chance to dream like you and I do. A journey for this world to wake up and take care of its people. A journey for all the wonderful work that ROSE CHARITIES has done and is continuing to do. A journey for you!!

Please donate, even if a dollar is all you can afford, trust me it will make a big difference. It is people like you that make the difference in this beutiful yet unfair world. I will be doing something that doctors DO NOT think is possible, and I hope you will do something I know is possible.

Thank you for taking the time to read my fundraising page. If you are interested in following my journey I am taking with my father, you may add me to facebook. Search for Denis Dronjic. I’ll be posting pictures and stories periodically when I arrive at a village that has internet. It is said that a person walking the Road to Santiago has a spiritual awakening during his/her journey, so I am sure my blogs will be an interesting read :-)

Thank you and may God bless you
Denis
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Donating through Justgiving is quick, easy and totally secure. It’s also the most efficient way to sponsor me: Rose Rehabilitation Trust gets your money faster and, if you’re a taxpayer, Justgiving makes sure 25% in Gift Aid, plus a 3% supplement, are added to your donation.

So please sponsor me now!

CAMBODIA: The high price of jealous. Acid violence in Cambodia

Photo: William Grut/Rose Charities

Many children also suffer when some of the acid thrown towards an adult accidently drops on them

PHNOM PENH, 26 March 2009 (IRIN) - Sreygao is house-bound, her life destroyed after a jealous wife doused her face and neck with acid. It burned into her skin and blinded her.

“Everything has been taken from me because someone was very jealous,” she told IRIN.

Before the attack, Sreygao worked as a hostess at a karaoke parlor. Every night over beer, she flirted with and sometimes solicited sex to wealthy men, prompting an angry wife to take revenge on the 19-year-old.

“I have no face, no job, and I will suffer forever,” she said.

Deeper than scars

Acid throwing is a common form of retribution in Cambodia, usually perpetrated by jealous lovers, said William Grut, a physician at Rose Charities which provides free treatment.

“Whether male or female, jealousy is jealousy,” he told IRIN. “It's not a question so much for gender discussions but rather why it's so prevalent and how it can be reduced.”

Cambodia's pattern of gender blindness marks it out from Pakistan, India, and Malaysia, where it is usually the men who use acid on women for punishment or reasons of honour.

Between 1999 and 2002, the Cambodian League for the Promotion and Defense of Human Rights (LICADHO) documented 44 cases in local newspapers – the most thorough research to date, as no government body or NGO compiles data on acid attacks.

An attack occurs every 25 days, the group said in its report. But Jason Barber, a human rights consultant for LICADHO, told a radio station that the real number of attacks remained unknown since many went unreported.

Grut said the numbers available correlated with more populated areas, such as the capital, Phnom Penh, and smaller cities in Kandal and Kampong Cham.

Manifestation

I have no face, no job, and I will suffer forever.

The widespread availability of acid to replenish old batteries, weak law enforcement mechanisms, and what Grut calls “tertiary conflict injury”, have all popularised acid-throwing.

Tertiary conflict injury is a mindset in war-torn countries that problems can only be solved with violence, with beatings and acid attacks commonplace.

For decades, Cambodia has experienced coups, civil wars and a genocide in 1975-1979 that killed two million people.

“Cambodian history has regularly been very stressful for the [ordinary] person,” he told IRIN.

“This is not the same as PTSD [post-traumatic stress disorder], though arguably it may be a sort of long-term manifestation of it,” he said.

Repairing the damage

Corrective surgery is out of reach for most Cambodians, with 35 percent of the population living on less than US$1 a day, according to government statistics, so most sufferers must rely on emergency services from NGOs.

“Clearly in Cambodia, facilities are far more limited than in western countries, where one would have a long series of repetitive operations gradually working things back, reconstructing, and grafting,” Grut explained. “It would all be accompanied by very close counselling and peer assistance.”

But first, more attention needs to be paid to acid attacks as they are usually not a priority for local NGOs and government agencies, he added.

“There's not enough recognition at the NGO level, but at the street level there is,” he said. “People tend to know about acid attacks as the word goes around.”

Geoffrey Cain

Iron Woman of Rose Charities Australia to help Cambodian rehabilitation !

Canadian Model Noot Seear recently returned from a trip to Cambodia and Vietnam to visit some of the Rose Charities projects that she has been supporting for years. Noot is a model and actor and has used her celebrity contacts to help raise thousands of dollars for children and families in USA and worlwide. She is rumoured to have been cast as Heidi in the movie New Moon, which is a sequel to Twilight. This photo was taken at an orphanage in Vietnam, She also visited the Rose Charities Eye Clinic that treats over 10,000 poor cambodians for eye disease, and the FIRST Rose Clinic that conducts free surgery for children with cleft palate, burns and oter injurues. Noot is president of Rose Charities NY. for more info www.rosecharities.org

Thank you to Rose Charities Vietnam for a wonderful meeting
(click on letter below to enlarge)

OPERATION SMILE MAKES ME HAPPY

2009 March 17

tags:

by jaotte

We’ve got 6 OR tables running. Not 6 rooms, really, because some rooms have 2 tables. All the bleep bleep of anesthesia machines can make it confusing, but generally we’ve got it down.

Yesterday I assisted Prabir, a friendly plastics man from India. We did a really really huge bilateral cleft lip - not a lot of tissue to work with, a facial cleft (Type 7) and some skin tag removals, a unilateral repair with rhinoplasty, and something else which I am forgetting at present. It was a pretty good day once we got going - don’t know what the delay code is for “Luke left the key to the OR suites back at the hotel”, but that’s what happened!

Today was much smoother. Our scrub ‘techs’ were not around for the first case, so I served as the scrub nurse. I’m pretty bad at it - didn’t know all the names of the instruments, had a hard time hearing what the surgeon asked for, and even dropped a needle driver on the floor! But, we got through and our lovely Phillipino surgeon didn’t bat an eyelash. Then I found myself next door, thinking I was just observing, when I got pulled over to intubate. Easy peesy! But - the RAE tube was a bit too small [there was a little leak] so I had to extubate and by then we had some laryngospasm; it was tough to get the 2nd tube in, so the Anesthetist handled the finishing bit thankfully.

I had fun teaching a first year med student from Tulane how to scrub, and she did a great job. Didn’t contaminate anything or piss anyone off = fantastic for a first go! Waiting in the wings to scrub on the next case - a facial cleft - there was a heck of a time getting an IV in the kid. Dehydrated and cold (thanks to cranked A/C), 4 paeds anesthetists, a paeds intensivist, and a NICU nurse tried, but all they got was a pin cushion. So, the surgeon did a venous cutdown, which seemed the definitive solution but even then, a juicy vein could not be found. We were lucky that the little girl fed vigorously in PACU because that IV flow kepts ceasing. I took out the IV in post-op recovery, since she was sucking back the Tang with no problem (and the IV was just an object to be thrashed away).

Long day. About 11 hrs on the feet, with a lunch break and a bit of loitering in between being needed. I love the variety I’m getting but I’m hoping tomorrow to scrub with Dr. Sarom and see what he can do. Sounds like he is one of the best in Cambodia and I haven’t really gotten to work with him yet.

The amount of collaboration, teaching, and learning is incredible. Surgeons from each country visit their colleagues tables to see how they are doing this flap, where they are stitching this bit, whether they are using collagen here or not. Our crack dentist rigs up prosthetics for the palate and the nurses are turning heads and taking names by being superb at their jobs. We’re all learning from one another and making things go smoothly. It’s amazing what a very-well funded, well-staffed production can do in such a short time.

On Saturday, the crew will all be heading to Siem Reap. The poor among us, and those who want to see the countryside, will take the bus. The rich Yanks will take the plane. I’ll return and have another 4-5 days with Dr. Sarom. I may splurge on the return journey so that I can squeeze in an extra day in Phnom Penh. Gotta get my evaluation sorted and I’ll be off to Saigon for 2 weeks of ER in Cho Ray Hospital!

p.s. I’ve got so many rad photos, including many of the surgeries I’ve been on, up close shots of the venous cutdown, and videos from the back of the moto… but these will have to wait for my return as I’ve yet to find a cafe with a memory card reader here.

Noot Seear of RoseCharities USA has he hair done in a Somaly Mam training center for hairdressers. Rose Charities USA is a stong supporter of the anti trafficking organization, 'Somaly Mam', as well as the local Cambodian Rose Charities medical and surgical rehabilitation projects. Rose Charities itself supports anti trafficking activities in Nepal.
RoseCharities USA also runs its own USA based media-education project with native American groups in Idaho.
Noot is currently (Feb-March 09) with fellow model Annie Henley, and digital artist Jason Rosenstock, visiting Vietnam and Cambodia, partly for the 2009 RoseCharities International and Regional Planning meeting.

It is rumoured that Noot is currently auditioning for a role in the Twilight (New Moon) movie as Heidi. Good luck Noot !

Noot Seear (RoseCharities USA) assists Somaly Mam, by modeling at their annual charity fashion show 2008

Somaly Mam is a wonderful Cambodian NGO dedicated to ending exploitation and slavery. They report...

"Many people are shocked to hear that more people are enslaved today than at the height of the transatlantic slave trade. Modern day slavery is a thriving and growing business and has been able to stay out of the public eye until recently. Action comes from conversation and conversations about slavery cannot happen unless the public is educated.

The Somaly Mam Foundation is dedicated to raising global awareness through the news, media and entertainment, celebrity voices, speaking engagements, encouraging university and high school involvement, internet communities, and other forms of communication."

Rose Charities has been working in Cambodia since 1997 and is of its leading organizations medically helping victims of acid-violence, as well as providing cleft palate, and other surgical rehabilitation procedures for the poor in properly recognized Cambodian hospital environment. With a Cambodia wide network, the organzers of Rose Charities well know what wonderful work Somaly Mam carries out and lauds their achievements strongly. Noot Seear was one of the founder members of RoseCharities USA. It is a Rose Charities policy to coodinate efforts where it can with any honest organization which will bring benfefit to the needy.

The impact of disasters on children. By Dr Yaya de Andrade

(clicking on article below will enlarge it)

A huge CONGRATULATIONS and our best wishes to President Barack Obama on his inauguration today 20th Janary 2009 from the whole RoseCharities USA and the whole Rose Charities Network.

Note. 2008 Annual Report. Now up on www.RoseCharitiesReports.blogspot.com

Christmas and New Years message from Mr Louis Lap Nguyen, Chairman of RoseCharities Vietnam 2008


I wish you and your families a very merry Christmas and a Happy New Year. I am especially thankful and honored to have met and worked with a talented and dedicated group of people. This year has marked the beginning of Rose Vietnam in many special ways and we had jointly made it happened. We had built a solid foundation under the mission and framework of the larger Rose International Charities Family for which I am grateful for the guidance, support and resourcefulness. Our momentum will continue into the the years to come. I believe that the hopes and dreams of whose lives we had touched on serve as the shinning light for our purpose, the motivation for our cause and the force that had brought us together.

At some point in life I had read a phrase that goes like this: \"The finest form of charity is to enable a poor man to support himself with honor and usefulness,\" and with the little difference that we make out there in incremental pieces, I also recall someone saying this: \"To make something-something real, visible, fruitful and productive-where once there was nothing is a fine expression of one of the deepest and healthiest human instincts.\" Since then, I carry this baggage with me and reflect on it from time and again. But now, I am immensely optimistic...because...I am not traveling alone...I have you by my side.


Louis Lap H. Nguyen RPh. MBA

Christmas Message from Lawrence Cheah: Chairman Rose Charities Malaysia
www.MyRoseCharity.com

Today is Xmas day.Christmas is a time for gathering family and old friends together. Christmas never fails to bring to mind the divine words."Peace on Earth and Goodwill towards fellowmen ."So, on this Christmas Day, while we exchange good wishes and entertain visions of a better future for us and for everyone else, we solemnly dedicate ourselves to do whatever is in our power for the realisation of "Peace on earth and goodwill towards our fellowmen "

But just as it makes us feel loving and loved to open the door to familiar faces and new faces of Rose Charities International global village volunteers and welcome them in,it's also a time that reminds us of those who are no longer there.

So in the midst of all our drinking,eating and getting very merry, we shouldn't forget that Christmas is also a good time to stop the usual noise of our everyday life........to remember and then celebrate those we're loved and lost .

Former Indian prime minister Jawaharlal Nehru once said : " What we really are matters more than what other people think of us " .

To achieve our international global mission statement,we will build on the strength of our volunteers,our track record and professional reputation .

WE should forge ahead towards new levels of excellence in order to create sustainable growth and distinctive value for our members and the community at large .

Mother Teresa said : " Never worry about numbers ,help one person at a time and always start with the person nearest YOU ."

We should also empower our international pool of volunteers to serve their communities,meet humanitarian needs, encourage peace and promote international understanding and goodwill through Rose Charities Centers throughout the world .

We should have passion for everything that you do,then joy will come from that passion " .

Theodore Roosevelt once said : " DO WHAT YOU CAN,WITH WHAT YOU HAVE WHERE YOU ARE '

As volunteers , we must demonstrate to others......how much good can be achieved ( the numerous projects and activities carried out by Rose Charities CHAPTERS )by sincere efforts,unselfish spirit of service and excellent spirit of suport and co-operation in the community in which we live in .

IF you give somebody hope ,you give them dignity. Most important, you show them that somebody cares. That is how i found what i call purpose of life .. trying to lend a helping hand to someone and show them that somebody does CARE .

With another milepost in sight and another year bckoning us with hopes and opportunities for service to the commuity, we stop a moment to reflect upon our pleasant relations of the year about to close.

It is indeed,with gratitude that i look back upon the past year and thank you for your continued support and trust in electing me your Malaysian chapter president.

Your presence will be the barometer for our efforts.It will spur the adminsttration on to greater heights and achievements .It will be more than an indication of support,it will be an inspiration for even better and more projects and activities for the malaysian organisation .

May i extend to you,your family and volunteers from Rose Charities global village bst wishes for a very happy,healthy and properous NEW YEAR .

Warmest regards


Lawrence Cheah..

If you are short of a Christmas present.. why not buy two in one. !! A Rose Charities Madagascar ($Canadian 15 each), not only gives a calendar but also an (almost) $15 donation to Madagascar Child Education. (the printing costs are donated). Contact Emma (Vancouver/Victoria. BC). Or the see http://www.rosemadagascar.com/

Making Momo's.. Rose Charities New Zealand learns from Rose Charities Nepal.. !
.. (Click on frames to enlarge)...

RoseCharities UK, Vietnam, Australia, New Zealand. Short report of visit and AGM's. Fall 08

13 years ago in Paris, Project IRIS was founded. I had been working in Cambodia since 1992. It was then a land devastated by conflict, brutality, genocide and pain. I arrived shortly after the United Nations troops had started to come in which followed on from the Paris Peace accord where the conflicting parties had agreed to put down arms and let in the UN as a transition government to organize elections. I went to Cambodia to work on an AMDA Japan project to assist setting up health services for repatriated refugees from the border camps. Working out of a shaky field clinic in fringe Khmer Rouges country (the Khmer Rouge had reneged on the Paris accord and not put down their weapons), we saw, among the vast array of sickness at Phnom Srouch many treatable eye conditions and that was my personal call to try sometime to do something about them. Cataract blindness is so relatively easy to treat, yet there was almost nowhere in the Cambodia at that time where the poor could get the operations they needed.

Michele Claudel, a generous Swiss philanthopist a friend of a medical colleague of mine, Dr Francois Lette who had also come to Cambodia with AMDA had visited Cambodia during this time and sponsored several Cambodian students to go to France for advanced training in Tropical Medicine. This wonderful educational initiative of hers was something hugely needed by the country. We had become friends and we decided that we should initiate an eye project. She arranged the meeting in Paris and introduced me at the time to the third of we three IRIS founders, John Stewart.

There was then a period of yo-yo'ing back and forward to Cambodia both for Michele and I, setting up infrastructure etc. The key to it all happening though was through my informal AMDA connections with AMDA Nepal, a wonderful and very organized medical organization and part of the AMDA world network. The level of expertise in Nepal developing country eye surgery was wonderful, yet there had been virtually no contacts between the Nepal and Cambodian systems. My good friend there Dr Bal Kumar Katri Chetri ('Dr KC') introduced me to Dr Basant Raj Sharma (now one of Rose Charities most experienced consultants and advisors),of Lumbini Eye hospital, the run by SEVA, who advised on our purchase of equipment and logisitcs. We decided that the 'eye camp' approach would be the most fruitful, to try to get out to the almost medieval conditions in the countryside and take the operations to where they were most needed. Without the Nepal input, and specifically that of Dr Basant, who supervised and operated at the first (and many others later) IRIS eye camp, IRIS simply would not have happened. In that sense, Dr Basant can be considered is the true founder of both both IRIS and Rose (which evolved from IRIS)

John Stewart, one of we three IRIS directors, also a talented writer and documentary maker generously made and donated this film (part shown here..for more see www.RoseCharities.org ) for IRIS promotion. John was initially a board member of Rose Charities Canada after Rose Division of IRIS became its own organization. Both John and Michele can be considered two amongst the most important founders of Rose Charities as, without their agreement, the Rose division would not have been separated from IRIS. IRIS continues to this day, expanded and carrying out wonderful work in its almost exclusive focus of ophthalmology. In 2004 the Rose Charities Eye clinic, then fully re-equipped after a terrible looting some 2years earlier by a crooked expatriate , was offered to IRIS Cambodia to be run by them or as in a joint collaboration. The offer was graciously declined. Will Grut

RoseCharities Surgery

Rose Charities Rehabilitation Surgery - the '2TS' Principle Since 1997, Rose Charities has been promoting rehabiliation surgery in Cambodia and as a model for developing countries in general. This is a brief synopsis of the founding principles put into the Rose Charities Cambodian projects at that time by Will Grut. The Kien Khleang Center was identified at that time as being a suitable location for the project and Grut successfully obtained permission from the Ministry of Social action to open the Rose Charities Rehab Surgery center there. In 2002 after a horrendous robbery, looting and vandalization, the non ophthalmolgical part of the project was tranferred to Chea Chumneas Hospital and Operation FIRST established with Dr Nous Sarom to run it. This change has been most appropriate as the Kien Khleang Center, not being a proper hospital does not have proper facilities for responsible surgical procedures other than eye surgery (local anaesthetic, no risk of transfusion being necessary) and is not run by the Cambodian Ministry of Health. The following was written in 1997, but applies as much today as it did then in many countries in the developing world as well as to Cambodia

Rose Charities work with victims of land-mine and conflict injury, acid burns, cleft lip and palate, and other surgically treatable conditions ( meningoencephalocel , club foot, slow tumors , congenital malformations and many others ) is now well known all over Cambodia. Dr Nous Sarom , Operation FIRST with RoseCharities have been pivotal in this work and continue today increasing operation spectrum in areas such as micro-surgery , orthopedics, ear surgey etc, as well as training new surgeons, nursing and physical therapy staff . FIRST-Rose has an open door policy, welcoming bona fide students, residents, and other groups, local and international who genuinely and honestly wish to help the people and health system in Cambodia.



Conflict injury

Based in 1992 in Phnom Srouch, a heavily landmined and conflict infected area of Cambodia, Dr.William Grut observed that conflict health problems fell into one or more of three categories

Primary conflict injury / disability : Injury resulting directly from the conflict. Amputees, other land mine injuries, bullet wounds etc.

Secondary conflict injury / disability: Injury, as a result of the disruption of infrastructure of the county. Thus, elimination or serious reduction in health services, and / or access to those services or clinics. Lack of education. Lack of vaccination programs. Lack of health surveillance. Dangerous transport methods over destroyed roads, bridges etc. Polio, post meningitis, cerebral malaria handicaps, effects of measles, shistosomiasis etc.

Tertiary conflict injury / disability. Injury / disability caused by the 'physical conflict mindset' which sees the solution to any problem as being the use of physical violence. Thus, deliberately inflicted acid burns, beatings and other physical cruelty. Forceful control, rape etc. Tertiary conflict problems can be very much accentuated by secondary conflict effects such as the lack of a fair and functioning judicial system and / or corruption in the law enforcement services.


The Rose Charities '2TS' rehabilitation surgery concept

The focus of the Rose rehab surgery model is aimed entirely at two aspects . .. 1) an improvement in quality of life for the sufferer of the disability.... and..... 2) the ability of the country or region to sustain facilities which will lead to such improvements for future suffers.

This is achieved by the paradigm called by Rose '2TS' which stands for ... 'Treatment sustainability & Training Support' ..... and in its most basic form it is this which was defined as the basis of the Rose model based on the following observations, practical experience, and summation, below...


Treatment sustainablity

To be sustainable, health services in any country must be at a cost consistent with what a country can afford and give maximum benefit for the money spent. Since the 1970s the formula to achieve this has focused more on 'Primary Health Care (PHC), elements of vaccinations, mother and child health, sanitation, clean water, education and basic treatment of the most prevalent diseases in the community. PHC continues to give enormous benefits to the health of populations when administered properly. It thus must always be in the front line of the health improvement processes in developing countries.

Due perhaps to the success of PHC however there has sometimes been a tendency to see it as the only health process which can be sustainably implemented at acceptable cost. Surgery, on the other hand is seen as expensive, non cost effective, far to complex and sophisticated and needing inappropriately large resources to sustain a trained level of human resources.

The 'Rose model' however shows both theoretically and (by the work of Rose Charities , www.RoseCharities.org ) and in practice, that surgery too can be cheap, effective in the improvement of quality of life, sustainable, safe and highly desirable.

The Rose model is based on the observations..

Rehab surgical procedures, carried out properly in developing countries by locally trained surgeons can have costs per procedure well equivalent or less than the cost of many of the longer term drug treatments (i.e. for TB, Leprosy etc. etc). Thus a cataract operation which will restore sight to a blind person can cost as little as USD 17 (Rose Charities Cambodia figures for 2005), or a cleft lip or palate, land mine amputation etc, USD 30 - 50)

Rehab surgical procedures often have an enormous benefit, not only for the sufferer of the disability but also for her / his family, village, community. A child who has had a cleft lip or palate repaired is no longer considered 'an idiot'; he/she can go to school, get married, be employed etc. Rehab surgery thus can significantly increase the D.A.L.Y. (Disability adjusted life years ) of an individual, community or even, with nation programs, the whole country.

Populations WANT rehab. surgery. People, wherever they are, want to be cured of or at least helped with their disabilities. If you ask a group of villagers in almost any community whether they would like a clean well, instead of the old muddy stream that they and their animals may be drinking from OR sigh restored to their parents, or their children's cleft lips repaired, or their men to get proper surgical assistance to get a an artificial limb, they will invariably choose the latter. This is not an incitement on PHC, simply a statement of the fact that it is the quality of life perceived by the community itself which should be taken into primary consideration and not just the perceptions of the planners. (who, far more often than not, are not those who live in the villages where the assistance is being made.


Training support.

Support for training - the implementation of cost effective training programs is the crucial element in ensuring treatment sustainablity above. Dr. Grut realized that appropriate training programs....

Need not be expensive. They can be implmentable with the assistance of relatively small international funding agencies and/or national resources. Resources for training can be left within the country in the form of upgrades to existing facilities and or equipment donations

Already have the the basic human resources in place i.e. already qualified physicians, anaesthetic nurses, even nurse-practitioners in outlying areas already in place and interacting with the population in need.

Can be implemented by volunteers from the industrialized or other countries by multiple short term voluntary visits. This has the multiple effects of giving the international trainer a fascinating and enormously appreciated new facet to her / his vocation, making new friendships, linking the trainees into an international network, as well as the main goal of improving health care in the developing country.

Can be linked into a region or nation wide network

Have a multiplying effect, in that once trained, the recipients of training can go out and train others...

Can be linked and integrated with PHC individual or team training to provide the most comprehensive health care 'package' for the country.

NEW ROSECHARITIES NEWS BLOG. RoseCharities News blog is shifting to ...
www.RoseCharitiesNews.blogspot.com .
This blog-site will remain though for general comment, words, thoughts, ideas, non-urgent updates etc, ie. here, on www.RoseCharities.blogspot.com

Acid Violence in Cambodia

Sunday, June 22, 2008

Acid Violence in Cambodia

"Acid violence defies any bounds of comprehension. It is a violation born and nurtured in hell itself, pitiless, hideous evil. It takes away both skin and flesh and the very soul of the victim. And it does so with a finality that is very often absolute.

I saw my first acid violence injury around 10 years ago. I had set up Rose Charities as an extension of my previous organization, Project Iris. Iris dealt with eye injury and sight restoration but so many injuries extended beyond the eye to the face and torso. Rose went beyond the eye to facial and other injuries. Word had gone around that there were ‘foreign doctors’ helping the injured and we had set up a simple operative and treatment clinic on the outskirts of Phnom Penh. I came in in the morning and she was there in the waiting area, led brought in by a friend.

It is hard even now, even as a physician who has seen many physical horrors in a lifetime horrors to think back on that face and body. It was as though the world had brought out a being so alien, so mutated that no other thing would ever recognize it. She just sat there on the hard wooden bench as I took her hand. She could not cry, she had no tear ducts the skin fused tightly over where here eyes may or may not lie underneath. She just sat gazing forward the mottled leather membrane, the shrink-wrapped skin of her face no longer with any elasticity or innervation to display any expression.

She had been beautiful, it was the only possession of value she owned. She had got low paid job in a restaurant. She had a boyfriend. One day it seems she refused the advances of a much older man, a government official of some importance. That evening two men were waiting. They held her down and slowly poured on the acid. And they continued to hold her while it did its work.

That’s the thing. . Simply throwing acid in someone’s face gives the person time to rush to water and prevent much of the damage. Acid will continue working and if the victim is held then it can be poured onto specific areas; the eyes, the genitals, the breasts. There are of course cases where acid is simply flung at the victim, often in a large quantity, like most of a bucket full. If the victim can then get to a source of water very quickly she can limit the amount of damage – though it may still be severe and have irreversibly damaged the eyes.

Now, some 10 years later I have seen victims of acid burn attacks at our Rose Charities Surgical Rehabilitation or Eye Centers. Although statistics are scanty and subject to the inaccuracies of translation (Khmer is a notoriously difficult language to translate into English with the same exact retention of meaning) it would seem that around 50% of attack causes are the consequences of real or perceived extramarital affairs and/or other aspects of life leading to the seeking of revenge, hate, or jealousy. A further 15% are ‘accidental’ in the sense that someone, most usually a child, has gotten in the way of thrown acid. The rest result from disputes such as over land. Cambodia’s history of conflict and successive imposed governments has ensured an enormous uncertainly in land ownership resulting in claims and counter claims.

Cambodia’s conflicts of the last 50 years have been extreme and brutal. Despite attempts to keep neutral, the country became heavily involved in the Vietnam war, its people first being hit by both sides, and before eventually succumbing to one of the most genocidal regimes of human history, that of the Khmer Rouges. In this period, some 2million persons were slaughtered, tortured, starved or worked to death. Women were forcibly married to strangers, forced to watch as their children were taken away or their babies bayoneted in front of them.

The injury and illness of conflict and post conflict zones lies in three broad categories. There is ‘primary’ conflict injury, that which is mostly associated with wars; bullet wounds, blast injuries etc. Then there is ‘secondary’ which is the disease or untreated trauma caused by the conflict induced breakdown of infrastructure and then there is perhaps the most pernicious, the most long term, the ‘tertiary’ injury of the mind where the control of others is linked with violence fear, terror. While sadly the control and abuse of women is not only restricted to post conflict scenarios it may well be one reason why it remains rife in Cambodia.

The throwing of acid is particularly linked with the third and second categories above. A very weak and corrupt legal and law enforcement system (category 2) means that the control by physical abuse (category 3) is rarely punished, or prevented. The direct injuries (category 1) can be inflicted with almost no fear of being apprehended by the legal authorities, and in the event that this does occur, it is easy to buy immunity with an appropriate payment to the right person.

Rose Charities, a partner organization of ‘One in Three Women’ has been dealing with the results of violence against women in Cambodia since 1998. Over this time the range of acid injury has been very wide indeed, ranging from a few superficial covering one or two isolated areas to 60% or more body coverage with deep penetration down to (and even affecting) bone. Scalp eyes, ears and nose may be partially or entirely burned away.

Acid burns create a spectrum of disabilities for the survivor ranging far beyond the terrible disfigurement and physical disability. Livelihoods are ruined; there is social stigmatization, breakup of families, marriages and relationships. Full time care is often needed and this, in a country such as Cambodia is not provided in any way by the state. If the victim has no family or friends to look after them then they will be utterly outcast. So often the attack takes from the victim the only real asset owned in a quagmire of poverty, physical beauty, which in many societies is the only way for a woman to advance. So the damage is also both psychological and social.

Medically and surgically help may be limited. Rose Charities has two operative surgical / medical facilities in the Phnom Penh area to try to assist the victims. One deals specifically in eye care and the other with general rehabilitative surgery. Both facilities are directed by experienced Cambodian surgeons. One of these, Dr Nous Sarom is probably Cambodia’s most experienced maxillofacial surgeon and has trained extensively both with Rose Charities and previously with other organizations including Doctors without Borders. Acid contact with the skin can have an effect akin to ‘melting’. Thus adjacent areas, such as a limb with the trunk, the space between fingers can end up being fused together. There is also a shrinking effect so that the joints can be pulled into horrific distortions. Simple surgery can usually manage to release these adhesions and contractures. but more complex injuries to areas such as ears, eyes, nose or lips ideally need specialized reconstructive surgery, usually beyond the scope of the facilities available in Cambodia. Eyelids are a particular problem. Even if the eyeball itself is spared, a functioning lid is necessary to keep the surface of the eye lubricated: otherwise it will dry out, ulcerate and eye will be destroyed. Often, in the absence of the sophisticated facitlies needed, the most appropriate action is simply to suture up the remaining lids themselves, thus protecting the eye below for some unspecified time in the future when it may be exposed again.

Physiotherapy, preferably with specialized burns therapists are hugely important, but again such personnel are limited and the specialized training is lacking in Cambodia. What is then needed are the facilities for the lengthy rehabilitation process, vocational training, reintegration etc.

Over the years, Rose Charities has done what it can on its budget to improve the situation through training of surgeons, the encouraging of specialized teams to visit Cambodia and occasionally managing to send a particularly bad case for overseas treatment. Such operations however are fund limited, but the work continues.

Cambodia is a small country with a population of warm, artistic people who have a long cultural heritage leading back to roots in the great empires of South Asia. Cambodian lives are full of tradition, ceremony and colour. People smile a lot. I think back to those smiles and my heart goes out again to those who cannot smile. The world can be harsh and cruel, but surely little surpasses the cruelty of the acid attack.

William Grut MD
www.RoseCharities.org

Rose Charities was one of the first organizations to identify and target acid violence in Cambodia. Its treatment center has now been operating since 1998. It has been assisted by several specialist overseas groups who generously provide expertise and resources to help Rose Charities Surgeons deal with the problem

One such wonderful initiative has been that of the Virtue Foundation of New York

"..Led by Dr. Ebby Elahi, an oculoplastic and reconstructive surgeon, Virtue Foundation deployed a team of physicians to Phnom Penh, Cambodia in November 2004 to teach and perform plastic and reconstructive surgery at the Rose Charities Clinic, where many of the patients bear the gut-wrenching scars of callous acid attacks.
Deeply moved by the plight of a young Cambodian mother by the name of Yem and her infant daughter Sophan, who were both burned and disfigured by an acid attack that occurred while the baby was breastfeeding, Dr. Elahi arranged through the Virtue Foundation for mother and baby to travel to the United States in an attempt to prevent their blindness and to alleviate their deformities at the Mount Sinai Medical Center.
The entire cost of the patients’ treatment was donated by the Mount Sinai Medical Center and a team of highly specialized volunteer surgeons, including Dr. Ebby Elahi, Dr. Lester Silver, Dr. Penny Asbell, Dr. Michael Shohet, and Dr. Steven Rosenberg. Multiple surgical procedures on mother and child were followed by three months of intensive rehabilitation and follow-up care.
In January 2006, Dr. Elahi returned to Cambodia with a small team for another round of treatment to acid attack victims and patients in need of critical surgical care. During his visit, Dr. Elahi was heartened to once again see and provide follow-up care to both Yem and Sophan, whose surgeries in the U.S. last year had turned out to be highly successful, with the baby's vision now fully restored. Virtue Foundation hopes to deploy additional teams of physicians to Cambodia to continue the vital tasks of raising awareness of acid violence and training local physicians in surgical and reconstructive procedures."

Donations for any of these works are very gratefully accepted

www.RoseCharities.org

27 June 2008.

Happy Birthday Nelson Mandela from all at RoseCharities. You are an inspiration to us all, and to the whole world !

With appreciation and best wishes
The Rose Charities Volunteers

Pipe Line to Burma. A Musical Fundraiser for the Victims of the Myanmar / Burma Cyclone. Proceeds go to local organizations assisting in the relief work including RoseCharities Organized by Len Walker and 'Tsunami Haven' . Saturday 21st June. Nanaimo. See www.RoseCharities.ca for link to more information. Pipeline to Burma. Donations via www.TsunamiHaven.org or www.CanadaHelps.org (and look under Rose Charities)

Update Emergency missions 1st June 2008

Sichuan

AMDA has so far dispatched 29 personnel (including 12 doctors, 8 nurses, 1 pharmacist) in collaboration with other AMDA Chapters. According to local report, relief supplies such as　tents, blankets and sleeping bags are in need for evacuees out on the streets. The evacuees were obliged to move out from homes which could easily collapse in the case of after shock.

1. AMDA HQ/Taiwan Emergency Medical Mission in Sichuan

i) Sichuan Academy of Chinese Medicine Sciences in Chengdu

AMDA has formed its third relief team on May 23rd for further medical assistance at the Sichuan Academy of Chinese Medicine Sciences. The team comprises 3 doctors, 2 nurses and 1 coordinator. Despite after two weeks from the devastating quake, still a number of patients have been waiting for surgical operations as well as traumatic cases commonly seen. Beside surgeries AMDA doctors are providing counseling for the latter cases.

ii) West China Hospital in Chengdu

On May 22nd AMDA’s second team has completed its four-day mission at the West China Hospital which included 2 surgeons

iii) Mobile clinic in Anxien

AMDA’s first team held mobile clinic at the mountainous village in the suburbs of Anxien. The clinic was held at a local school used for evacuation shelter.

2. Evacuation site in Sufang
AMDA’S relief team (1 surgeon, 2 nurses, 1 coordinator) has been continuing its medical relief at a gym

Myanmar

Mobile health team expands work

AMDA’s clinical staff and local township medical personnel have been workign in the remote areas of Mankaleik
RHC (Rural Health Center) of Kungyangon Township
in Yangon Division.


With 17 members, 5 doctors, 2 health assistants,
1 midwife, 3 nurses, 1 coordinator,
4 health assistants, and 1 logistic assistant in total,
the team has decided to split in two teams so as to
effectively reach severely-affected remote communities.

Under the coordination of TMO (Township Medical Officer)
of Kungyangon Township, the mobile teams plan to extend
their coverage areas to Dayae Lu RHC
and Let Khoke Gon SH (Station Hospital) sections
as soon as they complete the work in Taw Kuu.

In addition to clinical services, the teams also provide
sanitary items such as soap and water purifying tablet
along with IEC materials.

The program is based on the following...

1.Provide medical care and support to needy patients
in timely and professional manner.
2.Coordinate field work in line with MoH guidelines,
in particular those of the ER section.
3.Collaborate with existing health infrastructure and
personnel on the ground, in particular ones
in the public sector, who know the area most.
4.Promote participation from community members
who suffered but are willing to give hands
to their neighbors.
5.Maintain communication channels with various stakeholders
that include UN agencies and diplomatic missions.












AMDA-RoseCharities Canada support these missions. Please donate via www.CanadaHelps.org AMDA-Rose Charities Canada is run by volunteers and so there are almost zero administration costs. All your donation goes entirely to one or other mission (as chosen by yourself)

Images from AMDA Emergency Relief Clinics Myanmar

Update 23rd May. Sichuan Earthquake relief

1. AMDA Taiwan Emergency Medical Mission in Sichuan

On May 17th, after having obtained permission from local authority and

assessment of the area previous days, AMDA Taiwan Mission carried out

medical activities in a village located in a mountainous region of

Anxian. 3 tents were provided to the mission where temporary clinic was

set up. 10 patients received treatment.

AMDA Taiwan Mission, consisting of 17 medical professionals, was joined

by Mr. Nithian Veeravagu, a coordinator from AMDA Headquarters, Okayama,

Japan.

On May 18th, the mission was instructed by local authority to evacuate

the area because of the possibility of dam breaks. AMDA Taiwan donated

medical supplies to village hospital and doctors and headed toward

Chengdu.

On May 19th, Sichuan Provincial Health Department issued permission for

AMDA Taiwan Mission to work at West China Hospital, West China School of

Medicine, Sichuan University(Chengdu) AMDA Taiwan Emergency Medical

Mission is the first overseas organization to receive such permission to

join the staff of West China Hospital in their efforts to treat the

victims of the earthquake disaster. As of 19th, there are 2 orthopedic

doctors, 2nurses and 2 coordinators in the mission.

2. AMDA Sichuan Emergency Medical Mission

AMDA Sichuan Emergency Medical Mission made up of 1 surgeon, 2 nurses,

and 1 coordinator. The team continues to provide medical care to the

victims in a gym, designated evacuation spot in Sufang.

Rose Charities Canada supports AMDA Canada and AMDA International. Please donate via www.CanadaHelps.org All donaations to the China Earthquake fund go to these efforts.

Myanmar / Burma update relief Update 20-May-08

AMDA mobile clinics (commenced 11-May-08) continue to operate at full capacity. Hundreds of victims treated though needs are overwhelming.

Please Donate via Canada Helps. www.CanadaHelps.org - Rose Charities is listed there in the emergency donor section. All donations go directly to the AMDA clinics which began their work within a few days after the cyclone had struck.

China earthqake and Myanmar cyclone disaster update 16th May 2008

For todays update please cut and paste into your server the YouTube clip
http://www.youtube.com/watch?v=z4ws4-rT1LU

Or go to www.YouTube.com and search under AMDA Canada (or) RoseCharities

AMDA International field assessor Veeravagu Nithiananthan is now on site working with combined AMDA team. Expected to report back to AMDA HQ in next 24 hours re further team deployment.

Myanmar and China: Donations continue to be needed. Please see www.CanadaHelps.org where Rose Charities is listed

Updates 15th May 2008

China earthquake: An AMDA-RoseCharities Canada / Chinese University of Hong Kong (CUHK) response team is now preparing to leave for Szechuan. Dr Collin Yong (AMDA-Rose Canada) is planning to join the CUHK team members in Hong Kong and proceed from there to Szechuan. Yesterday the AMDA Japan / AMDA Taiwan team departed to join their local medical response counterparts in the area.
Dr Collin Yong is a pediatrician at B.C. Childrens Hospital and has extensive international experience including tsunami in Sri Lanka (see picture) on the AMDA-RoseCharities team.

Myanmar. Clinic work continues as per report yesterday. The death toll is now officially over 40.000 and it is likely that there are many more dying daily as many of the areas affected are reported to be still isolated.

Donors. A huge thankyou to all those donors who have helped so far. RoseCharities funds go directly to the Myanmar clinic and the China earthquake medical team support. We are all volunteers so there are no administration fees. Easiest donation method is via www.CanadaHelps.org (look under Rose Charities). There, you can choose either cause. Donations are tax deductable. Please help if you can even small amounts add up.

Myanmar cyclone relief update. 14th May 2008

1. AMDA has started Mobile clinic activities from the 11th of May for

the victims of recent cyclone.

2. The clinic is conducted by local medical professionals under the guidance

of the local Ministry of Health.

3. AMDA-RoseCharities Canada have dispatched funds to help with this effort. Further funds are needed.

DONORS. Please see www.CanadaHelps.org (and look under Rose Charities)

Szechuan China Earthquake update 14th May 2008

AMDA-RoseCharities Canada is involved now in the following initatives

1) Supporting and AMDA Taiwan / AMDA HQ medical support team initiative scheduled to start work today with local counterparts

2) Sending of an experienced AMDA-RoseCharities paediatrician to join University of Shanghai paediatric relief team within next few days

3) Liaising with contacts at Chinese University of Hong Kong to recruit professional personnel to assist activities

4) Fund raising for above initiatives and or general relief for this disaster

DONORS. Please go to www.CanadaHelps.org and look under Rose Charities. There is a special donation field for the Chinese Earthquake Relief fund. UK, USA, Australia, NZ donors can also go through their own RoseCharities group sites (see www.RoseCharities.net ). Thank you. Everything you donate goes to relief with zero admin. costs as Rose Charities is run by volunteers.

Szechuan (China) earthquake, and Myanmar relief updates 13th May 2008

A powerful earthquake with a 7.9 magnitude hit the central region of China. The earthquake brought down buildings schools and chemical plants, killing about 10,000 people in the towns set in the hilly areas north of Sichuan’s provincial capital Chengdu. The earthquake happened at about 14:30 and could be felt as far as Vietnam. Rescuers are still searching frantically for more survivors among the rubble. Continuing rain in the region is hampering the effort of rescue. According to the latest news, in the town of Juyuan, south of the epicenter, a three story high school collapsed, burying about 900 students and killing at least 50.

Rose Charities is supporting its senior partner in international disaster relief, AMDA. AMDA Taiwan has a request pending to the Chinese Government to send a relief team and AMDA HQ is in negotiation to send a team from Japan. AMDA-RoseCharities Canada has experienced disaster personnel standing by (Dr Collin Yong - B.C. Childrens's Hospital, and R.N. Kirsten Reems - VHG) and is collecting donations and resources to assist.

In Myanmar, AMDA Myanmar health team is currently assisting in the disaster area manned mainly by local AMDA employees and volunteers. Funding has been sent form AMDA-Rose Canada but more is needed.

News from AMDA Myanmar Relief. Also see www.AMDA.or.jp

May 08, 2008

Myanmar Cyclone Disaster I

Early morning of the 2nd of May a powerful cyclone, Nargis hit the central and southern part of Myanmar. According to the state owned TV station there are 22,000 people confirmed dead and more than 41,000 are missing. The assessment of damaged has been faced with delays and the number of victims is more likely to increase. According to some latest unconfirmed reports the death toll might rise up to 100,000.

According to the Government of Myanmar 5 regions, Yangon, Ayeyarwady, Bago divisions and Mon and Kayin States have been affected by the Cyclone and as a result are decreased as disaster areas. It is also reported that there are more than 100,000 people are facing lack of evacuation centers and drinking water. Many of them are seeking shelters at their relatives or friend’s house and temples.

Because of the scale of disaster and AMDA’s presence in the country for more than ten years, there have been a lot of inquiries and interest from the media, general public as well as from our partners and donors. The safety of AMDA-MINDS staffs (2 Japanese and 9 local staffs) is confirmed and there are no injuries. However it was reported that some of the local staff’s home were damaged by the cyclone and water.

Because of the damage to the infrastructure communication was quite difficult to establish and fallen trees and roofless houses can be seen everywhere. Cost of living has soared since the disaster. Cost of food has doubled and the bus fare has gone up by 20 times. Markets and banks have partially opened in Yangon. Public hospitals have suffered considerable damages from the cyclone and some of them are not in operation. Infrastructure has broken down and most of them are still not in operation. Especially water is causing a lot of concern. Many of the victims are drinking lake water which may result in greater health problem. Myanmar Government’s national disaster center is asking the world community for the following items: funding, medicine, tent, blue sheets, instant food, construction material, blankets, and summer clothing.
Considering the scale of damage AMDA is planning to mobilize local doctors and medical staff from the current office location in central dry area to the affected areas.

Head quarter plans to organize mobile clinic with AMDA Myanmar office and its local staff and has already given instruction to get the approval from the government.
UN, its agencies and other big organizations are sending in relief goods to Myanmar. AMDA could act as a coordinator in distributing these goods to the people in need. The instruction has been also given to look into the possibilities.
Latest news:
Early this morning (8th May) one of the head quarter staff has left Japan for Bangkok to purchase relief items for the victims.