Helping those who have literally nothing in the way of medical care, these local doctors are saving the world one patient at a time.
Dr. Chip Skowron in Guatemala
Single-engine planes, rickety trains, helicopters and horseback. These are but a few of the modes of transport for the globetrotting Greenwich doctors who make arduous annual treks to remote villages, where the people are poor and the resources scant. Hauling donated equipment and medicine by motor scooter and city bus, they arrive at the far reaches of the world, offering care, dignity and hope to complete strangers who suffer maladies from malnutrition and painfully infected teeth to hernias and heart defects.
Stopping the Tears: Dr. Al Repicci
One would be hard-pressed to meet a local doctor who has embraced overseas missions with more zeal than Dr. Albert Repicci, a Greenwich-based orthodontist in private practice who lives with his wife, Janice, in Riverside. Though Dr. Repicci enjoys writing, sailing, golfing and spending time at Greenwich Point and Island Beach, his true passion lies in helping the helpless in undeveloped countries. What started out as a one-time dental mission has turned into a twenty-eight-year commitment to helping needy foreigners procure everything from immunizations to housing and education.
On his first solo mission trip in 1981, to the newly independent Island of Antigua, Repicci got off the boat and found there was no clinic and no one with information concerning his upcoming volunteer stint. About to head home, his cab driver suggested he seek out a pastor who had an old dental chair in the back of his church. He recalls, “I implored a street vendor to assist me in the call to this pastor’s church. Sure enough, Pastor Mills answered and, after I shared my disillusionment with him, he persuaded me to come back and work from his church, which I did, for ten more years.”
After serving on annual two-week missions in Antigua, for the next decade, he began volunteering with Medical Ministries International (MMI), an organization that takes medical surplus that would end up in American landfills to Third-World countries. For the next fifteen years, he served with MMI on as many as three two-week projects a year in the poorest corners of the world.
From the start, he recognized that his U.S. dental training (filling cavities, in-stalling crowns, etc.) had little application in third-world countries, where surgical removal of painful, diseased teeth and oral tissue was the most reasonable service he could offer. He says, “That philosophy was reinforced when the mission projects expanded over those next twenty-seven years to jungles, mountainsides or remote villages that offered no access to water, electricity or even a chair.”
Though treating 200 or so patients in a given country may not have made much of a dent in their overall quality of life, he says, “These dental projects facilitated my access to remote people, providing me with the opportunity to see, firsthand, the bigger picture of a definable population’s needs.”
That’s when Dr. Repicci began turning obstacles into opportunities. For instance, after enrolling his children in the local Catholic school during a two-week mission in Antigua, he noted a dire need for fluoride. “Through the intercession of the bishop and concurrence of the Minister of Health,” he says, “we had enough sodium fluoride delivered to offer monthly doses for five years to every child in Antigua aged six to twelve.”
Back in Greenwich, he started putting together a team to address many of the larger issues he encountered, such as widespread disease. “In most of the countries we visited, among the diseases that prevailed, such as malaria, TB and malnutrition, the incidence of AIDS was about thirty-five percent, so it was not only a considerable risk to those of us doing surgery, but it was a devastating circumstance for the inhabitants to endure. Education, therefore, became an important service that was complicated by the contradictory information natives received from the threatening witch doctors.”
So Dr. Repicci switched gears from providing dental care to providing education and assistance in whatever form fit the bill. In Swaziland, for instance, his team saw the need for a vehicle to transport the native practitioners to remote villages, so they provided a jeep. In the Philippines, they introduced chicken, duck and goat farms to sustain the population. In Kenya, they implemented an immunization project to serve several thousand people per year. In Mongolia, they provided nomadic homes, or yurts. Along the tributaries of the Amazon in Peru, they installed water wells and, while in Cambodia, they established a center for women and children at risk of exploitation that offers meals, literacy, health service, hygiene and alternative-career guidance.
Moved by the horrors he witnessed in Cambodia, Dr. Repicci inaugurated the Stop the Tears Foundation in 2002, an organization dedicated to helping exploited women and children in Third-World countries. Of the Cambodian plight, Dr. Repicci says, “The women are young peasants who had come to Phnom Penh to work in the factories for a little over $1 a day. They live in slum conditions and are easy prey for trafficking. Southeast Asia, and especially Cambodia, has the largest incidence of sex trafficking in the world. With the economic downturn, their meager jobs are now at even greater risk. The abandoned children of the factory workers who would otherwise just roam the street at risk of being exploited are being fed, schooled and instilled with the cultural history of their country.”
Every year, Dr. Repicci and his colleagues in MMI pack up supplies and make a grueling trek. To get to Cambodia/Vietnam, for example, they fly from New York to Tokyo then on to Bangkok, stay overnight, and then move on to Phnom Penh, Cambodia. The next day, they take a river barge up the Mekong River, disembarking on a muddy landing where they are greeted by a horse-drawn cart and motor scooters that climb the muddy trail to the village where they will be working. To reach many other remote populations, the team has been dropped off by helicopter in the Himalayas, by single-engine aircraft on the plains of Mozambique and by boat on the Amazon.
The missionaries think nothing of the rigorous journey when compared to the rewards. Dr. Repicci says, “My enthusiasm is fueled by each preceding project, while the colleagues I work with are my inspiration. I also realize that in every project I represent my country, the United States, as well as my profession, dentistry. These, too, are motivating factors. I have come to realize that international diplomacy is not just for career diplomats, it occurs at the person-to-person level.”
Visit stopthetears.com for more information.
Mending Broken Hearts: Dr. Robert Michler
Dr. Robert Michler, an internationally renowned heart surgeon and Harvard graduate, met his wife Sally when they were both at Dartmouth (he at the Medical School, she at Dartmouth College), married and raised three daughters in Riverside. They feel blessed to live on the water and to be longtime members of the Riverside Yacht Club, where Sally is on the Board of Governors, Robert is fleet surgeon and they both are completing their term as chairmen of the admissions committee.
“I enjoy every minute I can steal away to be on the water,” Dr. Michler says of his sails around Long Island Sound aboard his Sabre 38. When he’s not sailing, biking or taking his girls for spins on the family’s Grady White motorboat, Dr. Michler, who is Surgeon-in-chief, Samuel I. Belkin Endowed Chair and professor, and chairman of both the Department of Surgery and the Department of Cardiothoracic Surgery at Montefiore Medical Center and Albert Einstein College of Medicine in New York City, can be found hard at work at his other passion—planning for an upcoming medical mission to Guatemala, the Dominican Republic or El Salvador.
A noted expert in adult valve repair and coronary artery bypass surgery, Dr. Michler put together his first volunteer team of New York-based pediatric health care professionals to travel to Guatemala in 1994. The following year, he founded Heart Care International (HCI), a not-for-profit group that has performed more than 600 open-heart surgeries, more than 200 interventional heart catheterization procedures and screened more than 1,500 children and young adults in these impoverished countries.
“From our home in Riverside, Sally and I organized the first few years of trips, until the effort became too large and overwhelming,” he recalls. “We formed a board of directors and the former Second Congregational Church minister, Reverend Ron Allison, helped with the initial organization and guaranteed airfare for the team’s first mission.”
The Second Congregational Church has been instrumental in the success of HCI, says Dr. Michler. In fact, several church members serve on its board of directors, and “Allison Scholarships” have helped provide six nurses and three doctors with additional training in the United States and Mexico for missions to Central America.
Michler can’t say enough about the medical team of more than 150 specialists from over twenty major medical centers across the States and beyond who donate their time and expertise, and the forty-plus companies who generously donate supplies, services and funds to make the missions possible. “Thanks to the contributions of private individuals, team members and partner companies, Heart Care International is able to perform lifesaving procedures and surgeries at a fraction of what it would cost in the United States,” he says. (Each surgery costs HCI approximately $2,500 when performed in the host country, compared to a minimum of $25,000 for a similar surgery when performed in the U.S.)
This is no hit-and-run operation. HCI establishes a complete state-of-the-art cardiac-care center in a local hospital and commits a minimum of five years to a host country in an effort to train local healthcare professionals in the medical and surgical management of congenital heart disease. “By enabling local professionals to provide cardiac care within their own country, Heart Care International strives to leave a legacy of hope and self-sufficiency, as well as improve general health care,” explains Dr. Michler.
The organization provides all the supplies to perform the procedures—from sutures to heart monitors and heart-lung bypass machines—and the team is comprised of highly trained staff including anesthesiologists, cardiologists, intensive-care physicians, surgeons, pediatric intensive care nurses, operating- room nurses, perfusionists, respiratory therapists and administrative staff.
Despite helping so many, Dr. Michler describes how an interaction with one fourteen-year-old boy who lived in poverty and sickness continually reminds him of the power of the mission’s work. “Come with me for a moment to Canilla, a poor little village in the mountains of Guatemala, to meet Hector Noriega,” he says. “When he was very young, he contracted rheumatic fever, a disease that attacks the valves of the heart. Over time, his breathing became more labored and his walk to school became too much for him. So he stayed at home helping around the house, until even this became too much.
“You see, in Guatemala, health care is not readily available to the poor, especially heart surgery. When I first met Hector, he could hardly walk without stopping to catch his breath. His father would pick Hector up in his arms and carry him to the table for meals, since Hector wanted to be with his family. He was dying, and everyone knew it, even Hector.
“His parents could not afford to travel to the United States for help. But word had spread that a team of heart doctors and nurses from the U.S. were traveling to Guatemala to perform heart surgery. Hector’s family made the long journey to Guatemala City to meet with Heart Care International.”
More than ten years after Dr. Michler replaced Hector’s heart valve, he received word that Hector is studying to become a doctor. “The thought that Hector might become a doctor gives me and my team the strength to work long and hard hours on as many children and young adults as possible, because who knows which one of them will grow up to make a difference in their country,” says Dr. Michler. “The world is a hard place to change. Good has a hard time winning out. But, you know, it is the simple act of giving a little of yourself, with whatever talent you possess, that one day may take shape and influence the character of someone else and provide the strength for them to endure,
persist and succeed.”
Visit heartcareintl.org for more information.
Healing the Children: Dr. Elizabeth Ryan & Dr. Kevin Burbige
In 2007, while working as a clinical anesthesiologist at Greenwich Hospital, Dr. Elizabeth Ryan started researching various online mission programs and learned about a trip to El Salvador through Healing the Children, a nonprofit volunteer organization dedicated to providing children around the world with access to medical care.
When Dr. Ryan, who lives with her husband, Michael, in Greenwich, got the call to go to El Salvador, she says, “I appealed to my good friends, Kym McGillicuddy, a registered nurse, and Kevin Burbige, a specialist in pediatric urology, to join me.” They enthusiastically agreed. As did two of her other good friends, Ofelia Melley, a former ER physician and Kathy Gibbons, a C.R.N.A. formerly from Greenwich Hospital. “We were also fortunate to have Trish Minicozzi, an RN, functioning as our pediatric nurse, along with Diane Zarilli, R.N. Our second trip in 2008 was led by Stephen Salzer, ENT surgeon, and also included Grace Bricetti, C.R.N.A., Margaret Lazlo, R.N., Valerie Romanello, L.P.N., Gloria Vivona, C.S.T., and Ricky Mathieu, R.N. Everyone is on staff at Greenwich Hospital, with the exception of
Ofelia and Diane. All these people gave up precious vacation time with their families to participate.”
Both Drs. Ryan and Burbige recall the daunting feeling that settled over them when they arrived at the hospital to see all the patients they would be taking care of for the week, patiently passing the time in the halls and the waiting room. “They were dressed in their best clothes, and all the children were neat and clean,” explains Dr. Ryan. “They had traveled very far distances to be seen at this little hospital. We had no idea where they would be staying during the week, but they were willing to wait the entire week, if that is how long it took, to schedule surgery.”
Despite the remote facility, she says, “We were pleasantly surprised that the hospital was so clean. Though it was no surprise when we met Sister Cecilia, the founder of Hospital de Maternidad la Divina Providencia. She is a ninety-three-year-old Belgium nun, living in El Salvador for the past fifty years. The hospital is guarded and gated and, though it is a maternity hospital serving this poor area without government funding, it has two available operating rooms that are reasonably well equipped. Visiting medical missions frequently use the two ORs.”
For a week, the doctors saw patients for tonsillectomies and inguinal hernia repairs. “They might sound like simple surgeries,” Dr. Ryan notes, “but without access to adequate medical care, the implications of not treating these children could be devastating. The stamina of the children we took care of ranging in age from one year to teens was remarkable. All of our surgeries were ambulatory and, indeed, these children walked out of the hospital. Many of them had to walk up a half-mile long steep road because they had no access to public transportation.”
Though sanitary and welcoming, the facility is sorely lacking in basic medical supplies and technology. The electrical supply, for instance, cannot accommodate several machines at once. “It only took one medical mission to realize the simplest technology is the safest, because the resources to repair equipment are limited,” says Dr. Ryan. “We brought most of the supplies, which were kindly donated. Through the experience and intelligence of all the volunteers, we were able to stretch our supplies in order to take care of every child in safe and sanitary conditions. For instance, a cautery pad that helps stop surgical bleeding but does not come in contact with the wound site is normally discarded after one use. We were able to get multiple uses from one pad,” she explains. “We came home with the impression that we have tremendous waste of our expensive materials in our own hospitals, a fact that contributes to our expensive health-care system. This waste is often generated because of lengthy rules and regulations that put restrictions on medical staff and equipment.”
Dr. Burbige found it humbling that patients were so profoundly grateful to be seen by the doctors, regardless of the fact that the doctors were not able to give patients pain medication upon their discharge from the hospital. “Doing our work in an area that is poor cuts both ways.
People are so appreciative and thankful of all the little things that we take for granted that it makes you feel guilty.”
Dr. Ryan reminisces about the last consultation day when a large family sat waiting. “Dr. Burbige said, ‘Have them come in’ to our tiny exam room. ‘But there are ten of them,’ I replied. They were all members of an extended family that made a long trip to our hospital. Five required surgery.”
Dr. Burbige was similarly moved by the plight of a young girl who had put off her own double hernia operation because
her family had saved up $200 so that her father could have an operation and get back to work. He says, “The mother was there visiting the husband when she found out that we offered to do the daughter’s surgery free of charge. She said, “First there’s God, then there’s you.”
Visit healingthechildren.org for more information.
Making Friends in Africa: Dr. Sunil Rana
Greenwich internist Sunil Rana has a thriving local practice and a close-knit family, but he has left his comfortable local environs several times over the past few years to participate in mission trips to help the needy.
The Rana family moved to Cos Cob in 1998 after Dr. Rana completed his second medical residency in Manhattan. Together with his wife Eun Hee, whom he met while working in Saudi Arabia, the Ranas are the proud parents of two boys: Juho, who attends Greenwich High School and Benjamin, who attends the International School of Dundee.
Dr. Rana’s desire to use his medical training to help the impoverished was born overseas. “While we were in Saudi Arabia, we wanted to go on a mission trip and help,” he explains. “When we moved to town and found Harvest Time Church involved in different missions around the globe, we immediately felt the tug in our hearts.” Serving on the board of the church since 2002, Dr. Rana learned more about Friends in Africa, an organization involved in providing health care to the impoverished, and signed on. On the family’s first mission, to Trinidad, Dr. Rana cared for needy children in orphanages. Mostly though, he says, the doctors were focused on treating the locals who lack much-needed health care.
“It was a very moving experience for me as well as for our eldest son, who was impacted a lot by visiting the orphanage,” he recalls. “It is so very different from practicing at home. It is a different feeling of joy that you experience.”
Since the family’s first expedition, they have been to Trinidad, Senegal and also Louisiana after Katrina on missions organized through the church. During their trips, the Rana family lodges in modest hotels that are a far cry from the accommodations that we take for granted in the States. “Sometimes you could not finish a shower completely because the water stopped and you still have soap all over your body!” Dr. Rana says with a laugh.
Though his family has shouldered minor inconveniences on these weeklong missions, he says it’s the poor working conditions, such as lack of hygiene and proper sterilization, that sticks with him. “It is always appalling to see the lack of health care, primarily because the financial situations are so dire.”
But even the poorest residents find a way to show their appreciation for the kindness of strangers. Dr. Rana recounts an emotional experience where a woman who had lost everything in Hurricane Katrina had returned to thank him. “She came back with a small glass bear and a hug to thank me for what I did for her. I could say nothing, the tears just welled up in my eyes.”
On another mission, while in Senegal ministering to a seven-year-old boy suffering from malnutrition, Dr. Rana was deeply moved. “I have my own seven-year-old, so to look at him just grieved my heart.”
One of the rewards for Dr. Rana is having his wife and sons by his side when he does his mission work. “My family always joins me on these trips and they are always a great help.”
Though this year’s planned trip to Bangladesh was canceled for personal reasons, Dr. Rana has pledged to keep plugging away on future missions. “My wife and I have helped build housing for an orphanage in Uganda and would like to help the needy as much as possible in the future. This experience brings great joy to our entire family.”
Visit friendsinafricasenegal.com for more information.