Weekly Meeting – 30 August 2018

Weekly Meeting – 30 August 2018

ROTARY CLUB BALI NUSA DUA
District 3420/Club No. 28992

BULLETIN August 23, 2018

BALI NATIONAL GOLF RESORT, NUSA DUA, BALI

ATTENDANCE
13 Rotarians attended. For details please check with the Secretary.

LEAVE
2 Rotarians are currently on leave.

VISITING ROTARIANS and GUESTS

Visiting Rotarians and Rotaract Members
Rtn. Wolf Goettel, RC Queenstown, Singapore

Guests
Mr. David Kuper, guest of President Hugh Brown
Dr. Soe, guest of Rtn. Ari Murti
Ps. Carol Friesen, guest of Rtn. Gerrit Ten Veen
Mr. Andre Purey, guest of PP Karl-Heinz Schmelzer
Mr. Graeme Nicholas, guest of PP Wes
Ms. Sylvie Alice, guest of PP Wes
Ms. Syta Plantinga, CEO Kolewa Foundation, guest of PP Wes
Dr. Henk Schoemaker, Volunteer at Kolewa Foundation, guest of PP Wes

ANNOUNCEMENTS, REPORTS

SAA Edward Naus
SAA Edward rang the bell calling the Meeting to order at 1.00pm.

President Hugh Brown
President Hugh gave a warm welcome to everyone able to attend today. Very nice to see Rtns. Axel and Mirella again after extended absences.

President Hugh reported that prior to today’s lunch the Board met again to review our efforts to solicit funds on behalf of D3420. The need is great and with the wet monsoon on the way, the Board is in favour of the District’s efforts to help with shelter.

President Hugh thanked Gerrit for his efforts to organise a wonderful fellowship dinner last week ar GaRaSi Restaurant in Balanagan. Very good food, relaxing and comfortable atmosphere and friendly camaraderie.

President Hugh invited any and all members to join him to attend a District Membership Conference in Jimbaran on Saturday.

President Hugh reminded everyone that our 18th Annual Golf Tournament is on 8 September. Invite your golfer friends and even if you don’t golf please attend the Awards Dinner (great make up…).

President Hugh then presented Andre Purey (above photo, right) with a Paul Harris Fellow pin (+4) for his personal contribution to our Global Grant for Cleft Lip and Palate operations. Thank you and Congratulations Andre!

With that President Hugh passed the REAL microphone (yes, it works again!) for news and views.

PP Risto Poskiparta
Wrt the Golf Tournament, PP Risto announced that he had met with Bank Mandiri and they had agreed to sponsor IDR 30 juta plus Hole-in-One. To date IDR 100 huts have been secured from sponsors.

Rtn Gerrit Ten Veen
Rtn Gerrit thanked members for coming out last Thursday, 18 members attended plus spouses and friends.

Gerrit also mentioned he followed up the request received on our FB page and went to visit the Portuguese man in BIMC whose mother is president of the Rotary Club of Sesimbra Portugal. Thank you Gerrit :-)

Guest Andre Purey
Andre announced that he is looking forward to playing in the tournament and he is honoured to be recognised as a Paul Harris Fellow (PHF+4) by Rotary.

Rtn Axel Kneip
Axel also announced that he and Nunie have signed up to play in the golf tournament.

Guest Graeme Nicholas
Graeme introduced himself (his vocation is as a water engineer and currently living in Jimbaran. Graeme offered his services if the club ever finds itself in need of a water engineer for water project on Lombok (or anywhere). Thanks Graeme… ;-)

Guest Carol Freisen
Carol introduced herself as the interim Pastor at Bukit Doa International Church for the coming month.

Guest David Kuper
David introduced himself, engineer and former member of RC Bali Nusa Dua and worked on the upgrade of the Bali Blood Bank with former member Mimi 2001-2002.

GUEST SPEAKER
Syta Plantinga, CEO of Yayasan Kolewa

Syta began her presentation with a brief recap of RC Bali Nusa Dua and Kolewa’s successful co-operation and partnership… Beginning July 2016 Rotary Club Nusa Dua Bali and the Kolewa Foundation started to collaborate on the cleft lip, cleft palate and bone-graft surgery. Children and young adults mostly from Bali and Nusa Tenggara Timur (NTT – islands east of Bali) were given free-surgery in RSU Dharma Yadnya. Since then, together we have managed to provide 140 operations.

Kolewa’s organises and provides the following services:

    01. scouting for children and young adults with CLP
    02. traveling – providing transport to and from Denpasar
    03. hosting – providing accommodation
    04. dental care – ensuring older children receive primary dental care
    05. panoramic X-ray (as necessary)
    06. surgery – transport patients to hospital for surgery
    07. recovery – accommodating during recovery after surgery
    08. last control – ensure patient is well enough to return home
    09. back home – transport back to village
    10. monitoring – follow up monitoring and sechedule next surgery if needed

The Kolewa team members scout for children on Bali, Rote, Sumba, Alor & Timor monthly. Kolewa visits other islands on demand i.e. Flores, Kalimantan etc.

Hosting includes: 3 meals per day for 1 patient and 1 guardian, tooth brushing classes, morning dance, homeschooling, speech therapy, outside activities & games.

Every guardian signs house rules. They need to take full responsibility of their child and the medical journey. They promise to help the Kolewa staff there where needed, such as housekeeping, cleaning vegetables and other activities. They allow us to use pictures of the patient and guardian on social media and in reviews for sponsors and the Global Grant administration.

Healthy food is very important. Kolewa staff prepare all meals at the Kolewa Foundation. However the children that had a palate surgery or bone-graft operation can only eat porridge for at least two weeks. For them we also use Betadine Gorgel

Every morning children are gathered to brush teeth, one of the educational subjects in our health-program. Right after that there is a dance-session for children, guardians and team members as a team-building activity.

Two of Kolewa’s staff members are qualified teachers. Daily there is a homeschooling program for a few hours. There is also exercise with speech-therapy using the special booklet sponsored by Rotary Club Bali Nusa Dua’s Global Grant.

Besides all the consultations, treatment, operations and wound-care there is of course a program for playing games, creativity or outside trips like going for a pick-nick or a playground in the park.

All children above 4 years old get the opportunity to go to the dentist before they go to the plastic surgeon for their first consultation. After cleaning the dentist will decide about filling or extractions. Pre-surgery dental care is part of the Global Grant program. There is a MOU signed by Rotary Club Nusa Dua Bali and Bali 911 Dental Clinic.

A panoramic x-ray is required if the patient will have a bone-graft surgery (filling the gap in the jaw with a piece of bone from the hip). This X-ray is done at Bio Medika lab in Denpasar.

Surgery is performed primarily at Dharma Yadnya Hospital by dr. Asmarajaya. There are 4 types of surgery:

  • Cleft lip (single or double);
  • Open Palate;
  • Bone graft;
  • Combination surgery;

After the first consultation, surgery is often quickly scheduled. The patients stays in total two nights in hospital before they return to the shelter home of Kolewa Foundation. After one week they are seen by the surgeon again to remove the stitches and control the wound. If there are no further complication patients stay in total 2 – 3 weeks in Bali under Kolewa’s guidance and care.

All patients are monitored and tracked for their (next) surgery. Children with a double cleft lip often need more than one time surgery. Palates can show a little hole again when the child grows or need bone-graft in future. Minimum requirements for surgery:

  • cleft lip: 3 months old / 5 kilo;
  • palate: 1 years old / 10 kilo;
  • bone graft: 7years old;

Congenital abnormalities like cleft lip can also cause hearing-problems. In case of a suspected hearing problem Kolewa Foundations offers a free hearing test, hearing aid and every weekend speech therapy and sign-language lessons at Kolewa’s shelter home in Bali and every Sunday in Karangasem .

Dr. Henk Schoemaker, CEO of Yayasan Kolewa
Dr. henk began his presentation with a quick bio… born and raised in Malaysia until 13 years old when his family moved to The Netherlands, graduate University of Groningen with Bachelor of Medicine 2011-2014 with Minor in Economics 2015; Stem cell research, regenerative biology at Havard Medical School 2015-2016. Currently visiting Bali through September working and studying with Dr. Asmarajaya.

Dr. Henk’s Stem cell research, regenerative biology studies at Harvard Medical School posits that most be believe that Youth is Beauty. But what if Youth is not always Beauty? i.e. children with cleft lips if other disfigurements?

Some statistics:

    Prevalence of Cleft Lip or Cleft Palate

      Asia > 2 per 1,000 live births;
      Caucasians > 1 per 1,000 live births
      Africa > 0.4 per 1,000 live births.
    • Indonesia: 4.2 million births per year
    • Bali + NTT: 240,000 births per year +/- 500 children born with clefts per year

    Cleft Lips tend to occur more commonly on the LEFT side.

      Current ratio: right side 30%; bilateral 10%; left side 60%

    Cleft Lip (only) 20%; Cleft Lip and Cleft Palate (combined): 45%; Cleft Palate (only): 30%

    Cleft Lip (only) and Cleft Lip and Cleft Palate combined is TWICE as common in MALES.

    Risk of familial recurrence of cleft lip:

      No other family member: 0.1%
      If one parent is affected: 3-5%
      If one sibling is affected: 4%
      If two siblings are affected: 9%
      If one parent and one sibling are affected: 17%

    Causes:

    • No single gene has been identified as the cause of cleft lip / palate;
    • Etiological factors include Maternal smoking (especially in first tri-semester, familial or genetic predisposition;
    • Maternal medications: anti-epileptics (phenytoin, an anti folate drug) increases the risk of cleft formation by 10 times!; salicylates, tretinoin (retinoids), benzodiazepines, steroids.

    Mitigating factors.

      Overall it does seem to help to plan pregnancy and do ‘good’ things, i.e.healthy diet; multi-vitamins B6, B12; folic acid folate containing foods – sunflower seeds, breakfast cereals,baker’s yeast, leafy vegetables.

Treatment Availability Comparison:


Treatment Specialist Indonesia The Netherlands
Plastic Surgeon Yes Yes
ENT doctor No (Dr. A) Yes
Craniofacial surgeon No (Dr. A) Yes
Pediatrician No (Dr. A) Yes
Logopedist Yes Yes
Audiologist Yes Yes
Psychologist No Yes
Clinical geneticist No Yes
Dentist Yes Yes

Cleft Lips are treated by a procedure known as the Millard’s Technique
The Principles and Art of Plastic Surgery. 1958

Cleft Palate are treated by a procedure known as the Von Langenbeck Technique

Conclusions:

  • Rotary Bali & Kolewa’s efforts are up to par with ‘Western’ standards
  • Peri-operative care similar to NL
  • Surgical techniques same as NL
  • Complication rates similar to NL
  • Amazing results with fairly limited resources

A very appreciative round of a applause was given to both Guest Speakers.

And then it was time for SAA Edward Naus to draw the raffle…

Raffle
Raffle tickets of IDR 1,200,000 were sold with Rtn. Hugh winning a bottle of red wine. Congratulations Hugh. President Hugh and other past winners still owing prizes were reminded not to forget to make their contributions at forthcoming meetings.

Fines
Fines of IDR 20,000.- were collected for all and sundry offences.

There being no other business President Hugh thanked everyone for joining today. The bell was rung and the meeting promptly adjourned at 2:10p.m.

Next meetings/events.
06.09.2018 – Fellowship and lunch meeting at Bali National Golf Resort, 12.30-2.00PM
08.09.2018 – 18th Annual Charity Golf Tournament at Bali National Golf Resort, 11.00AM
08.09.2018 – Charity Golf Tournament Awards Dinner at Bali National Golf, 6.30-9.00PM

13.09.2018 – Fellowship and lunch meeting at Bali National Golf Resort, 12.30-2.00PM

Birthdays this month
Klaus-Otto Paehler, 6 August
Martin Smyth 12 August
Ian Cameron, 26 August

Recurrent data information on next pages
Board of Directors and Service Chairs

More photos and club info at: