Diaries of Tzu Chi Medical Care Vol.14 JULY 2012 105
Taichung Continuing Effort to Dissuade Smoking and Betel Nut Use April 19 Cigarettes and betel nuts pose serious health risks to users. However, the substance users often ignore the repeated advice and continue merrily with their risky behavior. Public Health Center at Taichung Tzu Chi Hospital established antismoking and anti-betel chewing classes, but the outcome was not satisfactory. Nevertheless, with a can-do attitude, they decided to take a different approach. On April 19, Dr. Chien-Ming Liu, a thoracic internist, gave a seminar on the dangers of smoking and chewing betel nuts to a cleaning crew in Tantze. After the seminar, only two persons enrolled into the quitting program. Although the number Thoracic internist Dr. Chalien-Ming Liu ueses slides to explain to the cleaning crew the dangers of smoking and chewing betel nuts. was small, it was a good beginning. Team leader Bo-Hsiung Yang said, For everybody s health, we must continue our effort. If It Fails, Try Something Else Smokers are not always betel-nut users, but the betel-nut chewers tend to be smokers as well. Most of the users are laborers. It is common to see those smoke cigarettes and chew betel nuts at the same time. Once they are addicted, is it that difficult to persuade them to stop? The staff at the Public Health Center knew the feeling of failure. They planned classes for substance users and offered monetary reward with help and care from the volunteers. However, the events turned out to have twice as many staff members than the substance users. It Cleaning crew leader Bo-Hsiung Yang explains to the users that chewing betel nuts hurt their savings. was quite frustrating for the organizers. Based on their strong desire to safeguard public health and the belief that they can overcome obstacles, the Public Health staff in Taichung decided to change the course of action. On April 19, they visited the Tantze team. They found 80% of the workers smoked or chewed betel nuts. Dr. Liu, the thoracic specialist, used slides to illustrate the dangers of smoking cigarette and chewing betel nuts. He said, Stop these bad habits can even help impotence. He is very knowledgeable about betel nuts because a relative is in the business. His definitive advice is Never start. The cleaning crew at the seminar listened attentively. However, some long time smokers said, I ve heard it many times. If I m afraid they d kill me, I wouldn t have started! These sentences show the obstinate attitude of the users and the difficulty to persuade them to quit these bad habits. They were sinply not afraid to die. These talks would not do any good. One said I ve been smoking and chewing for forty some years. Even though I got a heart stent last year, I just can t stop smoking or chewing betel nuts. No one was able to persuade him. Frustrated, some said to him You ll die from this bad habit! Sixty-one year old worker named Chen just shook his head while exhaling his cigarette smoke. Bo-Hsiung Yang, the team leader, pointed out another angle, i.e. saving money. He shared his experience in eastern Taiwan where he helped to establish a betel nut-free zone. Stopping it completely is difficult, they start asking the users to reduce the consumption by two packages per day following a policy set by the Public Health Agency. He reported Community Health Center Staff administer lung capacity test for the cleaning crew. Persistent persuasion by the medical staff succeeded in enrolling two crewmembers to the program. Mr. Lin (third from left) had tried to quit before joined the program. He wants to try quitting again for his mother who had been diagnosed with cancer. 106 Tzu Chi Medical Care Vol.14 JULY 2012 Tzu Chi Medical Care Vol.14 JULY 2012 107
that 630,000 NT dollars were saved in 5 months from 43 students enrolled in the classes. That is a significant number. Quit Smoking to Benefit Family and Environment Mr. Lin, a 26-year-old worker, started smoking when he was fifteen. He tried to stop five times. It became worse, from half pack a day to three packs. He said his maternal grandfather died of lung cancer. Two years ago when he last tried to quit smoking, he succeeded for a while. His family, his friends and he himself were very pleased. Unfortunately the effort failed because he celebrated by smoking cigar which led him to cigarettes again. He was not sure it would work this time. Mr. Lin wanted to quit for a long time mainly because his mother had cancer and second-hand smoke was not good to her health. He just could not stop. To avoid mosquitos, he smoked behind closed doors. When the doors opened, the room filled with smoke. All the clothing smelled cigarette smoke with white ones stained yellow. He knew it was terrible. Mr. Yang knew it was difficult to quit smoking or chewing betel nuts, he believed it was worthwhile even to save one life. He hoped to start with one or two and add many more eventually, returning smoke-free clean air to the public and the environment. Dalin Chiayi Weight Loss Program Harvesting in the Field June 30 Although the accreditation for Dalin Tzu Chi Hospital is scheduled to happen soon, the hospital rice field is ready for harvest. The first season of the hospital s Dai Ai healthy rice was happily harvested on June 30. County Magistrate Hua- Kuan Chang, Legislator Ming-Wen Chen and Dalin Mayor Chen-Yu Huang made a special trip to Da Ai Farm to participate in the harvest experience. To show support for the Weight Loss Contest of Chiayi County, Dalin Tzu Chi Hospital donated At the first term of Dai Ai rice harvest, Superintendent Chien led a group of mothers and children, sharing and working together happily. 1000 Kg of germinated rice as prizes. Dalin Superintendent Sou-Hsin Chien said he would like to take this opportunity to enable his colleagues to get away from the hospital temporarily, help with the harvest, be recharged in the fields and at the same time, enjoy the rewarding feeling for having contributed to the harvest. Farm Work Prompts Weight Loss With the afternoon sun above the sky, seniors from Shanlin Village, stood on the public square next to the rice fields and danced to the light music of Five-Step Dance Exercise. Several guests, Superintendent Chien, Vice Superintendent Lai and the hospital colleagues also joined them in the dance. Everyone enjoyed the good laughs and the hearth-strengthening exercise. Representing the hospital, Superintendent Chien presented the healthy rice to County Magistrate Hua- Kuan Chang. The magistrate thanked the hospital for their donation of 1000 Kg healthy rice. She hoped that through this harvest and donation activity, it would encourage people to obtain a balanced diet and maintain an exercise habit. At the same time, people can also gain good health and lose weight. She hopes that the county government s Lose 1 Kg, Get 1 Kg of Rice program would encourage Before harvesting, Superintendent Sou-Hsin Chien (second from left), Vice Superintendent Ning-Shen Lai (third from left) and County Magistrate Hua-Kuan Chang (left) exercised along with the seniors. people to lose weight. Superintendent Chien remarked that Dalin Tzu Chi Hospital has been growing rice in Da Ai Farm for several years. And he has witness the surrounding areas of the fields have become more beautiful, demonstrating the progress Chiayi has made in the past few years. He asked hospital colleagues to work in the fields so that they can physically experience the hard work of farmers as they labored. Once, I only worked for only half an hour work in the fields, and my hands were trembling the next day. As a member of Chiayi County, Chien is very glad that they can donate most of their harvest as prizes for the Weight Loss Program and join the promotion for healthy living concepts. After the donation ceremony, everyone put on straw hats, gloves and carried 108 Tzu Chi Medical Care Vol.14 JULY 2012 Tzu Chi Medical Care Vol.14 JULY 2012 109
sickles to experience the joy of harvesting. Superintendent Chien s secretary, Hsin- Chen Chou, brought her kindergarten son with her. The little boy enjoyed the work so much when the group called for a break, he pouted and wanted to continue. To him, harvesting was more fun than work. After the break, he returned to the fields merrily and went straight to work. ENT doctors Chen-Young Lee and Sai-Jen Hou came to the fields together. Dr. Hou had planted rice seedlings before, so he invited Dr. Lee to come along to experience the harvest. Dr. Hou said that by doing the work ourselves, we can really experience how hard it is for the farmers to sow rice seedling and get muddied all over. We cannot comprehend the hard the work if we stayed in the hospital with air conditioning. Dr. Lee agreed and said that it is indeed a back-breaking job. He perspired so much after only a few cuts of rice. Besides those donated to the government, the harvested rice will also Showing support for the Jia Yi Hsien Weight Loss Program, Superintendent Chien, represents Dalin Tzu Chi Hospital to donate healthy rice. Magistrate Chang (right) accepts the donation. become the ears of grain in the Year-End Red Envelops. The process to make the grain is very complicated. Dr. Chien said that during the process of making the grains, one could practice calmness and learn to appreciate the beauty of each full rice grain. This is like what Master Chen Yen has said, One grain of rice contains many months of hard work. Kuanshan Moon Festival Greetings September 1 & 2 The Moon Festival is one of the three major Chinese holidays. According to the tradition, families are reunited as a whole when the full moon appears. The Moon Festival is considered a holiday that celebrates familial harmony and poetic beauty of the moon. On September 1 and 2, members of the medical service staff and volunteer team of Kuanshan Tzu Chi Hospital visited the hospital patients as well as many of the elderly who live alone. The team wished to deliver the festive atmosphere to everyone with a warm holiday blessing. Holiday Blessing to the Needed Ones On September 1, Superintendent Pan and the staff of Kuanshan Tzu Chi Mr. Yu was hospitalized due to the gout tophi break at the bottom of his right foot. Superintendent Pan was accompanied by the team of medical service staff and volunteers to deliver necessities while attending to his recovery and conditions. Hospital visited patients in each ward and delivered vegetarian snacks and personal sanitary kits provided by Tzu Chi Foundation. Among the patients, the 48-year-old Mr. Hsu had been in a car accident and underwent a brain surgery more than 20 years ago. After the surgery, he did not fully recover and consequently lost his job and marriage. His three children had to be cared for by their Grandpa Pan was not defeated by his physical disability. Everyone was amazed by his skillful farming technique using a longhandled shovel. A sickle in hand and a straw hat on the head, 110 Tzu everyone Chi Medical experienced Care the Vol.14 hard labor JULY and 2012 fruitful result of harvesting. Tzu Chi Medical Care Vol.14 JULY 2012 111
Director Pan and the volunteers brought a holiday greetings to the elderly who lives alone. grandfather after Mr. Hsu s divorce. In mid-august, Mr. Hsu visited the hospital to suture a cut in his leg. Because he had not return for subsequent treatment, he was hospitalized again due to serious inflammation. In addition, he is a chronic alcoholic and has a speech impediment. Superintendent Pan expressed concerns for the wounds in Mr. Hsu s lower limb and ankle, and urged him to stop smoking and drinking and most importantly, to love himself. Two other 46-year old men, Mr. Yu and Mr. Huang, are also divorced. Mr. Yu leaves his children to be cared for by their grandfather while he works at parttime labor jobs. In late August, he was hospitalized for an inflammation in his right foot from a gout tophi. Mr. Huang is a person with physical disability. In late July, he was brought to the emergency room to treat cellulitis from a forearm cut. The hospital cleaned his wound and performed skin graft surgery. Superintendent Pan told them to take good care of their health and presented them gifts on behalf of Tzu Chi. The next day, the Kuanshan Tzu Chi Hospital team extended their care to the disabled seniors who live in solitude. The visits will also help follow up with these patients needs. Having Strong Will Despite Poverty and Illness Ten o clock on September 2nd, Superintendent Pan was accompanied by the Control Room associate manager, Kun-Feng Huang, as well as Jui-Ching Chen and her volunteer peers, to visit Grandpa Pan s house. Although he has family descendants, 82-year old Grandpa Pan lives alone next door to his younger brother. Grandpa Pan is in a wheel chair due to a disability in his lower limbs; he receives disability and low income welfare each month. When the team arrived, his home care assistant was accompanying him. Every day, Ms. Lee spends two to three hours helping with house chores and accompanying Grandpa Pan. She said Grandpa Pan is great at gardening. Things like trimming trees, plowing soil, and removing weeds are his specialty. The flourishing greens, aloe plants, taro, and Chinese toona tree in the front yard show his devotion to gardening. He even showed the volunteer team how to rake the soil. It is unimaginable that the Grandpa Pan was able to take the custom-made extended shovel and loosen the soil skillfully. Everyone applauded and cheered for his amazing skills. Superintendent Pan was also curious how he could cut dead wood branches. He explained how he modified the tools. Everyone admired his ingenuity. At the end, Superintendent Pan wished grandpa well and told him to ask them for help whenever he needs. After the visit, the team moved on to Mr. Gu s home at Kuanyuan Village in the town of Hai-Ray. Mr. Gu was disabled 10 years ago due to a spine injury at work. After his injury, he was divorced. Although he has two daughters, he lives alone in his friend s empty house. Mr. Gu has a poor health condition due to complications from diabetes. He is financially supported by low-income and disabled welfare. When the team arrived, the vivid color paintings on the wall stunned the visitors eyes. Mr. Gu said timidly that he started painting to help with the physical therapy for his wrist to prevent muscle dystonia. Now the Tzu Chi volunteers visit him periodically and bring Tzu Chi publications. Despite The lively paintings on the living room wall was done by Mr. Gu as a way to prevent his focal hand dystonia. his disability, he has a strong will and a healthy and pleasant attitude. He does physical therapy at home by himself and sometimes with the in-home care assistants. The team encouraged him to unveil hope and share his optimistic, positive attitude with the community. The Moon Festival holiday blessing visits by Kuanshan Tzu Chi Hospital not only brought warmth and care to the disabled, but also brought joy to the staff and volunteer team after seeing the strength and courage of the patients who have created miracles despite their disability. The staff and volunteers also found reinforcement of the meaning of their work. When we genuinely treat the patients, the patients will return their gratitude with stronger vitality. This visit has made this year s Moon Festival a special and meaningful holiday. 112 Tzu Chi Medical Care Vol.14 JULY 2012 Tzu Chi Medical Care Vol.14 JULY 2012 113
Yuli Music Greenery and Good Health August 22 On August 22, Tzu Chi s volunteers from the North Region gathered at Yuli Tzu Chi Hospital. At the lobby, volunteer Hsueh-E Kao organized a Tzu Chi song musical feast for patients to enjoy the lyrical mood of the traditional instrument guzheng. On that day, patients immersed themselves in a humanistic atmosphere. While listening to the music, many relaxed their body and mind as well. Besides the feast for the ears, the greenery around the hospital was also pleasing to the eyes. The hospital flowerbeds and gardens are regularly attended by Tien-Fu Chen and a group of seven volunteers. The volunteers applied their green thumbs to make the garden not only aesthetically pleasant but also friendly for the environment and the people. Sweet Melody Relaxes Body and Mind Hospital is a place not only for curing diseases but also a community center that promotes awareness on health and environment. Tzu Chi Volunteers from Taipei gathered at the hospital to deliver health awareness and music to this small town. Some volunteers played music to ease patients body and mind, hoping The soft and lyrical melody of guzheng soothes patients, and indirectly relaxes patient s mind. it will lead to a worry-free state of mind. Some of the volunteers worked in the garden and trimmed bushes. Together, they have committed themselves to maintain a friendly hospital environment. The volunteers aim to come to Yuli regularly to spread the concept of health promotion and environment protection into the community. Volunteer Hsueh-E Kao from New Taipei City with two other members of guzhen class performed Chinese zither at the hospital lobby. Although they are not professional musicians, their performance earned enthusiastic applause from the audience. The beautiful sound of the Chinese zither filled the hospital lobby, making everyone present experience the elegance of the intrument. The performers too were encouraged by the audience s welcoming response to perform at the hospital every month. The superintendent of the Yuli Tzu After being a volunteer gardener at Yuli Tzu Chi Hopsital for more than three years, volunteer Tien-Fu Chen not only improved his health, but also created a comfortable environment at the hospital. Chi Hospital, Yuh-Lin Chang said, Yuli Tzu Chi Hospital is a Health Promoting Hospital. Its goal is to mitigate patient s pain. The hospital soothes patients mind with music and culture-rich programs and to provide an all-in-one care to ensure the health of body, mind and spirit. Extend Love to Create a Green Environment Three years ago, an asthma attack left Tzu Chi volunteer Tien-Fu Chen, who lived in New Taipei City, then fate brought him to Yuli Tzu Chi Hospital. The clean and fresh air of the east coast alleviated his symptoms. From then on, he volunteered as a gardener at the hospital. Whenever the weeds is too tall or the fence is broken, he would call in more Tzu Chi friends from the north region to help. Because of him, the hospital has impeccable hedges and well-groomed gardens, making visitors and patients admire the details and cleanliness of the greenery. The hospital staff sees Chen as a member of the hospital. His devotion and dedication have earned much respect and trust. 114 Tzu Chi Medical Care Vol.14 JULY 2012 Tzu Chi Medical Care Vol.14 JULY 2012 115
On the afternoon of June 27, Yuli Tzu Chi hospital conducted a crisis training class for medical personnel in response to attacks and violence during an emergency. The goal is to prevent tragedy so that the lives of patients and caregivers are protected. Do Not Panic in an Emergency The Hualien County Police Department was invited to teach medical The superintendent of hospital, Yuh-Lin Chang expressed gratefulness to the gardening volunteers. workers how to respond in case of emergencies, along with vigilance and Instructor Chong (second from right) demonstrates selfdefense technique. The medical personnel practices techniques of selfdefense; it is not as hard as they thought before the class. Every year, prior to typhoon season, self-defense techniques. The seminar his team assisted with tree trimming at was meant to be informative so medical Instructor Chong reminded everyone example, if a person s wrist is gripped parking lots and prepared the plants for personnel are aware of the latest to remain calm in face of danger and by an attacker, there are techniques one the strong wind and rain. Chen said, After development in security and violence strenuous situation, and call for help could adopt to escape. Perhaps the coming to Yuli, my asthma has been prevention in the workplace. or assistance whenever possible. For easiest way is to flip one s wrist and push under good control. Therefore, I come more often. My gardening team started with a couple of members but now has All medical personnel gathered inside the classroom to learn about the techniques of self-defense. the gripping hand out of the way. In case the attacker is powerful, close up to the attacker and followed by a sudden turn grown bigger. Under the scorching heat, around to escape. People can practice the volunteers had only one goal in their these simple but effective steps during mind, which was to support the hospital emergency with calm, confidence and to be a well-rounded Health Promoting safety in mind. Hospital by doing what they do best. Disputes and conflict may arise due to a failure in communication, but Yuli Crisis Management and Quality Care it is the job of the medical personnel to protect lives and to reduce harm June 27 to everyone. When medical personnel become knowledgeable in sudden In today s dynamic healthcare outbreak of violence, their relationship environment, it is important for a medical with patients can be more confident staff to be cautious in handling a crisis. and effective in terms of service quality. 116 Tzu Chi Medical Care Vol.14 JULY 2012 Tzu Chi Medical Care Vol.14 JULY 2012 117
Taipei First Case of Child Oral Cancer August 5 Diagnosed with oral cancer from another medical center, a 7-year-old boy, Liao, sought treatment from Dr. Hsia, one of the oral cancer treatment experts in Taiwan and Director of Oral and Maxillofacial Center at Taipei Tzu Chi General Hospital. The medical team of the Oral and Maxillofacial Center successfully removed the tumor. At the press conference held on August 5, Liao presented a thank you card he drew to Dr. Hsia and Taipei Tzu Chi Medical team. A Rare Case of Oral Cancer In the past, oral cancer was mostly diagnosed in the older age group from 50 to 60 year-old. Recently it has been diagnosed in the younger age group from 30 to 45 year-old, but the case of a young child suffering from oral cancer was quite rare. In the documented medical journals of the past four decades, there were only six patients under the age of 12 diagnosed with oral cancer in the world. Among them, the youngest was 6 years old. This 7-year-old being boy treated at Taipei Tzu Chi hospital was the second youngest Taipei Tzu Chi Hospital Oral and Maxillofacial Center Director Hsia and the medical team are performing surgery to remove the tumor for Liao. oral cancer patient in the world, and the youngest oral cancer patient in Asia. In the beginning of the year, Liao s baby tooth fell and the wound did not heal as it should. Liao s parents did not pay too much attention until two months later when they noticed a pustule-like protuberance at the site where the tooth had fallen off. At first, Liao was treated at a dental office in his neighborhood and the wound still did not heal. After he was diagnosed with oral cancer at a medical clinic in the northern Taiwan, he was referred to Taipei Tzu Chi Hospital where the diagnosis was confirmed. He was hospitalized and had the cancerous tumor surgically removed. He has been closely monitored for three months after the surgery. Currently, his recovery is stable and there is no sign of recurrence. Director Hsia explains that when a sore in the mouth does not heal in two weeks, the patient needs to seek treatment from a doctor. Successful Surgery with a Recovery Plan Director Hsia, has been a dental and oral surgeon for 30 years. He has performed surgery for oral cancer patients up to 100-year-old. He is the authority in the field of oral, jaw and maxillofacial surgery in Taiwan. Director Hsia indicated that oral cancers cases occur in children are very rare and Liao is the second youngest patient diagnosed with oral cancer. Furthermore, unlike most of the young patients, Liao s lesion was nested in the lower jaw gum closed to the neck lymph. These factors made the treatment much more difficult. Since the alveolar bone needed to be removed, the possibility of uneven facial development of the left and right cheeks was highly elevated. Therefore, Liao had to go through a long term monitoring program and a pediatric dentist had to be part of the treatment plan to ensure a balance development of his left and right cheeks. Currently, Liao has been discharged from the hospital. With routine follow-ups, he has been recovering well. The pediatric dentist at the Taipei Tzu Chi Hospital developed a treatment plan to ensure Laio s teeth would grow normally. For now, spacers were put in between teeth to make sure that the teeth would grow straight and the facial development would be normal. Going to be a third grader, Liao attended the press conference with his parents today. He made a thank you card for Tzu Chi Hospital and Director Hsia, When I entered the operation room, I was very scared. But I knew Dr. Hsia is a very good surgeon, and I believe that I would be able to survive the surgery. In tears, Liao s mother also expressed gratitude to Director Hsia and Dr. Yi-Hung Chen who will be the pediatric dentist for Liao s recovery plan. To Mrs. Liao, these Tzu Chi doctors are angels. She said, My son was diagnosed with such a disease at such a young age. It was an unbearable shock. We had a hard time accepting this fact. However, we feel blessed that we met Dr. Hsia. He saved my son s life. 118 Tzu Chi Medical Care Vol.14 JULY 2012 Tzu Chi Medical Care Vol.14 JULY 2012 119
Be Cautious of Unhealable Wounds Liao is discharged from the hospital after a successful surgery. Taipei Tzu Chi Hospital gives a model car as a gift to Liao. Liao drew a thank you card to show his gratitude to Tzu Chi medical team. In Taiwan, over 90 percent of oral cancer patients have the habits of smoking or chewing betel nut. The reason that Liao, who does not smoke nor chew betel nut, has oral cancer is still unknown. Nevertheless, Dr. Hsia wants everybody to know that once a sore in the mouth that does not heal in two to three weeks, it might have a higher chance to become malignant. People should pay special attention to children and elderly when they have sores in their mouths. Generally, oral sore usually takes about seven to ten days to heal. If a wound does not heal in more than two to three weeks, the person must seek an oral surgeon for further examination and diagnosis. Dr. Hsia indicates that it is actually very easy to self-diagnose an oral cancer. However, oral cancer patients usually come to the clinic at either the third or the last stage of the disease. This is because patients take the situation lightly at the beginning. They thought they were just having a periodontal disease or an insignificant infection, and the problem could be solved by brushing teeth or applying some ointment. They thought the wound would heal itself and therefore, missing the golden time for treating oral cancer. 120 Tzu Chi Medical Care Vol.14 JULY 2012