Uganda Mission 2012

July 24, 2012

Uganda Day 2

Contributed by Rachelle Lieberman

Today is our second day in Uganda and we are hitting the ground running.  The words “jammed packed” have several meanings for us today.  Our schedule is packed with appointments.  We were at Mulago hospital by 8 am this morning. Immediately we began to examine all the prospective patients for this year.  We also followed up with patients who had surgeries in previous years.

Below is a picture of some of the patients in the spine ward.


Izzy with Stella a patient he operated on in 2010 who is doing great!!!

 Izzy examines one of the kids from the orphanage.

 We ended up examining over 40 people in a matter of five hours. Today was undoubtedly another emotional day for all, but the look on the kid’s and parent’s faces when they find out they are going to get the surgery they need makes it all worthwhile!

Doctors examine a patient in the Mulago Spine Ward.

After all the patients were seen we then planned out the entire first week of surgeries as well as some of the second week. It is truly amazing to think about how many lives we are going to touch in just two weeks.

Izzy giving Dr. Nyatti a book Dr. Jack Zigler authored about spine trauma.

When I said earlier our day was jammed, I didn’t just mean at the hospital, I also meant the traffic! We were stuck in multiple traffic jams while traveling back and forth between the hospital, apartment, and dinner. To paint you a picture, imagine a small town with only a stoplight or two.  Sometimes they work, sometimes they don’t.  Now imagine no driving lanes and no rules of the road – other than honking your horn gives you the right of way. This was slightly stressful for those of us on our first trip to Uganda, but it didn’t seem to faze the mission veterans.

We have another full day tomorrow starting at 7:15 am. Two surgeries scheduled on the books so far, as well as lots of other meetings and organizing to do. More to come soon…

Uganda Spine Mission 2012

It is that time of year again when Dr. Lieberman and his team travel to provide spine care for the citizens of Uganda.  This year Dr. Lieberman’s team consists of the following members:

1) Izzy Lieberman (spine surgeon) Dallas

2) Brian Failla (equipment manager) Ft lauderdale

3) Paul Holman (spine surgeon) Houston

4) Krzysztof Kusza (anaesthesia) Poland

5) Zbigniew Szkulmowski (anaesthesia) Poland

6) Ejovi Ughwanogho (spine fellow) Dallas

7) Sherri LaCivita (scrub technician) Dallas

8) Elizabeth Wolhfarth (scrub technician) Ft lauderdale

9) Negozi Akotaobi (physical therapist) Dallas

10) Jason Ehrhardt (monitoring tech) Dallas

11) Rob Davis (equipment manager) Dallas

12) Rachelle Lieberman (teacher) Boulder, CO

13) Erin Sadler (medical student) Toronto

Today’s post was contributed by Erin Sadler.  Enjoy!

Day 1 – Arrival to Entebbe, Kampala

 The team all congregated at Heathrow Terminal 5 for a 9:15 pm departure to Entebbe International Airport.  After some brief introductions the team seemed to quickly mesh well together and a warm dynamic was almost instantly evident. The team this year is quite large with thirteen members with various backgrounds, from the United States, Canada, and Poland. After boarding the plane many of us were exhausted from our travels that brought us to Heathrow, and thus tried our best to take advantage of the 8 hour overnight flight to Entebbe and get some sleep!

We landed in Entebbe at 745 hrs after a few hiccups from the flight deck in their attempt to land with heavy tail winds. We were all pleasantly surprised by the beautiful weather with temperatures in the mid 20s (68 degrees fahrenheit). We all gathered our gear, minus a lost bag from Poland, and made our way to meet our buses that would be responsible for our transportation for the next 2 weeks. We loaded up the buses quickly and began our journey to Kampala. Along the route there was much to be seen and taken in. The first glimpse of the fertile Ugandan landscape, the vibrant Ugandan people everywhere you look, the pop-up stalls along the road, and the many handmade bed frames for sale along the roadside, without any mattress stores in sight kept us all entertained throughout the journey.

 We arrived at the Golf Course Apartments in Kampala where we will be staying for the next 2 weeks. These accommodations are very comfortable and well outfitted to suit our needs. Between the thirteen members of the team there are two apartments.  Once we had moved our luggage in and had a chance to refresh ourselves and brush our teeth for the first time in too long, we were once again off into Kampala to do some shopping to buy food items for breakfasts and other necessities like water, hand sanitizer, and the odd bottle of wine!  One hefty shopping bill later, and buses packed to the brim we headed back to the apartments to unload and organize ourselves before taking off again to go visit the two hospitals we will be working at.

The first hospital we visited was Case Hospital, which is a private hospital, relatively affluent with decent equipment, services and patient care; quite similar to a standard hospital in North America.

Izzy unpacking more surgical equipment.

Conversely, we then went to Mulago Hospital, which is the national public hospital; located on a sprawling campus of single story bunker-like buildings that serve as different wards. We specifically visited the Spine Ward, where we will be performing operations in the theatre, and the Orthopedic Ward.

Some surgical equipment at Case.

The spinal ward at Melago.


Supplies at the spinal ward in Melago.

Both were equally eye-opening: wide open rooms with several beds lined up side by side, filled with patients, and more surprising, the patient beds were surrounded by families. It was very interesting to see the dynamic of patient care in the Mulago setting, where the families seem to be the primary care givers despite the inpatient nature of the hospital accommodations. The families were huddled around the patients, sometimes having created a small area near the patient`s bed where they have essentially set up a temporary squatting home, feeding them self-prepared food, bathing them, and really the only people in the hospital providing vigilant care to these patients. Futhermore, the familial presence extends beyond the hospital walls, where as you walk outside you notice families have found a space to call their own on the hospital property and are essentially squatting there as their loved one remains in hospital. As I toured these poorly faciliated wards, I couldn`t help but question how these native Ugandans view us: as foreigners who are coming to try and help, or perhaps do they question our role in their medical care? To continue this enlightening cultural experience, we then went to walk through a nearby slum in Kampala. As a group we walked through narrow dirt alleyways for streets, which were covered in garbarge and had waste water running down the middle, as beautiful friendly people waved and smiled at us through the hanging laundry, and curtained doorways fondly yelling “Muzungu” as we passed them by. This was unlike anything I have ever experienced before in my life, and not because I haven’t seen images like this on television or in other popular media outlets, but I think I was most taken by the joy and sense of community that I felt in this incredibly extreme and impoverished environment. I guess I expected to feel sadder and helplessness, which I definitely did feel, but these negative feelings were overwhelmed by my feeling that although these people live in the most horrific conditions, their sense of community is really quite powerful and uplifting. Moreover, the throngs of beautiful children with toothy grinned smiles from ear to ear was also quite a powerful sight, for there seemed to be such a sense of responsibility of the older children to look after the young, and the spirit of the child was so clearly evident, it outshone any despair that they, or more likely I, was feeling.

Boy from the slums.

Ejovi playing soccer with some of the kids.

Picture of the slums.

As we got into our buses and drove 5 minutes down the road into our plush apartments it became very apparent how contrastingly different Ugandan life can be, just simply a few blocks apart. We couldn’t help but feel incredibly spoiled as we spent the rest of the afternoon cooling off by the pool, and then heading to an amazing Indian restaurant for a lively dinner and some delicious curries. Before everyone fell asleep at the table, we headed home to spend our first night in Kampala, and have sweet dreams of the upcoming days of hard, yet extremely meaningful work to come!

Our group at dinner.

Stay tuned for more updates!


It’s not too late to find a job that inspires you!

My name is Kelly Phariss. I have worked at Texas Back Institute for 8 years and for the last 5 years I have been part of the sales team. I love it!

 As a sales manager, I spend the majority of my time speaking with physicians, who refer their patients to Texas Back Institute. I educate these physicians about the procedures and technologies TBI utilizes which can help their patients with back pain and neck pain.  I also participate in various events throughout the community.  These events include health fairs, golf tournaments, community events and events with the chambers of commerce.  While at these events, I educate the community regarding how Texas Back Institute can help treat neck and back pain.  My goal is to not just educate but also build relationships.

One of the most rewarding parts of my job is when people stop by the TBI booth to share their story saying Texas Back Institute physicians “saved” their life.  I love hearing success stories like these from those who have been to TBI and are now living a pain-free and active life. 

This makes me proud to work for TBI.  I know our physicians are not only expert spine surgeons, but good people who truly care about the well-being of others!

Kelly Phariss

North Territory Manager

Walk Away from Back Pain

January 13, 2012


Can you help protect your back by a regular walking routine?

Back pain is one of the leading causes of missed work, and chronic back pain is something many people must cope with every day. Back pain can be excruciating, debilitating, and in some cases, even disabling. For many back pain sufferers, the types of exercise and participation in physical activities often become limited. According to Dr. Rey Bosita of Texas Back Institute, walking can be one of the most effective remedies for your back pain.

At Texas Back Institute we love participating in charity walks. They are a great way to give back, spend time with friends and get some exercise!

Our group at Race for the Cure!

The Texas Back Institute group at the American Diabetes Association Walk!

Benefits of Walking

There are many inherent health benefits from a regular routine walking for exercise, such as:

  • Strengthens muscles in the feet, legs, hips, and torso. Walking increases the stability of the spine and conditions the muscles that keep the body in the upright position.
  • Reduces stress. Walking helps release the feel-good chemicals endorphins and serotonin in the brain and reduces stress that often makes back pain worse.
  • Nourishes the spinal structures. Walking for exercise facilitates strong circulation, pumping nutrients into muscles and removing toxins and inflammation that are causing pain.
  • Improves flexibility and posture. Exercise walking, along with regular stretching, allows greater range of motion and helps prevent awkward movements and susceptibility of future injury.
  • Helps with controlling weight. Any regular exercise routine helps maintain a healthy weight, especially as one ages and metabolism slows.

For people with ongoing back pain, a balanced and stable walking regimen maintains and enhances one’s ability to continue doing everyday activities while reducing the likelihood and/or severity of additional episodes of back pain.

To realize the full benefits of walking, certain guidelines need to be followed as outlined below.

Tips to Effective Walking for Exercise

There are several stretches and techniques that will improve the benefits of walking, as well as help prevent injury.

Stretch before walking. Prior to exercise walking, stretching should be done to prepare the joints and muscles for the increased range of motion needed. It is important to take an easy five-minute walk to warm up the muscles before stretching so they’re not completely cold when stretching.

Using the following techniques will help improve the benefits of walking:

  • Walk briskly, but as a general rule maintain enough breath to be able to carry on a conversation.
  • Start out with a 5 minute walk and work up to walking for at least 30 minutes (roughly 2 miles) at least 3 to 4 times a week.
  • Avoid hills or uneven surfaces. Hills require leaning forward and increasing your effort, so try to walk on level ground to avoid injury.
  • Maintain good posture while walking to get the optimum aerobic benefit with each step and help protect the back and avoid injury. These elements of form should be followed:
    • Head and shoulders: Keep the head up and centered between the shoulders with eyes focused straight ahead at the horizon. Keep the shoulders relaxed but straight—avoid slouching forward.
    • Abdominal muscles: It is important to actively use the abdominal muscles to help support the upper part of the body and the spine. To do this, keep the stomach pulled in slightly and stand fully upright. Avoid leaning forward as you walk.
    • Hips: The majority of the forward motion should start with the hips. Each stride should feel natural—not too long or too short. Most people make the mistake of trying to take too long of stride.
    • Arms and hands: Arms should stay close to the body, with elbows bent at a 90-degree angle. While walking, the arms should keep in motion, swinging front to back in pace with the stride of the opposite leg. Remember to keep hands relaxed, lightly cupped with the palms inward and thumbs on top. Avoid clenching the hands or making tight fists.
    • Feet: With each step, land gently on the heel and mid-foot, rolling smoothly to push off with the toes. Be mindful about using the balls of the feet and toes to push forward with each step.

Walking can also help prevent back pain. The better toned your muscles are, the less likely you will have frequent spasms. So, strap on a good pair of tennis shoes and start walking to possibly help reduce your back pain, and keep on walking for long-term better health.

What type of exercise do you like to do to stay healthy?

****Disclaimer: Please check with your physician prior to startnig any kind of exercise program to make sure you are healthy enough to begin. ****

Uganda Spine Mission 2011

August 16, 2011

Day 1

DAY 1 – August 14th:

Our mission began at the London Heathrow airport on Saturday August 13th. Jet-lagged from our trips from Toronto, Florida, Texas, and Poland, some remained in the airport while others day-tripped into London before the connecting flight. The anticipation grew upon the arrival of Dr. Isador Lieberman (Spine Surgeon) and Ngozi Akotaobi (Physical Therapist), who created and delivered our 2011 Uganda Spine Surgery Mission shirts which we wore proudly.

The team had doubled in size since the previous year. Hugs were shared among veterans and handshakes among rookies, and we were all excited to reach our destination.

The team in London.

For others, the mission had already began.   Dr. Mark Kayanja (Surgeon), the motivation for the first Uganda Spine Mission 5 years ago, arrived on Monday August 8th. He was joined by Amy (RN) and Dr. Selvon St. Clair (Surgeon) on Tuesday, after a day of unanticipated passport problems. Together, Dr. Kayanja,  Amy and Dr. St. Clair saw over 30 patients in the clinic and performed three surgeries. The surgeries included: 1) a T10-L1 posterior fusion for 20-year old male who fell from a mango tree 6 weeks prior, 2) the removal of an abscess causing kyphosis (hunched posture) in a 9-year old girl suspected of having tuberculosis of the spine, and 3) repair around an irritated nerve in the lower back of a 39-year old woman with back pain and numbness of her leg. They scheduled four more surgeries in preparation for our arrival so we could hit the ground running and maximize our impact during the mission.

We landed in Entebbe at 7a.m. local time exhausted from consecutive overnight flights only to learn that the airline had misplaced two bags: those of our fearless leader, Dr. Izzy Lieberman.

We were enthusiastically greeted by our driver, stuffed two vans with our luggage and supplies and drove to Kampala. It was a familiar drive for the vets and eye-opening for the rookies, as we all snapped shots of the diverse scenery of lush landscapes and busy town markets.  We arrived at our accommodations, bunked up and unpacked.

We met at 12:30pm to discuss our plan for the week. Two surgeries had been scheduled at Mulago, Kampala’s general hospital and another two at Case, a private hospital nearby. We also planned a clinic for 15 children at Mulago who were traveling to Kamapala to see us. We discussed some of the challenges to be overcome, including licensing and new regulations about moving our critical equipment between hospitals. With a team of 13, we divided into two groups so we could work at Case and Mulago simultaneously, for the first time.

We like to call this the situation room!

After the meeting, we went grocery shopping and returned home for a much-needed nap. Later in the evening we ate dinner at the nearby Serena Hotel, where we shared thoughts and laughs in anticipation for the days to come.

We had the pleasure of meeting a few wonderful individuals. In the Heathrow terminal our shirts were recognized by Elizabeth Iverson, an Italian dentist who moved to Uganda in 2009 to treat children born with cleft palates. She lives there with her family now and had much to share about humanitarianism, her experiences and the culture of the Ugandan peoples. We were joined at dinner by Brooke Stern, and her colleague Nick, from an organization called Supportive Opportunities for Ugandans to Learn (S.O.U.L.) based out of New York. Brooke had read about our mission online and wished to meet up with us in Kampala. She was an impressive young nurse who started and grew this organization. She has now reached many Ugandans, raising school fees for 250 children and supporting an additional 300 women in cooperative programs such as fish-farming and subsistence farming.

Brooke, Ngozi & Nick

We look forward to the many more remarkable individuals we will encounter over the next two weeks.

Quote of the Day:

“I’m gonna have to re-adjust my malaria meter.”

Texas Back Institute was built on the foundation of patient care, research and education, so of course when one of the local high schools asked us if we would let a couple of students shadow one of our surgeons, we were all for it!

Dr. Guyer, one of the founders of TBI and one of the co-directors for our fellowship program, jumped at the opportunity to share his passion with two young students.  They spent the day by Dr. Guyer’s side, learning what it takes to diagnose and treat back and neck pain and what it takes to be a compassionate doctor.   Here are a couple of photos from the day!

Dr. Guyer with his two students.

A couple of action shots!

We had such a great time and are so happy we were able to do this!

Did you ever think you wanted to be a doctor?  What either got you there or changed your mind?

We have talked about Dr. Belanger before, but for those who haven’t heard about him, he is the latest addition to the Texas Back Institute physician team. He joined our team in January and works out of our Rockwall office.  He is an orthopedic spine surgeon and he is in Rockwall full-time! We are so excited to have him as part of our TBI family! 

Since it has been a full 6 months since Dr. Belanger came onboard we decided we wanted to thank some of the physician’s in the area that have helped welcome Dr. Belanger into the Rockwall medical community.  What better way to do this than a sunset sail on Lake Ray Hubbard? 

Our view walking from the shops to the pier.  Gorgeous!

Cheryl and Dr. Bean on the boat.

Dr. Belanger and his wife Toni.

The grub!

The whole gang!

We had such a good time and were so happy that everyone was able to make it out!  Thanks for everyone who came! 

As a final thought, check out how cute this little duck family was! Adorable!

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