Acharacterintheclassicsci-finovel‘Dune’saysthat“thehighestfunctionofecologyisunderstandingconsequences:”becauseecologiesaresuchcomplexinteractionsbetweenanear-infinitenumberofvariables,“prediction”isoftenaconceit,butunderstandingisanachievablegoal--lookatasmanyaspectsofasystemasyoucan,andtryandseehowtheyallinteracttogether.Thenyoucanlearnthebestinterventionpointstotryandguidethewholesysteminthedirectionyouwant—inourcase,towardshealthierindividualsandcommunities,andbettercliniciansmoreequippedandmotivatedtocontinuekeepingserviceapartoftheirlives.Healthisverycomplex.‘Health’isalandscape,notonlyafewfactorsaffectingindividualsbutacontinuumofnear-infinitefactorsthatallinteractsimultaneouslytoaffect‘howweare.’It’snotjustaboutbloodpressureorautoimmunediseaseorpre-natalhealth.Thoseareimportant,buthealthisaboutmuchmorethanthebody’scondition:Mostpeoplefeelthattheyaremorethanjustthesumoftheircells(andperhapstheyaremorethanthemeredivisionofus!).

Sowedoalotmorethanjustseeingpatients.Whydowehaveaveterinaryprogram?Becauseit’srighttohelpanimalsthataresuffering?Ofcourse—butitalsoreducestick-bornediseases,healthieragriculturalanimalsmeanmoreprosperousandbetterfedfamilies,morechildrenfinishingschoolandfamiliesabletotraveltoadistanthospital.Italsoencouragesmorecompassionforanimals,andbeingkindtoanimalsisgoodpracticeforbeingkindwithothers.

“Helpyoursister’sboatacrossthewater,andyourstoowillreachtheotherside.Kindnesscanbecomeitsownmotive:wearemadekindbybeingkind.”-EricHoffer

Similarly,whydowetryanddocumentapectsoftheindigenousculturewhomweserve?Becausetheircultureisvanishingbeforeoureyesanditissopoorlydocumentedthatwhenthecurrentadultgenerationdies,avastportionofwhotheyaremaydietoo.HowcanwefocusonlyonparasitesandtuberculosisandHIV—allseriousissues—andignoreeverythingelse?Sothatiswhat‘integrativemedicine’meanstome:aholisticapproachtoALLaspectsofthe‘healthlandscape’inwhichthepatientexists.Thus,asabusiness,our‘products’are:healthierandmorerobustindividualsandcommunities,moreskillfulcliniciansonmissionsorathome,morecompassionandkindnessintheworld,andalotofpersonalgrowthandcommittmenttofurtherserviceintheheartsofthevolunteerswhocomeandgivesomuchofthemselves,butreturnhomemadegreater,notlesserfromtheirgenerosity.Theycomeandtheygive,butwhattheytakeawayimpactscountlessotherlivesaroundtheworld.So,whatweworktoachieveisstaggeringlysimple,butwedeliverthesegoalsinamultitudeofways.IcouldnotbeprouderoftheimaginationandcreativegeniusshownbysomanypeoplewithinFloatingDoctorsthisyear(andeveryyear)andseeingwhathasbeenachievedforsomanypeopleinPanamaandaroundtheworld.FairWinds,

AmeriCaresAmigosdeBoqueteBlessingsInternationalCleantheWorldFoundationDanfordFoundationFriendsoftheAsiloGlobalGrinsGlobalStarGlovesGoGlobalGlydeInternationalAidTheLawrenceFoundationMATTER

MDFinstrumentsMinisteriodeSalud,PanamaOptimistClubofPacificPalisadesQlikAnalyticsRemoteCareCMESermoSmileSquaredSonoUltrasoundWipeSonositeTomandLindaMcCormackFoundationVitaminAngels

Ourprojectsandthecommunitieswehavehelpedthisyearweremadepossiblenotonlythroughourefforts,butthroughthesupportiverelationshipswehavefosteredwithmanygroupsandorganizations.

Specialthankstoourpartnersin2017:

FloatingDoctorswishestoextendoursincerestgratitudetoalloursupporters.Withoutyourgenerosity,wewouldneverbeabletoworktowardachievingourmission.Below,wewouldliketorecognizeourfinancialandin-kinddonorsof$500andabovefortheannualyear2017.

BarbaraSuttonBevCombsColadCharitableTrustDouglasWalker&AnneMarkwardKoryCamposRandalSchwartz

RaymondChangReneeKaswanRianonMateerPeterGordonRobertBezeauTedHannig

$10,000andAbove:

$1,000to$10,000CarlosYuChaminadeCollegePreparatoryDarkBurnCreativeFaithLutheranChurchGeneCaineJamesPaulGerkeJillTawKathleenAngus

KetakiAbhyankarLoraandKevinFlemingMarijkeUittenbogaard-WijnbergMaryWestbrookPacificPalisadesLutheranChurchPrinceWilliamTaylorSoYoungAn

$500to$999ChelseaRajkumarDianneBandlerDorothyONeilF.S.Almendariz&AssociatesHansErikvanRijsoortHollyGettingsJohnC.BaileyKarlaandJosephMorrisonKativaStricklandKevinandShellySpeer

KristopherHarrisLinLawnandAndySacherMarkDorfmanPaulLaBrotBrownRobervanOudheusdenSanderDekkerThomasLaBrotVenice-Marina-LALionsClubWorldMedClass

TheFloatingDoctors’ongoingmissionistoreducethepresentandfutureburdenofdiseaseinthedevelopingworld,andtopromoteimprovementsinhealthcare

deliveryworldwide.

Goals:1.  Providingfreeacuteandpreventativehealthcareservicesanddelivering

donatedmedicalsuppliestoisolatedareas.2.  Reducingchildandmaternalmortalitythroughfoodsafety/prenatal

education,nutritionalcounselingandcleanwatersolutions.3.  Studyinganddocumentinglocalsystemsofhealthcaredeliveryand

identifyingwhatprogresshavebeenmade,whatchallengesremain,andwhatsolutionsexisttoimprovehealthcaredeliveryworldwide.

4.  Usingthelatestcommunicationstechnologiestobringspecialistmedicalknowledgetothedevelopingworld,andtoshareourexperienceswiththeglobalcommunityandpromotecooperationinresolvingworldhealthcareissues.

Foundedin2009,FloatingDoctorsbeganasasmallprojectwiththegoalofbringinghealthcareservicestoisolatedareas.Overthelastseveralyears,wehavegrownintoanorganizationwithinternationalrecognitionthatthrivesviavolunteerengagement,communityoutreachandeducation,extensivepartnershipswithlocalhealthorganizationsandeducationalsystems,andanadaptabilitythatallowsustotailorcaretotheneedsofspecificcommunities.Since2011,FloatingDoctorshasdeliveredmedicalservicestocommunitiesmadeupoftheNgäbe-BugleindigenouspopulationlivinginBocasDelToroArchipelago.Wecombineaccessibleandcomprehensivehealthcareservices,rigorousscientificresearchandinternationallyaccreditedmedicaleducationopportunitiestosavelives,introducelongtermhealthcaresolutionsandbreakthecycleofpovertyanddiseaseforthesecommunities.Throughourvolunteerprogramandtrainingopportunities,FloatingDoctorsregularlyvisitsover20communitiesspreadover10,000squaremilesofjungleandmangroveforests.

Traveltoahealthcarefacilityis,formostofourpatients,nearlyimpossibleduetotimeconstraintsandtheexpenseoftravel,nottomentionthedifficultyofnavigatingthehealthcaresystem.Therefore,itisimperativethatwebringhealthcaretoourpatientsintheformofmobileclinics.In2017,FloatingDoctorsspent176daysdeployedincommunitiesthroughouttheregion,seeinganaverageof75patientsperday.Becauselargefamiliesarecommon,andoverhalfofourpatientsarepediatric,themostcommonformofconsultatourclinicsisthe“familyconsult.” Seeinguptosixpatientsduringone

consultcanbedauntingatfirstformanyvolunteers,buttheyquicklylearnthebenefits:treatingillpatientsandaddressingtheentirefamilywhenonememberpresentswithahighlycommunicableissue.Italsoprovidesustheopportunitytoperformwell-checksonhealthypatients,providechildren’svitamins,soapandde-wormingmedicationforeverychild,andmonitorkids’growthratesanddevelopment.

Giventhelargefamilysizesinourcommunities,about75%ofourconsultsarepediatricForthesevulnerableindividuals,eveneasilytreatablediseasesandinjuriescanhavedevastatingimpactswithoutimmediatecare.

FloatingDoctorsisproudtoworkalongsideFriendsoftheAsilo,aswellastheMinistryforSocialDevelopment(MIDES),toprovidehealthcareandpalliativecareforresidentsandoffercompanionshipandcomforttooureldersinthecommunity.

Inourregion,childrenstilldiefromdiarrhealdiseaseandrespiratoryinfections,andlesslife-threateningissueslikescabiesandwormsleadtoschoolabsencesandchronicdebilitation.Itisourmissiontoreachthesepatientsandtreatthembeforetheproblemtakesitstoll,andtoeducatethecommunityonthebestwaystopreventthespreadofinfection.

In2017,wewereabletospendnearlyallofournon-clinicdaysattheCasadeAsilo,thegovernmentnursinghomeinBocasdelToro.TheAsiloishometosome30patientswithvaryingdegreesofhealthandmobility.Somepatientsarewithoutsight,somewithoutlimbs,manyhavevaryingdegreesofdementia.

Mostofthetime,weareabletodiagnose,developatreatmentplan,andfollowupwithapatientintheirowncommunity.Somepatients,however,requiremoreadvancedcarethancanbeprovidedbyourclinics.Inthesecases,FloatingDoctorstransportspatients,accompanyingthemandadvocatingontheirbehalfforin-hospitalandspecialistcare.Wearehonoredtobeabletoassistourpatientsinreceivinglife-changingcare,whetherforcataractsurgeryorherniarepair.In2017,wehadseventeenchildreninthirteenislandcommunitieswithheartmurmursandwouldneedechocardiogramsattheChildren’sHospitalinPanamaCity.Wearrangedtransportationforallofthesepatientsandaparenttovisitaspecialistfortheirconsults.

Formanyofthesechildren,itwastheirfirsttimeleavingtheirvillage,buttheywereincrediblybraveandtookitinstride.Nearlyeverychildinthegrouphadastructuralproblem,butwelearnedthatmostcaseswerenotlife-threateningandwouldresolvewithtime.Wecontinuetomonitorthesepatientsonourregularclinicschedule.Unfortunately,welearnedthatfourofthechildrenhadissuesthatwouldrequiresurgeryassoonaspossible,

ortheirliveswouldbesignificantlyshortened.Withthisknowledge,FloatingDoctorscommittedtoassistingthesepatientsandtheirparentsinmakingthemultiplepre-surgicaltripstoPanamaCityaswellastheirsurgicalvisitandpost-operativefollow-upcare,savingthesechildrenfromalifetimeofhealthissues.

“Thistripshowedmeasideofmedicinethatisnotlearnedintextbooksoraclassroomenvironment.MytimeinPlayaVerdehighlightedtheimportanceofbeingabletocommunicatewithcolleaguesandsetasideanydifferencesforthepurposeofprovidingthemaximumcareforthepatient.”VolunteerBelenChairez

800+PrenatalUltrasoundsPerformedintheField

43%IncreaseInvolunteersfrom

2016

3332017Volunteers

30Life-alteringSurgicalProceduresFacilitated

26K+VolunteerHours

“Eldersholdknowledgeandstoriesofthepast.Letsmakesuretotakecareofthem,bysupportingtheAsilonursinghomeinBocasdelTorothattakescareofeldersinPanama.“VolunteerAngelJ.Martinez

“SoclassictowatchthisNgäbe-BuglèfathertakinghischildrenhomecoveredwithstickersIhadgiventhemandastuffedanimalinthefrontoftheboat.Amemory,pictureandfeeling...I'llneverforget....IfeltlikeIhadgivenalittlesomethingbacktotheworldthatday.”VolunteerDr.MichaelPond

57DaysSpentwithAsilo

Residents

Over340,000Children’sVitamins

Distributed

10,000+PatientVisits

Over150PatientTransports

Itisfrequentlysaidthathealthywomenbuildstrongcommunities.Thisisespeciallytrueinallofourcommunities.BeingthecornerstonesoftheNgäbecommunities,itisessentialthatwomenreceivequalityhealthcare,particularlyinregardtoreproductivehealth.WithhighbirthratescomparedtotheaverageinPanama,anabsenceofaccesstobasicmaternal/reproductivecareisadangertotheoverallstrengthofacommunity.In2017,FloatingDoctorsmonitoredtheprogressof750pregnancies,providingroutineultrasounds,nearly375,000prenatalvitamins,andensuringhigh-riskpregnanciesweredeliveredinhospital.

Asimportantasmonitoringourpregnantpatientsisprovidingaccesstofamilyplanning.Whetheracouplewouldliketobedoneexpandingtheirfamilyortheywanttoputoffstartingafamilytofinishschool,accesstoreliablecontraceptionisanimportantservicethatwearehappytoprovide.WiththesupportofthePanamanianMinistryofHealth,FloatingDoctorsprovidedcontraceptivecareto575womenthispastyear.

Peopleoftendon’tthinkofdentalissuesasamajormedicalpriority-untiltheyhaveatoothache.

FloatingDoctorshaslongadvocatedthatdentalhealthandoverallhealthareintertwined.Overthelasttwoyears,wehavedevelopedawell-equippeddentalprogramthatcanaddressmostdentalissuesandofferprimaryprevention.Inadditiontotreatment,allpatientsareofferedanewtoothbrush(andtoothpaste,whenavailable,)andourvolunteersregularlyteachdentalhygieneandbrushingtechniques.

In2017,FloatingDoctorswasabletotreatover1,500dentalpatientsanddistributehundredsoftoothbrushes.Asourprogramandvolunteerrelationshipscontinuetodevelop,welookforwardtoaddressingthousandsmore.

Attheheartofourmissionistoreducethepresentandfutureburdenofdisease.Werealizedlongagothatthismeanttreatingthecommunityasawhole.

Thehealthoftheanimalsinacommunityandthewaytheyaretreatedcanbeanindicatoroftheoverallhealthofacommunity.Manyparasitesthatplagueourcommunities,particularlyworms,oftenliveintheanimals,sopartofcreatinghealthycommunitiesisriddingtheanimalsoftheirparasites.

Overtheyears,wehavehadthepleasureofhostingveterinariansfromallovertheworldandworkingwithlocalveterinariansandgroupstoprovidecaretoournon-humanpatients.Withoutthiscriticalcare,childrenwetreatforwormswouldbere-infectedwithinafewweeks,familieswouldlosevaluablefoodsources,andtransportofgoodswouldbemuchmoreburdensome.

Towardtheendof2017,webegantodevelopwhatisbecomingafullveterinaryprogram,andwelookforwardtofurtherenhancingourholisticapproachtocommunityhealth!

Asimportantastreatingoursickpatientsisarmingthemwiththeinformationandskillstoreducethechanceofcontractingandspreadingdiseaseinthefirstplace.Inthepast,wehaveheldinformaltalks,calledcharlas,aboutvarioushygieneandhealthpracticesifandwhenwehadavolunteertospareoragroupcomingdownwithspecifictopicstheywantedtoaddress.

Thisyear,weworkedtodevelopneedsassessmentsoneachcommunitytoidentifyareaswherecommunitiesneedadditionalinformationandtraining.Someofthesetopicsincludeproperhandwashing,whywaterisimportantandwaystoavoiddehydration,properdentalhygiene,women’shealthissues,physicalactivity,andothers.Thesecharlasaresopopularandeffectivewithyouth,teens,andadultsalike,thatwearelookingforwardtodevelopingaformalHealthEducationProgramwithadedicatedHealthEducationCoordinatorearlynextyear.

Tofurtherencouragepractitionerstobetterunderstandglobalhealthissuesandremotecare,we’vecontinuedourrelationshipwithRemoteCareEducationandtheUniversityofMinnesotatohostACCME-accreditedcontinuingeducationcourses,combininglectures,practicaltraining,andfieldpracticeinourcommunities.Withtwocoursesin2017,over70CMEhourswereofferedatourbase.

VolunteersarethebackboneofFloatingDoctors.Withoutourwork,enthusiasm,anddedicationtoqualitycare,ourmissionwouldneverbeachievable.In2017,wehosted333volunteersfromallovertheworld.

VolunteeringwithFloatingDoctorsprovidestheindividualwithopportunitiestohonetheirdiagnosticandclinicalskillswhilealsolearninghowtocareforsomeonewithdifferentculturalnormsandworkforthebestpossibleoutcomesinaresource-limitedsetting.We’reproudtobeabletooffereducationalandlife-changingexperiencesforvolunteersofalltypes,fromnon-medicaltranslatorsthroughexperiencedclinicians.

Inadditiontogeneralnon-credittraining,wehavebeenandcontinuetodeveloprelationshipswithinstitutionsworldwidetoroutinelysendstudentandfacultyvolunteersforcredit.Manystudentsalsoindividuallyjoinusandreceiveelectivecreditfortheirstay.

FloatingDoctorsishonoredtohavecredit-approvedrelationshipswiththefollowinginstitutionsin2017:

•  CardiffUniversity•  TexasTechUniversity•  StonyBrookUniversity•  SUNYatBuffalo•  UniversityofCalifornia,Irvine•  UniversityofCalifornia,Los

Angeles

•  UniversityofMinnesota•  UniversityofSouthern

California•  UniversityofSouthern

Denmark•  ViewpointHighSchool•  WilkesCommunityCollege

FloatingDoctorsisproudtohavehostedindividualsfromallovertheworld.Thisyear,volunteersfromthefollowingthirteencountries:

•  Australia•  Canada•  Chile•  Colombia•  Denmark•  Ecuador•  Germany

•  Netherlands•  Panama•  Spain•  Switzerland•  UnitedKingdom•  UnitedStates

DirectSupportVolunteerContributionsGrantsIn-KindSupportContributedServices

95%FloatingDoctorsTeam

areVolunteers

3.67%SpentonOverhead

$971,000EstimatedValueofDonatedCare

RevenueDirectPublicSupportFundraisersFoundationGrantsContributedServicesVolunteerContributionsCorporate/OtherContributionsBoardContributionsIn-Kind/Misc.TotalIncome

$90,796$4,616

$100,202$971,000$334,175$37,193$51,820$11,863

$1,601,663

Administrative

Facilities

Clinics

Pharmacy

Volunteers

ExpensesGeneral/AdminFacilitiesClinicalCostsVolunteersPharmacyTotalExpenses

$55,224$192,000$209,493$999,808$47,296

$1,503,820

*InternallyPrepared

As of December 31, 2017

ASSETS Current Assets $22,869 Fixed Assets

Boats $180,646 Buildings - Island Structures $671,806 Equipment - Medical & Marine $86,266 Furniture & Fixtures $71,135 Other Equipment $182,662

Total Fixed Assets $1,192,515

Total Assets $1,215,384

LIABILITIES AND EQUITY Liabilities

Total Current Liabilities $(361) Total Long-Term Liabilities $373,408 Total Liabilities $373,047 Equity $842,338

TOTAL LIABILITIES AND EQUITY $1,215,384

OfficersoftheBoardofDirectorsChair:PeterGordon

VicePresident:RyanMcCormickSecretary:PaulaLaBrot

Treasurer:RandalSchwartz

BoardMembersJimAdamsGeneCaine

LauraHamadyBarbaraSuttonGeorgeLaBrotReneeKaswan

AdvisoryCouncilJolieLaBrotSkyLaBrot

RobertLandesMarkSchelbert

ExecutiveLeadershipPresident&Founder:BenjaminLaBrot

DirectorofVolunteerResources:GenieDunai