The children’s smiles and the look of gratitude on their parents’ faces is what keeps an all-volunteer medical team from Lucile Packard Children’s Hospital and Stanford Hospital returning every year to Central and Latin America to provide orthopedic care to some of the world’s poorest children. This year the team, composed mostly of Packard Children’s staff, returned to Esteli, Nicaragua.
Orthopedic surgeons James Gamble, MD, PhD, and Lawrence Rinsky, MD, have become familiar faces in the town of Esteli where they have performed a range of orthopedic procedures for the past 13 years. Operation Rainbow, a nonprofit organization based in San Francisco, coordinates the yearly trips that are partially funded by private donations and partially by the Packard Children’s team.
Gamble said the Packard Children’s team is particularly effective because it is a comprehensive group, much like a military field hospital, that includes doctors, nurses, interpreters, therapists, coordinators, and technicians.
During their most recent trip, the team saw about 175 outpatients and operated on 40 of them. “The conditions we treated covered a whole spectrum of orthopedic conditions from congenital anomalies, metabolic problems and traumatic injuries,” said Gamble. “We typically operate on dislocated hips, club feet, and pretty significant orthopedic problems. On this latest trip, we operated on both upper and lower extremities on a third of the patients.”
Rinsky said the patients who come from neighboring villages usually travel in the back of pickup trucks, on top of buses or sometimes in ox carts or on burros. The patients are not charged for the surgeries and receive free follow-up care by the local doctors, who are paid by Operation Rainbow for their services. The organization also donates much needed medical supplies and equipment such as crutches and wheelchairs.
“Some of these kids who can’t walk have never had a wheelchair; they are carried around by their parents,” added Gamble. “The impact we make is absolutely huge.”
Rinsky said part of their work is to teach local doctors how to perform certain procedures. “One of the most useful things we’ve done is to teach doctors how to treat club feet without performing a major surgery,” he said. “There’s no longer a huge reservoir of club feet or badly treated club feet like there used to be. There is a tremendous sense of accomplishment when you have taught someone something.”
Gamble said he returns year after year to Nicaragua and other international locations not only to provide much-needed services but also for the personal joy he gets back in return.
“It’s rewarding when I see a child who can’t walk and now is able to walk or we fix the feet of a child who has never been able to wear shoes because of such severe club feet. Sometimes they come back to visit us the following year and they walk in with big smiles on their faces. It’s just a sense of eternal joy to be able to help them.”
- Stanford Children's Health
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