Neiser is a nine-year-old boy who has never walked. He scoots around on his bum, using his hands to propel himself forward, like a 12-month-old infant who hasn’t yet learned to walk.
Both his lower limbs are badly twisted club feet. He is in Grade 1, loves painting and listening to music.
His dad says his trouble started when he accidentally drank some bath water when he was a baby. Doctors believe he was a difficult birth with some anoxia, too little oxygen to the brain. Whatever the cause, Neiser is a special needs, shy boy, one of six children who live with their parents on a small farm in the province of Orellana in Ecuador. His dad is able to grow enough pineapple, corn, cocoa and peanuts to feed his family, not enough for market.
When word got to the farm that the Canadian doctors and nurses were returning to Quito, doing surgery to correct problems like his, Neiser kept asking, “When will I walk?”
It took he and his dad 11 hours to get to the clinic for assessment: 1 1/2 hours to the main road by foot, Dad carrying Neiser, then a 90-minute taxi ride to the city of Coca, followed by an eight-hour bus ride to Quito.
When he arrives at the Hospital Padre Joe Carollo Un Canto de la Vida, Neiser is a frightened child, far from home, among strangers all dressed in blue. He never smiles, rarely makes eye contact with anyone other than his father. We only get a picture of his face by standing next to his dad, who makes him smile, briefly.
Two days later and a day after surgery, Neiser wakes up and looks down to see his legs covered with two very colourful fiberglass casts. Then he sees his feet, both pointing straight ahead, just like his brothers and sisters, his mom and dad. He looks directly at the nurses and breaks into a huge grin, from ear to ear, with anticipation of walking one day.
It is a moment I may never forget, seeing the joy and happiness on a child who has been given a new life.
I ask his dad what Neiser’s dreams were. Neiser had told his teacher before leaving for Quito, “When I am able to walk, we will dance.” Then he tells me, through a translator, “She is pretty, I love her.”
His dad tells Neiser his siblings are anxious for him to come home … soon he will be able to help with chores! And this is met with a huge grin from Neiser.
Without CAMTA, Neiser’s family would never have been able to give him this hope for his future.
Helping the underprivileged
I think every nurse, at some time in her career, thinks about going on a medical mission.
Just over a year ago at an orthopedic conference in Edmonton, the Canadian Association of Medical Teams Abroad (CAMTA) had a presentation. This is an Edmonton-based medical organization, a group of doctors, nurses, physiotherapists, translators, students and lay people who volunteer their skills and time, all with one goal … to help underprivileged people suffering from orthopedic problems in Ecuador.
I got up the courage to apply for their 11th annual mission to Quito, Ecuador in February 2012. The mission’s goals were to perform surgeries on the poor: total hip replacements on adults and to treat children with club feet and hip dysplasia. I am asked to come as a pediatric recovery room nurse.
Each of us must fund-raise a minimum of $2,500 to pay for flights, rooms and shipping of supplies and equipment. Thanks to the amazing generosity of friends, colleagues and companies, I raise the funds, and more.
For the flight down, each of the 52 volunteers is assigned a 50-pound hockey bag full of various medical supplies that we will need during the 10-day mission. We must bring everything from sheets and blankets to IVs and IV tubing, to anaesthetic supplies, hip prosthesis, operating room equipment and crutches, to sterile and unsterilized gloves.
I discover the bags are not light as we unload the truck at the Edmonton airport at 3 a.m. We arrive at Quito about 11 p.m. in the pouring rain. The hockey bags are put on a truck destined for the hospital and the rest of us are bused to our hotel where we fall into bed after a very long journey.
Day one was a day of adjusting to the 9,800-foot altitude. Altitude sickness can be an issue with people visiting Quito, presenting itself as a flu-like illness with headache, fatigue, gastrointestinal symptoms (nausea and vomiting) and dizziness. We are encouraged to take it easy the first day and to drink plenty of bottled water.
Word of our arrival has spread through the towns and villages and on clinic day, people come from miles around to see the Canadian doctors in hopes of being accepted for corrective surgery. The interpreters are busy; there is little English spoken. Potential patients are examined, histories taken, doctors determining if they can help in the short time we’re here, surgeries explained, operating room slates set up, and hope for a better life abounds.
The team sets a pace of four hip replacements and three pediatric club feet repairs or hip dysplasia repairs a day. This will be a busy week.
Our surgical day starts with the bus picking us up at 7 a.m. from our hotel and driving us the 30 minutes to the hospital. With the translators we get the patients into gowns, take their vital signs (blood pressure, pulse), make sure the paper work (consents, histories) is in line, and when necessary, that the blood for possible transfusion is on site and available. There is an early morning bustle.
Adult hip replacement patients often need a blood transfusion after surgery. In Ecuador the patient must buy the blood, at $40 a unit, pick it up from the Red Cross and bring it to the hospital, then provide two family members to donate blood to replace the units they bought.
Our days are long at the hospital. Every member of the team is vital for a smooth patient flow from the clinic, through surgery and recovery to discharge from the ward. From the “office” staff, preparing all the needed paperwork, to the operating room anaesthetists, surgeons and nurses, to the post op pediatric and adult ward nurses, to the physiotherapists teaching patient mobility and safety, and of course to the valuable translators, everyone with a role and everyone working as a team.
Babies and adults helped
Twelve-month-old Kevin and his 17-year-old mom, Evely, came to the CAMTA clinic to seek help for Kevin’s right club foot. Evely is a single mom who lives with her parents and two younger sisters in Latacunga, 90 kilometres south of Quito.
For Kevin, it was his dad’s aunt who told Evely about the Canadian surgical team and the possibility of correcting Kevin’s foot, giving him hope for a better life and the ability to walk and run. After a long bus ride and a tiring day at the clinic being seen by physicians, nurses and physiotherapists and communicating through translators, Evely is told Kevin’s surgery could be done the next day, no charge.
Without CAMTA, Kevin’s extended family would have to try to raise the money required for the surgery. Money is tight and health care is expensive, perhaps he would never have had the repair. But he gets the surgery and Evely is all smiles as she cradles her son afterwards knowing he will now be able to walk and run and, hopefully, live a normal life.
Silvia Christina is a 32-year-old single mother who cares for her two children and her parents. She lives in Chimborazo, a two-hour bus ride from Quito, where she owns a small grocery store. Seven years ago Sylvia fell while playing soccer, dislocating her left hip. As the pain worsened, the young mother lost her ability and desire to work and interact with her family. She was resigned to living a life with constant pain.
Sylvia’s cousin, a nurse at the Hospital Padre Jose Carollo, suggested to her that she might be a candidate for free hip replacement surgery from CAMTA. After seven years of pain, she makes the trip to Quito in hopes her cousin is correct. She is.
After surgery Sylvia sits in bed and works with the CAMTA physiotherapist. She is determined to heal well, to get back to work, to provide for her family. She is excited for the future, and for enjoying a pain-free life with her children.
Repeatedly we hear, “Thank you. Thank you to everybody. Thanks to all of you and this mission, my (son/daughter/husband/wife/sister/brother/mother/father) will be able to walk. It has been our dream for a long time. Please never stop coming.”
The work is hard, the hours long, but the reward of seeing Evely, Neiser, Sylvia and others smile and anticipate a happy life is heart-warming and humbling all at once.
The patients surely do benefit from our presence, but it is us, the mission volunteers, who are the winners, for our lives have been truly blessed and our hearts have been fulfilled and we thank them for letting us into their lives.
In 2001 a small group of Edmonton-based medical practitioners formed the Canadian Association of Medical Teams Abroad to provide orthopedic surgery to pediatric and adult patients who are in need of that care and unable to pay for it themselves.
Every year since then CAMTA has sent one, and eventually two teams to Ecuador. Each team is comprised of about 50 members including pediatric and adult orthopedic surgeons, anesthetists, family medicine doctors, respiratory therapists, physiotherapists, operating room, recovery room and ward nurses, residents, nursing and medical students, lay people, general students and translators. The team works together with local hospital staff to deliver up to 80 surgeries in a two-week period. Team members, now from across Canada, volunteer their time and expertise. Each team member is also responsible for raising a portion of the annual budget. Each mission costs about $300,000. CAMTA is a registered charity that raises funds year-round. Visit their website at www.camta.com.
During each medical mission, a group of our surgeons visits rural hospitals to interview potential sites for establishing a SIGN Nail program. The SIGN Nail treats fractures of the long bones, (http://www.sign-post.org/). CAMTA donates a SIGN Nail system to the chosen site and helps train the local orthopedic surgeons in its use.
CAMTA also ships large containers of donated hospital equipment and supplies to our partner hospitals in Ecuador.