Hope Clinic International

Hope Clinic

Pediatric Surgical Care

In Nicaragua, Hope Clinic International has experienced first-hand the untold suffering of children who received inadequate surgical care and the frustration of local surgeons without the ability to help; either because of a lack of essential equipment, drugs, and other supplies or because of the lack of training. On our first mission trip in 2000, HCI became aware of the urgent need for help in caring for children with surgically correctable acquired or congenital defects. Without surgical repair of this defect children are doomed to lifelong ostracism and social isolation.

Although the numbers served are lower and expenses are higher, performing surgery has often been our most critical and life changing work. In 2008 HCI’s volunteer pediatric surgeon, Dr. Joseph Lelli, began working with pediatric general surgeon Dr. Alfredo Valle at the only children’s hospital in Nicaragua, training him and his surgery residents on laparoscopic techniques and the repair of complex congenital and acquired defects. Our nurses have assisted the Nicaraguan staff in the postoperative care of these children and provided much needed pediatric supplies.

There is nothing more moving than stories of children with life-threatening injury, disease, or congenital defects who are suddenly saved from disability or early death by the hands of a skilled surgeon. Many of us who have been privileged to be members of a surgical team can tell you what an amazing thing it is to be a part of a child’s miracle:

Karen was 7 years old when we met her on our surgical mission to Nicaragua. We were told Karen had survived 5 previous abdominal surgeries and she was no better but in fact, was dying. She was being fed small amounts of formula which was keeping her alive but almost everything just drained out of openings on her abdomen. HCI’s pediatric surgeon decided her only chance of survival was to operate immediately. Karen’s surgery was 12 hours long during which she needed a transfusion. Dr. Joseph Lelli painstakingly worked to remove the entire damaged bowel and then put everything together again. When it was all over he told the family she would be fine and indeed she was. One week after the surgery Karen was eating and drinking and she left the hospital healed.

The tragedy for children in countries such as Nicaragua is that surgical care has often been viewed as too expensive and as a non-essential service. Parents in poor countries wait for word of the next surgical team to visit in the hopes they can get the care their child desperately needs. But what happens to those children who need urgent or emergency care who can’t wait for the next team to arrive? A bulletin of the World Health Organization published October 2002 states: “poor surgical care results in significant numbers of deaths and disability in developing nations.” The bulletin went on to say, “A major problem with pediatric surgical care is that there is a general lack of knowledge in the care of children with surgical conditions…[and] there is a chronic shortage of qualified pediatric surgeons.”

Even when expert surgeons arrive in these countries, many times the facility, drugs, diagnostic equipment and supplies needed to handle complex cases are nonexistent; this leaves no alternative but to appeal to US hospitals for charity care. While major studies have focused on the impact on child health from infectious diseases, poverty, unsafe water, and malnutrition, there are few studies documenting the impact of surgical diseases on children.

The purpose of our Pediatric Surgical Care is not just providing surgeries, but to train Nicaraguan doctors to perform surgeries, so they can continue the work between the Surgery Mission Trips.