Posted by: calloftheandes | March 20, 2015

Multicultural Team Does 25 Surgeries to Help Ecuadorian Children Improve Mobility

While a young Peruvian boy sleeps in an operating room in Ecuador, a life-changing transformation begins taking place as surgeons work to insert the supports he needs for legs and feet that have not developed normally.

The skeletal structure that 12-year-old Cristian de la Cruz awoke with a little more than two hours later included the realignment and fusion of two bones. Such procedures are used to improve function and diminish pain.

The four surgeons, two from the U.S. (Drs. Mike Healy and Tom Novacheck), a Brazilian (Dr. Ana Paula Tedesco) and an Ecuadorian (Dr. Isaac Morales) were assisted by an anesthetist and by former Reach Beyond missionary surgeon Dr. Eckehart Wolff whose medical training was in Germany.

By working simultaneously on either side of de la Cruz, the doctors condensed the surgery time. This was just one innovation developed years earlier by members of the multicultural group. Each year they combine their efforts to help Latin American children walk while continuing their quest to improvise new and better surgical procedures.

With 13 members on the team this year, the visiting surgeons return year after year, being on a first-name basis with people of other nations whom they see only once a year. Some share the same faith in Jesus Christ as Wolff who has served as a medical missionary in Ecuador for 25 years.

“Over the years of working together, Drs. Wolff and Gage saw the program grow. They also recognized the opportunity for surgeons in Ecuador to benefit from this experience and use that knowledge to help their own patients every day,” said Novacheck. “It is gratifying to see that this dream is now becoming a reality with Drs. Geovanny Oleas, Isaac Morales and Gustavo Ramirez participating in the program.”

During a period of two weeks at Hospital Vozandes Quito (HVQ) each year they operate on at least a couple of dozen children, many of whom suffer from cerebral palsy, a brain disorder causing a crippling of the musculoskeletal areas of the body. This year the number of patients was 25.

Dr. Isaac Morales

Dr. Isaac Morales

“This is a 20-year-old program for disabled kids,” added Wolff. “I see them and could do some surgeries in Shell and Quito in the past, but the big cases we do together. I do the follow-up and prepare new cases. I have about 650 kids in my list, and see about half of them throughout the year.”

In the two years since the surgeons last visited Quito, Wolff and Oleas, an orthopedist at the Carlos Andrade Marín Hospital in Quito, documented the cases and looked after logistics so that that the Feb. 19-March 6 surgeries would go smoothly.

While the patients’ families are required to pay a few thousand dollars for the surgeries, the same surgeries if done in the U.S. would cost at least 10 times what they paid. Costs are lower at HVQ, and the children are able to return home more quickly.

The surgeons donate their time and cover their own travel costs. The price for using the operating room is also reduced at HVQ, a hospital owned and operated by Reach Beyond. The mission agency announced in mid-2013 that it was selling the 76-bed facility, only to see the deal fall through a year later.

Some carefully inserted orthopedic plates will hold the realignment of de la Cruz’s ankles and feet and help him to walk, though the boy’s problem will be ongoing. Difficulties with nerve function will continue to cause problems in his development. After the surgeries, Wolff watches the miracles of mobility occur during follow-up care of the children.

Historically, the children’s care has centered around Dr. Jim Gage, the former medical director (now retired) at Gillette Children’s Specialty Healthcare, an independent, nonprofit hospital in St. Paul, Minn. The facility focuses on pediatric medical treatment and research. Gage is known for his views and procedures in analyzing and treating gait disorders and for his treatment of muscle and bone deformities caused by cerebral palsy.

Dr. Ana Paula Tedesco

Dr. Ana Paula Tedesco

Throughout the years visiting surgeons have arrived from Argentina, Brazil, Chile, Colombia, Venezuela and Ecuador. A hospital chain in Chile (named Teletón à la Jerry Lewis Muscular Dystrophy telethons) took to sending physicians each year for the Quito surgeries.Gage said in 2011, “I think this little program has become the focus of neuromuscular work for all of South America.”

Now in retirement, Gage and his wife, Mary, did not make the annual trip to Ecuador this year. It was the first time in many years that he did not head up the annual volunteer effort which began in the mid-1990s in Shell, Ecuador, a five-hour drive southeast of Quito.

Gage had received and responded to an invitation to perform surgeries at what was then Hospital Vozandes-Shell. That invitation came from Reach Beyond retired physician Dr. Wally Swanson, a fellow Minnesotan. (Wolff worked there for many years and now lives in Shell.)

On that visit to Ecuador, Gage did a bilateral hip surgery and it was the beginning of an annual event that helps children to put their best foot forward and get a new lease on life.


The surgeons helping with the 2015 effort to promote mobility among children included Drs. Leonardo Cury Abrahão and Ana Maria Tedesco of Brazil; Drs. Ana Paula Aravena and Alejandro de la Maza of Chile; Drs. Patricia Díaz, Isaac Morales, Geovanny Oleas, Gustavo Ramirez, María Villareal and Eckehart Wolff of Ecuador; and Drs. Mike Healy, Steven Koop, Tom Novacheck and Steven Sundberg of the U.S.

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