Posted by: calloftheandes | April 20, 2017

Orthopedic Surgeons Offer Ecuadorian Youth a Chance to Walk

Photos and story by R. Kurtenbach

Converging on Quito, Ecuador, for two weeks, orthopedic surgeons recently traveled from four countries with the aim of correcting that which is mal in their pediatric patients and making it right.

 “The work is to help children who have malalignments of their legs to function better and to help preserve their joints,” explained Dr. Tom Novacheck of Gillette Children’s Specialty Healthcare in St. Paul, Minn. “So many of these children have developmental problems—maybe neurological, maybe muscular—that affect the way their feet develop, and [their] hips and knees.” Former Reach Beyond surgeon Dr. Eckehart Wolff coordinated the Feb. 23-March 3 operations on 23 patients, ranging in age from three to 23.

Orthopedic surgeons on their feet for long hours in an operating room at Hospital Vozandes-Quito means one thing to those whose walking is impaired or impossible: feet and legs that can support and carry them.

Drs. Tom Novacheck (left) and Camilo Turriago. (Reach Beyond archive photo)

Their approach of using two surgical teams—a team working on each side of the patient—allows for simultaneous correction of mobility problems that are often a consequence of cerebral palsy (CP). The multiple operations approach is what Dr. Jim Gage has called “one of the things that differentiates our approach from conventional CP surgery.”

Gage was medical director at the hospital in St. Paul when in 1995 he met Reach Beyond’s Dr. Wally Swanson, who asked him to be a volunteer surgeon at Hospital Vozandes Shell. The program of helping Ecuadorians to walk began with one child. Gage was asked, “Can this boy be helped?” as he studied before him a 12-year-old whose mobility consisted of crawling. Struck by a car a decade earlier, the boy had been left crippled.


Drs. Ana Paula Tedesco and Steven Koop

“Not here [Shell]; his problem is too complex,” Gage responded. And yet after multiple operations, the boy, Ivan Sisa, not only can now walk (aided by crutches) but he also went on to become a physician in his own right.

Helping one boy began what would become an annual event. Orthopedic surgeons travel to Quito from South and North America to give Latinos (mostly Ecuadorians and mostly kids) a hand at getting to their feet. A hospital franchise in Chile, Instituto Teletón (a la Jerry Lewis Muscular Dystrophy telethons), sends physicians annually.

“It’s really not possible for people from here to go to the U.S. for medical care,” said Novacheck, continuing that the children’s families don’t face crushing financial burdens after the surgeries are done. “We pay our own expenses, so that is part of our mission.”

Drs. Geovanny Oleas (left) and Eckehart Wolff

The surgery schedule and logistics are set in place by Wolff who operates a family practice clinic in Reach Beyond’s former Hospital Vozandes del Oriente in Shell along with Ecuadorian surgeon Dr. Geovanny Oleas and a couple of young orthopedic surgeons. They keep in regular contact with families of the patients.

“Many times these malalignments are at multiple levels,” explained Novacheck. “It’s not just a single foot problem for a patient—it could be their hip and their knee and their foot (or ankle)—all together. So packaging all those surgeries together is difficult and complicated work, and Wolff sees these patients through the course of the year.” It is during follow-up that conversations about Christ happen with the patients’ families, according to Wolff.

On one particular day in surgery, Drs. Ana Paula Tedesco (Brazil) and Steven Koop (U.S.) work steadily at the right hip with Drs. Leonardo Abrahão and Lucas de Oliviera are at the left hip of the patient, a teenage girl. Periodically, Abrahão calls out, “Rayo,” requesting an updated view of their work as shown on HVQ’s C-arm fluoroscopy (a moving x-ray image).


Drs. Lucas de Oliveira and Leonardo Abrahao

Other equipment is lower tech—a wisp of vapor rises perhaps from cauterizing a blood vessel within the incision; a tape measure (“Measure twice; cut once,” quips Koop in a conversation later that day) and even the tap, tap, tap of a hammer.orthosurgery2017

In the skillful hands of these volunteers are the tools that might sound like a workshop—a workshop where the gift to a child is mobility.

This year’s participants included Drs. Ana Paula Tedesco, Leonardo Abrahão and Lucas de Oliviera from Brazil; Drs. Ana Maria Aravena, Alejandro de la Maza and Leonardo Pavesi from Chile; Dr. Luis Becerra from Colombia; Drs.Wolff (a German missionary) and Geovanny Oleas from Ecuador; and Drs. Mike Healy, Tom Novacheck, Steven Koop and Etasha Bhatt from the U.S.

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