Anju Thomas, PA
Anju Thomas, PA
General Surgery · Philadelphia, PA

Honduras Hand Surgery Mission

September 21st

Project Description

This trip involved University of Iowa Hospital and Children's hospital of Philadelphia. 2 hand surgery teams unite in order to spend 5-6 days in Honduras to perform surgeries on children who may not have otherwise had the chance. The team sets up clinic in the city of Siguatepeque for families to be seen for their injuries and/or congenital deformities. Once patients are diagnosed and evaluated, they are set up for surgery within the week. The hand surgeries performed within the week long stay range from simple procedures to complex corrective reconstructions. I will be traveling on this trip to Honduras this fall in September of 2019 with Apurva Shah MD (hand surgeon at CHOP) in order to assist him with these operations.

Population Served

Rural communities in Honduras. Some patients and families travel 9 hours away to see the team and require multiple bus connection or travel by horse in order to be seen. There is no comprehensive pediatric orthopedic care for pediatric injuries or congenital deformities in the area. The hope is to bring this care to a rural community which will lead to a lifetime of impact for 1 child at a time.

Expected Impact

We hope to provide specialized care in order to provide a lifetime of impact on children who may not have otherwise had a chance to receive such care in their lifetime. This trip is multifactorial in the learnings I expect to carry forward. First and foremost it confirms my commitment to providing care for children and communities who need it most. I hope to be able to provide knowledge, expertise and care to a global community. The ability to do so will only enhance my ability to care for the patients I already know and love here in Philadelphia. The privilege to provide care to a rural community will provide me with more knowledge to be able to continue care in either the same community or other communities who need such specialized expertise. I hope to write about this experience to inspire myself and other PAs to pursue global healthcare. Furthermore, I hope that one day I as a physician assistant can use my skills to help organize more mission trips as it is my passion to help those in need.

Trip Photos & Recap

This past week I was able to join a team comprised of members from the Children's Hospital of Philadelphia and the University of Iowa for a pediatric hand surgery mission trip in Siguatepeque, Honduras. This is the team's fifth annual trip, and my first time as part of the team. Over the last 4 years the team has successfully completed 105 operations. This year we screened 58 patients in clinic and operated on 33 children with congenital hand anomalies, brachial plexus injuries, burns, cerebral palsy and traumatic injuries. Patients traveled from over 10 hours away, by boat and even by horse in order to be seen and treated for their injuries.

In order to protect patient privacy I have not included any of the names and faces of the children we were able to treat.
You will see close up photographs of a toddler whose hands were burned in a pot of boiling oil during the annual corn harvest. Her hands were surgically reconstructed last year, and she can now pinch and grasp effectively for the first time. Included are also photographs of a patient in surgery with a congenital fused elbow who was treated with an osteotomy in order to provide her the function of feeding herself as she gets older. We treated numerous congenital hand anomalies using skin grafts in order to enhance the function of their hands day to day. The conditions were not what we were used to back in the states, challenges included recurrent power outages. Our anesthesia team was able to maintain patient safety while our surgeons, nurses, and scrub tech team continued operating with iphone and head lights.

I am so grateful to have been a part of this team. Our surgeons included Apurva Shah MD from Children's Hospital of Philadelphia and Ericka Lawler MD from University of Iowa. It was an honor to work side by side these incredible physicians in providing their time and expertise to this underserved population. Our nursing team included 2 OR nurses and 2 PACU nurses. Our nursing team included: Kathy Marascio RN, Liz Alfonso RN, and Deb Fuhr RN. Mary Dowling RN and Wendy Read RN. Our scrub tech team included Lynn Burleson and Kelly Beard. I have not met a harder working group of people. On day 1 they began the process of cleaning, sterilzing and organizing instruments to be used during surgery. All 4 operating days, they functioned as the team processing instruments, scrubbing cases and turning over the operating rooms. In addition to this team we had Meagan Pehnke, an exceptional occupational therapist from CHOP who created splints to optimize postoperative recovery and taught stretching and range of motion exercises to the families to enhance their recoveries. She did not rest until every family had detailed postoperative care ready to go. Without our anesthesia team none of this would have been possible. Mindy Seering MD, David Cohen MD, and David Swanson MD made sure our patients were safe and sought to their pain management throughout their operations and postoperative recovery. I am so humbled by this teams hard work and compassion towards taking care of kids.

Lastly, included is a picture of me doing exactly what I love in Honduras: taking care of kids. I love every aspect of patient care, this trip reminded me of that fact. What amazed me most about this trip was the Honduran people we encountered. They were so kind and friendly to us even though they did not know us. To me, it didn't make sense for the children and families to just give us their trust. But it wasn't just trust. I could see they had faith in us and what we do. Faith makes a fool of what makes sense. I am so grateful to have been a part of this experience and give back to an underserved population. I hope to do more like this in the future.