A United States - Honduran Podiatric Humanitarian Effort

by Jarrod Shapiro, DPM
PRESENT Resident Editor
Botsford General Hospital
Farmington Hills, MI

Often as residents, we are consumed by the pursuit of surgery and numbers and lose sight of the ultimate purpose of medicine - to heal. I recently had the honor to participate in the Baja Project for Crippled Children’s mission to Tegulcigalpa, Honduras. While on this memorable and rewarding trip, we performed surgical corrections on the feet and ankles of many patients in need. Have you ever seen a patient with such a severe neglected clubfoot that his feet are essentially backwards? It’s a heartbreaking sight.

We saw patients with foot deformities secondary to cerebral palsy, spina bifida, idiopathic conditions, as well as a variety of other neuromuscular diseases. I wasn’t in the hospital five minutes before I realized these people truly needed our help.

 I wanted to help as many of these people as possible, and it was frustrating to know that only a small amount of the need would be met.

Honduras is a third world country in Central America with a desperate need for medical assistance. Landing in Tegulcigalpa, the capital, made me immediately aware of the low quality of life of its citizens. As in many Central American countries, a strong dichotomy exists between the wealthy and poor, with no hint of a middle class.

Many of our patients had come from hundreds of miles away for the chance to have debilitating foot deformities repaired and the opportunity for a new life. One of the Peace Corps volunteers told me about a woman who’d left her subsistence farm and took a six hour ride, standing up in a bus over mountains, leaving her village for the first time in her life, so her daughter could have her clubfeet treated. As one resident put it, “Man, these people have it tough.” Understatement of the century!

With the hard work of the Peace Corps, the Rotary Club of Tegulcigalpa, the Hospital San Felipe, and numerous individuals, a large number of children of varying ages, with absolutely no access to health care, were preoperatively screened and triaged. In a hospital pitifully in need of updating, we managed to accomplish high quality podiatric surgery.

Our team successfully corrected 47 feet in 35 patients. The vast majority of these patients had untreated talipes equinovarus; however we also treated talar AVN and vertical talus among others. From an academic perspective, the pathology we saw was incredible, an opportunity I’m very lucky to have participated in. The attendings treated us well, and we gained a level of pediatric experience that is incomparable. Additionally and more importantly, we changed the lives of many deserving people. The team who participated consisted of 5 residents and 2 students as well as a group of attending podiatric surgeons.

The residents involved were:
Naleen Prasad, DPM (City of Angels/Baja Project, LA, CA) – our very capable chief resident.
Theodore Qozi, DPM (Lakewood Regional Medical Center, LA, CA)
Nguyen (AKA “Juan”) Ky, DPM (East Valley Medical Center, San Jose, CA)
Lawrence Ward, DPM (Botsford General Hospital, Farmington Hills, MI)
Ramon Gendy, MSIII (NYCPM)
Byron Carrrasco, MSIII (NYCPM)
And myself

My admiration goes out to Naleen Prasad, DPM for her level of logistical excellence at organizing this trip. Imagine shipping virtually all of the podiatric surgical equipment of your local surgery center (including power instruments, tourniquets, etc) thousands of miles to an underserved area, all the while maintaining a level of sterility and safety we’re used to here in the United States. It’s a monumental effort, which Naleen performed flawlessly!

Unfortunately, our week-long mission was a drop in a monumentally large bucket. These people, as well as others around the world and here at home, need our humanitarian and professional help. It’s easy to become wrapped up in our own lives—residency training is demanding and time consuming—but I urge everyone to involve yourselves in some altruistic activity whether abroad or locally. We each have the capacity to improve the world even a small amount. If anyone’s interested in participating in the Baja Project for Crippled Children, which currently travels almost every weekend to Mexicali, Mexico—an excellent academic and philanthropic experience—email Naleen Prasad, DPM at atishnal97@yahoo.com

Have any residents participated in programs such as this? If so write in and tell the rest of us about your experiences. If you have, I’ll bet someone out there considers you a HERO.