Glennon’s Doctors and Nurses Volunteer for Missions Around the World

Caring for children is the life’s work of pediatric doctors and nurses. For many who follow this calling at SSM Cardinal Glennon Children’s Hospital, the mission continues during off-duty hours, nights and weekends. Their volunteer work often fills entire vacations spent in far-away places.

Today in Nicaragua, three respiratory ventilators retired from SSM Cardinal Glennon Children’s Hospital are keeping children alive in a hospital known as La Mascota. Surgeons at Lima Children’s Hospital in Peru are doing a better job in their operations thanks to surgical instruments once used at Glennon.

One of Glennon’s old clinic microscopes, replaced with newer technology, continues to provide service in an operating room in Honduras. An electrocardiogram machine has found a new home in Jamaica.

And thousands of children in these countries as well as Belarus, Russia and China are enjoying better health and quality of life thanks to visits by members of Glennon’s medical and nursing staffs who have made voluntary missionary work a part of their lives.

“There is so much illness and disease in a third-world country that is preventable and treatable if someone takes the time to do it. We can literally change a patient’s life in one day,” said Thomas Donovan, M.D., director of the department of otolaryngology at Glennon and a St. Louis University associate professor of otolaryngology.

Donovan has visited Peru 16 times on mission trips and recently began accompanying another group of Glennon doctors and nurses to Honduras, which he has visited twice. “Once you do it, you are hooked,” he said. “It is a way of giving something back. The people we see are so appreciative.”

Advanced Operations in Peru

Donovan first went to Peru in 1996 when he was invited by a surgical resident who was training at Glennon and going on a church missionary trip.

“They were going to a deaf school. That is a particular interest of mine, because I have a deaf son,” Donovan said. “We took 100 hearing aids and amplified about 80 children who had never had hearing aids.”

The team visited Lima Children’s Hospital on that trip and established relationships that would foster care to be contributed on future trips. Donovan and other members of his group analyzed the needs of Peru’s children and doctors.

“The hospital had archaic equipment. Some of it was from the 1940s and 50s and didn’t work. They had laryngoscopes and bronchoscopes with burned-out lights. They were trying to use their head lights to look through them. You just can’t do much with that,” Donovan said.

The hospital also faced chronic shortages of basic supplies. “Lima Children’s Hospital does all the major pediatric care for the whole country. The patients have to get there at their own expense. Their family has to provide all the disposables that will be used in the operation — the surgeon’s gloves, dressings and sutures,” Donovan said.

“Although they have available free care, the very poor are excluded. They can’t afford to get to Lima. If they don’t provide the supplies, they aren’t scheduled for surgery.”

On subsequent visits, Donovan and other members of the visiting team carried supplies and equipment that dramatically advanced the capabilities of the local surgeons.

“We took probably $200,000 worth of equipment over a few years,” Donovan said. “About half of that was brandnew, donated equipment from companies here. The other half was equipment that was discarded from our hospitals. In the United States we discard equipment that is scheduled for replacement or when technology changes. There is no means in this country to re-service, refurbish and re-use equipment.

“We took a lot of general surgical equipment, stuff that is not the greatest anymore, but it still works and they don’t have it. We throw away equipment that is so usable in third-world countries.”

The team with which Donovan traveled has provided staff training and surgeries for the children in Peru.

“We’d go down for a week and take over a couple of operating rooms. They bring in close to 100 people at the beginning of the week. We’d go through them and decide which surgical cases are appropriate to do. We’d do 40 to 50 cases a week,” he said.

“We did a lot of major ear surgery, neck masses, congenital masses, nasal polyps and nasal tumors. It was very rewarding to see all that happen.”

The capabilities of Lima Children’s Hospital advanced to the point that Donovan began reducing his visits there to move on to other challenges. He continues to send discarded medical equipment he collects from Glennon and friends who do surgery at other hospitals in St. Louis.

Donovan became acquainted with another mission from the St. Louis area to Reque (pronounced ray-kay), a rural town about 500 miles north of Lima. Ken Byron, a retired Boeing Company computer scientist from Florissant, Missouri, lives at the mission and is supported by his church here.

Donovan became part of group visits that have built a medical clinic and school for the children of Reque and provided nutritional, medical and dental care.

“When we started going there, the kids were very malnourished,” he said. “The best we had any of them on the Peruvian growth charts was the 25th percentile. Over half of them were not on the chart. There was a lot of parasitic disease and chronic infections.”

During week-long trips to Reque, groups of seven to 30 people from the U.S. have included construction workers, pediatricians, family practitioners, otolaryngologists, dentists and medical support staff. They have erected buildings and provided vision screenings, general health care and education in nutrition and hygiene.

The mission’s supporters have provided breakfast and lunch programs for students in the school, who now number 250. Donovan and 11 other doctors supporting the mission donate one month of salary each year for a local nurse to staff the clinic.

“She probably does more for the health of that population than we do because she is there all the time,” Donovan said. “The kids there are now between the 50th and 75th percentiles in growth. They are much more alert in school. It is fun to see all this emerge.”

From Russia with Love

Elizabeth Engel, M.D., and her husband, Tom Otto, M.D., made their first trip to Belarus in 1997 to begin the process of adopting their children, Alexandra and Peter. They have paid several return visits to Belarus and Russia to participate in an international conference on adoption and help build playground equipment at orphanages.

“Most children in the orphanages will stay there until they are 16 years old. The orphanages have very little. The playgrounds and facilities are run down. The economies of their countries aren’t great, so the governments don’t routinely give money to the orphanages unless it is absolutely necessary,” said Engel, who is an orthopedic surgeon at Glennon and associate professor of orthopedic surgery at St. Louis University.

“We thought we could use our resources to help the children who are left behind.”

Engel and Otto, an orthopedic surgeon at St. Louis University Hospital, have visited Minsk and Gomel in Belarus. They first adopted Alexandra, who was born without part of her left arm, and brought Peter home a year and a half later. Both are now eight years old.

“There are a fair number of orphanages in these countries. They sprang up during World War II when there were a lot of children without parents,” Engel said. “Now people put their kids in orphanages because they can’t take care of them economically. It is socially acceptable. But people there rarely adopt.”

On one visit, the family participated in an international conference staged by the government of Belarus to promote local understanding of adoption.

“Adoption is frowned upon in eastern Europe,” Engel said. “There are some people who view us as rich Americans who are buying or stealing children. They can’t understand why these foreigners would want to have somebody else’s child.

“One of the reasons they invited us to the conference was so people could see how Alexandra was thriving. She is an incredibly bright, beautiful child. People would ask us why we would adopt a child with a handicap. We would say she is not handicapped, she just can’t tie her shoes very well. We hoped to foster the idea that adoption is a good thing.”

On the latest of its six trips to the region, the family visited orphanages at Gomel, Belarus, and Krasnodar, Russia. They helped perform building repairs and build playground equipment. They also assist other families in raising funds for their adoption agency, called Small World Adoption Foundation of Missouri.

“We’re spreading some good will and providing something the children would not otherwise have,” Engel said. “The people there are now more open to international adoption. We have thoroughly enjoyed what we’ve done and plan to do more in the future.”

Breathing in Nicaragua

Last spring, three pediatric respiratory ventilators that had seen years of use at Cardinal Glennon were shipped to a children’s hospital in Managua, Nicaragua. The shipment immediately boosted the country’s inventory of pediatric ventilators by half.

“The last time I was there, there were only six pediatric ventilators in the whole country, and two of those didn’t work,” said Robert Lynch, M.D., Ph.D., director of pediatric intensive care at Glennon and a St. Louis University professor of pediatrics.

Lynch was first invited to visit Nicaragua about a decade ago by an orthopedic surgeon he knew in Milwaukee. The plan was to take equipment and supplies and provide medical instruction to physicians and students.

Lynch lectured at a military hospital where the country’s physicians complete their training and visited a children’s hospital known as “La Mascota.”

Lynch realized that the kids there needed help. “By and large the hospital provides charity care. The first time I was there, there were weeks when the hospital didn’t have any antibiotics. When the patients needed drugs or things like intravenous catheters, their parents frequently were sent down the street to a pharmacy to buy them.”

Lynch has visited Managua three more times, the most recent trip in 2002. “Each time we go we take equipment and disposable supplies like drugs, intravenous catheter equipment and dialysis equipment,” he said.

He collects discarded equipment and donated supplies for annual shipments to La Mascota. He works with Adda Farrar, a native of Nicaragua who now lives in St. Louis and formerly worked for Lynch at Glennon as a laboratory research technician. Farrar’s parents still live in Nicaragua.

“There are many well-trained physicians in Nicaragua, but their resources are very limited,” Lynch said. “There are lots of needs.”

The infant ventilators sent from Glennon last spring were retired after ten years of service. “It is an old design, but it works well for patients who are not cataclysmically ill. There are plenty of those in Nicaragua. A baby who is born prematurely but is of reasonable size and has just a week of disease to be managed through will make it. These ventilators are going to save a lot of lives.”

On one of his visits, Lynch met Erika Perez de Luis, a Nicaraguan girl who previously had been brought to Glennon for a complex heart surgery. “She was about ten years old then. She was fantastic,” he said.

Lynch is planning to visit La Mascota again in the near future. “It is about time for another trip,” he said. “It’s rewarding to do something that is needed. It provides encouragement to the practitioners there — that somebody is aware of how hard you have to work, but that it is worth doing and we will try to help you.”

“I Miss the Kids”

“There is no ambulance. There is no hospital that is close. There is nothing there. What do they do?” said Boots Dixon, R.N., a nurse in the same day surgery unit at Glennon who has accompanied Donovan on his last three trips to Reque, Peru.

She assists in examining children and adults on the mission’s clinic days. “I do vital signs and help Dr. Donovan clean ears and play with the children. I have such a good time,” she said. “We visited a nearby town to do physicals and saw 397 people in one day.”

Her first impression of Reque was sadness for the poverty experienced by its people. But she also has become attached to the children there, and has been sponsoring one of them, a six-year-old name Yerli, for three years.

“On Mondays when we start our clinic, we are standing there waiting for them to come through the gate. I hug kids,” she said. “When I come back home, I feel blessed. I realize that I don’t want for anything.

“I will keep going. If I’m not needed as a nurse, I’ll help in the kitchen or do whatever I can. I like what we do. I miss the kids if I’m not there.”