100 Hours of Volunteer Time for 1 Guatemalan little Boy

It has been estimated that each child COTA brings out of a developing country for donated surgery requires 80-100 hours of volunteer time. Other agencies that we network with confirm that they have found the same to be true. Osvaldo is the most recent beneficiary of some of those many hours. In his particular case, the hours of volunteer effort will be much higher than 100.
Children of the Americas discovered Osvaldo when the determined women in this photo
got together and decided that this little boy in remote Guatemala needed help. Osvaldo was born with a congenital anomaly of his mid-face. Surgical correction of this life threatening issue could only be accomplished with the finely tuned effort of three pediatric surgical specialists: plastic surgeons, neurosurgeons and ENT surgeons. Once The World Pediatric Project in Richmond, Virginia agreed to accept Osvaldo into their program for donated surgery, the network between COTA and TWPP came together for the benefit of one little boy with a big problem.
In upper right photo: (L-R) Rosemary Vance, Executive Director of COTA; Teresa Godsey, volunteer; Dr. Carol Cottrill, President; Tom Rolfes, volunteer; Bety Davidson, volunteer; Osvaldo, lucky little boy. Photo on upper left: Osvaldo with Jenna Garber, Program Assistant with World Pediatric Project in Richmond, VA. She took Osvaldo to visit the James River before his surgery.
In the five days since Osvaldo left Guatemala, he has flown on both a commercial (wonderful donation from American Airlines) and private (thank you Roger Teague!) plane for the first time. He had his first McDonald's french fries within hours of landing in the states, and like most children, he knew instinctively how to play on the playground. The photo (upper left) shows Osvaldo visiting the river in Virginia this past holiday weekend.
He is getting an MRI as this post is being written,and has a CAT scan scheduled for later today. Surgery is on Thursday. One hundred hours will turn into hundreds more before his health is restored, and all of the people in Osvaldo's circle of concern will consider it time well spent.

Pediatric Malnutrition Continues in Guatemala

http://www.economist.com/node/14313735

An interesting article posted this week.

Baby Brayan and His Circle of Concern

These health care professionals in Lexington, KY are some of the many people who have donated their time, skills, knowledge and love to our newest cleft patient from Guatemala.
Dr. Carol Cottrill (seated) arranged the donation of surgical care while she and her husband (Tom Rolfes in yellow jacket) donated the remainder of the medical care bills. Rosemary Vance, COTA Executive Director, worked out the details of Brayan's travel and visa. Dr. Henry Vasconez (holding Brayan) donated his surgical skills. As of two days ago, Brayan is home in Guatemala.

A Big Smile On A Little Baby

This little charmer is the newest stateside COTA patient.
Baby B was flown into Cincinnati last week thanks to the excellent and well-coordinated efforts of the American Ambassadors Escort Program.
While he awaits his donated surgery, Baby B keeps his caretakers happy just watching his smile.

The Image of Strength

There are few photos that capture the essence of a Guatemalan mother more than this image taken by a COTA team member.
Children of the Americas has provided hundreds of donated surgeries and thousands of clinical visits/pharmaceuticals to rural Guatemalan women since we first started bringing our annual teams to this Central American country. By supporting the health care needs of Guatemalan mothers, we are enabling them to better care for their children.
On average, a rural housewife in this part of the world spends 10-14 hours a day providing for the needs of her family. The following is an excerpt from the 2003 report issued by USAID:

While Guatemala is the most populous Central American country (11 million) and largest economy (2000 Gross Domestic Product (GDP) of $19 billion), its largely rural, Mayan population lives in extremely difficult conditions. Distribution of land, income and other wealth is highly skewed toward a small percentage of Guatemala's Spanish-speaking population. An estimated 57% of Guatemalans live in poverty, and the roughly five million Mayans are isolated socially, economically, and politically due to geographic and language barriers as well as the lack of educational and economic opportunities. Overall, adult literacy is estimated at 65%, but literacy among Mayan women is estimated as low as 30%. Fewer than half of rural Guatemalans have access to running water, electricity reaches only a quarter, and only 16% have access to modern sanitary facilities. Infant, child, and maternal mortality rates are among the highest in Latin America, despite decreases in recent years. These indicators reflect the country's persistent under-investment in social services and basic rural infrastructure, as well as past practices of political and socioeconomic exclusion of the indigenous population.

COTA is making a difference in these statistics, one healthy mother at a time.

Our best-kept secret

Shhh...don't tell our secret.
For years, Children of the Americas volunteers have returned from our annual team trips looking weary after a long week of work in rural Guatemala, which gets us a lot of sympathy from our families for a few days after we arrive home.
Our volunteers typically see over 1,400 clinic patients, and do 80-120 surgeries in a week. Our dental team pulls countless teeth, our pharmacists dispense thousands of medications. Orthotics staff give out hundreds of crutches, special shoes, and several dozen wheelchairs. We should be tired!
Barb Buss, seen above this past January on our last COTA team, has divulged our secret. Her smile gives us away. We LOVE what we do. There is no more meaningful way to spend a week of volunteer time than to offer medical/surgical/dental/orthotics care to those in rural Guatemalan who have no ability to obtain this for themselves.
But please, don't tell our family members. They might stop pampering us when we get home!

Covering our Patients in Comfort

For the last five years, Children of the Americas surgical patients in Guatemala have been the beneficiaries of many hand-made quilts. Hundreds of quilts and infant bibs have been made by this group of dedicated volunteers in Mt. Carmel, Indiana. COTA staff has made a tradition of gifting one of these special donations to each surgery patient we help on our teams. A big thank you to the amazing residents of this tiny but compassionate town.

Message on Team 2011 from COTA Board Member

“I am always in awe that COTA can assemble a team of 120 professionals from around the country, have them "parachute" in to a remote location, work so well as a team under adverse conditions and produce so much work. Helping people is the most important part of what COTA does but metrics set benchmarks for the next trip.
Dick Schmitt
COTA Board Member

COTA Finishes Team 2011 in Salama, Guatemala

These are a few of the outstanding professional volunteers who helped Children of the Americas on our recent medical/surgical/dental team last week. Thanks to the dedication of over 100 volunteers, we were able to see 1,600 clinic patients, perform 83 surgeries, assist 120 dental patients and donate 4,200 prescriptions to the citizens of this northern city. Twenty prosthetics patients were fit for donated limbs and donated walkers and crutches were given out.
Great job COTA volunteers!

Baby Alex Two Years Ago in KY After Coming To KY For Donated Cleft Surgery, And Now as a 4 Yr Old.

Inmer Shows off His Repaired Cleft

Many of our readers, and especially our Team 2010 participants, will remember Inmer. (See earlier posts below). This baby presented to our clinic in Retalhuleu with a cleft lip and palate, and he was in a near-starvation state. Unable to breast feed, Inmer had declined in weight and stamina. After careful instruction from Barb Buss, RN, COTA cleft instructor, Inmer's mother felt more confident in trying to maintain his nutritional needs at home with donated formula. Unfortunately, the baby got sick again, necessitating a trip to the states for donated lip and palate surgery.
He was returned home in August to happy and relieved parents. We couldn't resist showing him off in this recent photo.

COTA Team 2010 Slideshow

COTA Prepares for Team 2011

Children of the Americas board members have been busy since June working on the details of our upcoming team. In January of 2011, over 100 volunteers will depart the U.S. for Guatemala.
This past summer, several COTA board members drove throughout Guatemala searching for the best Team 2011 site. Many things have to come together in order to create a successful team experience, and Salama had the right combination. Since the scouting trip, supplies have been gathered from several locations, inventoried, boxed and shipped to Guatemala. All team applications have been received and approved by a team committee. Professional CV's are ready to submit to the Guatemalan Ministry of Health. Hundreds of clinic and OR forms have been printed and packed, COTA is networking with other NGO's for prospective surgical candidates, and plane reservations are being made by our volunteers.
All of the above is done by board members who work full-time and volunteer in their "spare time" for our organization.

Jose moves to his new foster home

Jose, who you will remember as having the large AV malformation of his face, was transferred to his new foster home in Cherry Hill, NJ on June 20th. His long-term stay with Margaret and Scott in Tennessee was a wonderful and nurturing environment, but their home was a long way from Roosevelt/St.Luke's Hospital in New York City. Jose is scheduled for his final surgical revision of his facial tumor on July 22, and COTA foster parents Beverly and Warren agreed to host him. This will allow Jose easier access to his surgeons in NYC, and will make the post-operative course less concerning in case of medical care issues. Beverly, an RN, and Warren, who is an OB/Gyn surgeon, have fostered three other children for COTA, and are well-versed in the issues of fostering a medically-fragile child. Shown above in Warren's plane, Jose is preparing to enjoy is first-ever ride in a private plane.

Imner has a new palate repair

On every COTA team, there is one baby in particular that is critically ill and captures the hearts of team members. Imner was that baby for Team 2010. It is hard to believe that on January 18th of this year, he was severely malnourished, had a baseball sized hernia, cleft lip and a cleft palate. He was limp in his mother's arms when she brought him to our clinic. He didn't have enough strength to eat.
Imner has just completed his last of three surgeries, and will soon be reunited with his mother in Guatemala. Although COTA has sent photos of Imner's progress while he was in foster care here in the states, we are sure she will be surprised to see what a sweet and healthy smile he has now. Imner has been very blessed with the excellent donated foster and surgical care in his adopted state of Illinois.

Baby Imner has a new lip!

He is almost hard to recognize. The tiny malnourished baby from the COTA Team 2010 is now a frisky, happy baby.
Imner was discovered in January by our COTA doctors when his mother brought him to our team in Guatemala seeking help for his malnutrition related to his cleft lip/palate. Imner also had a very large hernia that was life-threatening. His fragile health and low weight made fixing the hernia in Guatemala an impossibility.
Thanks to the diligent efforts of foster mom Nicole and foster dad Chad, Imner is a different baby. His cleft palate repair is scheduled and we hope to have him home to his mother in Guatemala by late summer. Nicole had great medical connections in her community due to her work as a physicians assistant. Imner has his own little "village" helping with his healing.

Update on Jose as written by his foster mother

Jose and I spent the first two weeks of April in the hospital in nyc. We flew Atlanta to La Guardia on Easter (Alan Jackson's album of hymns on the way with Old Rugged Cross was about the best Easter service I've ever heard). We visited the penguins in Central Park and the dinosaurs in the Natural History Museum on Monday and drank a lot of fluids and played a lot of Go Fish in the hotel that night. Jose got his two sclero surgeries on the 6th and 9th, where Dr. Berenstein'

s team injected the same drugs as last time into his neck to start the sclerosing process and create a plane for excision for Dr. Waner. The day after the 2nd injections, though, his labs looked funny...probably an error, they thought. But they rechecked, and several of the labs that indicate kidney function were too high. They rechecked once or twice a day for several days, and the labs kept getting worse. This, along with edematous arms, blood red urine, high blood pressure, and no appetite, showed that something had led him into acute renal failure and made the excision impossible. His labs and physicals and renal ultrasound from before admission had been normal, so all the docs seemed to agree that he'd finally had enough of the drugs, or maybe they did something else different with the slow-flow clotting factor; nobody was positive, they had never seen this before, but the head doc on the pediatric intensive care unit and the pediatric nephrologist said they would not approve any kind of surgery for Jose for at least several weeks or months, and then only after a good renal workup.

Thanks to God his kidneys did turn around that 2nd week, and everything went back to normal. After needing blood drawn every 12 or 24 hours, his veins went into hiding and they'd try 2 or 3 times to get blood. Sometimes his old IV line would work, but usually that came out so slow it would clot before getting to the lab. A couple times they had to do arterial sticks. Once I was holding Jose's free hand and trying to get him to look at me instead of staring at the needle; but, still tensed up and staring at the needle digging in his arm, he held up his free arm and hand toward me as if to say: Please be quiet; I simply have to watch; it's OK. He'd cry but always be extremely still for the nurses. Actually, he started suggesting veins they might want to try the next time and reminding them what hadn't worked the last attempt. The first time his urine went back to yellow I held up the plastic container and said, Look, it's beautiful! He laughed and laughed that I called his urine beautiful.

We left the unit Saturday morning, the 17th, after one last check of his blood pressure and creatinine and urea nitrogen levels. We walked out by the nurses station; they were happy and telling Jose bye and clapping, and of course Jose was very happy to be going -- While walking around the picu circle earlier that week we had pretended to think of ways to get out those doors without anyone noticing! It was a little sad, though, because of another patient who had been up there the whole time, unconscious, and whose mom was looking up funeral homes that morning instead of expecting to get to walk out with her boy. But she waved goodbye and told Jose to take care.

So we've been back home in Chattanooga and Jose is again a healthy happy active functioning little boy with his kidneys and everything working well again, and for that we are so thankful. The sclero they injected in his neck may actually help minimize the overgrown veins there a little bit, which would be good. Not wanting to risk more serious kidney issues, though, he will probably not get an excision any time soon unless all his docs and the nephrologist agree it wouldn't be overly stressful on his kidneys. But he will definitely never get any more sclero!

As of now it looks like Jose will head home as planned on June 2nd with April. He has two parents who will be very happy to see him, and 2 little brothers who, I am told, like to play Spider Man and chase and to go fishing in the river with Jose. He's also going to try to fit the fire engine in his suitcase this time, but we'll take out the batteries first so he won't set off any alarms at the airport!

Alex Turns Four

There were few cleft babies in our stateside program over the years who were more photogenic than little Alex. Under the loving care of his KY foster parents, Jay and Kim from Simpsonville, Alex grew into a chubby, happy baby who was well-nourished for his surgical repair (donated by Dr. Andy Moore in Lexington,KY.)
Alex has been home with his parents in Guatemala for three years now. He is shown here in a photo taken yesterday, when his mother went to Mayan Families in Panajachel, Guatemala to receive this donated food.
It was a great Mother's Day gift for foster mom Kim to see Alex looking so healthy.
Many thanks to all the great staff at Mayan Families for continuing to meet this child's needs.

Maylin celebrates Easter in KY

As Maylin's foot heals, she continues to enjoy her first spring in the United States. Thanks to excellent donated wound care, her foot is healing very well. We hope she can be reunited with her family in Guatemala by late spring.

Imner prepares for cleft lip surgery

Baby Imner has recovered very well from his hernia surgery here in the states. His cleft lip repair is on the calendar, and meanwhile he is enjoying lots of formula and TLC. Foster parents Nicole and Chad have done a wonderful job of organizing surgical donations of care for this baby, and clearly, he is benefiting from the attention of dedicated medical professionals. COTA volunteers keep in close contact with Imner's parents to keep their concerns met.