Definition of a Father

fa·ther  (fär)n.

a. A male person who contributes to the conception of a child.

b. A man who adopts a child.

c. A man who raises a child.

Warren, COTA Foster Dad

Children of the Americas routinely touts the benefits, joys, trials and tribulations of fostering the children in our program who come to the states for medical care. It is not an easy job to enter into a long-term relationship with a sick child from Guatemala who speaks no English, is homesick, may be malnourished and will have medical care issues. Our accolades for this challenging job tend to go to the foster mothers. In honor of Father's Day, we are reversing the familiar ditty, by claiming that behind every good woman, is a great man.

Henry, COTA Foster Dad

There is something that happens in the heart of a woman when she feels the need to foster a child. That "something" is different for each person who takes this job on.

It may be an empty nest. Or no nest. It might simply be the need to assist a Guatemalan mother who needs help for her child.  The glimmer of an idea becomes a nudge that leads to a call to COTA volunteers and if the there is a need, a child finds a sanctuary in a foster home that leads to restored health.

Mike with foster daughter

None of this would be possible without the consent of an understanding husband who is willing to be second-best while the household revolves around the needs of a sick child.  
 Amazingly, 114 men have said "yes" when their wife uttered the words "Honey, we need to talk."

These men have agreed to long drives to airports, clinics, and hospitals. Our COTA foster fathers gave up timely meals, or sometimes any meal at all. They have shared disposable income, time with their wives, and days off of work. These foster fathers add sick children to family vacations, to carpools and to homework schedules. They worry, keep bedside vigil and change surgical dressings like a pro. Many of them agree to foster more than one sick child over a period of years. These men are fathers in every sense of the word. The best of the best. 

Vince, with COTA Foster Child

One of the most common misconceptions about our program is that our foster parents and board members get paid for our work. Our foster fathers do get paid, but not with money. Instead, their fortune is earned through experiencing the repair of a cleft lip, or the ability of a child's ability to walk again. These men understand that the intrinsic rewards of stepping up to meet a significant and worthwhile need are the best fortunes. In our organization, we  think there should be a new dictionary definition to the word father. For COTA purposes, the definition should read as follows: 

   fa·ther  (fär): one who agrees to take a sick child into his heart and home, only to have to return that child to the biological mother upon recovery. A man who is willing 

 to sacrifice for a child who is not his own. 

Happy Father's Day to our COTA Foster Fathers.

You have made the world a better place in every sense of the word.

A Good Kind of Tired

Children of the Americas surgical team members recognize the "look" (left). This volunteer's face radiates a mixture of heat exhaustion and physical fatigue during our recent medical/surgical and dental team to Retalhuleu,
Guatemala. When one gets this tired, the only thing keeping the body going is grit and determination and the kind of fortitude that makes someone sign up to volunteer for a team to Guatemala.

At the end of our week in Guatemala, even our patients are tired. They have often waited several days for our services.The women and children we donate medical care and surgery for know that if they don't wait their turn, the chance for restored health may not come their way again. So they wait, so patiently that it inspires us to push ourselves even harder. We perform surgery, pull diseased teeth, dispense a truck load of crutches and wheelchairs, see masses of clinic patients and dispense more medicines than we thought we could possibly do, so that the last patient in line gets cared for.

At the end of the week we go home to loved ones, and hug them a little tighter. We appreciate the ease of life in the United States just a bit more than we usually do. We complain less, stand in lines at the grocery more patiently, and are profoundly grateful for good medical care the next time we are sick. Gratitude for the abundance of necessities in our country is foremost in our minds when we return to the states.
During quiet moments, we think of the patients that touched our hearts while we were in Guatemala. There are always those special ones that we know we were meant to be in Guatemala for; the clefts that would not have survived, the children who might not have ever walked, the women who would have struggled with unresolved surgical needs. Gratitude: for the chance to both travel with COTA and return home...very tired.

(photo credits:David Horner)

Having a Bad Day?

Here are a few of those someones

Traveled all night for surgery, but still cheerfully waiting

Single Mother with no job, awaiting free medical exam

Children awaiting entry into COTA Team Clinic

 Thrilled that their daughter traveled to U.S. for donated surgery

Happy Birthday to Our Executive Director

Our Children of the Americas blog is usually reserved for updating our supporters and donors with current events related to our goals as an organization. But today we are making the choice to use this platform to thank our Executive Director, Rosemary Vance.

This is Rosemary's birthday, but our guess is that she spent it just like she has every day since joining COTA as a volunteer....thinking about the needs of COTA. Rosemary is one of our longest-term volunteers, which means that she has had COTA concerns on her mind for well over twenty years.
There isn't a job within our little nonprofit that Rosemary hasn't participated in. She has always done the "ABC's" of whatever Children of the Americas needed:

• Accounting.
• Begging for supplies.
• Caring for countless foster children.
• Doing all of the odd jobs nobody else wanted!
• Excel lists.
• Financing trips to Guatemala on her own dime.
• Going wherever, and whenever COTA needs her to.
• Hosting board members from out of town.
• Insisting that our board follow proper protocol.
• Juggling a full-time job with the demands of COTA.
• Keeping medical supplies in her house.
• Lifting boxes of medical donations when her doctor told her not to!
• Mediating (the many) issues on COTA team trips.
• Nudging donors to support our program.
• Orthotic and prosthetic patient care coordination.
• Pediatric surgical donation networking.
• Quotes the lowest price COTA can pay to save our donated dollars.
• Reprints forms that got soaked in Hurricane Sandy.
• Sending countless emails weekly for COTA.
• Travels to Guatemala at least twice a year.
• Understanding logistics of running an international nonprofit.
• Volunteers endless hours.
• Warehouse gleaning of supplies from other nonprofit organizations.
• X-tra understanding of those board members who occasionally falter with their energy.
• Yearlong devotee of anything concerning COTA.
• Zest for all things related to the concerns of the women and children of Guatemala.

It is not an understatement to say that Children of the Americas has continued to be a vital, life-changing organization thanks to Rosemary's dedication, intelligence and enthusiasm.
Happy Birthday Rosemary!

Perspectives on a COTA Team from Dr. George Quill

Suicide showers are...

• Somewhat slippery.
• Either freezing or scalding.
• Big enough to wash a Volkswagen as well as yourself, but only a trickle of water will flow down upon the both of you.
• Those that have windows that open onto the street below.
• Those that have exposed wiring around the spigot leading to the contraption that heats the water to either scalding temperature or reminds you of a dip in lake Michigan with the January Polar Bear Club.
• Those whose exposed wiring has been known to catch on fire the hair of a young lady who stands more than six feet tall (true story!).
• Those which I am slowly figuring out how to modulate the variable flow rates to get a somewhat tolerable temperature.
• Preferable to walking around all day and night so sweaty and greasy that, when you move, your clothes don't always travel in the same direction! 

__________________________________________________________________________

                        "If you can walk into my OR you can keep your boots on."

______________________________________________________________________

 I've only seen this once since 1987!
X-rays of a 19-month old Guatemalan girl with wide-set eyes, slightly blue sclerae, open cranial sutures and severe bowing of all her long bones.
In addition to a diaper full of caca, these films are consistent with Ricketts due to vitamin D deficiency.  We prescribed Tums and recommended that mom take her baby out in the sunlight every day.  Hopefully, we can check this child again on our mission trip next year.
  The pictures are a little difficult to make out because there are no functioning X-ray view
        Boxes down here and I had to hold up the film to the window to take the picture. 

_______________________________________________

 So, today, Wednesday, was a usual day except the power to the whole city was turned off for a while.  The. Hospital generator would work the anesthesia machine and tourniquet box, but not the A/C.  At one point the a/c came back on, but not the lights.  Finished the case by flashlight and soaking in my own sweat.  I'm always hot and always thirsty down here!

____________________________________________________

Puzzled

When our friends and family hear that COTA team members are planning our annual medical/surgical/dental/orthotics trip to Guatemala, we typically get one of two reactions. 

" Oh, I would love to do that someday."

Or

" How do you stand to go there and see all of the poverty and despair? "

Most of us have family responsibilities or limited financial resources, and we realize that willingness alone is not enough to make it the best time to board a plane and head to Central America to do good work. The second response however, leaves us puzzled. 
Children of the Americas volunteers typically have a long-term relationship with our organization. We travel to Guatemala regularly and for some of us, it is our international destination of choice. The lack of infrastructure in this tiny country makes travel difficult;

The hotels don't come with a four-star rating. Food is interesting, water needs to be regarded with caution, and the weather, especially in the rainy season, can be interesting.
It is expensive to go back repeatedly on our own financial resources, and we come back tired, sometimes even sick. Stateside matters of work and family take a back seat to all matters Guatemalan before and during the team. 

Why then do we return, time after time?
Here are the reasons:

For the Amazing Natural Beauty

Beautiful Old World Architecture

For the Children that Need Our Medical Specialists

And for the Mothers who need to stay healthy to raise them

Recipe for a COTA Team

Children of the Americas has been taking medical/surgical teams to Guatemala since the late 1980's. This may make us the longest-term organization that has consistently traveled to Central America for the purpose of delivering medical care to the citizens of Guatemala who have little or no access to these services. We have donated surgery for many hundreds of patients, seen thousands more in our clinics, and five years ago, we added dentists to our teams. Our pharmacy dispenses over 5,000 prescriptons on each team and the orthotics volunteers quietly and competently support our services with their work to benefit our patients. 
What does it take to create the miracle of donated medical care for the poor of Guatemala? 
There aren't enough words to tell the story. It would need to be a book instead of a blog. There are too many hours to write about, too many details to post, too many daily challenges to explain. Perhaps our story is best told with pictures. As they say, a photo is worth 1,000 words.

Some would think that forming a new COTA team starts mid-summer, six months before departure, when we start gathering supplies in our respective garages and basements.

Child with tumor who was brought to U.S for donated surgery in collaboration with Word Pediatric Project

Same lucky toddler, post-op, playing before departure home to Guatemala

Mary Knoll Nun, Jude

Few know that the next team starts within a few weeks of landing the team members back on American soil in late January. Children who couldn't make our surgery schedule in Guatemala, due to complexity of care, are networked into partner organizations or hospitals that will donate surgical intervention. All OR charts are flown home with us, organized and the information is compiled to share with the COTA board. Many emails go back and forth about the welfare of our surgical cases. Pediatric cases start arriving in KY for donated care that was too complex to fix on a team. Many, many hours and piles of paperwork later, the half-dozen cases from the previous team are safely operated on and back home to their parents in Guatemala. Which means we are then ready for new team referrals from our wonderful friends in Guatemala, like Jude (above,left). 
And then things get busy. We pack supplies: 

 

We fund raise:

Roger and Rosemary, presenting COTA to Lexington Church

 We travel to Ohio and Louisville, to glean supplies for the team.

Thank you to Matthew:25 !

Surgical, dental and clinical supplies arrive in Guatemala

After arriving in Guatemala, we unload all of our previously packed supplies and dispurse them throughout the clinical areas of the hospitals we are working in. Each item has to be taken to the respective parts of the hospital where the COTA volunteers will be working. Our dentists (below) need their

Our dental team is flexible enough to set up anywhere we can find space for them!

In the OR in Guatemala

These little feet needed help

instruments. The surgeons require the tools of the trade required to perform 120-130 surgeries the week we are in Guatemala. Our clinic doctors use the fewest supplies but see the most patients. The orthotics and prosthetics team has endless patience for fitting little feet, adjusting crutches and supplying vital devices to enable our pediatric patients to walk. 
It takes countless hours, endless emails, limitless energy. But pulling together a COTA team is worth the work for her:

 And for him:

And them:

 

No Ball? No Problem.

When little David came to our 2012 Children of The Americas team, he wasn't a typical happy preschooler. David had been born without adequate limbs, which in Guatemala, meant he was destined to live a life of immobility. There are very few resources in this Central American country for children with such extreme disabilities.
David's mother had heard of COTA, and she brought him to Zacapa to seek assistance from our volunteer orthotics and prosthetics team members. Shelley Ryan (Lexington, KY), Tim Macke (Denver, CO) and Jason Griffin (Lakewood, CO) worked diligently to fit and fabricate prosthetic legs for David. With the help of ROMP's lab in Zacapa, two new little prosthetic legs were donated to David.
This video shows David and Tim testing David's new legs in the Guatemalan hospital courtyard.
 No ball? No problem!

Many Hands Help One Child

How many Children of the Americas volunteers did it take to make the scene in this photograph happen? This little boy was one of our surgery patients this past January in Guatemala. His mother brought him to our free medical clinic in hopes of getting his hernia repaired, which was something she had not been able to afford to do for her son.
The gown he is wearing was donated to our organization, and one of our volunteers drove to the donor hospital, and loaded the boxes of gowns and other supplies into her car. Roger Teague, our volunteer in charge of trucking supplies, drove the boxes to our warehouse, which is located in Winchester, KY. The blanket that is lying on Pedro was lovingly made by a sewing group in Mt. Carmel, Indiana. They drive over a hundred hand-made quilts down to us every year, which we donate to our pediatric patients. These items are usually the first new blanket any of our patients have owned. The supplies used to give Pedro a bath before surgery were donated by Supplies Over Seas in Louisville, KY. Going through their warehouse meant a team of our COTA volunteers spent a long and very hot day going through box after box of items we might need, and packed them for all of the "Pedro's" who might benefit.

The IV in his hand, the armband on his wrist and the sheet under him were all gleaned from different hospital donations around the U.S. and saved in garages and basements until COTA had our packing day in September. The medicines Pedro needed post-operative were donated by our board member Mike Branstetter, who is one of our volunteer pharmacists.
We fed Pedro and his mother while they were with us in Guatemala with funds donated to COTA. Each medical caretaker he encountered paid their own international plane ticket to provide care for him. The surgeon left his two little boys and his wife in the states for a week to be able to use his talents to operate on Pedro. The monitoring machines in the operating room were donated and hand-carried to Guatemala by our anesthesia volunteers. Betsy cared for Pedro in our post-op unit, Kelley used her pediatric talents to nurse him back to health on the unit and Bernice volunteered her language skills to translate medical care questions and directions to Pedro's mother. None of the above events would have come together without the diligent efforts of our COTA board members who spend many months planning our team trips to Guatemala.
When Pedro was discharged, he faced a long and painful walk of 4 blocks to the nearest bus. Erin made sure he had money for a taxi. After all that, what do you think was the one thing he asked for?
Money so that he would pay his school fees and return to his education. Jennifer donated the necessary funding.
How many hands of United States volunteers did it take to make this happen for Pedro? Too many to count. We hope he is carrying his newly donated backpack to school, no longer in pain from his hernia. Many hands, many hearts and countless hours helped 128 patients regain their health this past January, and are preparing to do the same in early 2013. Job well done!

This Baby is Waiting....

While on a recent trip to the remote northern area of Solola, Guatemala, three COTA volunteers were asked by local villagers to evaluate this baby for his cleft lip and palate issues.
Children of the Americas volunteers love these unscripted moments in the mountains of Guatemala. Connecting and being able to help those with no access to medical care is what we are passionate about. It didn't hurt that this little one was so darn cute!
A few hours of time with this baby's mother left her with a sense of security that we will work with her to get her baby to our medical/surgical team in January, and we will be able to offer donated surgical correction. We offered transportation assistance (a 6 hour bus ride after a 2 hour truck ride down the mountain) and an assurance that the mother would have food while she and her baby was with us. Photos of this little one have been sent to our team plastic surgeon, who has approved him for surgery. The mother has done what she does best; loved and nurtured her baby so he will be in the best possible physical condition for his upcoming surgery. We look forward to being part of his journey to restored health. 

Our Volunteers Are the Best

The weather on this day gave a new definition to the word rain. It wasn't just water coming down from the skies on Saturday, it was a deluge. Blowing sideways. Hard. Which made the logistics of packing 154 boxes of supplies for our next Children of the Americas surgical team a bit interesting. We had over 20 volunteers who had driven into Winchester, KY to help our Director, Rosemary Vance, get this daunting task accomplished. There was no turning back, rain or no rain.

(L-R) Bobby, Rob, Franklin, Julie and her daughter Elizabeth

As usual, COTA volunteers made it work. And despite being wet, tired, dirty and sore, they worked with a smile on their faces. A common purpose and sense of camaraderie set the mood and the weather soon followed.
We packed every suture, scalpel, surgical instrument and medication needed for performing 125-135 surgeries in Guatemala during the week of January 13th, 2013.
Much more work remains to be done, but it will be done with the usual good cheer, competence and dedication that make our COTA volunteers some of the best!

Kit and Roger

One Happy Little Boy

This is Nelson. He is eleven years old, but his chronic protein deficiency has left him small for his age. Despite this, Nelson is a happy little boy who had no idea how sick he was.

On our last medical team trip to Guatemala, Nelson was brought to our clinic by his mother who was rightfully concerned about his infected foot. The chronic wound and drainage had been a long-term problem for Nelson, and his mother needed help before the infection settled into his bones.
Many hours of paperwork, travel arrangements and volunteer effort later, Nelson was in Lexington, Ky for donated medical care. Three months of wound care, surgery (for a urinary problem), dental appointments have left Nelson much stronger and healthier.
There are many COTA volunteers who have worked diligently to assist Nelson in his journey to health. For each stateside pediatric patient we bring to the United States for donated care, we estimate there are 8-10 adults who assist us by  volunteering their professional skills. These people act as substitute family members for our stateside patients.

F:  Foster Parents
A:  American Airlines
M:  Medical caretakers
I:   Information management of files.
L:  Lots of helpers--dentists, wound care specialists, surgeon, hospital staff, etc.
Y:  Yes! Nelson will soon be able to return home to Guatemala!

Patient with her former prosthesis, held together with tape

Most of us take the simple act of walking for granted. It is in our nature to automatically do the things our body was meant to do, until suddenly, for whatever reason, we no longer can.
This patient waited many hours in our line of hundreds of patients seeking care in January of 2012 when COTA worked in Zacapa, Guatemala. The heat index was over 100 degrees the week we were there, making physical exertion difficult, especially for someone with an ill-fitting worn out prostethic leg. It was not looking promising for this lady to get care the day she came to COTA--it was getting late, and our prosthetics and orthotics staff was running low on donated supplies as well as stamina. I wish I had a picture of her face when she was finally cleared by our triage staff to wait in our O and P lab. Priceless. Glowing. And inching her way, leaning heavily on a cane with an artificial leg held to her stump by a lot of tape and a little determination.
Jason and Shelley, our COTA volunteer O and P staff, worked for hours to get a new leg fabricated for this lady, working longer than they would have after hearing that travel back to Zacapa for more time with our team wasn't possible for this patient. The extra effort made a great impression on this patient, and she left with a new leg, and a big smile as she walked back out the gate and onto an easier life with her newfound ambulatory ability.

Three Generations of Patients for COTA

These three beautiful girls are part of a multi-generational family of patients who have followed Children of the Americas team since 2003. One of their family members was a stateside patient in our COTA program, and returned to the family after 8 weeks of staying in KY for donated surgery. Their aunt (background) had gallbladder surgery in 2008 during a COTA team. Their grandmother has had two surgeries, and little Rosemary (bottom right) has had three surgical corrections of her cleft lip and palate by our volunteer plastic surgeons. The patriarch of this large and close-knit family is currently very ill. A few months ago he lost his job picking coffee beans on a local plantation. His biggest concern is how his family of 13 children will continue to be financially viable if he becomes too ill to care for them. Albert is relieved to know that once a year COTA physicians and surgeons will be in Guatemala to make sure his family is as healthy as possible.

A Thank You to COTA

I just wanted to thank you again for your continued support and for helping little Sergio and Jonathan make their journey to Richmond.  You’ll be happy to know that I spoke to both their mothers and both boys are doing well and continue to get better and better every day.  I know this could not have been possible without you.  Thank you again for all you do an please let us know how we can continue to support the wonderful work of Children of the Americas.  Attached is a very cute picture of little Jonathan, his mom gave it to us right before they went back to Guatemala.  Enjoy!

Rocio G. Watson 

We Bring Program Director

World Pediatric Project

7201 Glen Forest Drive, Suite 304

Richmond, VA 23226

Office: 804.282.8830

Cell: 804-839-1955

Jonathan and his mother, just before returning to Guatemala

The Three Amigos

These three cuties were not all smiles in the post-operative pediatric ward after receiving their hernia surgeries this past January. But in this particular moment, they were enjoying the attention of a group of dedicated Americans who were visiting their city in Guatemala, and volunteering their time to make sure a little hernia didn't become a big hernia when the boys grew older.