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Mending Kids: Missions
Where in the World Honduras is located in Central America. The country is bordered to the west by Guatemala, to the southwest by El Salvador, to the southeast by Nicaragua, to the south by the Pacific Ocean at the Gulf of Fonseca, and to the north by the Gulf of Honduras. Honduras is prone to hurricanes and flooding, due to its close proximity to the Pacific Ocean and the Caribbean Sea. The country’s population of 8 million people is evenly divided between rural and urban regions. About 59% of the population live below the poverty line, and 36% live in extreme poverty. The agricultural sector employs about 40% of the population with many dedicating to the production of low-profit crops, such as bananas, rice and beans. According to the United Nations Office on Drugs and Crime, Honduras has the highest rate of intentional homicide in the world. In response to all the socioeconomic difficulties that are affecting the country, the Government has created a long term plan called Visión de País 2010-2038 y Plan de Nación 2010-2022. Healthcare in Honduras The quality of and access to healthcare in Honduras is directly tied to income levels. According to the U.S. Library of Congress, health services are not readily available to the majority of the population. Infectious and parasitic diseases are the leading causes of death among the population due to a lack of preventive measures. In the isolated regions of Honduras, there are almost no physicians. About 18% of the population has no access to basic health care services and a third of the population lacks access to sanitation. The Children Children under the age of 15 make up over 38% of the total population in Honduras. According to UNICEF, infant, under-five and maternal mortality rates remain stubbornly high at 30 per 1,000 live births. Over one-third of infants are malnourished. The average number of years of schooling stands at 4.3 in rural areas and 7 in urban areas. Children are vulnerable to violence, sexual exploitation, and trafficking. In Honduras, approximately 500,000 children hold jobs, which is about 15% of the youth population. The Mission From January 24-31, 2015, Mending Kids in partnership with the Mayo Clinic Rochester and Clinica Evangelica Morava of Ahuas will provide pediatric general laparoscopic surgeries for at least 5 children in Honduras. This mission will be led by Dr. Christopher Moir. The Clinica Evangelica Morava of Ahuas is a rural referral hospital that provides comprehensive care to the severely underserved region, but the medical staff require advanced scope training to be able to take care of cases without creating open wounds. Dr. Moir and his team will provide such training, and by doing so will create better sustainability of surgical care for the children in this rural community.Learn More
Where in the World The Philippines is an island country in Southeast Asia, situated in the western Pacific Ocean. The country is made up of more than 7,000 islands. Due to its geographic location, the country frequently suffers natural disasters, such as typhoons and earthquakes. The Philippines is the 12th most populous country in the world, hosting 100 million people. Approximately 34% of the population are children between the ages of 0-14 years. The country is newly industrialized, transitioning from being an agriculture-based economy to a manufacturing-based one. Extreme poverty in the country is estimated at 19.2% of the population, or about 18.4 million people. Most of the poor live in rural areas, although urban poverty has been increasing over the years. Healthcare in the Philippines Healthcare in the Philippines is comprised of both publicly (40%) and privately (60%) run sectors. According to the Philippines Health System Review, health status has improved dramatically in the Philippines over the last forty years: infant mortality has dropped by two thirds, the prevalence of communicable diseases has fallen and life expectancy has increased to over 70 years. However, improvements have slowed in recent years and considerable inequities in health care access and outcomes between socio-economic groups remain high due to high cost of accessing and using healthcare. Attracting and retaining staff in underserved areas is also a major challenge. Inefficiency in service delivery persists as patient referral systems and gatekeeping do not work well. The presence of a large private sector creates fragmentation and variation in the quality of services across the country. The Children Thirty-five percent of the population in the Philippines is made up of children, and almost twenty percent of them live in extreme poverty. The infant mortality rate is 30 per 1,000 live births, and the under-5 mortality rate is 34 per 1,000 live births. According to UNICEF, these numbers are highest in the poorest sectors of society. Malnutrition in the Philippines remains a serious problem. Recently there has been a measles outbreak with 60,000 suspected cases of measles throughout 2014. Child labor also remains a huge burden, creating health issues and a lack of access to education for children. The Mission The inaugural intra-country Mending Kids mission to Tacloban City in Cebu, Philippines will take place from January 25-29, 2015 in partnership with the Philippine Heart Center. This mission will take place at the Vincente Sotto Medical center, led by three pediatric cardiac surgeons, Dr. Juliet Balderas, Dr. Gerard Manzo, and Dr. Bernadette Azcueta. The goal is to provide life-changing cardiac surgeries for 15 kids while also training local cardiac surgeons in advanced procedures. They will mend children who suffer from congenital heart defects, rheumatic heart diseases, and more. Congenital heart disease is so common in the Philippines that the Department of Health listed the disease as among the top 10 causes of infant mortality. 20,000 babies in the country are born with CHD every year. Aside from cost, treatment is difficult since there are only about 10 congenital heart surgeons in the entire country. These conditions are not only painful for the children, but also pose major socioeconomic burdens on families and healthcare systems. Through this Mending Kids mission to the Philippines, our surgeons will provide life-saving operations as well as self-sustainable training to successfully improve the quality of life of children who suffer from these issues.Learn More
Mission: Costa Rica
Where in the World Costa Rica, located on the Central American isthmus, borders Nicaragua, Panama, the Pacific Ocean, and the Caribbean Sea. Widely recognized for its varied wildlife, Costa Rica has beautiful landscapes filled with forests, mountains, volcanoes, beaches, and rivers. The population of Costa Rica is about 4,300,000 people, a quarter of whom live in the metropolitan area of the capital, San José. Despite the fact that Costa Rica has one of the highest standards of living in the Americas, profound poverty still affects many people at the bottom of the socioeconomic ladder. Costa Rica’s poverty rate of 20-25 percent has remained the same for nearly 20 years. Poverty in Costa Rica is especially observable in rural areas and in certain parts of San José. Healthcare in Costa Rica The National Health System covers all medical needs of the Costa Rican population. The quality of healthcare in Costa Rica is considered to be one of the highest in Latin America. However, given the long waiting times for appointments (it can take months to see a doctor or undergo surgery), many residents choose a private hospital where appointments are more easily available. Private hospitals incur higher hosts for the patients and families than public health services. Currently, there are about 30 public hospitals and 5 private hospitals in Costa Rica. The majority of private hospitals are located in San José. The Children Following recent improvements to medical care, Costa Rica now has the longest life expectancy in Latin America. The Code for Children and Adolescents states, “all minors will benefit from medical care directly and freely from the State.” Despite a very effective health system, 10% of children die before reaching the age of 5 due to infections and other health problems. The main problem faced by children in Costa Rica is poverty. One in four children live below the poverty line. In addition, child labor continues to be a challenge in Costa Rica, with 21% of child laborers not attending school. According to the United Nations Children Fund, 36,000 children in Costa Rica are orphans. The Mission The Mending Kids Surgical Mission to Costa Rica is a two-part mission with the goal of providing life-saving surgeries for 12 kids, while training local surgeon Dr. Rafael Gutierrez and his colleagues from the Hospital Nacional de Niños in San Jose in more complex interventional cardiology procedures. The first part of this mission will be led by Dr. Timothy W. Casarez, pediatric interventional cardiologist from CHLA, and will take place from February 15-20, 2015. The second part of this mission will be led by Dr. David A. Ferry, pediatric interventional cardiologist from CHLA, and will take place in the Fall of 2015. In Costa Rica, there are about 7 children per week diagnosed with congenital heart disease who need stent placements. While healthcare is free to children in Costa Rica, such an advanced technique is still relatively new. Stents provide an opening to increase blood flow and circulation throughout the body. A teenager may need one or two stents placed to help ease breathing and circulation. Currently, local surgeons require advanced training for such complicated cases, and the waiting list of children is too long for the limited number of specialized local surgeons to manage. This Mending Kids mission will provide the necessary training in order to create a sustainable program for the cardiac needs of children in Costa Rica and all over Central America. Goals The long term goal for this mission to Costa Rica will be to use the Hospital Nacional de Niños in San Jose as a center of excellence for care of the region’s pediatric cardiac cases. Children from all over Central America and the Caribbean who suffer from congenital heart malformations will be referred to the HNN to successfully get their hearts mended. Currently, Mending Kids must refer such patients to India or Israel, so having a nearer hospital to refer them to will reduce the anxiety and culture shock children feel when going through their healing process. Having a certified hospital in the region will also help Mending Kids continue to provide ongoing and sustainable training of regional surgeons.Learn More
Mission: El Salvador
Where in the World El Salvador is bordered by the Pacific Ocean to the south, Guatemala to the west, and Honduras to the north and east. El Salvador is the smallest country in Central America, and its population of 6.29 million makes it the densest. It is also the most industrialized country in the region. According to the World Fact Book, the rural population represents thirty-nine percent of the country’s total population. Healthcare in El Salvador El Salvador’s healthcare system is comprised of both publicly and privately run healthcare sectors. Generally, the public healthcare facilities – especially hospitals – are under-staffed and poorly equipped. The private healthcare providers, located in San Salvador and Soyapango, offer better quality services, although not up to the standards usually found in the United States. Most private healthcare facilities in El Salvador will require payment up-front or proof of international health insurance coverage before treatment. The Children Forty percent of the population in El Salvador is made up of children, and fifty percent of them live in extreme poverty. More than twenty-five percent of children under the age of 5 in El Salvador suffer from chronic malnutrition. The mortality rate for children under 5 remains high at 81 per 1,000 children. Access to health and education services are limited, made worse by under-resourced institutions that struggle to meet basic technical and operational capacity. Violence plagues children in both urban and rural El Salvador. Half of all the country’s children and teenagers live on less than US $1.25 per day. The Mission The Mending Kids Surgical Mission to El Salvador will take place from February 22-27, 2015 in collaboration with the Hospital Nacional de Ninos Benjamin Bloom in San Salvador and Gente Ayudando Gente. This mission will be led by two Los Angeles pediatric plastic surgeons, Dr. Andre Panossian and Dr. Rady Rahban, with the goal of providing life-changing surgeries for 10 kids. Dr. Panossian and Dr. Rahban will also provide advanced training to local surgeon, Dr. Calderon. Together they will mend children who suffer from burns and birth defects such as cleft lip, cleft palate, webbed fingers, and more. Birth defects and pediatric burns are significant, yet underappreciated global health issues. Their impact is especially severe in developing nations, such as El Salvador. Birth defects are usually caused by high teratogen levels and limited maternal health interventions. Pediatric burns are usually caused by scalds or open flames and account for almost half of the population with severe burn injuries worldwide. These conditions are not only painful for the children, but also pose major economic burdens on families and healthcare systems. Through this Mending Kids mission to El Salvador, our surgeons will provide life-changing operations to successfully improve the quality of life of children who suffer from these issues.Learn More
Where in the World The Republic of Haiti occupies the western third of the Caribbean island of Hispaniola, bordered to the east by the Dominican Republic. Its biggest city and capital, Port Au Prince, has a population of approximately 3,664,620 people. The rest of the population, which creates a total population of approximately 9,923,243 people, lives in towns largely dominated by agriculture. The tropical climate in Haiti has created a country teeming with natural beauty. Yet, despite its appealing landscape, Haiti is the poorest country in the Western Hemisphere, lacking in infrastructure, social services, and health services. 59% of Haitians live on less than $2 a day. Since the 7.0 magnitude earthquake that devastated the country in 2010, Haitian and international NGOs have taken impressive interest in addressing the country’s needs. Still, if you travel through the county, you will notice the crowded, trash-filled streets, dirty water, half-built concrete homes, and families wanting for basic needs. Healthcare in Haiti One of the biggest problems with public health in Haiti is the country’s lack of infrastructure, which was worsened by the 2010 earthquake. Currently, surgical care is delivered in three ways. Private hospitals serve those living in metropolitan areas, and provide care for a fee. However, the fees and location limit the number of people who can access this care. Public hospitals charge a smaller fee, but require patients to purchase medical supplies themselves, which also limits the number of people these hospitals can serve. Charitable organizations comprise the third method of surgical care available, though many of these organizations also charge fees for their services. Although these options for surgical care exist, it is still difficult for the poorest Haitian families to access adequate, affordable health services because they live in rural towns far from these medical services. The Children Most of the children we treat come from Port-au-Prince and the surrounding areas. Some are orphans and some were displaced by the earthquake and live in camps with their family. Most all are impoverished and would most likely not get help, were it not for Mending Kids and other similar mission efforts. Throughout Haiti, poor infrastructure—which worsened with the devastating earthquake—makes it difficult for Haitian children to receive adequate medical care. Moreover, the destruction caused by the earthquake led to the world’s largest cholera outbreak, which still affects Haitian children today. According to UNICEF, malnutrition continues to be a major problem affecting Haitian children. These problems, along with the myriad of other issues that contribute to the weak public health system in Haiti, have led to a high rate of child mortality and low life expectancy in Haiti. The Mission The annual Mending Kids Surgical Mission to Haiti is an ongoing commitment to provide life-changing and life-saving help to the children of the poorest country in the Western Hemisphere. Although five years have passed since the earthquake, close to half a million of displaced people are still living in shantytowns like Cite Soleil, without access to clean water or sanitation. With the leadership of Dr. Cathy Shin, a pediatric surgeon from CHLA, this annual Mending Kids mission provides life-saving surgeries for over 60 kids in just one week! The all-female volunteer surgical team provides training of the OR staff and local surgeon, Dr. Jeudi, at the St. Damien Pediatric Hospital in Tabarre, Haiti. Mending Kids provides mentorship while establishing post-operative protocols for the nursing care on the pediatric wards. This year’s mission will continue efforts in training and in providing direct surgical care for the many Haitian children in need of surgeries. Goals Short term: The short term goals of Mending Kids in Haiti are to 1) assess and improve the treatment and surgical care of children in Haiti, 2) promote communication between pediatric anesthesia and pediatric intensive care, 3) improve training of supervisory nursing care on the pediatric ward, and 4) provide a patient-centered environment that reduces pain and suffering, as well as improves healing and the psychological well-being of the children. Long term: The long term goal of Mending Kids in Haiti is to create self-sustained pediatric surgical care at the St. Damien Pediatric Hospital. This will be accomplished by continuing training efforts until the local medical staff has gained the confidence and skills to perform both common and complex surgical procedures, without requiring the support of international missions. Special Thanks Mending Kids would like to extend a very special thank you to R. W. Smith & Company for sponsoring this mission! With their monetary donation we are able to fund several surgeries for the children of Haiti, and with their toy donations we are also able to put bigger smiles on the kids' faces!Learn More
Where in the World Nicaragua is the largest country in the Central American isthmus, bordering Honduras to the north and Costa Rica to the south. The population of Nicaragua, approximately 6 million, is multiethnic. The most populous city in Nicaragua is the capital, Managua, with a population of 1.8 million. Healthcare in Nicaragua The La Mascota Children’s Hospital lacks in many essential surgical resources. Much of the equipment is outdated or nonfunctional, including broken sterilization and echocardiograph machines. There is no catheterization laboratory and supplies are extremely limited. In order to treat children with heart defects in this region of Central America, advanced medical training and the construction of a modern medical facility is essential. The Children The main health determinant for Nicaraguan children is poverty. A staggering 20% of children less than 5 years of age are chronically malnourished. Data from the Ministry of Health show that 9% of children are born with low birth weight. Child mortality for all of Nicaragua is 11 per 100 live births. Out-of-pocket healthcare expenditures constitute a serious barrier for the poor, as well as the lack of access to healthcare in rural areas. Infant mortality remains highest in the poorest regions. The Mission The annual Mending Kids Surgical Mission to Nicaragua is led by Dr. Michael S. Womack, world-renowned interventional pediatric cardiologist. Dr. Womack is one of the first to introduce regional training on Mending Kids missions, providing interventional cardiologists from all over Latin America with advanced training in these procedures. Mending Kids brings together regional cardiologists from Nicaragua, Costa Rica, Panama and the Unites States to work together in our very own Pan-American Mission to repair young hearts. A confluence of cardiologists exchanging knowledge and perfecting techniques to better the lives of kids who have been waiting, some of them, their whole lives for Mending Kids. This year’s mission will take place from May 9-16 2015 in Managua. The goal of this mission is to provide 10-15 kids with life-changing and life-saving cardiac interventional procedures - giving access to care to the many children who have patiently been waiting for an interventional cardiac procedure, and most importantly a chance at a normal life. Goals Short term: Mending Kids will be working together with local physicians and a cardiac team at El Centro Nacional de Cardiologia to prepare for a new regional center of excellence, and a new Interventional Cardiac Catheterization Lab that is in its final stages of completion. Long term: Mending Kids hopes to create an atmosphere where a group of cardiologists with strong internal camaraderie can flourish and can continue to work anywhere, to maximally spread the educational value of the training and experience they will have acquired after all the cases Mending Kids is able to complete on its missions to Nicaragua. This mission was dedicated to the memory of: Dr. Domingo A. Bermudez, a person who throughout his whole life, planted: love, friendship, compassion, brotherhood, and humanity for his fellow man and had a special sense of humor. He had a natural gift for helping and understanding even the humblest of people. His ability to serve went beyond his patients. He was always willing to indiscriminately help any person who came to him.Learn More
Where in the World Tanzania is located in the eastern region of Africa. It is bordered by Kenya and Uganda to the north; Rwanda, Burundi, and the Republic of Congo to the west; and Zambia, Malawi and Mozambique to the South. The population of Tanzania is about 47.4 million and 45% of the population are children between the ages of 0-14. The population distribution of Tanzania is extremely uneven with most people living on the northern border or eastern coast. Many Tanzanians live on an equivalent of less than a dollar a day. The Mwanza Region is located in northern Tanzania with a population of 2,800,000, the second largest city in Tanzania. The Mwanza Region is occupied by various tribal groups. The region currently has 6 hospitals, led by the Bugando Medical Center. Healthcare in Tanzania Healthcare in Tanzania is not accessible to the entire population. It is only available to those who have income. Health insurance has only been recently introduced, but it is very limited and does not attend to the needs of the majority of Tanzanians, particularly those outside of urban areas. For a population of almost 50 million people, there are only approximately 800 qualified doctors in entire the country. This patient to doctor ratio is among the worst in all of Africa. The Children According to UNICEF, the under-five mortality rate in Tanzania is strikingly high at 81 deaths per 1,000 live births. The infant mortality rate is 51 per 1,000 live births. Tanzania is making considerable progress in the reduction of child mortality due to the government’s commitment to increase use of key health interventions. These include sustained high coverage of under-five immunizations, Vitamin A supplementation, insecticide treated bed nets, and better treatment for malaria. Tanzania has a high prevalence of congenital heart diseases. In a research study conducted at the Bugando Medical Center between October 2012 and January 2013, 29% of infants enrolled in the study had high prevalence of congenital anomalies. This Mending Kids mission will provide both open-heart surgeries and training in order to create a sustainable program for the cardiac needs of children in Tanzania. The Mission This inaugural Mending Kids cardiac mission to Tanzania will take place from March 20-30, 2015 in collaboration with the surgical team from Bambino Gesù Ospedale Pediatrico and the Bugando Medical Center. This mission to Tanzania will be led by Italian pediatric cardiac surgeon, Dr. Salvatore (Sasha) Agati. The goal is to provide life-saving open-heart surgeries for up to 15 kids, including training for local cardiac surgeon, Dr. Godwin Sharau, who just completed five years of training in Israel. Dr. Sharau is the first Tanzanian surgeon to focus solely on pediatric cardiac surgery. There are currently nearly 500 children on a waiting list to get surgical care at the center. Goals Short term: Mend a dozen hearts with requiring complex surgeries to help Dr. Sharau gain more skills and confidence. Intermediate term: Collaborate with Open Hearts International and Save A Child's Heart to send more missions year round for the next few years. This will not only empower Dr. Sharau but also encourage the Bugando Medical Center to allocate more funds for pediatric cardiac care. Long term: Establish a successful cardiac program in Tanzania so that children will no longer need to be sent out of the country for cardiac care.Learn More
Where in the World Bordered by Eritrea to the north, Somalia and Djibouti to the east and Sudan and South Sudan to the west, Ethiopia is believed to be the birthplace of man and where, Lucy, the oldest human fossil, was found. More importantly, Ethiopia is a country of nearly 85 million without any comprehensive heart care program. This is a land where 1 in 100 children suffer from some form of congenital heart defect. In Ethiopia, there are physicians capable of diagnosing basic heart problems in children, but unlike any major city in the U.S. and Europe, there is absolutely no congenital heart program. There are only 19 anesthesiologists in the entire country. The vast majority of children with heart problems in Ethiopia have no hope to live anything close to a normal life, and are destined to live a shortened life punctuated by repetitive illnesses. Healthcare in Ethiopia Although urban areas of Ethiopia have hospitals with full-time staff and physicians, 4/5 of Ethiopians live in rural areas and lack access to healthcare facilities. There is less than 1 physician for every 10,000 people. Besides a shortage of infrastructure and personnel, the population suffers from a wide range of health problems, largely due to preventable and communicable diseases, as well as nutritional disorders. The infant mortality rate is very high, standing at 77 per 1,000 live births. The Children Researchers are still trying to determine why so many children suffer from congenital heart disease around the world and in Ethiopia. These children require surgery, whether it is an open-heart surgery or an interventional catheterization at some point in their early life, to correct the defect and allow them to live a normal life. The children we hope to mend will be arriving from all over Ethiopia and come from very poor families with little education and no other options. The Mission The Mending Kids Cardiac/Cath Surgical Mission to Ethiopia will take place from June 12-21, 2015 in collaboration with the surgical team from Star Hospital in Hyderabad, India. This mission to Ethiopia will be led by U.S. pediatric interventional cardiology surgeons Dr. Timothy W. Casarez and Dr. David A. Ferry of CHLA, and by Indian pediatric cardiac surgeon Dr. Gopichand Mannam. Mending Kids has invited Dr. Yayehyriad (Yayu) Mekonnen, a pediatric cardiac surgeon in his third year of fellowship with Save a Child’s Heart in Israel, to observe and learn advanced skills from Dr. Mannam on this mission. Dr. Mekonnen is originally from Ethiopia, and plans to return to Ethiopia after his fellowship in order to aid in the cardiac care of Ethiopian children. Dr. Yilkal Chanie, the new director of the cardiac center, will also receive advanced training on pediatric interventional cardiology by Dr. Ferry and Dr. Casarez during the mission. The goal is to provide life-saving open-heart surgeries and/or catheterization procedures for 30-40 kids, including training for local medical surgeons and staff. Goals The first two missions were strictly about open-heart surgeries. Last year, we added an interventional cardiology component to the mission to provide mentorship in the Catheterization Lab. Our goal is to continue the training in pediatric interventional cardiology, open-heart surgery and anesthesiology, so that the local medical staff may gain the confidence to do these procedures without needing international missions to assist them. Our X-Ray technician, Lexi Lynn Lee, will support all facets of mentoring in the Catheterization Lab, which is an exciting development.Learn More
Mission: United States
The Need In Los Angeles, thousands of children live below the poverty line and are denied insurance coverage for non-life-threatening physical deformities that are considered “cosmetic” issues under state programs. Many families who do have insurance coverage for their children are still unable to afford the deductible required of them. Children living with these conditions have no options for healthcare coverage or governmental medical aid, and are therefore vulnerable to a life of bullying, shame, and embarrassment. This deprives children of their opportunity to thrive, develop self-confidence, and unfold their full potentials. The Mission Established in 2013 as a response to the growing need of basic surgical care in the most impoverished communities in Los Angeles, the Mending Kids Hometown Mission aims to give a second chance to these underserved children who lack insurance or who have been denied coverage for the treatment they need. Mending Kids is committed to providing all surgical interventions completely free of charge to these patients. Our team is comprised of volunteer medical personnel and board certified pediatric surgeons of various specialties, ranging anywhere from orthopedic, plastic & reconstructive, ENT, urology, and general surgeries. This is the 3rd annual Mending Kids mission of its kind, and will take place July 11, 2015 with the goal of mending 20 kids with outpatient procedures. Sustainability Mending Kids is committed to the growth of the Hometown Mission and has thus formed a partnership with the Specialty Surgical Center. This partnership will foster access to even more underserved communities all over Southern California and the United States. Mending Kids is also forging strong corporate partnerships that will help cover major transportation and medical expenses, in order to guarantee that the children receive the best possible care from the top specialists in the their fields. Mending Kids hopes to have several Hometown Missions throughout the coming years and in various regions of the United States.Learn More
Where in the World Guatemala is located in Central America and is one of the poorest countries in all of Latin America. It is bordered by Mexico to the north and El Salvador and Honduras to the south. Guatemala has a population of 15,824,463 people, 56.2% of which live below the national poverty line. 36% of the entire population are children below the age of 14. 40.5% of the population is made up by the indigenous community, facing harsh socioeconomic inequalities to this day. Healthcare in Guatemala Guatemala has some of the highest infant mortality rate and lowest life expectancies in the Central American region. Many Guatemalans lack access to healthcare services, as there are currently only 16,000 physicians for the entire population. The Children Our young patients come from all over Guatemala, some enduring long walks out of their mountain villages to reach roads in order to get rides into the capital and the Moore Pediatric Center. Current research has not yet confirmed why so many Guatemalan children have congenital birth defects, but suspicions lie in some genetic corn strains that block the absorption of folic acid. Unmet surgical care can contribute to the various diseases children die young from, and better perioperative care for those who are lucky enough to receive surgeries could improve the overall survival rate of these children. The Mission The Mending Kids mission to Guatemala each year is a shining example of our on-going commitment to provide life-changing and life-saving help to the children of a nation still recovering from a civil war nearly 20 years ago and a country where nearly half of its population is under the age of 18. In 2014, we sent two separate ENT missions there to provide specialized surgical care to the most underserved segment of the population. Currently in Guatemala City, there are only 4 ENT surgeons, making it very difficult to see these specialists. This July 2015, we are sending a joint ENT and Plastics mission, led by otolaryngologist Dr. Ayal Willner of Miller’s Children’s Hospital in Long Beach and Dr. McCoy “Mac” Moretz of F.A.C.E. of Beverly Hills. Dr. Willner and Dr. Moretz will mend near 50 children in just one week, while also providing training in complex and advanced procedures to local Guatemalan surgeons. In addition, our volunteer nurses and techs will also provide the local OR staff with further training in pre-op and post-op care of the children. Goals To expand the clinical training of on-site providers, to create partnerships with satellite clinics to enhance pre-op and post-op care, to expand the scope to include higher complexity surgical cases such as congenital anomalies, and to continue the training until self-sustainment has been established without the need for assistance from missions such as ours.Learn More
Where in the World Peru is located in western South America and is bordered by Ecuador and Columbia to the north, Brazil to the east, Bolivia to the southeast, Chile to the south, and the Pacific Ocean to the west. It is a country rich in cultural, ethnic, linguistic, socioeconomic, and geographic diversity. Yantalo is a small farming town with a population of around 3,000. It sits in the heart of the Peruvian Amazon and is one of the 6 districts of the province of Moyobamba, Peru. People in this region lack access to many essential needs, such as clean water, paved roads, and especially medical attention. Healthcare in Peru Peru is one of the world’s fastest growing economies and is classified as an upper middle income country by the World Bank. Despite this economic growth, it is still a developing country with a poverty level of 26%. Almost 40% of children in the country are living below the poverty line. The government offers universal healthcare coverage, however funds are not enough to cover the entire population. Only 50% of Peruvians with chronic health issues receive any sort of treatment. The Children In recent years, Peru has made important advances towards improving early childhood healthcare and outcomes. According to UNICEF, prenatal care and attended deliveries have increased significantly during the last decade, reducing infant mortality and infection rates. The Mission As a result of a meeting through the Rotary Club of South Pasadena, Mending Kids joined forces with Dr. Luis Vasquez of the Chicago Rotary Club, who was overseeing the build of a large hospital in the remote area of Yantalo Peru. Last year, general surgeon Dr. Dean Anselmo and anesthesiologist, Dr. Brian Kim, led a team to perform pediatric surgeries for children who had been waiting years for surgical aid. When the team arrived, they learned that the new hospital was not ready for them, so in a pinch they enthusiastically traveled a few more hours to operate an a different hospital for the week. This year, the same doctors are returning and are looking forward to getting settled into the new hospital in Yantalo. They will not only be performing upwards of 40 surgeries in one week, but will also be training local surgeons and medical staff to educate them on specialized techniques and aftercare.Learn More
Where in the World Mozambique is located northeast of South Africa on the Indian Ocean. It is a nation of 21 Million people, 14 million of which are children. A former Portuguese colony, the nation gained its independence in 1975. As a result, the majority of the Portuguese population suddenly deserted the country, erasing public service and infrastructure. Once a destination for wealthy South African travelers and globetrotters, and known for its breathtaking coastline, Mozambique fell into a civil war between 1977 and 1992. A million lives were lost and this beautiful country was devastated. For over twenty years, Mozambique has been struggling to rebuild its infrastructure and replenish the ranks of medical and educational professionals. To complicate things, the recent discoveries of vast natural gas fields has infused the nation with enormous amounts of cash, none of which seems to be immediately earmarked for pediatric health care. However, Mozambique is determined to regain a care system, and so Mending Kids is working to train the few native doctors in Maputo. The Children As a result of extreme poverty, young children are often left unattended for long periods of time while parents leave home to seek a subsistence lifestyle. Young children are often left to care for even younger siblings and babies. Since most heating and cooking is done over an open, indoor fire, it is common to see young patients show up with massive, scalding, third degree burn wounds in the winter months of June, July, and August. If they survive, their wounds often go untreated for days to months. The Mission The current burn surgeries offered at the Hospital Centrale in Maputo, Mozambique often lead to amputation rather than reconstruction, due to the disfiguring and scar tissue buildup. The shortage of supplies often have these children waiting months for their surgeries. With the leadership of Dr. David Kulber of Cedars-Sinai Medical Center, our annual Mending Kids mission to Mozambique tries to mend these children while also training the only local pediatric plastic surgeon, Dr. Celma Isufo, in advanced surgical techniques and proper post-op care. To hear about the Mending Kids Mozambique Mission from Dr. Kulber himself and how he is using Google Glass technology to improve surgical care abroad, follow this link to The Doctors show: http://thedoctorstv.com/videos/google-glass-for-virtually-guided-surgery This is the first ever surgical mission that anyone has ever used Google Glass for, and we are proud to use them to better the medical practices in developing countries. Progress and Goals Working in Mozambique and operating out of the HCM, we have gained an important understanding on how to better train the local surgeons and medical staff more effectively in future missions, given their severe lack of supplies, equipment limitations and thirst for specialty basic training. Also, thanks to Dr. Judith Brill, our anesthesiologist and Pediatric Critical Care Specialist, who gave a lecture and review on the safety steps required in anesthesia and the importance of the surgical team communicating effectively with the PACU (the operating room to which surgical patients are taken for nursing assessment and care while recovering from anesthesia). The residents and medical administrators were so impressed with her presentation; it is their hope she returns to lecture over a longer period of time. Our goal in laying a foundation for future missions to the HCM would be to have a specific training focus on fundamental plastic surgery training to reconstruct acute burn wounds, the seventh leading pediatric cause of death in the country (AIDS and Tuberculosis being the top two). Our hope is to make great strides at self-sustainment in burn treatment in Mozambique while making many more of these surgeries available to desperate children, all while gaining the trust of local surgeons and empowering them to provide these procedures confidently. Ideally, and hopefully in the near future, the government will see the need and be encouraged to build a dedicated pediatric surgery ward so that more children may have quicker access to surgery, rather than having to compete with the medical needs of the adult population. Only through awareness and positive results from missions may this goal become a reality.Learn More
Mission: Costa Rica
Where in the World Costa Rica, located on the Central American isthmus, borders Nicaragua, Panama, the Pacific Ocean, and the Caribbean Sea. Widely recognized for its varied wildlife, Costa Rica has beautiful landscapes filled with forests, mountains, volcanoes, beaches, and rivers. The population of Costa Rica is about 4,300,000 people, a quarter of whom live in the metropolitan area of the capital, San José. Despite the fact that Costa Rica has one of the highest standards of living in the Americas, profound poverty still affects many people at the bottom of the socioeconomic ladder. Costa Rica’s poverty rate of 20-25 percent has remained the same for nearly 20 years. Poverty in Costa Rica is especially observable in rural areas and in certain parts of San José. Healthcare in Costa Rica The National Health System covers all medical needs of the Costa Rican population. The quality of healthcare in Costa Rica is considered to be one of the highest in Latin America. However, given the long waiting times for appointments (it can take months to see a doctor or undergo surgery), many residents choose a private hospital where appointments are more easily available. Private hospitals incur higher hosts for the patients and families than public health services. Currently, there are about 30 public hospitals and 5 private hospitals in Costa Rica. The majority of private hospitals are located in San José. The Children Following recent improvements to medical care, Costa Rica now has the longest life expectancy in Latin America. The Code for Children and Adolescents states, “all minors will benefit from medical care directly and freely from the State.” Despite a very effective health system, 10% of children die before reaching the age of 5 due to infections and other health problems. The main problem faced by children in Costa Rica is poverty. One in four children live below the poverty line. In addition, child labor continues to be a challenge in Costa Rica, with 21% of child laborers not attending school. According to the United Nations Children Fund, 36,000 children in Costa Rica are orphans. The Mission In partnership with Colorectal Team Overseas (CTO), led by Dr. Marc Levitt, Surgical Director, Center for Colorectal and Pelvic Reconstruction, Nationwide Children's Hospital, our international team will be traveling to Hospital Nacional de Niños in San José, Costa Rica to train local pediatric surgeons as well as surgeons from all over Latin America. In addition to a surgical training conference on complex colorectal and anorectal surgeries, Dr. Levitt and his team, working alongside local surgeons, will operate on dozens of children requiring this advanced care. The team also includes advanced nursing care for the bowel management and wound care these children need post-operatively to be successful long term and to maintain independent bathroom habits.Learn More
In connection with the Trauma and Women Child Hospital in Ulaan Bataar, Mongolia, Dr. Robert (Matt) Bernstein and Dr. Evan Zhan, from Cedars-Sinai Medical Center will be traveling for the first time to Mongolia to provide orthopedic and interventional cardiac catheter training, respectively, to local surgeons at the hospital. This medical center is very remote and serves a vast area in Mongolia.Learn More
Where in the World China is the world’s most populated country, with a population of over 1.35 billion. China houses people of 56 different ethnic groups. About 17% of the population are children under the age of 14 years. Luoyang is located in Central China and is one of the four great ancient capitals of China. It has a population of about 6,500,000 people, most living in urban settings. The city is famous for the Longmen Grottos and its cultivation of peonies. Healthcare in China China’s rapid economic growth has pulled hundreds of millions of people out of poverty since 1978. Currently, 10% of the population lives below the poverty line. As of 2011, 95% of China’s population has basic health insurance coverage and there have been many improvements in health. However, due to the country’s high population density, public health problems such as respiratory illnesses and serious infectious disease outbreaks are an ongoing issue. The Children Every year about 900,000 children are born with congenital anomalies in China. According to the Ministry of Health, the birth defect rate has increased by 70% from 1996 to 2010. With this increase in children being born with birth defects, there has also been an increase in the abandonment of these children. Many who survive live in orphanages. Anorectal malformations (ARMs) are one of the most common congenital anomalies seen, yet research does not yet know why. ARMs occur when a newborn’s anus and rectum (the lower end of the digestive tract) has not developed properly or is sometimes completely absent. Children with such malformations are far less likely to find adoptive families in China than other orphans. A child born with an imperforated anus is considered the worst curse on a family, one that carries on for generations. The Mission The Mending Kids mission to China is all about hope, love, and mending children’s lives under the leadership of Dr. Phil Frykman and Dr. Keith Kimble of Cedars-Sinai Medical Center in Los Angeles. This mission exemplifies our ongoing commitment to sustainability by partnering with local surgeons who are interested in learning both open and minimally invasive procedures to correct anorectal malformations. Since 2011, Mending Kids has transformed the lives of 50 orphans in Luoyang, China who otherwise would have remained unadoptable because of their congenital birth defect. All of the ARM children on our mission are orphans living in the care of Maria’s Big House of Hope. They all are living with colostomies performed emergently in the first few days of life to relieve the obstructed colon. Unfortunately, all of these ARM children have little to no hope of being adopted without the corrective surgeries we provide. However, with the success of our sustainable colorectal surgical program over the last 4 years, 50 orphans have received surgeries and 12 of them have been adopted into loving families with a chance at a healthy life! Progress From training one surgeon in a private operating room to now performing surgeries out of Luoyang First People's Hospital, we are giving half a dozen local pediatric surgeons the opportunity to participate and lead laparoscopic procedures to correct ARMs. This past year we worked alongside the Luoyang Women's and Children's Hospital in partnership with Dr. Zhai, Dr. Yang, and their pediatric surgical colleagues. Through an exchange of knowledge and experience, Mending Kids participated in a Regional Pediatric Teaching Conference, utilizing the latest telemedical and live-surgery support, broadcasting several surgeries to young and mid-career pediatric surgeons throughout the region. The conference drew a large audience, raised awareness, continued building trust and culminated in a new declaration by the Chief of Pediatric Surgery. Dr. Yang announced, "We will no longer council parents of newborns with complex ARMs to take their babies home to die, because we have nothing to offer them. We now know how to repair these conditions and can offer infants not only life-saving procedures, but a good quality of life, thanks to the training your team has provided for us." The Pena stimulator and the new, lower-cost Frykman/Kimble stimulator were both developed as a result of past missions. These tools are muscle stimulators for the anal sphincter (also known as an anal “wink”), necessary to find the exact point to correct an imperforated anus. The Frykman/Kimble stimulator, developed by the Global Pediatric Surgical Technology & Education Project (GP STEP), proved its value in making ARM surgeries more affordable in China. This inexpensive, simple tool could be made available to local surgeons in China and aid thousands of children in giving them a chance at a healthier, more active life. Of equal importance, post-operative bowel management care, which is critical to the recovery of these young patients, was also taught and emphasized at the conference, with the participation of Janet Kimble, RN, an expert in the field and a veteran of dozens of missions with Mending Kids. Her instruction manual was also translated into Mandarin.Learn More
Our Four Core Programs
Kids with complex cases are provided transportation and are aided by our partner hospitals in India, Israel & Canada.
Surgical teams and volunteers travel to developing countries to perform surgeries and build sustainable programs.
In the span of one day, there are up to 20 free surgeries performed by volunteer surgeons for American Kids.
Kids from outside the United States are flown here for complex surgeries and stay with volunteer host families.
Who We AreMending Kids provides life-changing surgical care to children worldwide. Over the years, thousands of children have received corrective, transformational surgeries that have given them a chance at longer, healthier and happier lives. Most of the surgeries we perform are to correct congenital heart defects, orthopedic abnormalities, severe scoliosis, and significant cranial facial deformities.
Words cannot express my feelings nor our thanks for all your help. You are all a blessings to our family. You are all in our hearts forever and we treasured the moment you are there for us in time of our difficulties. My heart feels with joy and happiness that there are kindhearted people like you who value life and a helping hand to those in need and a HUMAN ANGEL to Heinrick's life.- Heinrick's Mom, Philippines
My heart is so full of joy that l don't even know what to write anymore. God bless you, your team and all those that donate to make this possible.- Joshua's Dad, Nigeria
Thank you so much and Mending Kids, at large. May God bless you so much for giving my child hope and live a new life as other people.- Susan's Mom, Uganda