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Mission: China October 18, 2015

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.Read more


Mission: Tanzania November 29, 2015

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. The Mission This inaugural Mending Kids ARM mission to Mwanza will take place from November 29-December 5, 2015 in collaboration with the surgical team from the Colorectal Center at Cincinnati Children's Hospital and the Bugando Medical Center. This mission will be led by pediatric surgeon, Dr. Jason Frischer. The goal is to provide life-changing surgeries for up to 15 kids, including training for local surgeon, Sister Dr. Alicia Massenga. There are currently hundreds of children at the center with complex colorectal malformations who are awaiting surgeries. Goals Short term: 1. Mend a dozen children requiring complex surgeries to help Sister Dr. Massenga gain more skills and confidence. 2. Train nurses on bowel management and post-operative care for their patients. Intermediate term: Collaborate with other mission teams to have a steady flow of surgeons travel to the Bugando Medical Center throughout the year to keep up the doctors' training. This will not only empower Sister Dr. Massenga but also encourage the Bugando Medical Center to allocate more funds for pediatric congenital colorectal care. Long term: Establish a successful colorectal program in Tanzania so that children from all over the country and region can be referred there for safe, life-changing surgeries.Read more