First Looks - Assessing the need
April 1, 2000 9:20 PM Barcelona, Venezuela

The hallway in the basement of Dr. Luz Razetti hospital erupted into applause as the team of 20 volunteers from Operation Rainbow made their way to a small room which doubled as reception hall and assessment room. Waiting for the team were potential surgical patients and their families. The expectant looks from each expressed the hope that the visiting doctors, nurses, and lay volunteers would provide change in their lives by repairing the deformities and birth defects.

The group will perform surgeries on two types of patients: orthopaedic patients and plastic surgery patients. Orthopaedic patients are those with deformities of skeletal system. Often these are "club feet" or other bone malformations at birth. The plastic surgery team will repair deformities of the skin. Most often these are cleft lips and cleft palates.

A mother holds her child as they wait to meet doctors from Operation Rainbow. The young child has a cleft lip under the tape

While the incidence of cleft lips is about 1:700 in the United States, it is at least twice that in most developing nations. The reason for the higher incidence is many things including family genetics, poor nutrition and environmental influences.

The initial day of the mission was filled with the unpacking of the supplies while the doctors reviewed the candidates for surgery. The local doctors screened 51 orthopaedic candidates and 132 plastic surgery candidates. When the orthopaedic team reviewed their cases, they selected 33 of the 51 patients reviewed for surgeries. Then, when they completed their scheduling, a second group of patients was identified and assessed. "The reason that happened is in the U.S., orthopaedists do every thing. Here they are divided into groups: trauma and orthopaedics," explained Laura Escobosa, program volunteer coordinator for the orthopaedic team. The structure of the orthopaedic specialty is different in the United States and Venezuela. In Venezuela, there is a separate specialty called traumatology which handles trauma.

The orthopaedic staff plan their surgery schedule for the week. From left, coordinator Laura Escobosa, Dr. Rick Coughlin, Dr. Bobby Satcher, talking with nurse anesthetist Ricardo Charles.

"When we told them what we wanted when we looked at the cases on the (trauma) ward they said-oh you want to do those, too?," Escobosa said.

The local doctors were appreciative that Operation Rainbow volunteers were willing to take on additional cases during this trip.

"Some of the most interesting cases--the most urgent-- are the ones we saw on the wards. In total we have 40 cases," Escobosa said.

Assessments for both orthopaedic patients and plastic surgery patients began shortly after 10:00 AM and continued until just before 8:00 PM. A portion of the day included scheduling the patients and coordinating the needed medical supplies with the needs of each patient.

The orthopaedic surgery decision is based on three criteria. "Basically it depends on a couple of things," Escobosa outlined, "it has to be a one stage case -- where one surgery can correct the problem and follow-up can be done by the local doctor." Since many of the patients travel hundreds of miles, their access to follow up care may be limited.

Dr. Richard Bosshardt examines a patient during the initial screenings as Kurt Monbloch -- a volunteer dentist at Hospital Razetti, looks on.

"The second thing depends on whether we have the equipment or it is available in the hospital. For example there is a case we would like to do, but there is no fluoroscope (a specialized kind of x-ray) so the case can't be done." "The third thing is, if we don't have the right hardware. There's a lot of hardware--screws, plates and rods--that are inserted in the bone to hold it together." Escobosa says that hardware is very expensive and it is often unique to a certain size of patient or kind of deformity.

Plastic surgeon Dr. Steve Drew carefully examines a patient candidate.

"It is very specific. You can't fake it. You can't modify it -- if you have a little child and you need a small rod, you can't a make a small rod from a big rod. When you go to the OR, you don't know what size screw you need until you are actually doing a case. You have to have the whole set available and sterile," Escobosa explained.

A young girl opens her mouth wide for an examination. Many children being seen by the doctors have congenital deformities in their mouths.

Nurse anesthetist Ricardo Charles, interacts with a patient during Friday's assessments

Delivering the instruments of change
March 31, 2000 6:44 PM Barcelona, Venezuela

Operation Rainbow's mission to Venezuela hit the ground at 8:54 PM Thursday local time, arriving at Simon Bolivar airport in Caracas. The team then transferred to a military C130 for a short flight to Barcelona, on the northern coast of Venezuela. [. . . read more . . . ]

The Universal Language of Caring
F.R. "Fritz" Nordengren - Project Producer

Welcome and thank you for taking time in your life to share the stories contained in this site. What you are reading is the result of work begun in August, 1999 in Armenia. During the mission there, the idea for this site was born.

Now, though the cooperation of the project sponsors, and my fellow producer Tom Burton, we are able to bring our work and the work of Operation Rainbow to you via the web.

This web site gives you, the reader, a chance to participate in a mission to heal children in Venezuela. While you may not be able to attend in person, what you will read here are the thoughts, reactions, and observations of the events, as they unfold. Once or twice each day, the project participants will publish new stories, photographs, and interviews with the team members, patients, and families making this project possible.

The people who you will meet and get to know come from a variety of backgrounds, nations, and families, yet all share a common language . . . the language of caring. We look forward to having you with us March 31, - April 8, 2000.