Day off

Darel before surgery

I had the day off yesterday and took the opportunity to visit one of my patients. His name is Darel and he's a 15 year old street kid. When he was 8 years old he fell out of a tree and broke his arm. It later became infected and although his mom took him to the hospital for treatment, they weren't able to fix it. He had 2 surgeries over the next 2 years, but both ended in terrible contractures. Some time after that he left home to live on the streets and take care of himself. I don't know much more about his past because it's still difficult for him to talk about, but I've heard similar stories in the past. When a person has a deformity like Darel's it can be difficult not only for them but for their family and friends as well. Often they are put out of their homes and abandoned. I don't know if that's what happened to Darel, but it wouldn't surprise me. Anyway, a local NGO that helps get children off the street found him this last year and brought him to our main screening in September and kept him at their center until it was time for his surgery in January.

during a dressing change onboard

Darel's surgery onboard wasn't an easy one and had to be done in two steps. Step one, the surgeon did a groin flap where he took a flap of skin and muscle from the groin area and attached it to the wrist/hand after releasing the contracture. It takes several weeks for a flap to get a good blood flow in the new area so it stays attached to both the old and the new site for 3 weeks. What I'm trying to say is that this boy's wrist was attached to his groin for 3 weeks. I've seen many facial flaps since I've  been here, mostly scalp flaps to the nose, but this was the first groin flap I've seen, and yes, it's as uncomfortable as it sounds.  Darel handled it like a champ though, and never complained. Three weeks later the surgeon released the flap and we began daily wound care on him. He had a few set backs along the way but last week we celebrated with him as he left the ship that he called home for 2 months and went back to the NGO center.

So yesterday I got to visit the center and check up on Darel. He's doing so well and was excited to show off his home and the people that take care of him. We took him to the local barber for a haircut, got sodas in the market and spent the afternoon visiting. It struck me as we sat there how much more like a boy he looks now. Darel has had a hard life, but instead of the hospital aging him even more, it seems to have given him back a bit of his youth. He wants to have a girlfriend, play football (soccer), go to school...and I believe he'll have all of those things and more one day. And what a blessing it's been to take part in his healing!

 

before

after