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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF Jan. 6, 2012 Issue | Archived Issues

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A New Chance for Hope

Cedars-Sinai Surgical Team Travels to China to Treat Children Abandoned for Medical Reasons

At Maria's Big House of Hope, a medical foster home in central China, 140 orphans wait for families who may never come. Available for adoption because each has a birth defect or a serious medical condition, these special-needs children struggle with the reality that their chances for adoption are slim.

It's complicated in China, where the low rate of adoption of Chinese orphans by Chinese families makes it challenging for the boys and girls at Maria's Big House of Hope to be adopted in their home country.

But for some of those children, the future became brighter as a team of doctors and nurses, most from Cedars-Sinai, arrived at the orphanage in the city of Louyang in November. Organized by Mending Kids International, a Burbank-based nonprofit, the 16-member team flew to China to perform pediatric surgeries and to teach the procedures to the local medical staff. Led by pediatric surgeon Philip Frykman, MD, PhD, the Cedars-Sinai contingent included pediatric anesthesiologist Keith Kimble, MD, as well as Janet Kimble, RN, Scott Short, MD, a surgical resident , Jennifer Ross, RN, a pediatric ICU nurse, and Claire Esguerra, LVN, a surgical technician.

"We were there to work with children with anorectal malformations, all of them abandoned within days of being born," Frykman said. The bias in China against physical deformities can sometimes lead families to believe that children who have anorectal malformations might bring bad luck to the family. (Pictured left: Dr. Kimble preps patient for anesthesia)

Children with these malformations who don't receive care soon die of sepsis or malnutrition. The lucky ones receive treatment such as a colostomy, and then go to one of China's orphanages. Adding to the gravity of the situation is the fact that specialized pediatric surgery is a rarity in China.

"The kids just accumulate because no one there knows how to do pull-through surgery on children, or if they do, the financial hurdles are too great," Frykman explained.

That all changed for a dozen or so children at Maria's Big House of Hope. Named in honor of the late Maria Sue Chapman, a Chinese orphan adopted by an American family in Tennessee, the facility is a light and bright building that is part of the New Hope Foundation, a U.S. charity. Once the Cedars-Sinai team toured the building, they helped unpack dozens of bags of medical gear and supplies, and then got to work.

Prior to arriving, Frykman conferred with the foster home's doctor, an American general practitioner, and with Dr. Zhai, a local surgeon. The trio selected the best candidates for surgery. Once there, Frykman and the team handled 11 cases in four days, including hernias, anorectal pull-through surgery, colostomy repairs and several emergencies.

"Dr. Zhai scrubbed in with me on every case, and I taught him how to do the pull-throughs," Frykman said. "He was very interested and very thankful, not just for the work we were doing, but for the training as well."

The orphanage is tucked into the strangest of spots - at the far edge of the city of more than one million, between an insane asylum and a prison. Despite a large and caring staff, the work was challenging, said Janet Kimble, RN, a CN IV at Cedars-Sinai's Maxine Dunitz Children's Health Center and a pediatric surgery specialty nurse.

Cedars-SinaiUnlike U.S. operating room tables, which can be raised and lowered, the OR table in the orphanage was fixed at a low level, Kimble said. The nurses were able to improvise ways to raise the tiny patients so the American doctors, all taller than six feet, could operate without hunching over for hours at a time.

By the time the Cedars-Sinai team left 10 days later, the fate of 11 of the tiny patients had greatly improved. Dr. Zhai, who had assisted in all of the surgeries, also had "graduated" by performing one on his own.

"We went in with three goals," said Frykman, pictured at right with the first patient of the day. "To perform high-level reconstructive pull-through surgery for these kids, to help train the local surgeon, and to establish a relationship between Mending Kids International and the facility to see what we could do in the future."

The only complication in 10 days, other than the occasional language barrier, was one minor post-op infection. Otherwise, the mission was a success.

"It was a great experience, and it reminds you of the reason you went into health care," Frykman said. "There's no bureaucracy, no dealing with health insurance. It's just the wish to heal, and the patient in front of you."