Trip 19 Cap Haitien, December 2009

Once again we return from another busy week at the Justinien University Hospital in Cap Haitien. As usual we had a busy clinic on Monday evaluating all types of problems many of which are rare and challenging. The following 4 days and nights are filled with operations. We come prepared to treat just about anything in spite of the relatively primitive conditions. Most of the patients we treat have no other options and would often be left to a life of disability. Even after many experiences in Haiti the people and the conditions encountered leave one in awe of the human suffering and motivate each one of us to try and do more.


Due to the regularity of our trips every 3 months we are able to provide relatively reliable follow up care in addition to what the local doctors help us with. It was exciting to see Chantale the 6 year old girl who previously was unable to stand up straight due to severe burns that she suffered after sitting on a kerosene lantern when she was 4 years old. During our last trip she was operated and her hip flexion contractures are resolved. She awaits release of her right shoulder and elbow on our next trip March 8, 2010.

A special thanks to Dr. Wade Faerber (orthopaedic surgeon), Dr. Matt Klima (orthopaedic resident), Dave Tunon (Synthes) and Andy Magan (anesthetist) who came from California to participate in this trip along with Dr. Scott Nelson and the CURE Dominicana team.

Spinal Deformity CURED

In order to provide the state of the art care to our patients who suffer from scoliosis and other spinal deformities an entire team is orchestrated consisting of experienced surgeons and nurses, experts in anesthesia, a neuromonitoring technician, an implant vendor, and pediatric intensive care doctor. Each plays an important role in the overall process and the quality results that are obtained. Thanks to the generosity of Biomet Spine and several people who have donated their time for children in the Dominican Republic we were able to again realize a successful week of spinal deformity surgery. Our goal is to give even the most economically challenged patients the opportunity to have a surgery that is equivalent to what is performed in the best medical centers in the United States. Thank you to Dr. Ray Woo, Dr. Henri Acosta and each of the important team members that helped make these life changing surgeries possible.

Limb Deformity Course CURE Dominicana

Date: 25 January 2010
Time 8am -6pm

Course Directors:
Scott Nelson MD
Medical Director CURE Dominicana
Santo Domingo, Dominican Republic

Shawn Standard MD
Rubin Institute for Advanced Orthopaedics
Baltimore, Maryland USA

Sponsored by CURE Dominicana with participation of Dr. Micaias Perez, Dra. Honna Silfa, Dr. Cesar Coradin

Cost: 3000DOP (discounts available for residents)


Preliminary Agenda:
Basic Limb Alignment
Basic Deformity Analysis
Blounts Disease
Bone Transport
Knee Contractures
External Fixation Workshop

Please call 809-682-5022 for more information or email Robbie Jackson at j_robbie@hotmail.com

Trip 18 Cap Haitien 21-26 Sept 2009

Chantale is a 6 year old girl who was badly burned last year when she sat on a kerosene lantern. Our hearts were saddened when we saw her for the first time last February. Due to the scarring she was unable to stand up, separate her legs or move her right shoulder and elbow. Her caring mother brought her again in June I promised that I would do something when I returned in September, not knowing if I would have the help I needed to do the case. Fortunately we were joined by Dr. Duncan Miles a plastic surgeon from Loma Linda University. After 5 hours of surgery we were able to excise the scars around the hip joints and rotate some normal tissue into place allowing her once again the freedom to stand up. The following morning I asked her how she felt and from under her mosquito net she replied “Sa va bien et toi monsieur?” In one of our future trips we will plan to release her shoulder and elbow contractures allowing her the use of her right hand.

We were joined on this trip by Dr. Brian Yost one of my orthopaedic surgery partners from Riverside County Regional Medical Center. He also brought with him Louise O’Rourke RN director of operative services and “Dr. Sagoo 2” one of our excellent ortho residents training at RCRMC. Their expertise, help and donations greatly added to our efficiency, quality of care, and international comraderie. As usual our Dominican anesthesiologist and 2 nurses were on fire from early in the morning until the late hours of the night.

We are progressing with plans to transition our quarterly trips into a more sustainable program that will involve several surgeons who are committed to making regular trips to Cap Haitien which will continue with the same frequency. We are planning the construction of some extra operating and storage space which will facilitate volunteers to provide services independent of our Dominican team and the armamentarium of equipment that we haul back and forth from Santo Domingo for each of these trips.

Our next trip will be Nov 29-Dec 12, 2009.

Announcing Release of Tolerances 3rd Ed.

This 100 page orthopaedic pocket book that offers invaluable information for orthopaedic residents and practicing orthopaedic surgeons. It is a comprehensive collection of acceptable ‘tolerances’ for fracture alignment as well as other essential numeric data that should be at the fingertips of orthopaedic surgeons. As Einstein said “don’t memorize anything that you can look up”. It is concisely referenced to major orthopaedic textbooks and landmark articles. Click the cover images to order your copy on amazon.com. This publication is not affiliated with CURE International and all proceeds benefit the Loma Linda University orthopaedic residency program.

Haiti Trip June 1-5 2009

Trip 17. We return every 3 months to Justinien University Hospital in Cap Haitien. As the major referral center for all of northern Haiti there is never a lack of work. The only orthopaedist in the region is planning to retire in the near future and many languishing patients are accumulating without resources or hope for urgent operations. Because of our commitment to quarterly visits we are able to provide adequate follow up for much of the work that we do. In spite of seeing many suffering patients we were encouraged to see some of our patients whose lives have been changed one by one due to our efforts, our supporters, and most of all God's healing touch.


Elena a 4 year old girl before and after surgery for severe clubfoot performed Dec 2008



Loudwige (R) with her sister after having an 85 degree scoliosis curve operated at CURE Santo Dominogo

Mirana a 12 year old girl with cerebral palsy walking for the first time after having severe knee flexion contractures corrected during our last trip.



A 5 year old Haitian boy after having bilateral "ulnarization" procedures performed for radial clubhand.




A mother with her baby cured of his clubfoot after serial Ponseti cast treatment and a minor operation



Dr. Ed O'Laughlin (Baltimore, MD) teaches Haitian resident anesthesia techniques as he puts another patient to sleep.

41 patients were operated during this trip. In spite of operating day and night, unfortunately many patients still had to be turned away.

Subsequent 2009 trips are scheduled for Sept 21 and Dec 7.

Haiti Trip Feb 15-21, 2009

For more images see http://www.pbase.com/scottnelson/haiti_recent

In spite of 16 trips to Haiti the needs are not declining… This trip we were privileged to have the expertise of Dr. Jim Matiko one of my previous professors from residency at Loma Linda University as well as Geordy a senior orthopaedic resident from New York City. Even more noteworthy than us 3 “gringos” are the 3 Dominicanas – two nurses and anesthesiologist that can worked tirelessly into the morning hours on multiple occasions this past week. Their unwavering devotion, loving attitude and efficiency are an inspiration to all.

Working with other surgeons is a rare privilege in the states, but in the DR and during these trips to Haiti it has been a great opportunity for me to join with colleagues continue my quest for learning. It is especially a privilege to work with a former professor. He always taught all of us residents to be “lazy surgeons”. In reality “lazy surgeons” are perfectionists. The principle is that you must do it right the first time so you don’t have a complication that will create extra work. In Haiti this is especially important as many of our patients get very little follow up. Thus, each case is started with a prayer and with God’s helping hand we consider each operation a sacred event and don’t compromise on anything.

There are few experiences in life that are more gratifying, however, that is not why we do it. The gratification I simply pass on to the donors, our CURE support staff, and my family for the great privilege of helping these people. More importantly, the exchange of love in this environment of raw suffering is a call to action. The old man in bed 17 who called out to us to fix his femur every time we walked by, the little boy with the elbow fracture who smiled and thanked us as he awoke from anesthesia are just a couple of the reasons that we continue into working into the late hours of the night on these trips. Hopefully this call to action will continue remind all of us of the importance of serving those less fortunate, no matter where we are in our walk of life.

A New Required Rotation? Matt Hiersche LLUSM4

I’m currently a 4^th year medical student at Loma Linda University with a rich history of overseas medical missionary work and an extensive international network of hospitals that accept visiting students. Why then, did I choose CURE International for my first away rotation in my senior year? I think that a statement one of my friends made in a recent email summarizes my motivation well. She said, ‘I’d love to work internationally, but as an anesthesiologist, I wouldn’t want to spend five years abroad using halothane and ketamine, watching my skills deteriorate in an international setting. How can I come back to the States later and feel comfortable working at our level again?’ Unfortunately, these doubts seem to permeate certain segments of the medical community. But might there be a cure?

Upon my return to the States and my regular studies, I continually found myself explaining my experience in the DR in one emphatic command. “If you’re interested in medical mission work, particularly surgical,” I kept exclaiming, “Then my month in the DR with the Nelsons should be a required rotation!” I, along with many of my friends, had long suffered under the false impression that following God’s command to serve His children abroad would simultaneously mandate that we regress in our level of medical care. What kind of vision of God is that, though? In finding CURE, I found an institution that believed in the God given directive of “providing the best care in the world for the least of the world.” In keeping with this vision, the CURE for my friends and me suddenly became clear. No longer would a first rate education generate a second rate level of care. No longer is it necessary to languish with only halothane and ketamine, while our skills deteriorate in “God’s service.” It is not our expectations or our level of care that needs to change when considering medical mission work as a future. It is our vision of God that needs to change. When we feel the call to serve, we must believe that God will provide a means by which we might serve at the level of His desire – that is at our best.