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Children of the Americas: Medical Care for Guatemala

Every January, about 110 American and Guatemalan doctors and other personnel pay their own expenses for the privilege of practicing medicine for a week in Guatemala, where the temperature is 100 F and there is no air conditioning. Each doctor sees 60-70 patients a day. The surgeons perform some 150 surgeries during the week. This is the annual outreach of Children of the Americas (COTA), a nonprofit organization headquartered in Lexington. It is believed to be the largest surgical team involved in international medical relief in Guatemala.

Jody Greenlee, Lexington pediatric nurse, wife of Lexington surgeon Dr. Thomas Greenlee, and vice-president of the COTA board of directors, says that six University of Kentucky Medical Center doctors are on the board, including current COTA Board President Dr. Carol Cottrill, a pediatric cardiologist who has worked at the UK Medical Center for 30 years. They and others spread the word and recruit doctors. COTA does dental work, prosthesis, orthotics, and various medical specialties for women and children.

Non-medical team members include those with translation skills and logistics planners. “You have to have somebody willing to stand out in the heat and the sun and handle the crowds,” said Greenlee. The first day the COTA team is working, thousands of people show up at the gate. Some have waited outside for days. One hundred at a time are allowed in to be triaged, and medical decisions are made about who needs most urgent care. Other team members are bus drivers and an electrician who rigs up lighting in the dimly-lit operating rooms.

Rosemary Vance, a Staff Attorney for the Administrative Office of the Courts, is Executive Director of COTA. Vance will travel to Guatemala in June to research four to six hospitals, selecting one whose management will agree to let the hospital be taken over for the one week that COTA is in Guatemala in January, 2014. The hospital must be located in a town where there are enough hotels to house and feed the volunteers. Vance also coordinates the medical teams so that team members can work together smoothly.

Next January, an advance team of 15 people will go to Guatemala five days early. Their setup work enables the doctors to hit the ground running. The rest of the American team flies into Guatemala City where the advance team meets them. Typically about 100 team members are from the states, the rest Guatemalan.

“The entire team works in hard conditions,” says Greenlee. “A sense of camaraderie develops and it creates a sense of kinship.” She adds that 80 percent of COTA’s volunteers want to return each year.

COTA doctors see all kinds of ob-gyn problems and much pediatric malnutrition. Cleft palate is a very common defect. In the primitive conditions of rural Guatemala, this can be fatal. Babies whose lips, because of a cleft, cannot form a good seal around the mother’s nipple, cannot nurse and often starve to death. Although cleft palate can be caused by a folic acid deficiency, there is a strong genetic tendency to the condition in Guatemala. The country is the size of Tennessee, but in that relatively small area, 27 dialects are spoken. Many people do not speak Spanish, and there is little travel between villages. The same gene pool passes the defect down. Greenlee, who has been to Guatemala 17 times, reports seeing families with four or five babies all with cleft palates.

Many surgeries are successfully carried out in Guatemala. However, some children are brought back to the States for more complicated procedures. Greenlee mentions a 12-year-old girl with third degree burns, who was brought to the Shriners hospital in Cincinnati. Greenlee has been working since January to complete the paperwork necessary to bring a one-year-old baby born with a closed rectum to New Jersey, where a specialist has agreed to do the complex surgery necessary to build the child a functioning rectum.

Children brought to the States are placed with carefully-selected foster families who are paid nothing for fostering a medically fragile child. The Guatemalan government prohibits parents from traveling with the child.

COTA, a 501(c)3 nonprofit organization, was founded by Judy Schwank, wife of Guatemalan neurosurgeon Dr. Bill Schwank, in Bowling Green, KY, in the 1980s in the wake of a massive earthquake that hit Guatemala. “There is no paid staff at all,” says Greenlee. “To last this long…says a lot about the integrity of the program.”

The COTA website is www.childrenoftheamericas.org. They welcome inquiries.

By Martha Evans Sparks, Staff Writer

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