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The day after a total knee replacement, 50-year-old Isabela didn’t just get out of bed and walk. She did steps for the Marenga by her bed and continued to progress so much that she was dancing through the halls of the Plaza de la Salud Hospital in the Dominican Republic within a week.
Isabela was one of 37 patients in the Dominican Republic who received total hip and knee replacements from a group of 30 BWH volunteers with Operation Walk in April. BWH Chief of Orthopedic Surgery Thomas Thornhill, MD, leads the Boston group of the national organization Operation Walk. Under his leadership and the coordination of Roya Ghazinouri, PT, DPT, MS, the BWH-based volunteer team plans to make this mission to the Dominican Republic annual.
“Our first visit was very successful,” said Ghazinouri, BWH’s clinical supervisor for Inpatient Physical Therapy. “The patients were extremely grateful and excited to have this surgery, which dramatically improved their quality of life.”
The team of surgeons, anesthesiologists, nurses, physical therapists, technicians and others operated on patients who could not afford surgery and were severely debilitated because of their disease or injuries. One young woman, a student, was not able to sit straight because of limited range of motion in her hip. Another young man in his 30s, with six children, limped because of a traumatic hip-spine injury. One woman suffered a hip injury so severe that she could not separate her legs.
“All of the patients, after receiving hip or knee joint replacement, were able to walk more than a thousand feet by the time we left,” Ghazinouri said. “That’s a tremendously quick recovery for this type of surgery.”
Patients began physical therapy two to three times a day on the day after surgery, and most were able to leave the hospital two to three days after surgery. “We did a lot of teaching for patients and their families so they could continue their exercises at home,” said Carolyn Beagan, PT. “They were so willing to work hard at recovery. The patients weren’t having surgery to fix the pain, but to begin their lives again.”
Operation Walk’s success depends on local advocates who help with all aspects of delivering care. In the Dominican Republic, Dr. Luis Alcantara Abreu spent long hours coordinating operations, visiting patients and staying in the hospital after the volunteers left each day to ensure goals were met and everything was prepared for surgery the next day. Alcantara and his associates evaluated more than 100 people preoperatively to create a list of potential patients for Operation Walk.
He also mobilized a large group of local bilingual volunteers to help Operation Walk members communicate with and manage patients, and he continues to follow up with patients and inform the team of their progress. “Luis is our angel there,” Thornhill said. “He is invaluable surgically and logistically, and it would be very hard to do this work without him.”
Operation Walk Boston was connected with Alcantera through BWH’s Amado Alejandro Baez, MD, of Emergency Medicine, a native of the Dominican Republic who serves as an emergency and disaster medicine advisor for Plaza de la Salud. Baez was instrumental with trip logistics and served as mission medical officer, caring for PACU and ward patients.
In addition to surgery, the Operation Walk Boston team delivered educational lectures to its counterparts at Plaza de la Salud.
A mission like this takes immense planning and coordinating. The Operation Walk group from Denver accompanied the Boston team on its first mission to ensure everything went smoothly. “The Denver group shipped more than 7,500 pounds of equipment, including antibiotics, narcotics, canes, crutches and surgical instruments for our first visit,” Ghazinouri said.
Now, Ghazinouri is in the full throes of planning for next April’s trip. While the team is made up of mostly BWHers, others in Boston are welcome to join. Operation Walk Boston is linking with Partners In Health to raise funds for upcoming missions.
“We plan to go to the Dominican Republic annually, and we’re also interested in going to other places that Partners In Health serves,” Thornhill said.
For more information on Operation Walk and ways to help, e-mail firstname.lastname@example.org.
More pictures at www.bwhpikenotes.org/media