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Group brings relief to Nicaragua

Aug 15, 2011  | Written by Kelsey Miller Staff Writer Source: click here

Dr. James Trauger, Gideon LaClair and Kevin Mull traveled to Managua, Nicaragua with La Merced, a non profit organization started at St. Francis de Sales church.

Dr. James Trauger, Gideon LaClair and Kevin Mull traveled to Managua, Nicaragua with La Merced, a non profit organization started at St. Francis de Sales church.

Fairly routine procedures for this doctor, but seven of his recent surgeries were hardly ordinary.

From June 26 to July 3, Trauger traveled to Managua, Nicaragua to perform total knee replacement surgeries on patients lacking adequate medical care and facing a life without relief or mobility.

The doctor, specializing in hip and knee replacement at Peninsula Orthopedic Associates in Salisbury, traveled to the country with the nonprofit organization La Merced, which was started on the Eastern Shore. Numerous doctors, interpreters, teachers and students have been traveling to the country for the past four years to help get proper education and medical care to those in need.

Started through St. Francis de Sales church in Salisbury — largely due to the efforts of Dr. Vincent Perrotta of Peninsula Plastic Surgery — the organization works closely with a sister parish in Managua, the country’s capital that has a population of about two million residents.

Trauger heard about the program a year ago and thought of it as a great opportunity to “help for the sake of helping,” he said. He noticed the groups had not yet visited adult hospitals and offered his services to work with orthopedic patients.

“It was the perfect opportunity to give back,” Trauger said.

Kevin Mull, a physician’s assistant at Peninsula Orthopedic, works closely with Trauger. He decided to attend the mission trip on his own and was surprised to see the doctor at the first meeting. The two decided they would work together to perform joint replacement surgeries in Nicaragua, a first for La Merced.

“I knew it would be a rewarding experience,” Mull said.

Upon arriving, Trauger and his team began seeing patients and touring the facilities of Hospital Escuela Dr. Roberto Calderon Gutierrez, where they would be working. The group quickly saw the obstacles they would face.

“The facilities that they have are really unbelievable,” Trauger said.

Equipment designed for one-time use was often sterilized and used again, he said.

“It wasn’t anything that we were used to,” said Gideon LaClair, a local Zimmer prosthesis representative who also made the trip.

The team learned to make do with what was available but were glad to have brought supplies of their own. The AmeriCares organization, along with the Zimmer company, donated $135,000 worth of prostheses. The local Zimmer branch also allowed the team to borrow various medical instruments, LaClair said.

Even with the donation, Trauger was concerned about properly fitting the limited number of protheses to the patients. Without X-rays to match the sizes in advance, Trauger had to guess which sizes to request. Of nine donated joints, the team was able to make seven fit the patients they had, performing total knee replacement surgeries for those Nicaraguans.

Trauger also met with local doctors and helped train them in new techniques. The doctors were very skilled, he said, but issues arose when patients could not afford the operations and waiting lists were years long.

“There were lots of good doctors, but their hands are simply tied,” Trauger said. “If you don’t have any money to pay for it, you’re not going to get it.”

The team also worked at the church’s free Roberto Clemente Clinic. Doctors dealt with everything from plastic surgery cases to injuries and birth defects. Trauger was again forced to work without many modern day technologies.

“It was a hands-on diagnosis without most of the tests we have here,” he said, adding it was the perfect learning setting for the college and high school students in the group.

Some of the most shocking aspects were the living conditions outside of the hospital.

“There was almost nothing that resembles a house at all,” Trauger said.

The city dump was the backyard for many Nicaraguans who scavenged in the trash for food. One man, whom the team met in the clinic, had fallen and broken his leg while in the dump. The doctors were able to see that he received the help he needed.

“That was really rewarding, being able to help those who don’t have those types of resources,” Mull said.

Trauger recalled another patient who learned the team didn’t have a prosthesis to fit his knee after he was already promised a surgery. He was, to the doctor’s surprise, not angry but appreciative.

” ‘Thank you doctor,’ ” the man had said through an interpreter. ” ‘Thank you for your effort.’ ”

Back in the United States, the team noticed the excesses in our medical system and how many don’t realize how well off they are.

“It makes you appreciate what you have here that you take for granted,” LaClair said.

All three men intend to return to Managua next year, hoping to be even more prepared. The team took X-rays to better match sizes and Trauger wants to perform revision surgeries.

They hope to return to help the man whose knee didn’t fit.

“He was so grateful and thankful,” Trauger said, and the doctor is equally thankful for the experience. “It was really nice to help people who otherwise couldn’t have their knees replaced