STEVE INSKEEP, host:
And now let's talk about a problem that is very visible in the developing world, even though it's almost invisible here. In this country, birth defects such as club feet, dislocated hips or fused fingers are routinely repaired and rarely seen in adults.
In the developing world, the situation is different. Those physical difficulties can cause social problems, which a new hospital in Honduras is attempting to correct. Here's NPR's Jason Beaubien.
JASON BEAUBIEN: In the waiting area of the CURE Orthopedic Pediatric Hospital in San Pedro Sula, parents sit on stiff metal chairs, clutching their children tightly on their laps. They hold them in a way that betrays a mixture of fear and hope - hope that their child can be made normal, yet fear that maybe this is all too good to be true.
Ms. RUTH DE CASTRO (Executive Director, CURE Orthopedic Hospital): We see children from zero - one day to 18 years old that suffer deformities.
BEAUBIEN: Ruth de Castro is the executive director of the nonprofit hospital. Honduras is one of the poorest countries in the hemisphere. And de Castro says its public health system - like most in the developing world - is ill-equipped to deal with bone defects.
Ms. DE CASTRO: And the reason for this is that the public hospitals, the government hospitals, are saturated with people who come with fractures. They have to treat the emergency first; therefore there is no elective surgery.
BEAUBIEN: On this day, doctors at the main public hospital in the capital were urging people not to come to that facility at all. The general hospital in Tegucigalpa had been overwhelmed by a dengue fever outbreak and patients were being treated on gurneys in the hallways.
In both rich and poor countries, club feet are so common that roughly one in every thousand babies is born with the condition. With relatively simple medical procedures, they can be completely corrected. But in developing nations, these deformities rarely get addressed.
Ms. DE CASTRO: So let's go into the ward.
BEAUBIEN: The CURE hospital, which opened earlier this year, charges a small fee, but De Castro says many of their patients can't even afford bus fair to get there. But then the services are free.
Dr. Warren Terry from Vancouver is making the rounds of the children in the recovery ward.
Dr. WARREN TERRY (CURE Orthopedic Pediatric Hospital): This is the day where we got one doctor, so I'm kind of covering between the clinic and the OR.
BEAUBIEN: The day before, Dr. Terry had done a complicated surgery on a four-year-old boy who'd had a dislocated hip since birth. The surgery involved re-forming his hip socket, shortening his femur by about an inch and lengthening some muscles.
Dr. TERRY: So it's a lot of surgery. It's about, you know, three and a half to four hours. And then once it's back in, we have to put him in a special hip spica cast.
BEAUBIEN: Dr. Terry and others here say the chances of a boy like him getting this surgery in the Honduran public health system is nil, and without the surgery...
Dr. TERRY: It would significantly impact his life. You know, he would have difficulty walking any long distances. He would have one leg that was a normal length and that worked normally, and this other one would be short. And he would have a kind of a lurching sort of a gait.
BEAUBIEN: Dr. Terry rushes across the compound to the operating room where another boy is waiting. As he's preparing for surgery, Terry says this work is about breaking a cycle where poverty leads to disability, which in turn leads to more poverty.
Dr. TERRY: And that's what you're trying to get these kids out of, right? You know, they start off with a bad club foot. They can't walk, so they don't go to school. And just about every kid who comes with a significant limb deformity, you ask their family and they don't take them to school.
BEAUBIEN: Twenty-eight-year-old Blanca Irma Orellana brought her youngest son, Rony, to the CURE hospital to try to get his feet repaired.
Ms. BLANCA IRMA ORELLANA: (Spanish spoken)
BEAUBIEN: I've come for an operation for my child to see if he can walk, Irma says. He's been like this since he was born. They told me they could help me. So that's why I'm coming.
Rony is three years old, solid and pudgy, but his right foot curls in sharply towards his left. Irma is a single mother. She has four other children and she washes clothes for a living.
Ms. ORELLANA: (Spanish spoken)
BEAUBIEN: And for three years she has been carrying Rony everywhere. Irma says looking after him can be very difficult, and at times she gets discouraged.
The staff at the hospital say that Rony's foot could have been repaired easily when he was born. Now it will require a fairly major operation, but they're planning on doing it. If the operation is successful, it will benefit his whole family. He'll be able to walk, his mother will no longer have to carry him, and the social stigma that often hovers over a family with an abnormal child will be lifted.
Jason Beaubien, NPR News.
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