from Jay Crary, orthopedic surgeon

Dr. Jay Crary, orthopedic surgeon

From my first experience in Ayacucho in 2012, I learned that  the city of Ayacucho has skilled orthopedic surgeons, but lacked the necessary equipment to handle common types of leg and thigh fractures in an ideal manner.  As a result, injured patients had to endure much more difficult, painful and less successful treatments that often resulted in long-term problems and disability.   

On this, my second mission, we decided to do something to make a lasting impact in this area.  Thanks to generous contributions of our supporters, Ayacucho Mission and the Peruvian American Medical Society partnered with SIGN Fracture Care International, an orthopedic non-profit, to provide the necessary equipment to enable the Ayacucho surgeons to offer their patients the best options for treatment of leg and thigh fractures.  

The initial phase of the program was the introduction of the equipment and instruction in the appropriate technique.  Alongside Dr. Cesar Aranguri, Director of the Mission, I led an instructional course for the orthopedic surgeons in Ayacucho.  Over the following week, I assisted two Ayacucho surgeons, Dr. Prado and Dr. Romero, on two cases.  The first was a 10 year old girl who had had a femur fracture 6 months earlier that had failed to heal despite previous surgery.  The second was an open tibia fracture in a young man who fell off a horse. Both cases were quite successful.  

During the first month after the Mission concluded, Dr. Prado and Dr. Romero did two more surgeries completely independently.  Both cases went very well, which is a testament to their skills as surgeons and the equipment and training provided by the Mission.  We believe this will be a very valuable program for the people of Ayacucho and the local medical community.  It will allow local surgeons to treat severely injured patients so that they can mobilize and return to their work and their families more quickly, with easier and more predictable recoveries and less short and long-term disability.  

Pre-operative x-ray of an 18 year-old man who fell off a horse and sustained open fractures of the tibia and fibula.  Local Ayacucho surgeons Dr. Prado and Dr. Romero worked alongside Mission surgeon Dr. Crary to apply the techniques and equipment introduced by the Mission to intervene on the patient.

Post-operative x-ray from the same patient showing the successful placement of a SIGN intramedullary nail to stabilize the tibia.  This patient was able to walk with crutches immediately after surgery and will begin weight-bearing on the leg after about 6 weeks.

A Circus, a Loudspeaker and El Gobernador: Our First Day in Quinua

Our first day found us in Quinua, Peru--an important historic and cultural site famous for its ceramic figurines, battle site memorial and rich Quechua heritage.  At nearly 11,000 feet above sea level, the city and its surrounding communities have very limited health infrastructure for its 6,000 residents.  It was a perfect place to start.

Working closely with the Quinua-based community health center, Asociacion VIDAS, our small mobile team treated nearly 100 medical and dental patients, and identified a number of surgical cases to bring to Ayacucho Regional Hospital to treat the following week.

Realizing that the patients requiring orthopedic surgery may not be able to travel to the clinic, we turned to Braulio Huaman, the town's Gobernador for ideas to reach the people.  He offered to drive around town in a mototaxi (imagine a rickshaw fused with a scooter) inviting individuals with fractures and other injuries to contact our group through the loudspeaker attached to the roof.    We loved the plan, but were disappointed to find out the town's loudspeaker was broken.  Never discouraged, the Gobernador came up with his second great idea:  Let's walk across the way to the traveling circus that had just come to town and ask to borrow theirs.

To our pleasant surprise, not only were the circus folk (a very nice family) happy to carry their speaker down from the big top and mount it to a mototaxi, but we found our first orthopedic surgery case--a trapeeze artist who had broken her leg in a recent show.  In no time, the Gobernador was rolling through town, getting the word out about the available services.  It never fails to amaze how many new ways we learn to work together.

Patricia of Circo Galax, traveling from the jungle through Quinua into Ayacucho and beyond

Raquel Yupanqui, Director of Asociacion VIDAS testing the loudspeaker atop the mototaxi

John Billimek and Braulio Huaman, El Gobenador de Quinua