Resources: The Clinic of Hope

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November 2001

By Pamela Lyke-Marquez, PT, GCS, and Katherine G. Hetzelt, MS, PT

The Clinic of Hope

A 7 year-old is fitted for a donated wheelchair.

Manos De Ayuda provides a variety of services, including rehabilitation, to needy families in Puerto Peñasco, Mexico.

Manos de Ayuda is a nonprofit organization based in Tucson, Ariz, with the mission of providing humanitarian, medical, rehabilitation, and educational services to underserved populations, while providing the means for increased self-sufficiency.

Hoping to make a difference
On the second weekend of every month, Manos de Ayuda volunteers travel to Puerto Peñasco, Sonora, Mexico, to conduct a free clinic for children with rehabilitation and special medical needs. The volunteers include physical, occupational, and speech therapists, nurses, translators, and students. Initially, a group of therapists had provided assessments and training at a school for children with disabilities.

A clinic was held in September 1998 to determine if there were other children in the community who needed physical, occupational, or speech therapy; 57 children were assessed at that clinic. Since that time, Manos de Ayuda volunteers have assessed more than 500 children from Puerto Peñasco and surrounding areas. The children's needs range from simple orthotics and exercise programs to life-saving medical treatments. Children come to the clinic with problems such as cerebral palsy, muscular dystrophy, spina bifida, orthopedic malformations, autism, and failure to thrive. Children with colostomies have come because the family does not have the basic supplies or training to manage them. Others need heart surgery, liver transplants, cleft palate closures and other facial reconstructive procedures, or treatment of injuries or other acute medical conditions.

Manos de Ayuda is not able to provide for all the children and adults who are brought to the clinic. Many are waiting for wheelchairs, braces, or other medical assistance. We have been able to bring a few children to Tucson and Phoenix where they have received services from physicians who have donated their time and expertise. Support from individuals, Rotary groups, and the Gift of Life Program has enabled the organization to assist some of the most critical children. One generous donor is paying the hospital costs for two of the children who need surgeries. Wheelchairs for the World Foundation and Wheels for Humanity have provided 35 specialty wheelchairs for some of the children who are most in need. Manos de Ayuda also solicits assistance from other nonprofit organizations to provide services that are beyond the scope of the clinic. Hope and persistence are the keys to the success of this program, along with the generosity of our donors and volunteers. The families have named our clinic Clinica Esperanza-the clinic of hope.
Miracles Can Happen
Santiago was 3 years old when he became paralyzed from Guillain-Barre syndrome. He had no diagnosis or treatment and he was brought to the clinic 2 months after the onset, moving only his head and right arm. Santiago was taken to Tucson; a physician donated his services, diagnosed the problem, and assisted with setting up a treatment plan. A wheelchair and therapy were donated and the family was taught how to continue his therapy. A year later, Santiago is learning to play soccer and has completely recovered.

Jesus lost both legs when he was run over by a train. Using donated prosthetic parts and volunteer prosthetic services, Jesus has been given back the ability to walk.

A prosthetist also fabricated a body brace for 7-year-old Antonio, a paraplegic because of a spinal tumor. The brace and a wheelchair have given Antonio mobility and independence, and the next step may be long leg braces.

Cesar's parents brought him to our clinic in December 1999, requesting assistance in obtaining ostomy supplies. At 3 months old, he weighed 8 pounds and had an ostomy, tracheotomy, pneumonia, and failure to thrive. The family had been managing his care since surgery 3 days after he was born with an intestinal malformation and fecal aspiration. They were suctioning him with a makeshift suction machine and rewashing his one ostomy bag. The father works as a mechanic and the family has no health insurance.

Services are not available for him in Mexico to reverse the ostomy or remove the trach. Manos de Ayuda has been able to provide the family with training, ostomy and respiratory equipment, and nutritional supplements. Cesar is now developmentally on target. He is talking over his tracheotomy. Surgery to reverse the ostomy and remove the trach will allow him to lead a normal life. The first of several surgeries has been completed through services donated by a physician in Tucson and soon Cesar will be without the ostomy and trach.

Many children like Cesar have come to Clinica Esperanza with medical needs that are beyond the scope of the therapists and other health care volunteers. Physicians are needed to provide assessments and consultations to determine ways to help these children. Some of the children may qualify for services from international organizations; however, they need initial evaluations and medical reports before the application process can be initiated.

Following are just a few of the people waiting for help:

Gabriel needs plastic surgery to remove a large cavernous hemangioma that covers half of his face.

Brenda, 8 years old, needs to see an ophthalmologist to assess tumors behind her eye. She has already had one eye removed and the other is at risk.

Beatrice has severe cranial and facial malformations. Surgery was started at age 5; however, the family has been unable to have her surgery completed. Beatrice is now 12 years old and is losing her vision and hearing because of pressure on her brain. She needs extensive plastic surgery.

Jorge is 7 and needs a liver transplant. He came to the clinic from San Luis. Many family members came with him, hoping to be tested as possible donors.

Because all funding comes from donations, Manos de Ayuda is always seeking the donation of services or assistance with funding. These children can be brought to the United States through arrangements with the Immigration and Naturalization Service, lodging, and transportation are provided by volunteers, and some of the other expenses can be covered by donations. Fund-raising is a major focus to enable the programs to continue.

Volunteers: the heart of Manos de Ayuda
All services are provided by volunteers. Many are from Tucson, Phoenix, and Puerto Peñasco, but volunteers have traveled from California, Washington, and Missouri to assist at the monthly clinics. Students and instructors from the University of Southern California and Arizona School for Health Sciences frequently attend the clinics.

These clinicians, translators, and general volunteers pay their own expenses in addition to donating their time and talents. Local volunteers and some families of children who have received services also assist with the operation of the clinic. The volunteers donated nearly 10,000 hours in the year 2000. More than 150 volunteers have attended clinics in 2001, and 95 new volunteers have joined the efforts of Manos de Ayuda in 2001.

The Ultimate Recycling Project
The American health care system and society as a whole have created an abundance of leftover equipment, supplies, and other usable materials. Many of these items that are often discarded can mean the difference in an individual's life. Discarded wheelchairs have enabled children to attend school. Surplus nutritional supplements have aided children who were failing to develop because of inadequate nutrition. Braces and prosthetics are being reused to fabricate new ones. Building materials are used to provide shelter for homeless families or being used in the building of our permanent clinic site.

Manos de Ayuda's product and materials donation program collects these items and distributes them to individuals and areas in need. Manos de Ayuda Inc is a tax-exempt 501(c)(3) nonprofit corporation allowing facilities and individuals who donate items that would have been discarded or stored to receive a tax benefit for their donation. In 2000, Manos de Ayuda collected an estimated $165,000 worth of equipment and supplies that would have been discarded.

Plans for the future

Katherine G. Hetzelt, MS, PT, sets up Jesus with a physical therapy home program.

Thanks to a generous donation of used manufactured homes, plans for a permanent clinic site are becoming a reality. Currently, the clinics are being held in space loaned by the special education school La Escuela de la Montaña. This has limited clinics to weekends, when school is not in session. Equipment, supplies, and charts must be stored and transported for each monthly clinic.

Three of seven units have been moved to land donated in Puerto Peñasco. Water and septic systems have been installed and repairs and refurbishment are nearly completed through donations of time, money, and materials. Much of the work has been done by the people whom the clinic will serve. The city will be providing electrical service in the near future. This permanent clinic site will provide room for therapy, medical services, offices, and space for storage and distribution of donations.

A permanent home for Clinica Esperanza will provide the opportunity to expand the scope and frequency of services. Eventually, the permanent clinic will include a day care/early intervention center and volunteer housing.

For more information, visit Manos de Ayuda's Web site: www.manosdeayuda.org.

Pamela Lyke-Marquez, PT, GCS, is the president and cofounder, and Katherine G. Hetzelt, MS, PT, is the secretary, cofounder, and director of clinical services for Manos de Ayuda Inc, Tucson, Ariz. They can be reached at (520) 760-8645.

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November 2001