The second patient that has benefited through the Saul Project was Milton. When Milton was two years old he fell off a tree stump and fractured his femur. He was living in a small village in a remote area in Izabal Guatemala. They have no phone, no roads and no electricity where Milton lives. The femur is the bone in the thigh, or upper part of the leg. It was an open fracture, meaning that the bone was sticking out of the skin. What happened after that was a nightmare. He was sent to the hospital in Puerto Barrios Guatemala and the bone was set and the wound was closed. Shortly afterwards, he developed an infection. His parents traveled the six hour walk carrying Milton back to the hospital in Puerto Barrios. Milton's wound,including his bone was infected. The decision was made to transfer Milton to the National Hospital in Guatemala City. Milton and his mother spoke no Spanish and his father spoke very little. Milton's family is Kek-Chi,one of the 21 different indigenous groups living in Guatemala. A very small minority of the Kek Chi speak Spanish. They only speak Kek Chi. Milton's family was no exception. Milton's father is an agricultural worker and makes $3 a day. He is the sole provider for his family. For Milton's family , going from their home to Guatemala City, would be like one of us going to Hong Kong and attempting to navigate a city they did not know, speaking a language they did not understand, with virtually no money. But Milton's dad was determined to see his son live. Guatemala has the highest infant and child mortality rate in all of Central America and in most of Latin America. Many, many, many children die every year of treatable diseases. No one knows how many. In villages such as the one Milton was born in, most children's births are not registered. There deaths certainly are not. With high fevers and an infected wound, Milton's father with his limited Spanish climbed on a bus and traveled 7 hours to the capital to begin a five year journey to find help for his son.
Milton spent the next two years of his life in the National Hospital in Guatemala City. His mother was only able to visit him a handful of times during this period. His father made every attempt to see Milton at least every 2 weeks, but he had to work to support the other children in the home. During this time, Milton underwent at least three major surgeries in attempts to graft a bone from another site to his upper thigh, where due to his infection, his femur had sloughed off, virtually dissolved. A graft was taken from his pelvis, from one of his ribs and from his right fibia. None of the grafts worked. Milton was kept in a bed, and was apparently in traction for a great deal of the two years, surrounded by strangers who did not speak Kek Chi. In fact, the back of Milton's head is flat, from lying on his back for such a long time during his early childhood. At the end of two years, Milton was sent home and his father was told there was nothing else they could do for him. Milton's leg hung limply at his side. He had good circulation in his leg and could feel and move his leg. But he did not have a femur. He had no structure in order to bear weight. His leg was more like a fin. It was about 6 inches shorter than his other leg.
In developing countries, children with such physical challenges are not treated like similar children in the United States. Children who are not physically capable of working will receive less to eat, fewer clothes and other things. Milton could not walk to school so he did not go to school. None of his brothers or sisters was able to carry him.
While Milton and his family had come to understand that there were no other options open to him in Guatemala, they continued to pray for an answer to his problem. Through his church, Milton's father heard of a medical group (Refuge International) that had helped another little boy and found out the dates they would be in Sarstun, Guatemala. Milton lived a 6 hour walk and a 3 hour boat ride from where the team was going to be, but his father made arrangements and brought Milton to Sarstsun. There he was seen by Christina Loeliger, a FNP from California who did an extensive history and physical exam. Photos were taken and information gathered, along with x-rays that were 3 years old.
All this information was gathered and sent to Scottish Rite Hospital in Dallas, Texas. The physicians there graciously agreed to try and help Milton. Once again, arrangements for travel included the long process of getting Milton and his father's
father’s passports and Visas. This required two exhaustive and expensive trips to the capital. Refuge International covers all of these expenses. Once all of the paperwork was in order, Milton and his dad got on a plane and flew to Texas.
Milton's case was like no other the incredible surgeons had seen at Scottish Rite. They are an incredible group of creative people who set out to help Milton walk. Milton's first surgery was over 8 hours, with ten different surgeons involved. A bone 'transplant'was done using his fibula from his left leg. It was the last site available to them for use. All of the blood vessels were moved to assure that the graft took place. Milton was then place in a Ilizeroff frame to hold everything in place. Nine months, several more surgeries and creative orthoprosthetic work Milton walked home. It was indeed a miracle. While most of the projects that Refuge International is involved in are more community based, serving many patients, whenever a child like Milton finds Refuge, we know that we are being "asked" to help them. We know that through the Saul Project we will do all we can do to help each and every one of them. Milton is now in school and is able to run and play like any other child. He will be returning to the US in 2008 for evaluation by Scottish Rite.
Refuge International continues to work on ways to make the process easier. For every child coming to the United States for surgeries such as Saul's and Milton's the expenses exceed $5000.
