Doctors Bring Surgical Miracles to Third World

There was the elderly woman in Nepal so disabled by arthritis that she couldn’t lift herself from bed alone. She spent two days walking from her rural village to reach the visiting doctors from America, whose surgical skills would restore her mobility.

In Nicaragua, there was the 35-year-old woman who had been crippled during an earthquake when her leg was crushed by a falling wall. The damage was so severe that local doctors couldn’t help her. But a visiting team of American surgeons reconstructed her knee and got her on her feet.

And there was the young Cuban woman who had given up on having children because arthritis had left her hip joints so stiff she could hardly move her legs. A double hip replacement allowed her to become a mom.

Orthopedics is not typically the stuff of high drama. It’s hard to find glamour in repairing a broken hip or replacing a worn-out knee

“You look into the eyes of these people when you take care of them and it’s like a miracle dropped out of the sky for them,” said Dr. Lawrence Dorr, the Centinela Hospital Medical Center surgeon who created Operation Walk almost 10 years ago.

The charity sends teams of doctors, nurses and physical therapists to developing countries to provide free surgery to patients who cannot afford hip and knee replacements, which cost about $70,000 in this country.

Dorr, a pioneer in joint replacement techniques, organized Operation Walk after he traveled to Russia in 1994 to teach a group of doctors new surgical techniques and found the hospitals and physician training woefully inadequate. “I realized there were so many doctors who needed the education and patients who needed the operations and I wanted to try to organize a way to help.”

He enlisted a team of volunteers, solicited donations of medical equipment and began traveling to developing countries to train doctors and perform hip and knee replacements. Since then, they have operated on more than 300 people in eight countries -- including China, Peru, Mexico and the Philippines -- and conducted three Operation Walk surgery marathons in Los Angeles.

He has no shortage of volunteers, he says.

“To the doctors and nurses, it’s like the purest form of charity

Each trip costs about $200,000.

“For years,” Dorr said, “it was hand to mouth. We’d schedule the trips, then we’d pray that we got the money.” This year, the group received its first major grant -- $1 million over five years from the Skirball Foundation.

On each visit, the doctors perform an average of 40 knee or hip replacements in three days. They take a team of about 30 specialists and all of their own equipment: everything from sterilizers and surgical tools to implants and bandages -- 18,000 pounds of supplies worth about $2 million.

“We can’t go operate in a MASH tent because, when you’re doing joints, everything has to be sterile,” said Operation Walk’s medical director, Jeri Ward. Still, the conditions often pose challenges.

“Cuba had the facilities, but they didn’t have supplies,” Ward said. “No defibrillator, no dressings, nothing to start an IV with. The doctors are fairly well educated, but they don’t have the stuff they need to do surgeries.”

In Nepal, there was neither expertise nor equipment. “We operated in a converted carpet factory with no special lighting or anything,” Dorr recalled.

In the Philippines, the power failed during a knee-replacement surgery “and I had to finish the operation with a flashlight,” he said.

The Operation Walk surgeons always operate with a local surgeon alongside and arrange a television camera, monitor and microphone so local physicians can watch and ask questions as the surgery is going on. In some places, Ward said, 100 people have crowded into the conference room to watch.

Doctors in the countries they visit typically do only a few hip and knee replacements a year, so they are often unskilled and unaware of surgical advances. And the typical patient is often a young person -- victim of an accident, congenital problems or a lifetime of inadequate medical care -- for whom the replacement of a damaged hip or knee will make the difference between self-sufficiency and poverty.

“Many of these countries have few accommodations for the disabled,” said Ward. “Here we have ramps; there are jobs a person in a wheelchair can do. There an injured hip or knee can make a person an outcast. So if we give a 40-year-old man a total hip replacement and that means he can get back to work and provide for his family, the effects of that surgery can ripple out and help an entire community.”

And the effects of Dorr’s vision have rippled out and back, to help the local community.

“A few years ago, we started thinking, ‘Well, we’re going to these other places to help and that’s great,’ ” Ward said. “But there are patients coming into our office because they’re in pain, and they don’t have insurance but they need surgery. What about these people?”

So they began Operation Walk L.A. In some ways, it’s more difficult to arrange. “In other countries, they give us 40 beds, shut the entire hospital down for a couple days,” Ward said.

Here, Centinela in Inglewood and John F. Kennedy Memorial Hospital in Indio have donated space, supplies and hospital stays and hosted three daylong surgery sessions, allowing volunteer medical teams to perform between 10 and 15 knee or hip replacements each time.

“These patients are absolutely no less appreciative,” Dorr said. “They bring tears to your eyes when they thank you. They’re so grateful, it’s almost embarrassing. “

Patients like Elinor Acuna, who could hardly walk and had been in constant pain for years because of a viral infection that destroyed her hip joints. An emergency room doctor referred her to Operation Walk and she had hip replacement surgery two years ago.

Now the Upland woman can do simple things that had been impossible before. “I can do my housework. I can go up and down stairs. I can have a job. I’m not living every day with pain,” she said.

“I call them God’s angels. There is no way I could ever have paid for this. From the minute I had the surgery, my life has changed.”