The colorful island clothing? From the Dominican marketplace. The new knee joints? From Denver. And so are the new hips they’ll use to dance merengue.
A 30-second radio spot broadcast in February in the Dominican Republic drew thousands of hopefuls clamoring for a chance to walk pain-free. The ad promised that Operation Walk Denver was coming to the capital of the Dominican Republic, Santo Domingo, with a team ready to replace destroyed knees and hips — and at no cost to the patients.
The surgical team arrived in April. Eighteen-year-old Damaris Contreras made it through the rigorous screening process and took her place in the exam room, sitting on the edge of her chair. She sat awkwardly; her left hip didn’t bend enough to allow her to fully sit, stand or lie down normally. A previous doctor told her the only chance for pain relief was to amputate her entire leg at the hip.
In the next room was a cab driver whose joints were so shot that he couldn’t bear to hit the brakes anymore. Nearby, Jenny Hernandez Rodriguez, a 25-year-old law student, told the team that she was crippled by arthritis and destined for life in a wheelchair. Down the hall, a man in his 50s who hadn’t been able to walk or work for years said through tears, “It looks like I’ll die in this wheelchair.”
“It’s tragic to see these people because the magnitude of their deformity is so much greater than what we see in the U.S.,” said Douglas Dennis, an orthopedic surgeon at Colorado Joint Replacement and founder of Operation Walk Denver.
“Their legs are much more crooked . . . and many of them are wheelchair bound. It’s heartbreaking to see. If they lived in America, they’d have had their joint arthroplasty done 10 years before.”
Operation Walk Denver is an all-volunteer team of surgeons, anesthesiologists, nurses, physical therapists and other staff who surrender a week of vacation to cross time zones and language barriers, helping those crippled by bone and joint disease.
The Dominican Republic’s unemployment rate is as high as 30 percent. Those who can’t walk, can’t work. But the average household income of $300 to $400 per month dashes hopes of ever affording joint replacement surgery.
Dr. Luis Alcantara Abreu, a leading trauma and orthopedic surgeon in the Dominican Republic, held a pre-screening before the American team arrived that whittled the list of thousands of hopefuls down to about 50 potential surgical candidates for this trip.
“It was an excruciating job to cut down the list. You must understand, the need here is so great and has been growing for so many years. Even patients with health insurance in the Dominican Republic don’t have access to enough joint implants,” Alcantara said.
The team was in surgery nearly non-stop for the first three days of the mission. Some patients had their surgery on the same day they’re chosen as implant recipients. Jackie Gorman with DePuy Orthopaedics coordinated the demanding surgery schedule on-the-fly, strategically alternating hip and knee cases so volunteers could wash and sterilize hundreds of surgical instruments between operations.
Gorman’s colleague, Steve Erickson, supplied each operating room with multiple sizes of joint implants. Surgeons can’t know the right size until they’ve removed the diseased joint and prepared the bone to receive the titanium and plasic components.
Erickson was even prepared for Damaris Contreras. The 4-foot-9-inch teenager, whose growth was stunted by high doses of prednisone for rheumatoid arthritis, needed a pediatric-sized implant.
All patients were required to begin walking the day after surgery. After years of debilitating pain, it was hard for them to believe that the joints will work so soon. Walking quickly became a competition, with enthusiastic patients encouraging their slow-to-believe compadres.
“On one of our trips to Panama, a woman got up and walked just a couple of hours after knee replacement surgery just to show the president of Panama, who was visiting the ward, what she could do,” says Dr. Todd Miner, clinical director for Operation Walk Denver.
Miner says the patient gratitude is overwhelming, “and they always have a smile, you always get a hug. It’s what medicine is all about, it’s what humanity is all about, and that really encompasses what Operation Walk Denver is all about.”
During this trip, 37 patients received 46 joints along with intense physical therapy. Some patients were so disabled that both knees or both hips had to be replaced.
The day before the team left, patients, their families, staff and the Operation Walk team gathered for a celebration of singing and speeches. Patients shouted their gratitude in Spanish and broken English. The tears and smiles said it best.
“Now you’ve got to just keep on walking,” Dr. Dennis told one patient, a knot in his throat.
Damaris Contreras lost both a bad hip and her shyness. As Operation Walk Denver left the hospital, she was surrounded by Dominican journalists who couldn’t resist hearing her story.
Operation Walk Denver raises mission money with its “Walk of Dreams Gala” each September, and through an endowment fund. Operation Walk started in Los Angeles in the mid-1990s, and Dr. Dennis began the Denver chapter in 2002. Denver has committed to serve Panama and the Dominican Republic annually, but also has gone to Nicaragua and Peru.
Dr. Stephanie Clements is a medical reporter and a documentary and video producer. She can be reached at medicalmediadoc@gmail.com.
