Source: Blog Post

A long travel day brought the Touching Hands Trinidad team together in Miami for the final leg of our journey to Trinidad & Tobago. Our gracious host, Godfrey Araujo, FRCS, met the team at the airport and escorted us to our home for the week, the Blue Cottage, in Diego Martin, Trinidad.

The team, Scott Kozin, MD; Andrew Weiland, MD; Carmen Aponte, OT; Randy Brenn, MD (anesthesiologist); Kimberley Russo, CRNA; and Scott Rogers, MD (fellow), got a few hours of much needed rest overnight before heading out bright and early to the Princess Elizabeth Centre for Handicapped Children (PECHC).


The PECHC is a special facility dedicated to serving children with physical and mental impairments, both as a boarding school and day school.  In addition to this, it also provides medical services to these children and others in the community, regardless of their ability to pay.  On our brief tour of the facility it was easy to see love and dedication of those who work with and serve the children there.

We next moved on to unloading the many large duffel bags of supplies needed to perform surgery and to facilitate post-operative recovery.


All of these supplies were generously donated by many individuals and companies to the THP.  A big THANK YOU to those who donated materials and their time in procuring and packing these supplies!  As you will see, they really made and will make a huge difference in many lives.

Once the duffel bags were cleared and organized we got started with our first case of the day.  Ethan was quiet 2-year-old with hemiplegic CP presenting with a left elbow flexion contracture and thumb-in-palm deformity.  

After he was evaluated we brought him to the operating theatre where we performed a myotomy of his brachioradialis and released this brachialis fascia before moving on to his thumb.  To get his thumb out of his palm we released his adductor pollicis, fractionally lengthened his FPL, and then finally performed a chondrodesis at his thumb MP joint.

At the end of the procedure we felt very confident that he could straighten out his arm and hitchhike wherever he would like, should the need ever arise.

Our second case was another beautiful 2-year-old [Pic 6].  Chad had bilateral long-ring finger syndactyly.  We tackled this by putting 2 surgeons to work on each hand – it was quite a sight to see 4 hand surgeons crowded around this little man!  The result was just as impressive.


Our final case of the day exemplified many of the goals of the THP and underscored the fact that non-pediatric specialty hand surgeons are needed in the THP.  Crystal was a charismatic 27-year-old woman who unfortunately suffered lacerations of her median and ulnar nerves at the wrist.  

Because she and her husband made too much money to qualify for public health insurance, but not enough to pay for private health insurance (sound familiar?), her care was delayed more than 5 weeks.  Ultimately she made her way into the care of our colleague Godfrey Araujo, FRCS.  With the imminent arrival of the THP team plans were made for the group to take care of her.  Knowing that nerve repairs and grafting would be required, the THP crew was able to procure and transport the appropriate instruments and materials needed, including a package of Tisseel and the necessary warmer/mixer.  When we got her to the OR we found a 3-cm gap in median nerve and a similar gap in the ulnar nerve that extended to the bifurcation in Guyon’s canal.  After cutting back to healthy tissue we were left with 6-cm gaps in each nerve that were neatly spanned by sural nerve autograft and glue.  

She has a long road ahead of her, but the THP Trinidad team did our best to give her the best outcome possible.

We closed up shop at the PECHC after darkness fell on the island and we returned home to the Blue Cottage.  We were treated to an amazing homemade Indian dinner made by the spouse of one the PECHC bus drivers.  What a great way to end a great day.  We’re all exhausted and looking forward to a good night’s rest and more fun at the PECHC tomorrow!