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Lending a Helping (Surgical) Hand

BY LENA SMITH PARKER December 4, 2017

Volunteers with Hand Help spent a week in Nicaragua helping people recover the use of their hands and arms. This slideshow features eight people whose lives were transformed.
  • Matias

    Matias’ mother, Jenifer, brought him to the hospital three months earlier because he was born with an extra digit attached to his thumb on his right hand. He couldn't comfortably suck his thumb.

    The hospital staff told her to wait until he was 6 months old to have the surgery. She brought him back during the week that the Hand Help team was there.

    “I hope the surgery is quick and he feels no pain,” said his mother. “It doesn’t cost us a thing to have this surgery today. I am happy.”

    Photo by Robert A. Lisak
  • Brigitte

    Brigitte, 10, has had ganglion cysts on both wrists since she was 1½ years old. People said she had “six fingers” on each hand. The painful tumors made it difficult for her to play, help her mom or attend school. Nicaraguan doctors drained the cysts with syringes, but they just came back—more painful than ever. Brigitte missed the entire last year of school because it was too painful for her to write.

    Hand Help surgeons removed the cysts, and, hopefully, they won’t return.

    “I think that this is a great blessing, the surgeons coming here,” said her mom, Enia. “Don’t stop doing it. God blesses you day after day, hour after hour, minute after minute, year after year.”

    For the doctors, it was a simple surgery. For Brigitte, life would be dramatically improved going forward. Her face shone with hope.

  • Leonor

    In 2016, Hand Help doctors treated Leonor, 75, for a broken upper arm and a terrible infection in her shoulder. However, she returned in 2017. The infection had healed properly, but not the arm fracture. She could move her hand and her arm, yet her arm bent outward unnaturally between the shoulder and elbow. It looked something like a second elbow, and it hurt when she played with her grandchildren.

    Hand Help’s Dr. Kevin Tomany, an orthopaedic surgeon from Lowell General Hospital in Massachusetts, examined her arm gently. After reviewing X-rays, he recommended a second surgery—one involving realigning the bone and holding it in place with metal plates and screws.  Warning her that the injured arm would be a little shorter than the other one after surgery, he promised that it would heal normally.

    Leonor agreed to have the surgery. She trusted him. Moments after this photo was taken, Dr. Tomany sat beside her on the bench and they hugged.

    Photo by Robert A. Lisak
  • Jonathan

    When Jonathan was 12, he fell while running and broke his left arm. It didn’t heal properly. The arm worked fine, but the elbow was twisted sideways. “It looks ugly. I don’t like it,” Jonathan said. “People try to make me feel bad about it but I don’t listen to them.”

    After he turned 18, he sought treatment at two local hospitals. Doctors told him that the bone couldn’t be fixed; it should have been repaired when he was a child.

    One of Jonathan’s neighbors who had surgery with Hand Help earlier urged Jonathan to go for an evaluation when the mission returned to Managua. Dr. Tomany realigned Jonathan’s arm. Jonathan was out of surgery and in recovery within two hours. The doctor told him his arm would look completely normal in a couple of months.

  • Cesar

    Cesar had made his living as a taxi driver, but, as a result of diabetes, the flesh on the top of his right hand was dying—making it impossible for him to drive and support his family. When the 44-year-old man arrived at the hospital, he seemed defeated.

    The Hand Help team performed a series of surgeries in attempts to save his hand but, at last, they realized they had to amputate to save the rest of his arm.

    The surgical team worried that Cesar would be despondent when he regained consciousness after surgery, but the opposite happened. “Removing that hand lifted a weight off his life. His cheerfulness and eagerness were just remarkable,” said Virginia Ells, the team’s occupational hand therapist.

    Ells helped Cesar regain strength in his elbow and shoulder. She suggested that part of his rehabilitation could be achieved through hugging his wife—who promised she would follow the recommendation. Ells said she wished Cesar could travel to the United States to get a prosthetic device to replace his hand. “I can tell he is the kind of man who would learn to use it very quickly,” she said.

    Photo by Robert A. Lisak
  • Carlos

    Carlos, 27, had been seriously injured in a motorcycle accident. He had a scar from his forehead to his chin. One of his legs was completely encased in a cast and his arm was wrapped from fingers to shoulder. He couldn’t feel his fingers, and he could only move them a little bit.

    The surgical team discussed the options. Unfortunately, the accident had occurred weeks earlier—and the delay put limits on what they could do for Carlos. They decided to focus on repairing his fingers, hoping to restore some strength and movement. Asked if he thought he would ride his motorcycle again, Carlos said, “Of course,” explaining that he had no other way of getting to work. He didn’t smile during his evaluation, but he gave the “thumbs up” sign in the recovery room after surgery. 


    Photo by Robert A. Lisak
  • Martha

    Martha, 48, had a ganglion cyst on her left wrist, which made it difficult for her to cook and do housework. She could not open jars or carry her large cooking pot. After surgery to remove the tumor, Virginia Ells provided occupational therapy. Ells made a splint by immersing a special thermoplastic material in hot water and then molding it to Martha’s hand. The splint was lighter and fit better than a traditional cast. The therapy hurt at first, but Martha was committed to it. She understood that it would improve her chances of achieving a full recovery.

    Photo by Robert A. Lisak
  • Miriam

    Miriam, 25, had a motorcycle accident four months before her parents brought her to the hospital for treatment by Hand Help. When she arrived, her right arm hung uselessly at her side. The nerves were completely severed from the spinal cord.

    A Hand Help surgical team performed nerve-transfer surgery, a complex procedure that lasted seven hours. After surgery, still lying on a gurney, Miriam was in high spirits in spite of the pain.  “Muchas gracias a la brigada Hand Help,” she said cheerfully, “I want to thank you all for my life.”

    After she spoke, other people in the recovery room broke into applause.

    “I thought she would lose her arm,” said Miriam’s mother. “The angels sent these doctors to Nicaragua.”

    Photo by Robert A. Lisak

Hand Help is a non-profit organization consisting of volunteer hand- and arm-focused surgeons and caregivers led by Yale Medicine plastic surgeon James Grant Thomson, MD. He has been leading similar groups to Latin America for 18 years, with medical staff using their own vacation time and materials donated by hospitals. You can read more about the 2017 Hand Help mission in Nicaragua here.