By: 1 January 2007

Jessica is a little girl who usually has a big smile. But even Jessica found it hard to keep smiling when the limb of a tree she was climbing broke, plunging her to the ground causing her arm to break.

For many children, breaking an arm is a part of growing up, and painful wherever they are. However, it does make a difference where they live. If Jessica lived in the UK, Europe or USA, she would likely have been rushed to a nearby hospital. Her arm would have been set properly, and the next day she might have had her friends autographing her cast. In a few months, her arm would be good as ever. However, Jessica lived in Honduras, and her story turned out very different.

Like many who live in developing nations such as Honduras or Africa, Jessica's family owned no vehicle to take her to a hospital. She had to ride a public bus for two hours and make several changes to get to the nearest hospital. When the accident happened it was too late to catch a bus, so she spent a night in severe pain, with her arm in a makeshift sling. By the time she got medical treatment the next afternoon, her common fracture had become a serious wound. The bone had pierced the skin, and she was becoming feverish.

Jessica ended up spending 20 days in the hospital before her first operation by local surgeons who inserted stainless steel pins. She was sent home for a few months to heal. The entire experience created an extreme economic hardship on the family. On top of medical expenses, her mother needed to stay with her and could not go to her job, thus losing that vital income.

Jessica's story typifies the plight of the many poverty stricken people in developing nations. The government-run hospitals that are available to them, sometimes known as 'the poor man's hospital, are usually severely under funded.

In order to receive treatment, patients must supply their own antibiotics, medical supplies and/or equipment. In the case of an orthopaedic injury requiring surgery, the cost is usually prohibitive for the very poor. Many are sustenance farmers who don't make enough money to adequately feed and clothe their families. When an accident occurs, they must scraper together money from somewhere. Then the injured often ride a series of local buses. It may take four or more hours to reach the hospital.

It is to this vast need that the Mercy Ships Orthopaedic Team responds. The team works as an arm of Mercy Ships International, a global charity that uses hospital ships to provide free surgeries to the most needy people in developing nations.

In keeping with Mercy Ships general practices, Mercy Ships orthopaedic teams are composed of volunteers who also do free surgeries in developing nations. These well trained surgeons, nurses, physician assistants and other volunteers often use their vacation time to serve in Africa or Central America with Mercy Ships. All are required to have at least two years practice or work in a hospital/medical facility before being accepted to serve on a team for direct medical work. Sometimes they serve onboard a Mercy Ship. On other occasions they work in a hospital, such as the Mario Catarino Rivas Hospital, located in San Pedro Sula, Honduras.

When the Mercy Ships orthopaedic team arrived at this hospital this past November, the beds were already full with patients waiting for surgery who hadn't been able to pay for the needed implants. Some, like Jessica, were children who had fallen from trees or were hit by cars while crossing the street; others were crippled by birth defects. Many adults were injured in car accidents or with machetes while working in the fields. There was a wide spectrum of injuries and needed operations.

It was here the Mercy Ships orthopaedic team first met Jessica, who had returned to the hospital. Unfortunately, her first surgery by the local surgeon months earlier had not been a success. She had developed an infection in the distal radius. The pins had bent and her wrist was twisted at an abnormal angle and there was a large sequestrum. The infection was still active.

The Mercy Ships team removed the pins, debrided the radius and put on an external fixator. Daily dressing changes were followed by Curettage and Gentamycin laden methyl merthacrylate (bone cement). She was sent home on antibiotics for four weeks. She will return for an iliac bone graft to her forearm. She may need the external fixator for four months but is tolerating it quite well. The team hopes that Jessica will recover full or nearly full use of her arm and hand.

Because of Mercy Ships orthopaedics team, Jessica's story will likely end well, as will the many others helped by the team. Without their intervention, such patients could only wait for weeks or months as broken bones knitted back together improperly, perhaps rendering the injured arm or leg useless.

During the past six years, Mercy Ships Orthopaedics has been land-based in Central America, collaborating with other nearby Mercy Ship efforts. More than 1,030 surgeries were performed. For 2007, a team looks forward to being based onboard a Mercy Ship in West Africa as well.

Volunteers are vital to the work of Mercy Ships orthopaedic work. They come from across the globe. Some spend a few weeks, others longer periods, but most feel a great satisfaction in what they are able to give.

Nurse Louise Nielsen from Copenhagen, Denmark took a one month leave from her job in a Danish hospital and joined the latest team in Honduras. With her sub-specialty in hip fractures, she was accustomed to orthopaedics, and was able to care for post-operative patients, doing daily dressing changes.

As Louise pushed a cart full of bandages and other supplies from room to room, her warm smile and kind words lifted spirits and encouraged patients. A troupe of merry children with arms in casts and slings often followed her as she did rounds.

Louise commented, “It is great to help the kids, knowing that they are so poor and they have so little. It takes so little to make them happy. To give a coloring book or balloon means so much to them. It's a great blessing to me.”

In order to carry out these desperately needed operations, Mercy Ships relies heavily on donated equipment and supplies. Dr. James McDaniel, Orthopaedic Consultant for Mercy Ships explained, “We have been blessed with a tremendous supply of usable orthopaedic equipment and materials from a number of manufacturers in the UK and the United States. They understand that we are a Christian humanitarian organization and have been pleased to provide us with relatively new equipment.” In places where there is no equipment, donated equipment that is a couple years old can be of great use. Everything from surgical implants to dressing material is needed as well as some major equipment.

If you would like more information about Mercy Ships orthopaedic teams, or want to donate orthopaedic equipment, finances or to find out about volunteer opportunities, please email Dr. James McDaniel at or

For more information about Mercy Ships go to