Saturday, June 16, 2001 -- York Daily Record

From YorkCounty, doctors reach out to Central America
By Jennifer Nejman, Daily Record staff

Jonatan Fuentes clutched a teddy bear, arms folded around the stuffed animal in miniature York Hospital scrubs. He wasn’t nervous.

The 10-year old, wrapped in a white hospital sheet, awaited another operation that would help him become socially accepted when he returns to Honduras.

Before his surgery at York Hospital he wasn’t able to sit on the toilet like other kids. He was born without an anus.

Jonatan arrived in January to begin testing. He had the first operation in April, the second procedure two weeks ago, and has one more to go in July. He should return home later this year.


Doctors in Honduras had created a way for waste to exit his body from his large intestine into a bag, a procedure known as a colostomy, but had not created an anus, said Dr. Domingo Alvear, his surgeon at York Hospital. Alvear performed the operation for Jonatan and another Honduran boy, Josue Rodriguez, 6, who suffered from the same condition.


Josue is further along. He is in the process of potty training, said Janet Boozer, his foster mother. Janet and her husband, Jay, live near Hershey and have been making trips to York Hospital for Josue’s testing and surgery.

On June 7, Jonatan poked his fuzzy blue surgical shoes out from under the sheet at the hospital. Between smiles, he talked with his foster mother, Denise Malanchuk of Millersville, and Alvear.


In the United States, Jonatan has learned to speak English – “not much,” he said, but with hardly a trace of an accent. He’s eaten chicken, hamburgers and milkshakes and played with Malanchuk’s cat, ridden a scooter, traveled with his family to Vermont and started working on math. Addition is easy; subtraction is coming up.


When Jonatan lived in Central America, he rarely ventured to public places because he smelled differently, Malanchuk said. For the same reason he’d never attended school. They didn’t have the proper medical equipment, so instead of bags to catch waste, which would be used in this country, people would tie T-shirts around him, his foster mother explained.


Alvear, the surgeon, said if Jonatan and Josue had been born in the United States, they would have had the operation as babies, probably before they turned 1.

The worldwide incidence of such conditions is one for every 10,000 births, Alvear said. In some Third World countries, children will die if nothing is done about the condition, he said said.


But in York, both children have responded well to treatments.

“They didn’t complain about pain,” Alvear said. “Their pain tolerance is high… They don’t cry like our kids. They can handle infection.” He said such high tolerance is necessary for the conditions they live in, which are below U.S. sanitary standards. They really have a good system –it’s God’s gift to them.


Malanchuk and her husband, Gabe, decided to care for Jonatan after they had spent time with the boys in Cathy Stauffer’s home. Stauffer, a York Hospital nurse, has made many trips to Honduras. She escorts children to the United States for medical treatments. Stauffer helps bring the children here through the Heart House, a program run through Mountville Mennonite Church in Lancaster County. Since 1997, a group within the church has brought 24 children to the United States, 11 to Pennsylvania, she said.


At one time this spring, Stauffer had five children in her home.

Just taking the children out of the country requires planning and paperwork. It costs about $400 per child to file the papers and lab work necessary, she said. That $400 doesn’t include the plane ticket, and testing for each of the boys costs $1,000, Stauffer said.


The surgery will make the boys’ lives easier. “Medically, they could have lived, but emotionally they would have a really hard life,” Stauffer said. “Now, when they go back, they will be able to go to the bathroom like anybody else and be socially accepted.”


Alvear volunteered his time through the York County Medical Foundation. The foundation and The Heart House coordinated efforts to get help for the two boys.

Alvear also is the founder of World Mission of Central Pennsylvania Inc. He said he may take his mission to Honduras and has a trip planned to India next spring.

About a year ago, York’s medical foundation started an initiative to bring children to York for treatment for procedures too difficult to do in their home countries, said Dr. Vasudevan Tiruchelvam, president of the foundation.


Earlier this year, they treated a child from Guatemala. The 13-year old had bone cancer that had spread to one of her lungs, Tiruchelvam said. She received treatment at the Penn State Milton S. Hershey Medical Center.


Physicians give their services for free, and the foundation has been holding events, such as a golf tournament, to pay travel expenses. They recently raised $5,000 through a dinner, Tiruchelvam said.


Doctors at York Hospital also go on medical missions, traveling outside the United States to offer help. In February, Tiruchelvam traveled to Ecuador.

On these trips, Tiruchelvam said, he sees children who need more sophisticated operations. “If we feel confident we can give the best care for the child, we bring them over,” he said.


Tiruchelvam said he chooses his cases carefully. He expects that once the program gets going, area doctors will help about four international children each year.

Meanwhile, Jonatan is recovering from his most recent operation. His surgeon says he’s handling this well. “These kids are tough,” Alvear said.