InDepth: On a Mission

In the span of two years, one child’s life has been changed for the better—forever.
Yorlene Reyes, of Uracco, Honduras, recently underwent a 10-hour surgery that corrected her deformed spine due to severe scoliosis and kyphosis. Surgeons at St. Louis Children’s Hospital removed five vertebrae and inserted steel rods to hold her up.

“When doctors saw her X-ray, they could not believe she wasn’t paralyzed,” Mary Gaertner said. “Her pulmonary functions were limited and all her organs were sort of squished together.”

Gaertner, a nurse, goes on a medical mission along with other volunteers to Honduras every year though an organization called ProPapa. It was during one such mission that the volunteers found Yorlene.

Yorlene (second from left) with some of her cousins, in front of their hut in Honduras. Yorlene lived with her grandmother, whom she called "Mama", and cousins. A ProPapa builder's team was helping to build a new home for the family when Yorlene's condition was first recognized.
Yorlene (second from left) with some of her cousins, in front of their hut in Honduras. Yorlene lived with her grandmother, whom she called "Mama", and cousins. A ProPapa builder's team was helping to build a new home for the family when Yorlene's condition was first recognized.

“Yorlene’s family lives in a village that is near the home of ProPapa’s directors,” Michelle Price, who was the first of the mission group to meet Yorlene, said. “I am not sure who found out about her situation, but ProPapa agreed to build her family a home. My family had been involved in caring for another child with spinal deformities so when I saw Yorlene’s physical condition, I thought maybe we could help her, too.”

Yorlene’s problem was twofold: scoliosis causes lateral, or side-to-side, curvature of the spine, and kyphosis causes hunchbacks. Afflicted with severe cases of both, Yorlene’s case would soon be made more astonishing when doctors found out that she was not only walking, but running around her village, behaving just like any normal child.

Price, who had gone to Honduras early to help with a youth construction group, called her mother, Marilyn Price—who coordinates mission trips with Gaertner—back in the U.S., asking her to make some calls about getting Yorlene help.

“There’s a physician in New York who’s affiliated with our organization,” Gaertner said. “He’s an orthopedic surgeon. When he went down [to Honduras] later that year, he evaluated Yorlene. It was then, that the process of getting her a visa to come to the states for treatment was begun.”

But once Yorlene finally landed in New York under the care of host mother Lila Benitez, test results showed that her case was much more difficult than originally thought. After a year in New York, she was transferred to St. Louis, placed under the care of Dr. Lawrence Lenke.

“[Lenke] is a world-renowned spine surgeon,” Gaertner said. “And we have him right here. He took her on at no charge, and the Children’s Hospital pretty much ate the cost.”

It was in St. Louis Children’s Hospital hat Yorlene’s case commenced. She spent six weeks in halo traction, and then went in for a 10-hour surgery. Afterwards, she would spend a few more weeks in Shriners Hospital for physical therapy as well.

Yorlene in her 'halo traction'. For six weeks, doctors prepared her spine for drastic surgery by fitting her in a 'halo' head brace that, as shown, stretched her spine upright. Yorlene reportedly grew a few inches just from the traction.
Yorlene in her 'halo traction'. For six weeks, doctors prepared her spine for drastic surgery by fitting her in a 'halo' head brace that, as shown, stretched her spine upright. Yorlene reportedly grew a few inches just from the traction.

“They literally drilled holes in her head,” Gaertner said. “Then they put this ‘halo’ on her head, and she was in traction, stretching out her spine, so when they went in to do surgery, it wouldn’t be a major shock to pull her out of a position she’s been in her whole life.”

The shock wouldn’t end in a physical sense. In her two years spent in the U.S., Yorlene would have to become used to not only a new life away from home, but also an entire way of living that was very different than what she knew in Honduras.

Adjusting from one world to another

Food, clothing, education and shelter, though easily found in the U.S., are not so near at hand in Yorlene’s native Honduras. Suddenly whisked from her small village outside Uracco, she found herself in an environment the likes of which she had never seen before.

“[Yorlene’s] whole story is very sad,” Gaertner said. “Her mother abandoned her. Poverty is very pervasive in Honduras, and in remote villages, and even in the cities, many lack electricity, and they live day-by-day.”

Yorlene was living in a simple stick home with her grandmother and nine cousins at the time when she met Michelle Price, who was part of the St. Louis team helping to build the Reyes family a bigger and safer abode. The children quickly befriended the builders.

However, it soon became clear, especially during preparation to get her medical help, that Yorlene had no concept of time, with no understanding of weeks, days, or hours, or even age.

“She only knew here and now,” Marilyn Price said. “Yorlene thought she would come to New York, have her surgery the next day and return to Honduras right after that.”

According to the St. Louis Post-Dispatch, Yorlene is 14 years old, but Gaertner estimates that she’s closer to 10 years old than anything else. Her exact age is still uncertain.

Yorlene had also had little in the way of formal education. She attended middle school while living in New York, though she had had only had perhaps a year of school beforehand.

“Yorlene only had a second grade education,” Marilyn Price said. “And it was very inconsistent. [In Honduras] she only went to school when she felt like it.”

Her condition in itself, Gaertner speculates, is due to the scarcity of available medical care, and that Yorlene’s condition worsened to the point that it was because, unlike children in the U.S., Yorlene’s town in Honduras had no means for any kind of regular checkups for children. The annual medical missions that Gaertner attends in Honduras are attempts to mitigate this, at least for one small town a year.

Many people have some form of mild scoliosis, Gaertner said, but Yorlene didn’t have a doctor who could catch it early on.

What most impacted Yorlene emotionally, however, was the food situation.

“She would call home every week,” Gaertner said. “Her grandmother would say things like ‘I haven’t had a grain of rice to eat all week’.”

In the U.S., Yorlene found herself in a culture where getting food was as easy as walking to a supermarket. At only 40 pounds when she initially entered the U.S., Yorlene was malnourished, but gained 27 pounds during her stay.

However, homesickness, plus the knowledge that she had plenty to eat in the U.S. while her family suffered back home, took its toll on Yorlene.

“She was very angry and very lonely,” Marilyn Price said. “She did not want to eat. She felt guilty knowing her family in Honduras had little or nothing to eat. She wanted Lila to wrap up her food and send it to Honduras.”

Yorlene enjoys a day in the U.S. Many of the things that Americans experience every day, such as enough food to eat, clothes, even skyscrapers were a novel thing for a girl who had lived in a stick hut back in her home village of Uracco, Honduras.
Yorlene enjoys a day in the U.S. Many of the things that Americans experience every day, such as enough food to eat, clothes, even skyscrapers were a novel thing for a girl who had lived in a stick hut back in her home village of Uracco, Honduras.

Though she loved her sponsor family, Yorlene’s wish was to go back to Honduras when she was done. According to the ProPapa website, Yorlene would often say, “Tell them to operate on me quickly.”

Lila Benitez found it hard in the beginning to help a girl who really only wanted to go home.

“She was incredibly sad and frightened,” Lila Benitez said. “She was a stranger in a strange land.”

The alienation didn’t last, however. Lila enrolled Yorlene in middle school, who found that she enjoyed riding the bus and making friends.

“The community Yorlene lived in totally embraced her,” Marilyn Price said. “She was learning English. She had friends in the neighborhood. Yorlene and her sponsor mom, Lila, were becoming very close. Although Lila’s children are grown, they treat her like their little sister, even coming to St. Louis when she had her surgery.”

Michelle Price agrees.

“I know at first Yorlene missed her family very much,” Michelle Price said. “She was homesick. However, many people here ‘adopted her’ and made her part of their families.”

Tanya Benitez, who initially alerted her mother Lila about Yorlene’s situation, agrees.

‘‘I remember the first time I took Yorlene into New York City and she had never seen a building in her life,” Tanya Benitez said. “We got out the train station and she was just in awe of the amount of people there. I then told her to look up at one of the skyscrapers and she almost fell over in shock, her eyes and mouth wide- just the expression on her face was worthwhile.”

The road to America

ProPapa Missions, America was established 15 years ago.

Beneath it runs the “Children to America” program, which takes care of one child at a time, making for a total of 15 children like Yorlene that it has helped. However, because the physician that works with ProPapa is stationed in New York, that is where the majority of those children were treated.

Gaertner and the Prices had taken care of another girl, called Maria Elena, two years prior to discovering Yorlene. Because the girl had also had spine deformities—though, Gaertner said, not as bad as Yorlene’s—Michelle Price recognized the condition.

The process of getting a child help is a difficult one, however, and not for the faint of heart. A specific process usually takes place, according to Marilyn Price, and can take up to a year to complete.

It begins with a help request.

Sister Laurinda Mayer, a St. Louis native who joined ProPapa in Honduras after she felt the need to work in a third world country, coordinates the mission trips from the receiving end. It is she who is approached by a parent seeking help for their child.

When the medical mission team arrives in the village, Sr. Laurinda typically directs them to the child. The process of bringing the child to the U.S. begins if child cannot be treated in Honduras and is afflicted with a life-threatening situation.

Such were the conditions that brought both Yorlene and Maria Elena, among others, to the States. Lab work, pictures, and x-rays are done in Honduras while the process of seeking a doctor and hospital that will treat the child—with no charge—commences.

“Usually a physician agrees on a ‘first time visit only’,” Marilyn Price said. “That means they want to see the child first to make sure the child can actually be treated. Once the hospital and physician agree on that, the next step begins.”

After a hospital is found, the legalities are then addressed. Sr. Laurinda accompanies the parent and their afflicted child to the Embassy in Honduras in order to obtain a Medical Visa.

Once the Embassy signals its approval (decisions take about one month), the child gets a passport as well.

The final stage is to find the child a U.S. sponsor to take care of them during their stay.

“The sponsor parent will house the child and take care of the child as if he or she were their own,” Marilyn Price said. “They take them to all the hospital visits and see that they have everything they need. This is a huge commitment, since as in the case of Yorlene Reyes, the child might be there for over a year.”

In Lila Benitez’s case, becoming a host mother turned out to be much more than she bargained for—but in a good way. A retired nurse and fluent in Spanish, she became aware of Yorlene’s situation when her daughter Tanya Benitez, a social worker, received an email seeking potential sponsor parents.

She decided to take on the challenge.

“Yorlene has thrived under her care,” Gaertner said.

  • Junior Colleen Kinsella, of Ursuline Academy in St. Louis, takes   the blood pressure of a patient. Kinsella attended last year's medical   and dental brigade.Junior Colleen Kinsella, of Ursuline Academy in St. Louis, takes the blood pressure of a patient. Kinsella attended last year’s medical and dental brigade.
  • For the duration of time that Yorlene stays in the U.S., Lila Benitez has legal guardianship over her.

    “As you can see, it is a difficult process that involves a lot of truly dedicated people,” Marilyn Price said. “The end result is wonderful and so rewarding. A child, who otherwise might not have lived, is given a chance at a normal, healthy life.”

    The home stretch

    The tail end of Yorlene’s ordeal is almost ended; she has had a few weeks of rehabilitation at Shriners Hospital—which, according to Gaertner, does a large amount of spinal surgery—undergoing physical therapy, learning to use muscles she hadn’t had to before, and regaining her altered sense of balance.

    During traction alone, Gaertner estimates that Yorlene grew a couple inches—but after the surgery, her newly straightened spine made her quite a bit taller, enough to cause her to need new clothes, a bundle of which she recently sent up to New York, where Yorlene is currently living.

    Though the whole ordeal was “exhausting”, Gaertner said, Yorlene’s rehabilitation “wasn’t as bad as you might think.”

    The one question that stands now is the future—and how, or where, exactly, to let Yorlene go. She will spend more time in the U.S., perhaps until July, for a follow-up visit to Lenke. After that, little, if anything, is known. During Yorlene’s stay in the States, Yorlene’s grandmother died, prompting questions about her custody and future.

    “We don’t even know what’s going to happen to her,” Gaertner said. “Lila wants to adopt her…we won’t abandon her, but we have to function within the legalities. She wants to go back to Honduras, but I don’t know how she’ll feel when she gets there.”

    Yorlene has three main options when she’s cleared by Lenke to return home. The least desirable option, according to Gaertner, is for her to move in with her 18 year old cousin who has three children, and who lives a 30 minutes’ walk from Yorlene’s old house.

    Secondly, she could stay in the U.S. with Lila as her foster parent, or thirdly, live in El Progresso, Honduras, with a friend of ProPapa Missions’ founders.

    “Lila is wonderful but Yolene wants to return to Honduras so in my opinion, this [third choice] is the best option,” Gaertner said. “She could catch up with her many missed years of education and attend a prestigious bilingual school there. If this happens, Marilyn and I are already planning to pay the tuition which makes this a very viable option.”

    Both Michelle Price and Gaertner, however, are unsure as to how Yorlene will go back to her old life of poverty now that she’s had a taste of American life.

    “After adjusting to cultural changes, the easiest part was probably enjoying the American way of life—toys, movies, clothes,” Michelle Price said. “A lot of times, it is hard for kids to go back to their former lives.”

    After just a couple of years, Yorlene will face the change between New York to Uracco once again… but this time, the other way around. However, wherever she goes, she will always carry with her a little of her life-changing stay, however short it may have been, in the U.S.

    What is ProPapa?

    For the past six years, Marilyn Price and Gaertner have jointly coordinated their yearly medical missions together, but it was Michelle Price who originally voiced the idea of mission work.

    “I had wanted to do mission work in high school,” Michelle Price said. “It didn’t take much to get my mom to agree. I basically just brought it up a couple of times and she was on board.”

    Her source of motivation, she said, was the inequality she saw regarding the basic needs in the U.S., as opposed to those of the people living in Honduras.

    “We have so much in the U.S.,” Michelle Price said. “The poor here are rich compared to the poor in Honduras and other developing countries. There is no welfare, Medicaid, food pantry… no safety net at all. I wanted to give these people something, however small, to ease their lives. I wanted to help people who had no other option.”

    Such missions now being annual, they begin planning their next mission six months in advance.

    A Honduran villager drives a load of crop down the mountain. Last year's mission spent one week in the remote mountain village of La Peña.
    A Honduran villager drives a load of crop down the mountain. Last year's mission spent one week in the remote mountain village of La Peña.

    “There are many aspects of the trip that need to be considered,” Marilyn Price said. “I think the objectives of the mission trips Mary and I have coordinated over the last six years have been to reach those suffering from severe poverty to help alleviate their suffering. We look at each trip in terms of accomplishments and struggles and improve our efforts where needed. We try to enhance those that have succeeded well.”

    Though it has been difficult for her to go on the trips themselves since she graduated from college and began working, Michelle Price tries to stay involved any way she can.

    “A lot of prep work goes into the trip,” Michelle Price said. “I help with making medication labels, fundraising and other tasks. Volunteers are needed both in the US and in Honduras.”

    It is not uncommon to see young volunteers on medical teams as well—CHS students, as well as other high school students, have gone on the trips in the past and continue to do so.

    Aaron Praiss, a 2009 CHS alum, went on the St. Louis medical mission last year.
    “I went to get more of a firsthand experience with medicine and patient care.” Praiss said. “It’s a completely different experience than an hospital in the States, it’s less organized. Besides that, it was also an excuse to go to a foreign country, which I love, and to speak Spanish.”

    The group that Praiss went with split its two-week stay in Honduras between two different villages. Praiss volunteered for registration for the first half, and assisted a pediatrician for the second.

    “The second village, La Peña, was a mountain village,” Praiss said. “It was extremely remote; so remote that we had to take pickup trucks to get there and then hitchhike with village people up the mountain.”

    Most of the patients had never been to a doctor before. Praiss saw conditions of varying degree, from infections to hydrocyphalus, a condition in which a baby’s head is formed too large due to the lack of folic acid while in the womb.

    “You heard crazy stories about people walking 45 minutes to see the doctors,” Praiss said. “There was the case of one patient who told the nurses that the rest of his family couldn’t make it—one son was completely blind, another had issues with mobility. We made a house call instead.”

    The blind son turned out to have cataracts, and was referred to a hospital to get them removed. Before the patients left the ProPapa clinics, they were given medicines, supplements, and basic hygenic supplies. The volunteers took great pains to stress proper use of all the supplies.

    “I don’t know how much stuck,” Praiss said, “but it was a good step in the right direction.”

    Gaertner’s daughter, sophomore Zoe Keller is going on the mission this year.

    “I love helping people in need and making a difference in the world,” Keller said. “I have been involved with ProPapa since the sixth grade when my mom went to Honduras for the first time. She has been going every year since and I am finally old enough to go with her. My mom always comes home with so many incredible stories about Honduras so I think it will be a great experience.”

    Keller will be doing mostly registration work.

    “I get to take down the personal information, blood pressures and weigh patients before they see the doctor, nurse or dentist,” Keller said. “At the end of the day, I will be responsible for tallying up all the medical forms and counting how many adults vs. children were seen that day and how many patients went to the dentist. I was told that I have to be flexible because my assignment could change depending on if I’m needed somewhere else.”

    ProPapa doesn’t just stop at medical aid, however. In addition, it also lends construction and dental assistance as well, and sends “brigades” of each specialty to Honduras throughout the year.

    A group of Hondurans waits for assistance outside a ProPapa nursing station. Most villagers had never been to a doctor before.
    A group of Hondurans waits for assistance outside a ProPapa nursing station. Most villagers had never been to a doctor before.

    For instance, construction teams build cinder block houses in Honduras for families who need them, as well as water purification systems and nutrition centers.

    “At the present time, ProPapa is building a bridge to replace a rope-style bridge,” Marilyn Price said. “The preexisting rope bridge was in such disrepair, that many lives were lost attempting to cross it. Many of those who died were children trying to get to school.”

    ProPapa itself began in Honduras about 30 years ago, founded by Benigno Ramirez, a street child who pulled himself from poverty.

    The mission statement of ProPapa is “To work with the people in Honduras to relieve their suffering through health, housing and education”.

    Children like Yorlene in need of medical care are not the only ones receiving sponsorship. For its 15th anniversary, ProPapa built a clinic which is kept open 24 hours a day. There, mothers and their babies can be supported, and are able obtain prenatal and infant care. Furthermore, ProPapa also has a scholarship program. For $50 per year, a child can be sponsored to attend school.

    “Both organizations [ProPapa Missions and ProPapa Missions, America] work together for the good of the people,” Marilyn Price said.

    This year’s upcoming medical mission trip is June 8-June 17th. As for Yorlene, wherever she lands, her life will have been changed forever by a group of determined supporters.

    “I recently got a thank-you note from her,” Gaertner said. “It was just so dear… The fact that we can change one person’s life so dramatically, I just feel like any good anybody can do is worth it.”