Author Archives: Children's Surgery International

Working together on day one

We had a great one!  After the usual day one challenges, 11 children received life-changing surgery. Today at every turn our team members showed their incredible focus, resilience, patience, compassion and skill:
  • The anesthesia team working to secure the necessary medications and fluids to prepare a child for surgery.
  • The medical records team organizing each chart and preparing the families for pre-op.
  • The OR nurses making sure instruments were sterilized and ready for the surgeons to do their craft.
  • The PACU team ready to support the unique needs of each child as they woke up after surgery.
  • The ward nurses and doctors securing the rooms, beds and tables needed for families as they spend the night recovering.  
We can’t wait to get back at it tomorrow!
Dody Barr, RN; Jan Gauger, RN; Dr. Bruce Ferrara; Dr. Jesse Hennum; Linda Sedgwick, RN
Tetee Urey-Morris, RN and Zoë Reker, RN

See more photos from our Ethiopia surgical mission on Flickr.

If you build it, they will come—A word from Zoë Reker, RN

Today was screening day. My first week as a CSI volunteer is finally getting started, and wow, did it begin with a bang! Twelve hours later and I am still trying to find words for my thoughts from the day.


ENT screening – Zoe Reker, RN; CSI surgeons – Dr. Greg Kelt, Dr. Alonso Carrasco, and Dr. Jon Robitscheck.

I worked in ENT screening with CSI volunteer surgeons Dr. Jon Robitscheck and Dr. Greg Kelts. We met with somewhere between 70 and 80 children. Kids of all ages arrived with hopes for cleft lip and palate repairs, as well as other ENT needs. It was a busy day, full of collaboration between the CSI and local medical team on planning the week as well as future visits.

Here we are as a group, providing mass surgical intervention, but also creating educational opportunities for growth of Bahir Dar’s current staff and developing medical students. It is empowering and inspiring to see everyone working hand in hand.

A favorite memory from today was seeing both Greg and Jon recognize children who had been CSI patients in the past. Numerous times, I admired how Greg would take one look at a child or parent and remember the cleft lip, immediately scheming how the palate could be fit into the surgical schedule. How amazing it must feel to see a child one year post cleft lip repair, back with parents, smiling with big eyes, ready for the next step in their surgical journey.  

Families, I learned quickly, travel hundreds of kilometers to make it to screening day in hopes of securing surgery during this week. Not only are these families dealing with the challenge of specialty surgical needs, the travel is extensive and intense. Getting to Bahir Dar is a journey that so many families are willing to take in the hopes of bettering the health of their child. Their travels alone are humbling.

Zoë and interpreter Desie announcing surgery schedule.

The mindfulness the team practiced while building the surgical schedule was astounding. Having a goal to create the most meaningful impact on the greatest number of children is no easy feat. At the early and later part of screening, I wondered how we could even start to make a dent in a place that needs so much. Today proved to be equally challenging as rewarding. For every “yes” to a scheduled surgery, there was also a “no.” I am impressed by the considerations that went into account: the type of surgery, physical health, length of operation time, resources, follow-up, length of travel. All of these factors played challenging and meaningful roles in the surgical schedule for the upcoming week. As a new team member of CSI, I see that these trips are more than quantity: they are quality, significant and intentional. 

As we packed up our supplies and walked out of the hospital today, a phrase came to mind: “If you build it, they will come.” This statement could not feel more true tonight. It speaks to the parents, who traveled by any means they could over vast distances, and the volunteers, who have donated their time for the love of a child. It speaks to those who have donated time, resources and money to build what CSI is here to do. With each of these trips, children, families and medical professionals from around the world are coming together to challenge, inspire and empower one another. I am so thankful to get started and be part of a week of miraculous work!! 

Medical records table – Cindy Halverson, Amy Fischer, Daniel (interpreter) and Linda Sedgwick

View more photos from the Ethiopia surgical mission on CSI’s Flickr site.

Preparations in Bahir Dar

The full Ethiopia surgical team has arrived! We had a good day of preparations with our partners at Bahir Dar University Tibebe Ghion Specialized Hospital.

We toured the hospital and also learned about a wonderful anesthesia training program collaboration through imPACT Africa (Improving Perioperative & Anesthesia Care and Training in Africa), Vanderbilt University, and Bahir Dar University. They hosted a two-week train-the-trainer program for anesthetists using their new anesthesia simulator—very cool! Tomorrow is screening day, and we are looking forward to helping about 60 kids during our stay. More updates to come!

Bahir Dar University Tibebe Ghion Specialized Hospital
ImPACT Africa (Improving Perioperative and Anesthestic Care Training)

Reflections from My First Trip – Mexico 2019

Sharalee Walton, RN ~ CSI Volunteer

My trip to Hermosillo, Mexico with CSI was actually the first medical mission trip I had the pleasure of going on.  It had been a desire of mine for several years, but the right opportunity had not presented itself until recently. Like many medical professionals I went into my field because I wanted to help people in need.  Growing up, my favorite toy was my Fisher Price medical play kit. As a result, my dolls and Cabbage Patch Kids were in the best of health. Some of them even had check ups daily. 

Blowing bubbles to pass the time.

I have an interest in working with children with special health care needs, especially in the area of ear nose and throat surgery and oral surgery.  So this trip seemed like the perfect fit.

With St. Andrews Children’s Clinic founder, Coca Romero

As excited as I was to go on my first trip, I also had some anxiety. I had never practiced nursing outside of the U.S. and my high school Spanish was rust, to say the least.  When we landed in Hermosillo we were greeted like royalty. There were parents and children, volunteers from CIMA, and St. Andrews Clinic. There was a festive reception in the hospital lobby, complete with balloons, cupcakes and Star Wars storm troopers. One five year old girl, a former patient, sang Louis Armstrong’s What a Wonderful World. There was not a dry eye in the room!   

Welcome ceremony hosted by Voluntariados CIMA

During this trip I had the privilege of serving in the recovery room. I witnessed parents and grandparents see their child for the first time after the surgery – tears of happiness,  expressions of joy, beaming with pride in seeing the lip or palate defect fixed. These experiences and connections with our patients and families are something I will never forget. 

My colleagues and I assisted 55 kiddos after surgery. I had the time of my life, and I can’t wait to go again.

See more photos from Mexico here.

Lube-Tech Day – Stories of Transformation

The strong support that CSI receives from Lube-Tech and Bame Foundation has allowed us to be here in Hermosillo, Mexico and help young and older children continue with their progression to living a normal life.  Thank you so much to all the employees for your support! Thank you, Lube-Tech. Here are just a few of the stories from the Lube-Tech day of life-changing surgeries:


Axel and his grandma ready for surgery

15-year old Axel lives with his grandparents in Ciudad Obregon, more than 3 hours by bus from Hermosillo. His parents have been out of the picture for as long as he can remember. They are very poor and for years were unable to find doctors to repair Axel’s cleft lip and palate, let alone pay for it if they did. Axel did not go to school for years because of his condition. 

Axel’s grandmother never gave up hope, and when she learned years ago that a CSI team comes every October, she begged and borrowed the money for the bus fare to get them three hours north to Hermosillo. On their first trip, our team repaired Axel’s cleft lip, then in 2017 his palate. We told Axel to return for evaluation, and this year, we were so pleased to see Axel and his grandmother again. 

He needed a bone graft surgery, where a small piece of bone from the hip is used to fill in a gap in the upper jaw. (Some children with cleft lip or palate also have a cleft in the gum ridge of the upper jaw that holds the teeth). With this surgery complete, it will be easier for Axel to eat, his nose and teeth will be better stabilized, and his speech and appearance improved. We were so excited to hear that Axel is now going to school! He is taking a special computer course, and says that he wants to work with computers as an adult. 


Sonora is a very large Mexican state, and although everyone tries their best, it’s impossible to let every parent know that a free cleft lip and palate mission is coming to Hermosillo in October. Which is how we received a frantic phone call Monday from the mother of three-month-old Ian from their home five hours away in the tiny border town of Aguaprieta. They missed screening day, but could she please bring Ian for surgery to repair his cleft lip. When we said yes, they jumped in the car, arrived at the hospital at 1:00am. Ian’s mother was so excited she couldn’t sleep all night!

Ian and mom drove all night to get surgery.

Ian’s surgery went very well, and he woke up VERY hungry! When she saw her baby boy for the first time after surgery, Ian’s mother’s exhausted look changed to tearful excitement and love. That’s the best part: seeing the faces of the parents as they embrace their children after a successful surgery! 


Jose and his sister Cecilia came all the way from Nogales, Sonora. Jose is now 16, but he first connected to the St. Andrews clinic as a small child with a cleft lip and palate. St. Andrews brought him to Hermosillo to CIMA Hospital for the CSI mission, and over the years he has had several surgeries. 

Jose and Cecilia

Jose’s mother tragically passed away when he was 12 years old. His much older sister Cecilia took over care of Jose, as well as their younger brother. “It was so chaotic at first,” she says. “The boys were 12 and 10. I didn’t know how to be both mom and sister, let alone a grieving daughter.” Cecilia continued to bring Jose every year to Hermosillo to be evaluated by CSI. 

This year Cecilia brought Jose for rhinoplasty surgery so that Jose will be able to breathe much easier. The surgery will also help his speech and ability to be understood. Which is important, because he now plans to follow in his sister’s footsteps and pursue additional training and ultimately a degree in electronics engineering. Cecilia and Jose are so glad to be here, and say “Thank you Lube-Tech for making this surgery possible!”

Screening Day – Mexico 2019

The 15th annual CSI mission to Hermosillo, Mexico got off to a rollicking start at 7 a.m. Saturday. We screened 108 children who came from all over the state of Sonora to see our surgeons. 

We are especially excited to be here for our Quincinera! We are celebrating the 15th anniversary of a unique collaboration between CSI, CIMA Hospital in Hermosillo, and St. Andrew’s Children’s Clinic, based in Nogales, Arizona. Working hand in hand with our wonderful partners, we have been able to provide top-notch surgical and ongoing care for more than 700 children!

For me, one of the best parts about our unique partnership with CIMA and St. Andrew’s is that we are able to follow children as they grow and need subsequent surgeries, speech therapy and more. I love to see kids come back who I met five or six years ago when they were tiny, knowing that now they are growing and thriving because they have been able to receive life-changing care from CSI.

Marco is a perfect example. I met Marco on my first CSI trip to Mexico in 2013 when he received his first surgery for a cleft palate. He was an active happy toddler, and now in 2019, he came back to us a handsome and outgoing eight-year old. He will undergo speech surgery on Tuesday, which will allow him to be more easily understood. I’m so grateful for this collaborative relationship with CIMA and St. Andrews which allows us to provide this extended care for Marco and hundreds more. 

Melanie McCall ~ CSI Volunteer

Click here to see more photos from Mexico.

Surgery & Education – Tanzania 2019

In addition to many successful surgeries each day, education is a significant focus for the team in Tanzania. Surgeons, nurse anesthetists, anesthesiologists and nurses are working side-by-side with their Tanzanian colleagues in the operating room. On the patient care ward, nurses care for kids as they recover – alongside their local partners.

CSI volunteer nurse Victoria Vandersteen visited two community health care centers to teach a course developed by the World Health Organization and the American Academy of Pediatrics called Helping Babies Breathe. Victoria taught participants how to assess the newborn and intervene if the infant needs help with breathing and ventilation within the first minute of life (the “golden minute”). Participants included nursing and medical students, as well as an OB/GYN physician and a dentist.

See more photos from the team in Tanzania here.

Surgery Day 2 – Tanzania 2019

The day started early but things have gone well. The mothers and children are beautiful. Can you imagine how these loving parents feel as they put their trust in CSI and our dedicated volunteers carry their precious child off to surgery? CSI Clinical Lead, Norie Wilson spent time with a mom today: “This poor mom was beside herself when her child was in surgery, crying inconsolably and hyperventilating. It must be very scary to hand your baby over to strangers who just blew into town. Much better now!”

When CSI is working at a site, we have two goals: (1) free, safe and life-changing surgery; (2) collaboration and education. Most CSI volunteers function in very different roles on these trips – sometimes we even get to see the full start to finish experience for a family and a colleague. For instance, we get to follow a family all the way from screening day to surgery day to discharge day – this is a powerful experience for us. In addition to the pride you feel in knowing you made a real difference in a person’s life, we gain so much that helps us be better providers when we return home.

CSI nurse anesthetist Jeannie Klein shared this thought today: “I can’t wait to share some of my pics of the kids. They are simply adorable. So innocent, so inquisitive and yet so apprehensive. I wish they all could have a better life. At least they are loved by their families…”

Toti and his beautiful mother

Check out our Flickr album for more pictures from Tanzania.

Safe arrival and straight to work!

We know many of you are anxious to hear the update from Tanzania!

The CSI 2019 Tanzania team has all arrived safely in Arusha after traveling long distances from their homes in Idaho, North Dakota, Pennsylvania, North Carolina, Minnesota and South Carolina!

CSI brings teams of skilled pediatric medical, nursing and surgical professionals together from around the United States – and occasionally around the world – to work side-by-side with colleagues in the countries we visit. Their goal this week is to teach local surgical teams and nurses while performing life-changing surgeries on children in great need.

The team screened 48 children on their first day of work at Arusha Lutheran Medical Center (ALMC), and they expect many more will walk in over the course of the week. The morning started with the CSI and Arusha teams working together to make a plan for the week, getting equipment setup and planning procedures for evaluating children for surgeries.

Nurse educator Victoria Vandersteen, RN, had a particularly special experience today when she reconnected with young Kristina. Kristina was a patient she and the team worked with last fall during CSI’s first trip to the region. At that time she underwent a rare pediatric urologic surgery performed by Dr. David Vandersteen and the Tanzanian surgical resident. Victoria is so pleased to report that Kristina is feeling bright eyed and whole. The local health-care team has been able to provide the ongoing care and follow-up that she needs.

Victoria Vandersteen, RN and Kristina

While his is the first mission trip for many on our Tanzania team, others have traveled with Children’s Surgery International multiple times, and they are promising great stories to come! View more photos in our Flickr album.

Heading Home – Ethiopia Spring 2019

We certainly finished the week on a high note! Yes, it has been a challenging mission in some respects, but we are constantly reminded of all the good that can come of it. This was never more evident than with our last two patients on the last day of surgeries. Both are teenage boys with severe facial deformities, who have experienced a lifetime of shame…. up until now.

One of those young men is 15-year old Ayeengida, born with a severe bilateral cleft lip. His caring and anxious older brother told us that Ayeengida has never been to school because he was too ashamed, and even would hide when extended family came to visit. All he wants, he says, is to go to school. He and his brother nervously waited all day, and their excitement was contagious! When it was time for Ayeengida to go with nurse Ana to the operating room, we were all smiling and laughing and cheering.
The surgery went very well, and the difference apparent immediately. When Ayeengida woke after surgery, we held up a mirror to his face. His eyes widened, then filled with tears, and he just stared at himself, shaking his head as if he couldn’t believe it. The room erupted in cheers as we wheeled him out to the waiting area and to his brother. When asked what he wanted to do next, Ayeengida immediately said “go to school,” followed by “I want to be a doctor.” More happy tears were shed by everyone in the room. No more shame, and a life full of promise for the future.

What a fabulous and emotional finish to an incredible week! 136 children screened, 58 surgeries performed, and so many lives changed forever. We are tired, we could use some more sleep, we are excited to come home, AND we eagerly look forward to returning to this beautiful country and people in November 2019.

See more photos from Ethiopia on Flickr