Earthquake victim’s journey leads to Children’s Hospital

From the Winter 2016 edition of Vanderbilt Medicine Magazine

Douglass Clayton, M.D.,  examines Dolman Morales-Ortiz, who was injured during an earthquake in his native Guatemala and later treated  at Children’s Hospital. Photo by Joe Howell.
Douglass Clayton, M.D., examines Dolman Morales-Ortiz, who was injured during an earthquake in his native Guatemala and later treated at Children’s Hospital. Photo by Joe Howell.

Eleuseo Morales-Garcia awoke suddenly to his San Marcos, Guatemala, home shaking violently on July 7, 2014. It was 5 a.m. and the walls were crumbling around him, his wife, Audelia Marta-Ortiz, and their five children.

The earthquake that hit their city that morning—and changed the family’s life forever—reportedly was a 6.9 magnitude. Because Guatemala lies on a major fault zone, earthquakes are not uncommon, though this particular morning was harrowing. He said about 180 homes, including his, were destroyed in San Marcos, a city in the western part of Guatemala near the Mexico border.

“We weren’t able to leave. The earthquake was too strong and the walls started to fall on top of my son, Dolman, and my wife. In this moment, I felt a lot of fear and I was not able to get my wife or my children out. I felt very sad, very desperate for power. My house was destroyed,” said Morales-Garcia, sharing his story during a visit to the Pediatric Urology clinic at Monroe Carell Jr. Children’s Hospital at Vanderbilt.

Morales-Garcia and his 8-year-old son, Dolman Morales-Ortiz, traveled to Nashville from Guatemala for the intricate surgery that Dolman desperately needed but could not receive in his poverty-stricken country. The wall that fell on top of the boy fractured his pelvis, severing his urethra from his bladder and leaving him unable to urinate. Dolman was first evaluated during a Children’s Hospital mission trip to the country. The father and son came to Nashville through a partnership between Children’s Hospital and The Shalom Foundation, a Franklin, Tennessee-based non-profit and humanitarian organization.

The effort took a coordinated team approach, from organizing the trip to the actual surgery, which involved Gregory Mencio, M.D., the Neil E. Green, M.D. Professor of Pediatric Orthopaedics and director of Pediatric Orthopaedics, and Douglass Clayton, M.D., assistant professor of Urologic Surgery.

Dolman underwent a procedure called transpubic urethroplasty, which involves removing all the scar tissue from the original injury and connecting the healthy parts of the urethra back together again. Mencio removed a section of the pubic bone to allow Clayton to gain access to the injured area for the repair.

“I feel optimistic about Dolman’s prognosis. I think we gave him the best possible chance to urinate normally like other children,” said Clayton. “Dolman really has this indomitable spirit despite the difficult circumstances he has faced. He is always smiling and happy no matter what. To see that is really refreshing, not only as a physician but as a human being as well.”

Dolman and his father stayed with a host family in Nashville, organized by Shalom, for about a month while the boy healed. He got to experience American life—hamburgers, American football and Chuck E Cheese’s.

“I would like to thank everyone—the doctors, the Shalom Foundation—and I thank God for granting his power to bring my son here,” said an emotional Morales-Garcia. “I feel very happy and content with the doctors who did the surgery. I will take with me the many good things I have seen here in Nashville. I am very thankful.”

Dolman’s case is not Children’s Hospital’s first international case from Guatemala.

Personnel from Children’s Hospital have been traveling to Guatemala about twice a year since 2006 and have performed more than 500 free surgeries on children. In 2011, Shalom opened the Moore Pediatric Surgery Center in Guatemala City, which is the base for Children’s Hospital care teams when they travel.

“The Shalom Foundation’s relationship to Monroe Carell Jr. Children’s Hospital at Vanderbilt has created life-changing opportunities for children in Guatemala,” said Ken Moore, M.D., medical director for Shalom. “The Vanderbilt medical staff’s annual presence in Guatemala at the Moore Pediatric Surgery Center has helped reduce the number of children needing important surgical procedures, but in selected special cases, such as Dolman’s, patients have been able to come to the Children’s Hospital and receive specialized care that otherwise would have never been possible.

“I personally thank the entire Vanderbilt medical family for the contributions that they are making to improve the health of so many that are underserved in Guatemala and the expertise that they unselfishly share with so many children and families,” Moore said.

Clayton said the mission gives him important perspective on challenges faced in other parts of the world, and allows him the chance to give back to children like Dolman.

“This surgery required a very coordinated effort between Vanderbilt, the Shalom Foundation and the Moore Center, and without all three entities working together this would not have been possible,” he said.