TheTimesTribune.com, Corbin, KY

January 19, 2009

‘God is at work in this’

Local doctors provide free care to teen from Honduras




By Samantha Swindler / Managing Editor

Editor’s Note: A special thank you to Gina Barajas, who served as a translator for Enrique Paguada. Without her help, it would have been impossible to share his story.

In all likelihood, Oscar Enrique Paguada was destined to die of a broken leg.

Instead, the 19-year-old student from Honduras is recovering from a series of surgeries here at Baptist Regional Medical Center in Corbin, where missionary doctors Elaine and Chad Eustis, surgeon Keith Belhasen and a handful of medical staff have saved his life.

More than eight months ago, Enrique was struck by a car while riding his motorcycle to school in his hometown of Catacamas, Honduras. The crash pinned and badly broke his left leg. But it took several hours to get Enrique treatment, and by that time blood was not properly flowing through the leg and it had to be amputated below the knee.

From his bed at Oak Tree Hospital in Corbin and through a Spanish translator, Enrique said he arrived at the public hospital in Honduras “near death” after his accident. A metal rod was inserted into his leg, and Enrique initially stayed in the hospital two months before being sent home to recuperate. But the wound became infected, and Enrique stayed at two different hospitals, enduring 14 different surgeries in Honduras — all ultimately unsuccessful in trying to stop the infection.

He said he was back in the hospital, suffering in great pain, unable to walk or even move his leg, when he first met the Eustises in early December.

The American doctors were on a mission trip sponsored by Jackson Healthcare and hosted by the Predisan Health Center, based out of Catacamas, Honduras. The organization gets its name from the Spanish words predicar, which means “to preach,” and sanar, which means “to heal.”

Chad Eustis, a general surgeon who works in the Tri-County, said he performed 41 operations in three days as part of the mission. While there, he met Enrique and quickly realized the teen’s treatment required equipment and facilities that exceeded what was available in his home country.

“The problem is the infection in the bone is making him sick,” Chad Eustis said. “With the infection, the bone never really healed... I just sort of washed out the infection from his leg while I was there. It just takes the pressure off from an infectious perspective.”  

On Saturday, Dec. 6, Eustis sent a short e-mail from Honduras to Oak Tree Hospital CEO Alan Coppock.

“Sorry I have to be brief, “ Chad Eustis wrote. “There is a 19 year old boy who has an infected left femur rod and a left bka... [below the knee amputation]. If I find an orthopod to help remove rod, can OTH [Oak Tree Hospital] donate his postop hospitalization?”

Coppock read that message on a Sunday morning after church, and starting making arrangements that week for Enrique’s care.

“I called John Henson, who’s the CEO of Baptist Care Regional,” Coppock said, “and I said ‘Dr. Eustis is in Honduras and has a 19 year old young man who needs some pretty intense work done, it’s pretty critical to his survival, and would you be willing to donate services if Oak Tree donates the actual nursing care.’ And John said sure; it didn’t even take two or three days to decide.”

Both hospitals and all physicians involved donated their services at no cost for Enrique. According to one letter from Coppock, post-operative care at Oak Tree alone was estimated to cost more than $1,100 a day.

A series of e-mails back and forth while the Eustises were in Honduras documents how quickly everything came together.

“The miracle continues!” Chad Eustis wrote. “...I am humbled and amazed at how quickly so many barriers have been overcome. Surely, God is at work in this.”

The Eustises arrived back in Kentucky on Dec. 10.

“Between the 10th (of December) and the 5th of January, a lot of things had to occur,” Coppock said. “We had to write letters to the United States Consulate in Tegucigalpa saying we were willing to donate this care as part of our charity program... The U.S. government had to grant him a medical visa... There were folks from Hal Rogers office that got involved, simply to say... these are real people, they’re not trying to pull anything over anybody.”

Enrique’s medical visa was granted on Dec. 30. He flew out of Honduras on Sunday, Jan. 4. and arrived in Corbin early in the morning Jan. 5.

“He was very badly infected, his left femur had a significant amount of infection that, if it had gone on much longer, would have been life threatening, I think,” Coppock said. “He was happy as a lark when we got him and I thought, ‘he doesn’t even look sick,’ but in fact when they started work on his leg, it was really bad.”

Enrique was in danger of becoming septic, a potential fatal turn meaning the infection would have entered his bloodstream.

So far, Enrique has endured multiple surgeries in the U.S. under the care of orthopedic surgeon Dr. Keith Belhasen, including an above the knee amputation on his left leg. Though doctors are pleased with his progress, they aren’t sure exactly how many weeks Enrique will remain in Corbin — not that the hospital staff minds.

“Our nurses have fallen in love with him,” Coppock said. “...He has been a delight, and I think everyone has felt part of a miracle, truly, that this man in Honduras, that comes from humble resources, had a broken leg. Can you imagine dying from a broken leg? Because he wasn’t able to get care quick enough? And that was the route he was on, had there not been a physician missionary and his wife visit Honduras and say we can do something about this.”

Though he hasn’t been able to leave the hospital, Enrique has been given a laptop with Internet access, several phone cards to stay in touch with family, and Coppock said some nurses have even lent him their cell phones.

One highlight has been Enrique’s first chance to see snow.

“We took in a cup of snow to him to let him see,” said nurse Debbie Burke. “And then I made a snow ball and threw it at him. He gave me a little grin and threw it back.... He just kept saying ‘snow beautiful, snow beautiful.’

“He’s just a wonderful person is all I can say,” she said. “I think one of the girls said it best when she said she’d just like to bundle him up and take him home with her.”

Doctors are working to get a prosthetic leg donated for Enrique, and they aren’t exactly sure how many more weeks he’ll need to stay in the U.S.

“I’m grateful for all of the hospital administration and Dr. Belhasen,” Chad Eustis said.  “I think it’s pretty cool.  It brings out the best in people... It’s been a real privilege for me to be part of this. It feels good.  It’s so different from regular healthcare...It’s like I get to be a missionary here.”

Eustis said he admires Enrique’s courage in coming to alone to have operation.

“I just think he’s incredibly brave,” he said.  “He’s got a great attitude and great outlook...he’s really inspiring to me.”

Enrique is grateful for the care he’s received, but is constantly battling homesickness. The teen said he has never been away from his close-knit family before. Not only was the trip to America expensive, but obtaining a visa is difficult as well and he had to travel alone. Enrique said his father is a construction worker and his mother is a dress maker. Enrique is the oldest of four children — he has a younger brother and two younger sisters who are twins.

His room at Oak Tree Hospital is relatively bare of person effects, except for the loaned laptop and a framed photo at the foot of his bed of the American doctors who helped him.

Tears come to his eyes when he talks about the care he’s received.

“They are people who are interested in helping others who need it,” Enrique said. “Thanks to God that they were able to bring me here. I’m very happy to be able to be here with them.”