Whenever he remembers the boy whose cleft lip he repaired while he was on a medical mission in Belize, Dr. Alan Burke loses his composure. "I always get teary when I even think of this story," Burke says during an interview in his Henrico County office.
"This little dude came in, just bedraggled, raggedy-Ann clothes, pale, skinny type," Burke continues. "When we came back the next year, I didn't recognize him at all. He was this bulked-up, plump guy. He had a sharp haircut, and he was dressed in his school uniform. And he goes, ‘Dr. Burke, do you remember me? Remember you fixed my cleft lip last year? Do you know I can now go to school? I even have friends?' "
Burke draws a long, shaky breath. "He was a second-class citizen in his little community because of the cleft lip. It sort of exemplifies it all for me."
The physician was relating one of his many experiences in Central America on medical missions with what is now called the World Pediatric Project (WPP). Since its inception in Richmond as the International Hospital for Children (IHC) in 2001, the organization has treated more than 10,000 pediatric patients in Central America and the Caribbean with the help of 29 Virginia physicians, most of them based in greater Richmond. The doctors work in general surgery and a variety of specialties.
In March, IHC merged with the St. Louis-based Healing the Children-Missouri and took on a new name: World Pediatric Project. Susan Rickman, president and CEO of the renamed organization, says the Missouri group was working in some of the same countries as IHC. A benefit of the merger is "to open another medical community to us, and another very philanthropic community like Richmond," Rickman says. The new name also is less likely to give the mistaken impression that the organization is a bricks-and-mortar institution, she says.
Many of the conditions the medical professionals see on their trips are easily treated in the United States. But in developing countries that lack pediatric critical care resources, the conditions can quickly escalate and become life threatening.
Rickman says the organization is transitioning from providing reactive care to including more preventive programs.
While volunteering in the eastern Caribbean, pediatric cardiologist William Moskowitz, of VCU Medical Center, noticed an unusually high number of children with rheumatic fever and rheumatic heart disease — a condition that develops from untreated strep throat. The WPP teamed with the ministry of health and the ministry of education in St. Vincent and the Grenadines, a chain of islands between St. Lucia and Grenada, to screen more than 800 children. They found that the incidence of rheumatic fever was 200 times higher than it is in the United States.
Since then, the WPP has developed a public health program that distributes penicillin to rural villages in the eastern Caribbean region. "It's getting out and educating schools, the health clinics, the parents — that when a child has a sore throat, just immediately use the penicillin to treat it," Rickman says.
This year, the organization plans to send 32 surgical and diagnostic teams to Central America and the Caribbean, an impressive leap from the four teams that were sent by the IHC in its first year.
Burke, a 43-year-old otolaryngologist and facial plastic surgeon with Virginia Ear, Nose and Throat Associates, travels to Belize once or twice a year with a team of nurses, anesthesiologists and surgeons to repair pediatric facial deformities. Burke says the most common procedure he performs is cleft lip and palate repair.
"The incidence of cleft lip in the Mayan communities is the highest in the world," he says. "In southern Belize, we're seeing five to 10 new clefts per year."
The average cost of a cleft lip and palate repair in the United States is about $28,000, according to the WPP. In a region where the average weekly wage is about $35, most families could not afford the procedure without help. In a week, Burke and Dr. Howard Krein of Philadelphia can perform about 50 surgeries.
Burke, who grew up in England and has a Belizian mother, sees the trips as his most meaningful charitable contribution of the year. "There is nothing I do that so positively affects other people in my whole entire life," he says. "When you're doing medicine for all the right reasons, it just feels different."