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Haitian infant with birth defect receives surgery at UI Hospitals and Clinics

Cindy Hadish, CR Gazette –

IOWA CITY — Worried about her baby’s failing health, a young Haitian mother entrusted her daughter to an Iowa City couple to secure the medical attention she needed.

Dr. Christopher Buresh, 36, an emergency physician at University of Iowa Hospitals and Clinics, has made dozens of medical trips to Haiti, but tiny Bedica Ermilus is the first patient he was able to bring to the United States for treatment.

“We have access to so much incredible care here and things in this country that I think we’re obligated to share that,” Buresh said.

His wife, Dr. Ginny Ryan, 39, was instrumental in navigating the bureaucratic channels needed for Bedica’s safe passage to Iowa City, as well as soothing concerns of Bedica’s mother.

“There were a lot of hoops to jump through,” said Ryan, an obstetrician-gynecologist at UI Hospitals, who at one point sat for two straight days in an office in Haiti to ensure the trip would proceed. “I was worried she’d get so sick that she wouldn’t be able to have the surgery. It was kind of a race against time.”

Bedica, who is thought to be about 14 weeks old, was born with anorectal malformation, a lower digestive tract birth defect that impeded her ability to defecate.

The defect affects about one in 3,000 babies, said Dr. Graeme Pitcher, a pediatric surgeon at UI Hospitals. While children might survive with the abnormality, the obstruction makes life “really uncomfortable,” Pitcher said, because they lack the intestinal structure to properly rid the body of waste.

Buresh said American operations aren’t set up to perform the specialized surgery in Haiti and Haitian hospitals have a dismal 100 percent mortality rate when it comes to the procedure to repair the defect — meaning Bedica’s only hope involved traveling out of the country.

Bedica’s mother, Carole Ermilus, brought her daughter to the attention of Dr. Matt Downen, a UI medical student who was checking on the needs of people door-to-door in St. Medard, where the family lives.

“The baby was very listless; her eyes were cloudy and she wasn’t eating much,” Ryan said, crediting Bedica’s mother with noticing the problems and seeking help.

Bedica was brought to Dr. Angie Kerchner, a UI medical school graduate doing a residency rotation in Haiti, who diagnosed the condition.

Carole Ermilus is likely in her early 20s — birth dates and even deaths aren’t recorded in Haiti, so no one is sure — but she and her husband knew enough to understand their daughter wasn’t thriving, Ryan said.

Still, they had reservations about sending their infant daughter to a foreign country. Concerns over child kidnappings were heightened after Haiti’s devastating earthquake in 2010.

Ryan said Ermilus seemed reassured by the fact that Ryan and Buresh have three children of their own and Ryan is pregnant with their fourth child.

“As a mom, it seemed like quite an emotional time,” said Ryan, who communicated with Bedica’s parents through an interpreter. “She’s very caring. I think she understood that this (surgery) couldn’t be done in Haiti, and she knows we’re taking good care of her.”

Even with the parents’ blessing, the doctors had to persuade Haitian authorities to allow Bedica out of the country.

State Sen. Liz Mathis, D-Cedar Rapids, and U.S. Rep. Dave Loebsack, D-Iowa, made calls to the U.S. Embassy to help expedite the trip.

“It really is a huge, huge effort to get everything lined up,” Buresh said. “We’ve tried in the past but never had much luck.”

When Bedica was finally allowed to leave Haiti, she was malnourished. So Ryan and Buresh focused their efforts on building her strength before she underwent surgery. Donated breast milk was used to help her gain weight.

The efforts paid off. Pitcher performed the surgery March 29 at UI Children’s Hospital.

The procedure involved no taxpayer funding.

“This was a complex surgical case, and every patient is different,” UI spokesman Tom Moore said by email, adding that private money was raised to cover the surgery. “We are very grateful to the generous donors who made this possible.”

Bedica was examined during a post-operative visit last week.

“Overall, we’re delighted at her progress,” Pitcher said.

Bedica is recovering at the Buresh and Ryan home, where Ryan’s parent’s, Cheryl and Charlie Ryan, traveled from Canada to help take care of the children.

She’s still small for her age but is gaining weight and should be ready to return to Haiti after several more weeks.

“I hope she’ll grow up a happy, healthy kid,” Buresh said. “I think she’s got a good shot at it now.”

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