The boy was born with his bladder outside his body, a rare and troublesome condition that would have been corrected when he was tiny, had he been born in the United States.
But he was born in a developing country where doctors had neither resources nor expertise to fix it. It became not just a medical problem, but a social one. He couldn't go outside and play, because he had to avoid injury. He smelled like urine and other children didn't want to play with him, anyway.
A team of American doctors from the Salt Lake-based International Volunteers in Urology not only corrected the birth defect recently; they trained doctors in his country to do such specialized operations so care won't hinge on periodic visits from foreign volunteers.
IVU was founded by two pediatric urologists, Dr. Catherine DeVries and Dr. Patrick Cartwright, six years ago. It has grown to nearly 1,700 members dedicated to bringing urologic care to people in 65 countries like India, Honduras, Peru, Bangladesh, South Africa, Haiti, Vietnam and Cuba.
"We teach them about current techniques, but it's not a one-way thing," DeVries said. "We learn and relearn about the management of kidney stones and other problems." They also learn and teach about pain management, which is very different in places with rudimentary health care.
IVU works with the World Health Organization and the Centers for Disease Control and Prevention, as well as others to help solve the problems that vary from country to country. In Haiti, for instance, mosquitos cause a parasitic illness that affects the scrotum. Poor countries like Haiti don't have resources to deal with it on their own.
Kidney stones are easily treated here; treatment must be taught and remedies made available in other parts of the world. Ditto prostate problems in men and incontinence in women.
The organization, which relies on volunteers and donations of equipment, medication, money and time, has several team projects a year, each one focusing on a particular urologic problem.
This winter teams will go to Honduras and India to provide pediatric care and training. In another country they will focus on reconstruction of congenital defects. There are also smaller projects, sometimes just a husband-wife team to provide training and care. IVU helps coordinate the trips.
Anyone who's ever had a urologic problem knows it can be miserable. But most Americans don't fully appreciate the social aspects because they don't face them. "Urological diseases take whole segments of society completely out of normal function," DeVries said.
One of the biggest challenges is providing equipment. Every American hospital has an endoscope, an instrument that lets doctors looks inside the body and even takes pictures. In some countries, doctors don't even know what it is.
Doctors who are retiring from practice have been generous with equipment, DeVries said. But even that generosity, coupled with the time and talents of volunteers, can't reach everyone in need. She receives e-mails from around the world requesting help. Some people wait years for operations. Some never get them.
The group is growing fast in terms of volunteer support. Funding support is slower.
Though doctors generally pay their own way, many of the nurses can't afford it. But they are as crucial to the program; they assist in treatment and train their counterparts in developing countries. The group often must buy some of the supplies, too.
Doctors in the countries they visit do the footwork, screening patients and booking hotels and operating rooms. That frees the medical teams to get to work.
The teams see as many as 125 patients in a day, all with complex problems. When they return home, they follow cases by e-mail. And they go back to each community in which they operate for at least three years not only to monitor their own handiwork, but to continue training local doctors.