Experience with the World Pediatrics Spine Team in Honduras

Frances Wensley, a pediatric anesthesia resident at UBC, spent one week with the World Pediatrics Spine Team in Honduras.

"I am so grateful for the opportunity to join the World Pediatrics spine team on their mission to Honduras in February 2026. This was a unique experience to join a team of surgeons, anesthesiologists, neurophysiologist and nurses to perform scoliosis surgeries for children in Honduras for whom it otherwise wouldn’t be possible. This team has been visiting San Pedro Sula for over 15 years, working at multiple hospital sites, most recently at Ruth Paz Hospital.

Ruth Paz was originally set up as a burn treatment hospital, a joint venture between the Paz family and the government. Unfortunately, the government couldn’t uphold their commitment to funding, so it

became a “private” institution, funded by mission trips (local and international). There are local surgical teams who operate there and various medical clinics running throughout the week.

We arrived on Saturday and went straight to the hospital to drop off gear and start unpacking. Our lead anesthesiologist, Dawn, had everything organized – before leaving she packs and labels boxes, takes inventory and makes a list of what to bring next time. At home she collects all the kit we need, again itemizes and labels it for customs, and a couple of weeks before we arrive she ships it to various members of the team to bring out with them. All this work made customs a breeze – only 2 hours waiting while the brilliant WP team moved from room to room negotiating with various officials!

We unpacked and organized our kit for the week, dividing it amongst surgeons, nurses

and anesthetists. We bring everything apart from large pieces of equipment such as, for example, the operating table or anesthetic machine.

Sunday is clinic day: the surgeons see everyone who shows up, booked or not. Some years it’s upwards of 50–60 patients, but this year it was closer to 30. We saw 18 that the surgeons felt were appropriate for review. Lynnie and I did the first together and then continued separately. I called in support from Lynnie or Dawn for anyone complex. Two of our patients were too complicated for us – one for anesthesia reasons (significant OSA and breathing difficulties expected post-op) and one for surgical reasons (severe kyphoscoliosis). WP follows these kids and tries to arrange for them to travel to the USA for their surgery so they are not forgotten. The rest were run through their pre-op assessment and added to a pile of “maybes.”

I can imagine it is stressful for families – some travel for hours or even days to get here. But then, maybe they’re used to it; one boy was taken to Guatemala by his family for cardiac surgery a few years prior. Many of our children here at BCCH have similar experiences, travelling the other side of the province or further for care. Saying that, everyone was so positive – optimistic, motivated and grateful for the opportunity to have their operation.

All the patients seen at clinic were then reviewed by the whole team to decide the slates for the week. We could do 1 to 2 cases a day in each OR, depending on complexity and available equipment. Generally, Monday cases are straightforward both surgically and anesthetically to enable everyone to get to know each other and the equipment and generally find their groove. Tuesday and Wednesday more complex, Thursday straightforward again as we wouldn’t be around if there were any complications, and Friday we did lengthenings.

We worked alongside local teams, including one surgeon (who our team are training to eventually work independently and to build up his own local team), scrub nurses, ward nurses providing pre- and post-op care, doctors providing post-op care, doctors trained in neurophysiology (by our own neurophysiologist, Kelly!), and so on. It takes a village. We planned to do 15 cases in 5 days.

Monday through Friday were OR days. Everything was on the same floor. There were two ORs where we worked and right next door, with a big window, was the sterilization center where our ortho rep, Matt, spent a lot of time making sure surgical tools were appropriately sterilized between cases and that we had the right stuff!

Patients arrived the night before their procedure for hydration and canulation pre-op – this was learned from previous years where patients arriving the day of surgery would regularly have had breakfast or would sometimes decide not to come or would arrive late. Everyone stayed in the same unit pre- and post-op and were looked after by two local nurses, a team of healthcare assistants and 4 WP nurses from California (2 in the day and 2 at night).

We arrived in the morning, had a brief handover from the night team, reviewed patients from the day before and set up our OR. There was a race to see who would start first, generally won by the team with the most cases planned!

Once the first patient was anesthetized (induction, intubation, monitoring, lines including peripheral IV and arterial line), the neurophysiology team (made up of Kelly and a local doctor he’d trained over the years) worked to connect all the cables for monitoring motor and sensory evoked potential responses and EEG. They were generally done in minutes, then would move next door to the other OR to do the same for the next patient. One of them would then stay in each room to monitor patients throughout the case.

Then we’d prone the patient, check positioning and prep for surgery. The local Honduran teammates worked tirelessly to keep everything running smoothly in their ORs as well as translating for us with patients and ensuring we had the right kit ready to go. Matt, our orthopaedic rep, worked similarly hard to make sure all the kit was ready and we didn’t run out of screws and other surgical necessities.

Between cases we reviewed X-rays from the previous day’s surgeries, checked in on patients and ate lunch. The local food was delicious – brought into the hospital each day for lunch or at the various restaurants we tried throughout the week. Then we’d continue with longer complex cases or start a second case.

Generally, we finished in the early evening and would round again on all the patients, ensure everyone was comfortable and handover to the night team. We’d head to bed after dinner, ready to start again the next day. By the end of the week, we were all appropriately exhausted, having successfully performed 11 scoliosis surgeries and 4 growing rod lengthenings. We saw

many happy patients and parents – everyone full of smiles, doing their daily walks around the ward. One mum was especially proud when she realized her daughter, once several inches shorter, was now the same height as me!

I am so grateful for having had the opportunity to go on this trip. It met my objectives and so many more – helping children receive life-changing surgery was easily the highlight and seeing them with their families post-operatively was an emotional experience.

I learned how a successful mission trip can grow and develop over many years with commitment from local teams and an international group of healthcare professionals. I witnessed the challenges experienced by patients, families and local teams trying to deliver care in a low-resource setting. I was blown away by the work done by World Pediatrics to ensure even the lowest income families were able to get to us in San Pedro Sula for their scoliosis surgery. I hope that I will be able to continue work like this in the future."