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Shriners offer special clinics for reservation children

ROSEBUD, S.D. - Specialists from Shriners Hospitals for Children of the Twin Cities examined more than 15 patients at the Rosebud Indian Health Service during a special clinic.

Physicians assessed the prospects of treatment for new patients and gave follow-up care to others who have been part of an ongoing outreach program during the Aug. 25 clinic, one of two conducted during the week.

The program, funded by Shrine Philanthropy, allows reservation health care centers to access specialized care at no charge to patients, families, third party payers or governmental agencies.

Since the partnership between the IHS and Shriners Hospitals for Children began five years ago, the specialists have traveled to remote reservations to reach every child in need of orthopedic care, said Shriners spokesman Lawrence E. Johnson.

Officials hope to expand the Twin Cities hospital's partnership with IHS. They have begun touring IHS hospitals in Lower Brule, Crow Creek, Wagner and Sisseton to talk about prospects for offering the same care patients have received in Pine Ridge and Rosebud and on Turtle Mountain Reservation in Belcourt, N.D.

"I would like to see Shriners become the provider for IHS hospitals across the nation," Johnson said.

Traveling clinicians screen patients for a variety of conditions involving muscles, bones and joints and neuromuscular or skeletal problems.

About 86 percent of Shriners patients have conditions requiring surgery, but not every child will have to undergo surgery. Some may respond to new medications. For others, Johnson said, it may be just a matter of refitting a prosthetic limb.

Very often children who have missing limbs as the result of birth defects or accidents make their way in for treatment. Those requiring prosthetic devices may need to be fit more than once a year and the prosthesis can be as expensive as $30,000 each. The cost of replacing them is also defrayed, Johnson said.

"Children will need a prosthesis usually twice a year while they are growing."

The work Shriners physicians do is a challenging combination of medicine and engineering when it comes to fitting patients with limbs.

While some conditions such as spina bifida seem to be declining in the general population, others such as cerebral palsy continue to surface in children born prematurely, he said.

The Minneapolis-St. Paul-based hospital, which serves a seven-state region, continues to see a large number of patients who have suffered traumatic amputations which Johnson attributed to farm and lawn mower accidents.

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However, on the Rosebud Reservation, another danger lurks for children whose caretakers use older wringer washing machines, he said.

"It was at Rosebud a couple of years ago a public health nurse developed a teaching sheet on wringer washer safety because they had seen the gloving accidents as a result of children getting their hands caught in wringer washers, Johnson explained. Gloving injuries, where the skin is peeled off the hand, occur as child attempts to free himself or herself from the wringer. Injuries from lawn mowers are common, he said.

Johnson said he sees the partnership as a good fit between the two organizations.

"When we come out to Indian Health hospitals, we find people who are motivated by the very same things we are. We're not doing this to make money off of anyone. We're doing this because it is helping to make things better for children."

When a child is accepted for treatment as part of the program the Shriners Hospital continues to provide medical care until they reach 18 to 21 years old.

"Families know we will be there for their child until they make the transition of becoming an adult," he said. "We accept any child who has a condition we can help. The people we would like to serve are those who would have a hard time receiving the kind of care that we can provide if it weren't for us.

"If you have money in America, you can get any kind of care you need. The trick is to get it if you don't have a lot of money or insurance which happens to apply to an ever-increasing number of people," he said.

The hospital has provided clinical care for children on reservations for about five years. It started out very slow," Johnson said.

Some of the clinics the team visits are rather small while others are much larger. Thirty-six patients were seen on the Turtle Mountain Reservation, he said.

Patients such as Austin Musseaux, 5, of St. Francis, regularly check in with physicians closely watching how he functions with clubfeet. Most onlookers watching the little boy wouldn't even notice the disability which was the result of a birth defect.

His mother, Melissa, said he will eventually need surgery to correct the condition, but for now doctors are watching it closely, waiting for him grow up a little more.

Lynn One Star, whose son, Isiah Brave, was waiting to be seen, has never seen her little boy smile. The boy, now 9, was born six months prematurely and suffered from a form of palsy rendering many of his facial muscles useless.

"He can't smile. We want to see if they can help," One Star said.

While the condition doesn't seem to bother the boy, who eagerly awaited a doctor's call to the examining room, he said he wanted to find out what doctors can do. He was hopeful as he passed the time chatting with his mother.