As the Hope Clinic International's surgical team was settling into their accommodations in Chinandega, a baby girl was entering the world in a rural Nicaraguan village.  She was born to a 15 year old girl and delivered onto the dirt floor of a remote hut.  It was immediately obvious that something was wrong: she had a defect known as gastroschisis.  The infant and her mother were brought to the hospital, a six-hour walk.  She was left in an incubator, covered with dirt, until HCI's surgery team arrived 12 hours later. 

The surgeons' challenge was to move the baby's bowels back into the abdomen without a ventilator and without the special materials normally used in the United States to perform such a procedure.

In a stroke of creative genius, David Charnesky, HCI's nurse anesthetist, suggested sterilizing a plastic IV bag to enclose the intestines.  The baby was then brought into the operating room where the sterile IV bag was stitched around her bowels and attached to the abdomen.  She now had a “closed” abdomen.  Each day small amounts of her intestines were gently pushed into her abdomen by rolling down the IV bag.

A second HCI surgeon arrived in Chinandega seven days after the baby was born.  He brought vital supplies needed to close Elizabeth’s abdomen completely.  Elizabeth went home from the hospital at 20 days old, gaining weight on her mother's milk.