Regina Hernandez, 3, scoots across the floor at the home of Dr. Brian Nielsen, where she and her mother are staying during their time away from Belize for the little girl's surgery.

Photos by A.E. Araiza / Arizona Daily Star

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Wearing a sparkly purple dress and knockoff designer sunglasses, Regina Hernandez skipped and twirled through the Nielsen family's Northeast Tucson home last Thursday.

Regina seemed oblivious to the cast on her right arm, the only visible sign of the orthopedic surgery the 3-year-old Belize girl had a day earlier.

She and her mother, Dominga Hernandez, were brought to Tucson from their small Mayan village of Big Falls — population 1,000 — by the Tucson Orthopaedic Institute to repair a poorly healed broken elbow Regina suffered 18 months ago. Tucson Orthopaedic has three locations in Tucson and on the Northwest Side, including its East office on North Wyatt Drive where Regina had her surgery.

Though the repair was primarily cosmetic, her pediatric orthopedic surgeon, Dr. Brian Nielsen, hopes when Regina returns home in a few weeks with a healed arm, it will be a first step in building trust between the Belize villagers and the Tucson Orthopaedic Institute doctors.

Regina broke her elbow while climbing a 3-foot plum tree in the family's yard. Instead of climbing down, she jumped and rolled down an embankment.

When her doctor in Punta Gorda, 30 minutes from the Hernandezes' village, treated the arm, "they set it at an angle and it healed at an angle so when she straightened her arm it bowed outward instead of straight," said Nielsen, who has provided his services pro bono in other countries, including Honduras and Mexico. "It certainly would be more obvious when she was older. A lot of people, especially in developing countries, are shunned somewhat when they have a deformity. It would probably impact her function a little bit."

"When she runs and plays crazy … her arm gets swollen," said Regina's mother.

Regina will wear a cast for three weeks, then Nielsen will take the pins out of her elbow and she will go through some physical therapy. She won't need much, because as an active child, Regina will regain strength in her arm by playing.

Nielsen and the institute want to continue providing free orthopedic care to the people in Big Falls who do not have access to specialists or enough money to pay for medical care. Other children in the Hernandezes' village and smaller surrounding villages in the southern region of Belize suffer from clubfeet, spina bifida and other conditions that can be repaired with surgery.

During the Hernandezes' four-week stay in Tucson, they are living with Nielsen and his family. His wife, Heather, and oldest daughter, Chloe Rose, 14, flew to Belize at the end of September to escort Regina and her mother to Tucson.

The Nielsens spent a few days in the remote village catching fish for food, eating fruit off trees, visiting Regina's preschool, washing clothes in the river and bathing in cold water before returning to Tucson with Regina and her mother. They wanted to bring Regina's father, Regino, to Tucson, too, but the Belizean government would not issue him a visa for fear the family would not return.

"It's not Third World like it is in Africa, but there are pockets," said Heather Nielsen.

Chloe Rose thought she knew what to expect on the trip.

"I'd seen pictures in National Geographic," she said.

But when they arrived, Chloe Rose learned village life was very basic.

"Everyone makes their own food and every other tree has fruit on it. There are no restaurants or grocery stores," she said.

"It was really interesting to be in a place where you can't get a hamburger," her mother said.

The trip inspired Chloe Rose to start a book collection drive for Regina's school.

Regina and her mother were similarly surprised by life in Tucson.

Neither had ever flown on an airplane before. After arriving at the Nielsens' home, Regina was frightened at first by saguaro cacti, thinking they were big animals with their arms raised. She was also concerned about the sound coming from the Nielsens' swimming-pool filter system.

"It's culture shock," said Dr. Nielsen. "She'd never seen hot running water. She kind of jumped back" the first time her mother bathed her.

Dominga had "never seen a washing machine or a dishwasher and hadn't washed her clothes in anything but a river before," the doctor said.

They've also never seen a clear picture on their television set in Belize.

Tucson Orthopaedic Chief Executive Officer John Cole learned about Regina's injury when he and his wife were vacationing in Belize. The couple befriended a Canadian doctor and his wife who told them about the little girl they had met while staying at an inn where Dominga was the caretaker.

"On the way back home, my wife and I started talking and (thought), 'Wouldn't it be interesting if we could find this little girl because Dr. Nielsen is a specialist in pediatric orthopedics,' " Cole said. "Here I was confronted with this by a doctor, and we have the resources from the medical perspective. It sounded like the right thing to do and it was also a bit of a challenge."

Though they didn't meet in person until the Hernandezes arrived in Tucson, Cole tracked down the family through the inn where Dominga had worked and offered to repair Regina's arm at no cost. Continental Airlines provided free airfare. The cost of the surgery — including pre- and post-operative care — is between $10,000 and $15,000, Cole said.

Cole, who has accompanied his son, a doctor, to Central America to provide medical assistance, anticipates Regina will be the first, but not the last, Big Falls child Tucson Orthopaedic will help. And the institute is considering setting up an education fund for Regina.

"We're kind of vested in her now," Cole said. "You can't just take something like this and throw it back in the wind."