“Your whole life can change in the blink of an eye,” says Vivian Pellas.
The Cuban-born philanthropist speaks from tragic experience. Her life-changing eye-bat occurred the morning of Oct. 21, 1989, when the jetliner she was traveling on with her husband slammed into the side of a mountain at 500mph, killing 132 of the 139 passengers on board.
“Carlos remembers covering his face from the ball of flames that exploded down the aisle of the airplane. I just remember thinking I was going to die, and feeling profound sadness,” she remembers in a soft voice.
It has been 22 years since Vivian and her husband Carlos—then 33 and 34 years old—miraculously survived the crash of Tan-Sahsa Flight 414. The Boeing 727 thundered into Honduras’ Cerro de Hule mountain range, tearing the plane into three pieces of burning, twisted scrap metal that were littered across 8 acres of rugged terrain.
The accident was caused by human error; the pilot misjudged the approach to Tegucigalpa’s treacherous Toncontín International Airport. When he realized his mistake, the pilot pulled back violently on the control yoke and lifted the nose of the Boeing 727 in the air, forcing the plane into a deadly belly flop. The maneuver saved the lives of the pilot and copilot, as well as several people sitting near the front of the plane. Almost everyone else died instantly.
“When the plane stopped moving, Carlos realized he only had a few seconds. He yelled to me, Vivian! Vivian! I heard his name, but in the distance. I think I was only partially conscious. I was still in the fuselage. Carlos’ mind remained very clear during the whole ordeal, but I wasn’t. I don’t know how long I was unconscious. But he grabbed me, opened my seatbelt—I am not sure how because he didn’t have fingers. He lifted me up and said, ‘Get up and follow me!”
Vivian says she remembers the next moments with nightmarish detachment, unable to distinguish what was real and what was imagined.
“I just remember looking at my feet and I saw a very clear light. Then I closed my eyes and I felt like I was going down a dark tunnel. What I didn’t realize was I was rolling around outside of the plane. When I got up, I remember seeing a rainbow – I don’t know if it was a hallucination or if it was true—and I thought of my children. Then I saw my fingernails touching the ground, with my skin hanging off. Then I started to run.
“Just then, the airplane exploded again and I was sent flying through the air. Carlos helped me up, and we both ran. I was falling and he kept helping me up. But I don’t remember much else. When we made it to the road, we saw a man in a pickup truck. He was in total shock. Carlos said to him, take us to the hospital, but he could barely talk from all the smoke we had inhaled. Then pilot and copilot also got into the truck. It took us two hours to drive down from the mountains to the hospital. The people we passed looked at us like they were watching a horror movie.”
When they finally made it to the Honduran capital, Vivian was put on the hospital’s only available stretcher, while her husband asked the driver to call her parents, who lived in Tegucigalpa and had been waiting for their daughter and son-in-law at the airport.
By the time Vivian’s father arrived at the hospital, he had to fight his way through a throng of doctors gathered around his daughter’s bed. She was barely conscious when he made it to her bedside.
“My dad said I was still moving my mouth, so he got closer to me and I was repeating: “I am going to build a hospital for burned children. I am going to build a hospital for burned children.”
Vivian says she doesn’t remember the moment clearly. But she never forgot the subconscious promise she made in her darkest hour.
A hospital born from tragedy
Two years later, after 28 reconstructive surgeries, skin grafts and an extensive rehabilitation program to relearn how to walk, eat and write, Vivian Pellas was ready to deliver on her pledge.
In 1991, she created The Association for Child Burn Victims in Nicaragua (Aproquen), the region’s first burn unit offering specialized, long-term integral care and rehabilitation for young burn victims.
Unbelievably, it’s totally free. For the past 20 years, Aproquen has provided tens of thousands of impoverished burn victims with free, world-class medical care that is rivaled only by the most exclusive and expensive clinics in the world.
“Aproquen’s model for the comprehensive care of burn patients is a model of care for the region and even the world. They are able to provide incredible care in a challenging environment with limited resources and infrastructure,” says Dr. Patrick Byrne, director of facial plastic and reconstructive surgery at The Johns Hopkins University School of Medicine, in Baltimore.
Byrne has been involved with Aproquen for three years, and says the dedication of the Nicaraguan staff has made all the difference.
“I became enthralled by the potential of collaborating with Aproquen once I got to know Vivian Pellas and her team of passionate volunteers,” Byrne told The Nicaragua Dispatch. “I realized this group is unique—they don’t see obstacles, but challenges to overcome.”
20 years of integral treatment
Aproquen operated its burn unit for 11 years in Managua’s Fernando Vélez Paiz Hospital before moving into its modern digs at the Hospital Metropolitano Vivian Pellas in 2004. In 20 years of operation, Aproquen has provided 330,000 free medical treatments, including 30,000 surgeries and 121,500 rehabilitations.
The more successful the clinic becomes, the more work it creates for itself—and the more expensive it is to operate.
“Our portfolio of patients grows every year. That’s because 70% of burn victims who are six years old or younger are going to need several years of rehabilitation,” says Dr. Ivette Icaza.
She explains that burn victims who need reconstructive surgery on their faces—or those born with a cleft lip or cleft palate—need years of rehabilitation afterwards to learn how to eat and speak.
“The operation alone isn’t enough, because without speech therapy the child will not learn how to speak and then no one will understand him and he will become socially marginalized and eventually drop out of school,” Icaza says. “People become isolated by their deformity.”
The physical pain goes away, but the scars don’t. And the emotional scars can be the hardest to heal, affecting people’s integration into society and the economy.
“Burns are for life. And it’s not just the skin, it’s the soul,” says Dr. Mario Perez, Aproquen’s medical director. “It’s a trauma that affects the whole family, the community, the school, and workplace. It’s very complicated.”
That’s why rehab has to be integral—a process that Vivian Pellas experienced personally, and one that she is now able to provide for under-privileged children at Aproquen.
The burn unit’s success has also been noticed internationally. Now Aproquen is exporting its knowledge to other countries in Central America. And it’s changing the way burn victims are treated throughout the region.
“Our accumulated experience has helped change the philosophy of treating burn patients in other countries,” Icaza said. “Now burn victims are being treated with more of a multi-disciplined response—rehabilitation, psychological counseling, nutrition education, speech therapy—and not just plastic surgery.”
Thanks to Aproquen’s outreach, Honduras now has its own rehabilitation center for burn patients (started by another survivor of flight 414) and doctors from Guatemala and Costa Rica are receiving training from Aproquen specialists to start burn units in those countries.
Aproquen also focuses heavily on prevention. Doctors and staff regularly visit schools with photo books to teach children about burn-risk factors, and have been instrumental in getting legislation passed to regulate the sale of fireworks—an obsessive behavior in Nicaragua that becomes particularly compulsive in December.
The Christmas-season prevention campaigns, done in coordination with the Health Ministry, the National Police and firefighters, are working. This holiday season Aproquen treated only two children who suffered burns from Christmas explosives—down from 19 burn victims two years ago.
Aproquen also notes a reduction in the percentage of new patients who need reconstructive surgeries and long-term integral care, indicating that prevention campaigns are helping to teach children to avoid risky situations.
Still, the battle is by no means nearing victory.
“Since man discovered fire, people have been burning themselves,” says Dr. Perez.
And as long as they do, Aproquen will be there to help them.
Life after tragedy
For Vivian Pellas, the unfairness of her injuries struck her during the painful months of her rehabilitation in 1990.
“I went to therapy in the United States and all the other patients were 80 or 90 years old. And I remember thinking, ‘My God, I am only 33. I am just starting my life and my children are just babies. Why me?’”
But she says her faith in God helped her get through the difficult moments and gave her the strength to convert her tragedy into hope for others—a philosophy that is reflected in Aproquen’s slogan: “Turning tears into smiles.”
“The accident was a horrible tragedy, but it led to good because this hospital has saved and continues to save the lives of many children,” she says. “We wanted to convert a tragedy into happiness and hope for others.”
People’s lives can indeed change in the blink of an eye, she says. But what matters is what people choose to do about it afterwards.
Editor’s note: Aproquen’s free services for burn victims is provided by an annual budget is $1.8 million, 75% of which comes from an annual fundraising drive that culminates each June with a musical performance in the Rubén Darío National Theater. Aproquen’s budget wouldn’t last a week in a comparable clinic in the United States. Yet with limited resources, the Nicaraguan doctors provide world-class care to all burn patients, without turning anyone down. To find out more about the clinic and how to help, visit www.aproquen.org.