Little did Noble Forrest Adair of Atlanta's Yaraab Shrine Temple know, more than 75 years ago, at an Imperial Council Session that his impassioned plea to have Shriners begin spending money for humanity would help pave the way for the opening in 1922 of the first Shriners Hospital for Crippled Children (now Shriners Hospitals for Children) in Shreveport, La.

Today, that dream-which followed on the heels of a resolution by the Shrine's Imperial Potentate Freeland Kendrick in 1920 to establish a Shriners Hospital-has blossomed into a world-renowned network of 19 pediatric orthopaedic care and three burn treatment hospitals that offer free quality medical care to its patients.

In the early 1920s when Shriners approved the concept that would become known as the "World's Greatest Philanthropy," they established several simple rules for the Shreveport Hospital, and all others to follow: To be admitted, a child must be from a family unable to pay for the orthopaedic treatment he or she would receive, be under 14 years of age (later increased to 18) and be, in the opinion of the chief of staff, someone whose condition could be helped.

After the Shreveport Hospital began admitting patients in 1922, the Shrine's network of orthopaedic hospitals began taking shape and grew steadily for several years in the following cities: Honolulu, Minneapolis, and San Francisco (1923); Portland, Ore., St. Louis, and Spokane (1924); Salt Lake City, Montreal and Springfield, Mass. (1925); Chicago, Philadelphia, Lexington, Ky., and Greenville, S.C. (1926). Following a lapse of 19 years, more orthopaedic facilities opened in Mexico City (1945); Houston, Los Angeles, and Winnipeg (1952); Erie (1967); and Tampa (1985). The Winnipeg hospital was later closed in 1977.

Dedicated To Providing Quality Orthopaedic Care

Today, there are 19 Shriners orthopaedic hospitals in the United States, Canada, and Mexico-all dedicated to providing specialized medical and rehabilitation services completely free of charge to children with congenital orthopaedic deformities, problems resulting from orthopaedic injuries, and diseases of the musculoskeletal system.

A few of the orthopaedic problems most commonly treated include scoliosis (curvature of the spine), hand and back problems, club foot, limb deficiencies, osteogenesis imperfecta (brittle bone disease), leg length discrepancies, and growth problems.

Shriners Hospitals were among the first children's specialty hospitals in North America, and their pioneering efforts have earned them an international reputation in orthopaedic medicine and research.

These hospitals treat children in a family-centered care environment, recognizing that while medicine might heal the child's body, tending to that child's sense of well being is equally important. The family, therefore, is involved in the child's treatment, and each patient finds special support in meeting the challenges of his or her particular problem.

To ensure comprehensive care for children with associated medical problems, Shriners Hospitals' medical staffs include pediatricians, urologists, neurosurgeons, plastic surgeons, geneticists, and other specialists. In addition, the interdisciplinary medical team includes physicians, nurses, specially trained orthotic and prosthetic technicians, gait lab specialists, physical, occupational and recreational therapists, and other medical personnel.

Among several of the special programs that Shriners Hospitals conduct for patients at their orthopaedic hospitals are:

CHOICES (Children's Healthcare Options Improved through Collaborative Efforts and Services) - Initiated in late 1990, the CHOICES program is a model of how public and private agencies, working together, can improve services and reduce costs at the same time. As a result of discussions held prior to 1990 between Shriners Hospitals and the Kentucky Commission for Handicapped Children (the Title V agency for the State of Kentucky), it became clear that children with special healthcare needs could truly benefit if Shriners Hospitals and state Title V agencies worked together in an open and collaborative manner. Though not all Shriners Hospitals are involved in the program, CHOICES has developed into a sophisticated comprehensive, multidisciplinary program addressing the total healthcare needs of a very special group of children.

Gait Analysis Laboratories - Visual observation before and after a child's treatment has long been an important evaluation tool for orthopaedic physicians. At Shriners Hospitals, physicians also use sophisticated gait analysis laboratories that provide extensive information about the activity involved in a child's walking. Using a system of reflective markers, infrared cameras and force-plate data, a computerized model of the child's walking pattern provides physicians with an objective method to diagnose the problems in a child's movements before treatment and to evaluate the effectiveness of the treatment afterwards.

Myoelectric Camps - A special program conducted by the Shriners Hospital in Philadelphia is a myoelectric camp. Myoelectric describes a prosthetic arm with a realistic-looking hand that uses an electrical signal from a patient's own muscle to control a motor that operates the hand. The patient opens or closes the hand by contracting a muscle in his or her residual limb. Though requiring some getting used to by patients, myoelectric prostheses are considered a major advance over the more traditional prosthetic limbs, which rely on a system of cables and harnesses to open and close the hook.

Recreational Programs - The 22 Shriners Hospitals are dedicated not only to providing the best medical care possible to their patients, but also to helping the children make the most of their abilities and function as normally as possible. A variety of recreational programs help make this possible. The hospitals offer their patients activities such as wheelchair basketball, racing and tennis, special camps, scouting activities, parties, holiday celebrations, and more.

Addressing Burn Patients' Needs

In the 1960s, recognizing the lack of medical expertise in the burn care field, the Shrine opened its three Shriners Burns Institutes (in Galveston, 1966; and Cincinnati and Boston, 1968), each with a three-fold purpose of treating severely burned children; conducting research and improving methods of burn treatment; and training and educating medical personnel in the care and treatment of burn injuries.

Today, the Shriners Burns Institutes remain pioneers in burn treatment and provide quality medical care to severely burned children. These institutes are actively involved in research, and many of the advances in burn care have been the result of Shrine investigations. Since the burns institutes opened, the survival rate for children with burns over 50 percent of their total body surface has doubled. Today, physicians at the Shriners Burns Institutes are saving the lives of children with burns over more than 90 percent of their body surface area.

Because the treatment of burn injuries has advanced so dramatically in the past three decades, so much so that the needs of burn patients can now be met, burn injury survivors face another challenge-returning to normal life in a society that places tremendous emphasis on physical appearance. As a result, Shriners' burn care professionals have turned their attention to helping burn patients function more normally in society by establishing special programs to address this challenge, such as the following:

Re-entry Program - Survivors of severe, disfiguring burns often encounter difficulties when they leave the hospital and return to their homes and schools. The burns institutes recognize that it is not enough to save children's lives, and many burn experts believe that the psychological, social, educational, and vocational needs of these children are as important as their medical needs. In 1988, Shriners Hospitals set up a program to help children return to their homes and schools. Through the Re-entry Program, staff members from the burns institutes travel to their patients' home communities to help with the child's re-entry into home life. Classmates learn that though the patient may look different on the outside, the person inside is still the same person they knew before the burn.

Makeup Clinics - The Shriners Burns Institute in Boston offers a reconstructive makeup clinic to its patients at no charge. In the early 1980s, a professional cosmetologist began volunteering his services to the hospital with the intention of teaching burn patients how to use corrective makeup to soften the impact of their scars. By 1986, the hospital had established the first hospital-based professional reconstructive and corrective makeup clinic for its patients with burn injuries and other skin disorders. The clinic is held weekly as part of the hospital's outpatient clinic and is offered to both males and females. Included is a consultation, beginning with a videotape of the clinic in action, followed by a demonstration of several makeup techniques. Patients are informed that the makeup will not remove scars, but is used to soften the severity of disfigurement and create an overall more natural appearance.

Sense Of Hope And Optimism For Spinal Cord Injured Patients

Each year, thousands of young people are paralyzed because of spinal cord injuries. In 1980, the Shrine opened the first of three special rehabilitation units at the Shriners Hospital in Philadelphia where such patients can find hope, strength, inspiration, and obtain the specialized medical care needed for rehabilitation. At that time, this was the first such unit in the United States designed to meet the specific needs of children and teenagers with spinal cord injuries.

Spinal cord injured children receive long-term rehabilitative care and intensive physical and occupational therapy intended to help them relearn the basic skills of everyday life.

Though patients often enter one of the Shrine's spinal cord injury units apprehensive about the future, after encouragement, support and rehabilitation, they frequently leave with a sense of hope and optimism.

Actively Seeking Solutions Through Research

The research of today is the patient care of tomorrow. Shriners Hospitals believe in this philosophy, and nowhere is this better exemplified than in Shriners Hospitals' research programs.

At Shriners Hospitals, medical research is having a strong, positive impact on the care-and cure-of children with orthopaedic disabilities and burn injuries. What began as a token $12,000 allocation about 30 years ago has grown into a multimillion-dollar international research program, with a budget for 1997 of $21 million.

The added emphasis on research today goes hand in hand with the Shrine's overall mission of finding ways not only to treat, but also prevent those afflictions which can keep our youth from leading full lives. Vitally important to that mission is the clinical and basic research that has been responsible for many major developments made in the orthopaedic and burn care fields.

Researchers at the St. Louis and Canadian Shriners Hospitals are achieving significant results in the diagnosis and management of children with metabolic bone disease. The genetics unit at Montreal has pioneered a treatment protocol based on vitamin D and large phosphate supplements to treat familial hypophosphatemia, the most prevalent inherited form of rickets. Effective application of this knowledge corrects the lower limb deformity and enables normal growth in many children, thus eliminating the need for corrective surgery.

At the Portland Shriners Hospital, investigators have demonstrated that a mutation in the gene for making fibrillin (a component of connective tissue that holds together skin, muscles, and organs) is responsible for Marfan syndrome, a potentially fatal inherited disorder, resulting in severe skeletal deformities, dislocated lenses of the eye, and life-threatening cardiovascular complications. With this new knowledge, it is now possible to accurately diagnose Marfan syndrome (even in unborn fetuses) before the symptoms actually appear.

There are many other research projects under way at Shriners Hospitals, including one in Houston where Jacqueline Hecht, Ph.D., a member of the hospital's scientific staff, leads a research team that recently uncovered the genetic link to pseudoachondroplasia, a form of dwarfism that strikes one in 50,000 people. Hecht says she hopes that eventually a treatment will be developed to help those with pseudoachondroplasia to grow and escape some of the physical ailments associated with the condition.

The condition limits average adult height to four feet and causes a number of problems related to bone development, including knock-knees and bowed legs.

According to Hecht, discovery of the dwarfism gene may one day lead to a better understanding of joint and bone disorders-including arthritis-and ways to treat them.

As with any research, however, solutions to today's medical problems are not discovered in a day, a week, or even a year. This important work takes time. Shriners Hospitals are committed to the sustained investment in clinically useful research so that fundamental knowledge can be acquired that will improve the quality of life of children with orthopaedic problems and burn injuries.

Moving Into the 21st Century In State-Of-the-Art Facilities

For 1997, the Shriners Hospitals are spending well over $1 million a day to operate their entire hospital system, to conduct research, and to continue their ambitious rebuilding and reconstruction program that was begun in the early 1980s. At that time, the Shriners Hospitals Boards of Directors and Trustees saw the need for such a program if the hospitals were to continue offering the most advanced orthopaedic and burn care well into the 21st century.

That program is coming to a close, with just three of the 21 hospitals still under construction-the Shriners Burns Institute in Boston, the Philadelphia Hospital, and the brand new Northern California Hospital in Sacramento. By late spring 1998, the Boston Shriners Burns Institute will be the last of the Shriners Hospitals to be completed.

The Northern California Hospital, which will replace the San Francisco Shriners Hospital that has been caring for children for the past 73 years, will be the Shrine's largest, as well as the first to incorporate all four specialties for which Shriners Hospitals are noted: pediatric orthopaedics, spinal cord injuries, acute burns, and research. With a total of 80 beds, 50 will be for orthopaedic care, including spinal cord injuries, and 30 for burn care.

When the new eight-story, state-of-the-art facility opens in April 1997, it will serve as the Shrine's flagship hospital and its primary burns center in the west, reducing the need for severely burned children to travel across the country to receive care at one of the other three Shriners Burns Institutes.

75th Anniversary Celebration Just Beginning

With 1997 less than two months old, Shriners throughout North America are joining Shriners Hospitals during the year in celebrating the 75th anniversary of this unique network of children's specialty hospitals.

The celebration is intended to increase public awareness and understanding of Shriners Hospitals in a manner never before undertaken. In recognition of the 75th anniversary, the Shrine has produced a one-hour television special, which could be considered an "un-telethon." The TV special is similar to the popular telethons but instead of fund-raising, it will focus on finding more children whom Shriners Hospitals can help, free of charge.

Videotaped at Disney's EPCOT in Florida, the special is co-hosted by TV star Pat Morita, himself a former Shriners Hospital patient, and Peter Graves of Mission Impossible fame and A&E's Biography series. It features a mix of information and entertainment, including guest appearances by several current and former Shriners Hospitals patients.

The program will be telecast initially in early April in every television market in which a Shriners Hospital is located (excluding Mexico City)-markets which hold the potential to reach 21 million television households.

In addition to the "un-telethon," a variety of public relations-related activities are taking place throughout the year, making the 75th anniversary celebration the most comprehensive PR campaign in Shriners Hospitals' history.

Two celebrity 75th anniversary public service announcement campaigns are being distributed, one early this year and the second in the spring or early summer. Featured in these PSA campaigns are television stars Erik Estrada, Dick Clark, Loni Anderson, and Morgan Fairchild.

A special 75th anniversary logo depicting a patient, a Shriner, and a physicianis being carried through on all elements used in connection with the anniversary celebration. The logo appears on such items as bumper stickers, newspaper rack cards, airport and mall dioramas, bus cards, bustail signs, truck and van decals, and more.

Also, most of the Shriners Hospitals will be hosting special patient reunions during the year.

Because of the variety of activities planned in conjunction with the 75th anniversary celebration, 1997 promises to be a year of opportunities for telling the story of Shriners Hospitals.