Guatemalan children burned by volcano arrive in Galveston for treatment with long recovery ahead

People flee El Rodeo village, Escuintla department, 35 km south of Guatemala City, after the eruption of the Fuego Volcano on June 3, 2018. People flee El Rodeo village, Escuintla department, 35 km south of Guatemala City, after the eruption of the Fuego Volcano on June 3, 2018. Photo: NOE PEREZ/AFP/Getty Images Photo: NOE PEREZ/AFP/Getty Images Image 1 of / 53 Caption Close Guatemala's Fuego Volcano erupts killing dozens 1 / 53 Back to Gallery

Six children severely burned from a volcano eruption in Guatemala arrived in Galveston early Thursday, potentially facing years of recovery as they begin treatment at Shriners Hospitals for Children.

Dr. Steven Wolf, the chief of staff at Shriners Hospital for Children in Galveston, told reporters at a Thursday press conference that the six children and five guardians arrived in Galveston at 4:40 a.m. via military transport and were immediately admitted to the hospital's pediatric Intensive Care Unit with life-threatening burn injuries.

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A medical "go team" of pediatric burn physicians and nurses from the Shriners Hospital in Galveston were dispatched to Guatemala within 24 hours of the eruption and assisted in moving the children to a centralized hospital to await transportation back to the burn center in Galveston.

Wolf said that he was able to talk with several of the families but that most of the children were on ventilators and unable to speak.

"We've already been able to treat a couple of [the children] definitively so far this morning and we'll get to the rest today, and we look forward to getting them on the road to healing," Wolf said. "We'll also be directing the rehabilitation and reconstruction from the scarring that will result from these injuries, going into the next several years, as it turns out from our experience."

A multidisciplinary team at Shriners is providing all aspects of burn care, including surgery, treatment, rehabilitation and psychological support for the children, whose names and ages are not being released because of patient confidentiality. All are 16 or younger.

The six children suffered contact burns from the ash cloud that erupted from the Volcan de Fuego in Guatemala, and were also examined for thermal burns to their airways from breathing in ash particles. Wolf added that severe burns usually mean that more than 15 percent of the patient's body has been burned. He declined to specify exact percentages for the six children.

Shriners Hospital for Children - Galveston Steven E. Wolf, MD, talks about the six children inured by the Guatemala volcanic eruption Thursday, June 7, 2018, in Galveston. The children arrived in Galveston on Thursday morning to receive treatment for serious burns, as the recovery effort around the volcano was halted due to dangerous conditions. less Shriners Hospital for Children - Galveston Steven E. Wolf, MD, talks about the six children inured by the Guatemala volcanic eruption Thursday, June 7, 2018, in Galveston. The children arrived in Galveston on ... more Photo: Steve Gonzales, Houston Chronicle Photo: Steve Gonzales, Houston Chronicle Image 1 of / 6 Caption Close Guatemalan children burned by volcano arrive in Galveston for treatment with long recovery ahead 1 / 6 Back to Gallery

"If you want to qualify it, a minor burn is 1 to 2 percent [of the body], a moderate burn would be up to 10 to 15 percent of their body, a massive or severe burn would be above that," Wolf said. "All of those kids have that final condition of severe burns."

Wolf said that the six children were selected for treatment because they fell in the "sweet spot" of victims of a mass-casualty event that were severely injured but not so much that they would not be able to recover with state-of-the-art care. He added that the hospital is on standby to help other Guatemalan children if needed, and that a second emergency medical team from a Shriners affiliate in Boston is also ready to travel to Guatemala if needed. The hospital network also has burn centers in Sacramento and Cincinnati that can admit more children burned by the volcano if necessary.

The general recovery timeline for burns is one day in the hospital per half percent burn. Wolf said that the first step is allowing the burn wounds to heal, which could include possible skin grafts.

Once the wounds heal, the hospital's team of occupational, physical, and speech therapists will put the children through a rigorous months-long rehabilitation process that includes psychological counseling. The rehab is typically done as an outpatient process, in which the therapists teach the children and their families how to take care of themselves outside of the day-to-day care of the hospital. After that process, the children will be seen by doctors at Shriners every three months or so, Wolf said.

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"Through the generosity of the Shriners' hospitals we'll pay for them to come up here and see them. We do not release these kids out into the world and say, 'Good luck,' we follow them along until they're adults."

When the scars mature, there is also a team of plastic surgeons at the ready to help reconstruct the lost skin and underlying tissue.

Wolf said that while the children have been through a horrifying experience, they often see great results from burn patients years down the road, a process known as "post-traumatic growth" which holds that people who endure psychological struggle following adversity can often see positive growth afterward.

"Everyone's heard of post-traumatic stress, the other side to that coin is post-traumatic growth," Wolf said. "How do we take a tragic event like this and turn it to the benefit to these children, who get a lot of personal interaction with a lot of professionals, and many actually go on to do better than their peers."

Medical costs for the children, which can soar into the millions given the level of care required, will be covered entirely by the hospital. Shriners in Galveston provides on-site housing for guardians while the children recover, as well as translators and counselors to assist them.

"We have to support [the families] if they're not going to be able to take care of their child," Wolf said. "We make sure their needs are met as well, psychologically."

Shriners Hospitals for Children has established a dedicated phone number -- (855) 393-7447 -- and website for those who wish to help the children from Guatemala.

Nick Powell covers Galveston County for the Chronicle. Follow him on Twitter and send him tips at nick.powell@chron.com