Creating a health system built around the child

For more than two decades, Dr. Castro has been part of caring for the children at Forever Changed. But his role has never been limited to seeing a child when they’re sick. Over the years, he has helped build a health system that looks at the whole child, where they’ve come from, what they’ve experienced, what they need today, and what will help them grow into a healthy future.

By the time Dr. Castro joined Forever Changed, he had already spent decades caring for and teaching about children’s health. He completed his pediatric training in Guatemala and England, served as an honorary professor at the University of Liverpool, trained pediatricians at the University of San Carlos in Guatemala for 25 years, and directed a pediatric department in a general hospital. He also worked as a UNICEF consultant in Central America, focusing on infant nutrition and breastfeeding.

After retiring from his academic and hospital work around 2004, Dr. Castro knew he still had more to give. He began working with children living on the streets and children in institutions in Guatemala City. That experience eventually brought him to Forever Changed.

“I saw an opportunity to serve children in vulnerable situations and put my experience and knowledge at the service of an institution that wanted to support the healthy growth and development of children without families or who had experienced abuse,” he explained.

One of his most important contributions has been helping develop Forever Changed’s internal health system. When a child enters the program, they receive a medical evaluation and a plan for their care. This is especially important because many children arrive with little or no medical history. Some have experienced malnutrition, abuse, developmental delays, or other health challenges that need to be understood before the right care can be provided.

Dr. Castro looks at each child’s history, symptoms, development, and medical needs to get as clear a picture as possible. From there, the team can create a plan for diagnosis, treatment, education, and follow-up. When a child needs a specialist or treatment that isn’t easily available, Dr. Castro draws on years of experience and professional relationships to help find the right resources.

And because a child’s health is about more than the physical, he doesn’t work alone. Many of the children Forever Changed serves have lived through poverty, malnutrition, abuse, and other difficult experiences. Their physical, emotional, and developmental needs can be closely connected. That’s why Dr. Castro works alongside psychologists, psychiatrists, neurologists, gynecologists, and other specialists when needed, helping make sure each child receives care that is safe, coordinated, and centered on their individual needs.

“The advances we’ve made include developing our own internal health system,” he said. “We have well organized preventive measures, and we’ve been very successful in caring for the health of the children. We also make sure every child has a diagnosis, a therapeutic plan, and follow-up.”

Building a system like this takes years of experience, careful planning, and a willingness to prepare for challenges before they happen. But eventually, every system is tested.

For Dr. Castro and the Forever Changed team, that moment came just six months after he began working with the organization. In 2007, an adenovirus outbreak left 48 children with pneumonia. Three children needed to be hospitalized, and for 17 days and nights, Dr. Castro worked alongside three nurses to care for the children.

But building a strong health system is only part of the story. In our next blog, we’ll share how that preparation was put to the test during some of the most challenging moments Forever Changed has faced, and how those systems helped protect our children.