The Kingdom of Bhutan: April 2010
In the words of Surgicorps Volunteer Lynda Dendtler

Arriving in Paro, Bhutan, from Pittsburgh, Tennessee, Virginia, Colorado and Spain, the 25 multidisciplinary Surgicorps volunteers were welcomed by 170 families eager to present themselves for surgeons Drs. Jack Demos, Sarah Pettrone and Marc Liang’s examination. Word had spread quickly in 2010 that Surgicorps was returning! With the assistance of Queen Ash’s Tarayana Foundation, families assembled from the far reaches of the kingdom in hopes of being accepted for surgical repair of a birth deformity or injury that would allow the child or adult to be able to eat or walk or use their hands and arms. And the Surgicorps team was equally eager to help as many as possible during the 2 weeks in country. Starting early in the morning and operating into the evening, some 89 surgeries provided improvement in the quality of life of these beautiful people.

During our fourth mission to this storybook kingdom, several children came for the next stage in procedures started one, two or even three years ago. Others returned to demonstrate their recovery and pride at being able to now extend and use an arm, hand or leg. One confident young boy was able to fully raise his arm above his head, no small feat for a child whose arm only last year was fused to his chest by scar tissue. His father was beaming as the boy showed his new “moves”. But the faces of the mothers whose babies and children’s cleft lips and palates repaired were the most joyful of all. After all, it fell to them to try to nourish their child since birth through badly misshapen lips that didn’t close, to keep their child from choking or starving. What could be more life changing?

Our team included doctors who made themselves available to the community at large. Upon hearing that a pediatrician was available, people lined up for Dr. Janet, who was able to confirm diagnoses or order further consultations, giving parents hope or confirmation. An anesthesiologist did not hesitate to help the staff during a crisis with a local baby in crisis. The monks of the famous Paro dzong streamed down the hillside for a “check –up” with Drs. Gino and Dr. Ron, who, in one case, solved the blurred vision of an elderly monk simply by giving up his own reading glasses!

The skills, compassion and dedication of each volunteer combined to gain the trust of a people who, though largely self reliant, hope for surgical intervention that is not yet widely available to all citizens of this kingdom. Every year children all over the world are born with a congenital lip and/or palate deformity (1 in 700). With the commitment of Surgicorps, many people of Bhutan need no longer face the social isolation, fear and health impairment that such a deformity can bring

Bhutan measures its citizens “Gross National Happiness”. One young mother shared details of her journey home following her son’s operation: 2 full days on a bus to the end of the line, then walking through the mountains from sunrise into the dark of night to her village, child wrapped in a shawl on her back. “But,” she said, “I am so happy…now he will be able to eat!” Surgicorps is pleased to be able to raise the measure of GNH in Bhutan in 2010!

In the words of Surgicorps Volunteer Melinda Handler:

Ethiopia was an exciting new destination for Surgicorps this February, 2010.

Dr Jack Demos and Dr Paul Kim once again performed operations on those who could not otherwise afford them. The two surgeons were assisted by a team of fourteen who accompanied them from the USA.

In order to be screened for possible care, many natives travelled from rural villages. Some walked up to two days just to reach a smaller city center. From there bus is standard transport, a ride that could last several days. The hospital was situated in the heart of Addis Ababa, the capital of Ethiopia. It is hard to imagine the fear or unease that must lie within oneself upon such a journey, the uncertainty of newly chartered territory. Still, hope must be ever present for the slight chance at change. They arrive tired and weary into our care. We are told many, due to their physical deformity, are rarely looked at, talked to or smiled upon within their community. Our smiles are wide and hugs are warm. It takes time for them to trust and to tell their story.

Twenty eight patients received fifty one procedures successfully over the course of five days. The majority of cases were cleft lips and cleft palates. We saw more adults than children, which meant these birth defects lasted well into their 20’s and 30’s (some suffered past that point.) In more developed countries, a defect such as a cleft palate is rectified at birth or soon after. Imagine, living through adulthood with a large open cavity at the roof of your mouth. The simple act of eating, (chewing and swallowing) is nearly impossible. The majority of food slips through the open gap, at times funneling through the nose. A surgery such as this can last between 2 to 4 hours, yet brings about significant change.

Every day a particular experience tugged at our hearts. There was the young, sweet 4 year old girl with a cleft lip. She had become a sort of mascot for the team, full of personality and energy. Her spirit was contagious. The surgery however, was canceled the morning of, due to testing positive for Malaria. Her family was obviously devastated by the news but the young girl still managed to smile and spread joy.

Another occasion involved two preteen girls who kept their facial deformities covered by wearing a wrap exposing only their dark eyes and long beautiful braids. On one particular morning the hospital staff discovered lice on both their scalps. A decision was made to shave their heads to prevent spreading within the ward. The girls were saddened by the thought of losing their feminine locks and how it would only add to the torture of an already visual affliction. Members of our team provided them with colorful silk scarves bought from the local market to help soften the blow.

On any Surgicorps mission a volunteer cannot help but be moved and affected by personal stories such as these.

By week’s end our goals were accomplished and all 28 patients were discharged and provided with follow up care. Once again they began their long journeys home, this time perhaps leaving with more confidence than before and with a better outlook for tomorrow.

In the words of Helen Keller- “Life is either a daring adventure or nothing. To keep our faces toward change and behave like free spirits in the presence of fate is strength undefeatable.”

It happens every day. Quickly.

But the scars last a lifetime.

Thao Ly, now 13, was holding a candle to provide light while she and her sister took a bath. The fabric beneath the tub caught fire. Thao and her sister were badly burned.

Thiy Then, now 18, was only 5 months old when her mother lit a fire beneath her crib to warm Thiy. Thiy fell out of the crib into the fire, and has been scarred since.

Bich Thuy, 47, a nurse, added alcohol to a cooking fire, and it exploded. After the accident, many of her patients were frightened by Bich and refused treatment from her.

Thao, Thiy, and Bich are just 3 of the 57 patients treated by a Surgicorps team of 25 volunteers who traveled in October to Ho Chi Minh City, Vietnam. Their burn scars and contractures were treated by Surgicorps surgeons, as were the cleft lips and palates of other Vietnamese patients, young and old. 57 lives were improved, altered, and in some cases, normalized that week in October.

Thao, Thiy, and Bich joined nearly 200 other Vietnamese, Guatemalan, and Bhutanese citizens who benefited from a Surgicorps mission in 2009. That number will increase in 2010, as Surgicorps teams add Ethiopia and Colombia to the annual trips to Vietnam, Bhutan, and Guatemala, and Surgicorps extends its mission to Africa and South America.

It happens every day. Quickly. Thao, Thiy, and Bich are evidence of that. But it happens every day at birth, as well - cleft lips, cleft palates, extra digits.

Surgicorps’ mission is to help others in developing nations, to see that the scars don’t last a lifetime.

A cleft palate is a cleft palate.

But the patients are always different.

They come from different towns with different stories and different faces. And that is why each trip to the same city, Antigua, is different – but just as rewarding as the last.

On August 15, 2009, a Surgicorps team of 47 volunteers (25 on their first mission) from Pittsburgh, Philadelphia, Florida, Colorado, Utah, Boston, Connecticut and California met in Guatemala for a week-long mission of surgeries and related medical care. Same hospital, same host staff – different patients, different lives to be impacted.

Seven days and 86 surgeries later, the team returned to the United States, and Surgicorps International added 86 names to the list of thousands whose lives have been improved in Central and South America, Africa, and Asia over the past 15 years.

Doctors, nurses, medical students, non-medical volunteers, all working daily in some large or small role to achieve the same goal: an improved life for someone in need. All working daily to feel what one volunteer, 16-year old Aarthi Ramesh, felt after working with her mother, an anesthesiologist, and her father, a general surgeon: “This might have been the best day of my life.”

Following the lead of some well-traveled and trustworthy friends, I made my first foray into this world of “voluntourism,” a week of service at your own expense in a foreign country. Now Bhutan was never on my travel hit parade, but I was jazzed about all the “firsts”: new place, people and challenges and all as part of a “medical” team.

I also was a little unsure of my own ability to do whatever was asked of me and not faint at the sight of – what? Let go, breathe, trust….

Okay, first day, it’s so clearly not about me and won’t ever be. Quick turn around from airport to hotel to hospital. This is the hospital? Yes, dial it down sister, people everywhere, quick introductions, get to work, here’s your job, I can do that, hi Jack…and presto! I’m in the Surgicorps “zone” and it feels great. Real and immediate and astonishing.

Wait, there are dogs in the hallway….

People in need and in pain accepting help from strangers who can turn their lives around. I am humbled and awed by the medical team, all week, non-stop. Short breaks, then who’s next and next and next?

Calm and focused – who are these people?

I share the non-medical jobs with my girlfriends (how lucky!) and a few other wonderful volunteers (lucky again!):

Following and updating the paper trail of patient charts and surgery schedules; helping to prep patients for their procedures – thanks to the translators who helped us here and everywhere, everyday; keeping the children supplied with crayons and coloring book pages; standing by a gurney to keep a patient from rolling off; sometimes fetch and carry and sometimes stand quietly watching and waiting for the next “ask.”

Some people like to be in the operating room but it’s very hot in there and I prefer the very real luxury of moving around.

Big treat – who knew? – doing rounds with Jack in the mornings learning how to have ready and anticipate those things he might need.

I don’t panic, I just do it, no problem…start thinking I’d make a good nurse but besides the math, I realize I’d never pass the “poking people with sharp things” class. Now, where are those crayons?

Thank you Linda and Sheryl for all my quick onsite training!

The luncheon with the royal family was “off the charts” special – a delightful conversation with Her Majesty the “First” Queen Mother revealed that we share the same favorite American Idol contestant!

Loved it! Loved her! We were all tearing up as we left them.

And oh yes, the beauty of the country and its peace-loving inhabitants, their very distinctive architecture and those mountains! Watch any one of a number of good films coming out of Bhutan these days and you will get a taste.

I’ll go back again…with Surgicorps. Maybe to Vietnam with them first….

The very last thing I do want to say and it is such a cliché but it applies:

After the week in Bhutan and my return home, I find I am maintaining feelings of deep gratitude and appreciation for the bounty and love in my own life. The resilience of the human spirit continues to amaze and inspire me through my days….

Thank you for letting me help.

In the midst of all the hard work, Surgicorps Team members had the opportunity to experience some of the traditions of Bhutan. At a local monastery, the team enjoyed a performance of local singers and dancers.

Kimley is a five-year old future basketball star, who entertained Team members with his hoop skills while waiting for his surgery time. Kimley was burned by an open fire, and the scar left him unable to fully extend his left arm. Surgicorps sees many burns from open fires in Bhutan and other developing countries.

After surgery and a splint on his arm, he was still able to charm Her Majesty Ashi Dorji Wangmo Wangchuk, Queen Mother, when she stopped by for a visit.

Her Majesty Ashi Dorji Wangmo Wangchuk, Queen Mother, visited Paro Hospital to meet many of Surgicorps’ patients during our Medical Mission Trip to Bhutan in April. She stopped by the bedside and talked with each patient. Her Majesty received a case update from Dr. Demos and Dr. Kim. The Royal Family is greatly loved by the people of Bhutan and many of the patients and family members were overwhelmed by her generosity and kindness.

After visiting with the patients, she hosted tea for the Surgicorps Team and the Paro Hospital staff to thank us for our work and make plans for the 2010 visit.

We first met Tandin Dorji two years ago when he was smiling and racing around Paro Hospital waiting for reconstructive surgery for a new nose. He had been attacked by a bobcat as an infant.

During our April 2009 Medical Mission Trip, Tandin was back to continue his reconstructive surgery. Now seven years old, he is pictured here waiting for his surgery.

During the April 2009 Medical Mission Trip to Bhutan, Surgicorps performed 62 life-change surgeries, a majority of which were for cleft lips.

2-year old Kiran, pictured here in before and after photos, was one of our patients. The team was able to repair his lip, helping him to better take nourishment, and improve his overall quality of life.