by Mario Gutierrez

Normally our first day of surgery is a bit hectic as we all get to know each other and settle into our respective roles, making sure that all of the equipment is functioning and patients are all scheduled and checked and ready for surgery. However, for some reason this year our first day has gone very smoothly— almost too quiet. But then this afternoon we were treated to yet another remarkable Bhutanese special moment.

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Our thanks to team members, Thad Ellis and Dave Fortun, for sharing their experiences.

In the Words of Dave Fortun, Surgicorps Volunteer

Sunday, they arrive. (more…)

In the words of volunteer Mario Gutierrez

Every once in while on these surgical volunteer camps reality raises its head, stares you in the face, strikes you deep down in your soul and reminds you just why we do this. Today was a one of those days. After the organized chaos of the first couple of days of getting to know each other, setting up the supply room, organizing the operating theater and just getting into the daily routine of the ebb and flow from pre-op to recovery, the third day usually goes smoothly. That day, we had a full schedule and thought we would be there late, but this remarkable team of 18 gelled very quickly, and surprisingly we were nearly through 13 cases in reasonable time. Lots of cleft palates, cleft lips, fistulas, a variety of burn contractures, cute kid with ear tags that Dr. Jack removed under local, and then, the last case, PATIENT #36 came out of surgery. (more…)

Paro, Bhutan

Wangdi is a 64 year old male who lives in the village of Punakua, a two hour drive from the Capital City of Thimphu. Three years ago, Wangdi and some of the other villagers were rebuilding their homes. When he and his friend went into the forest in search of more wood they had an unfortunate surprise encounter with a large bear and her three cubs that had been sleeping under a tree. While Wangdi’s friend managed to run away, the bear went after Wangdi, viciously attacking his face and head. With his head halfway inside the bear’s mouth, Wangdi desperately tried to pry himself free. In the process, the bear tore three of Wangdi’s fingers off his left hand. With his right hand, he was able to pull out his long knife from his “gho” and stab the bear twice before losing consciousness. In the meantime, his friend ran back to the village to get help. Although he was badly wounded, they were able to get him to the hospital and saved his life. Despite his terrible wounds he asked his friends to go back and try and find his watch, which had come off during the attack. Although they didn’t find it, they did find the bear lying dead a few yards from where they had found Wangdi. Today, Wanghi’s face remains badly scarred from the attack, although time and surgery have improved his appearance. He wears a fur hat to cover the loss of scalp on his head and stylish dark aviator glasses to mask the damage to his eyes.

He was first operated by Surgicorps in 2007 to reconstruct and reposition his eye socket. He has been back each year for additional surgeries. In 2010 a staged reconstruction of his nasal cavity was conducted with a rib bone graft, and his badly deformed eye was also further reconstructed. He’s back again this year (with cooler looking dark shades) to re-adjust the positioning of his lower eyelids to help stop his constant tearing and protect his eyes. He still carries his trusty knife with him at all times and says he’s very grateful that he still has his thumb and two fingers on his left hand so that he can finger his prayer beads and thank his good karma that he was still alive.

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.”