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Stories from Bhutan 2014

Posted by Surgicorps Volunteer, Betsy Utterback. Made possible by the generosity of Surgicorps volunteers and donors.
sonam-before-after

Sonam Wagmo

The love and support of Sonam Wagmo’s daughters convinced her to let go of her fears and finally come see the Surgicorps doctors. For over 50 years, Sonam lived with a cleft lip and palate. Due to these deformities, her speech patterns never fully developed and eating and speaking were a hardship. And although we assume that the appearance of her face affected her quality of life, she is a happy woman who coped with her disability. She had no idea how much easier life would have been with a corrective procedure that we see performed at home in the first year of life.

Sonam is a divorced mother of three. Her daughter, Bumjay Llama, brought her on the 9 hour bus ride to Paro where Dr. Demos and the team repaired her cleft lip. It was Bumjay’s insistence that convinced Sonam to have the operation. Her family felt that although she lived her life on earth with this disability, she should not go to the afterlife with it!!

Bumjay is a vivacious woman with a great sense of humor. Even though we had to rely on our interpreters, her sharp wit translated well! After her mother’s surgery, Bumjay’s first response was “Ok, Mommy. Now you can look for a new husband!”

Today, Sonam is back in Samse working as a weaver for a shop that makes the traditional women’s Kiras and men’s Ghos worn by the Bhutanese. Kiras are ankle length skirts which are wrapped around the waist and worn with a short silk jacket. The Gho is the traditional and national dress for men who wear them knee length and belted with a “kera”. Kneesocks and tie shoes complete the outfit for men. Traditional Kiras and Ghos are required to be worn by students in school, government workers or for any state functions. A bright sash called a “kabney” is worn over the shoulder diagonally for ceremonial functions.

Probably the most rewarding moment of the trip was watching Sonam finally look into the mirror after refusing to do so for a day. Her precious, tentative smile reflected her quiet excitement. She could not have squeezed my hand any harder. Of course, she was still not feeling 100%, but she managed to say thank you repeatedly.


sonam

Sonam Yangdon

Imagine yourself as a beautiful 14 year old girl walking alone along a familiar path to meet a friend when all of a sudden, a bear jumps in front of you and proceeds to maul you. This was Sonam, the unfortunate victim of an unprovoked bear attack eight years ago. Her face was literally swiped off by the claws of the bear who fortunately retreated before killing this terrified girl. In shock, she managed to run to a neighbor’s house. From there, she was taken to the local clinic in her small town of Mongara where they could only gave her painkillers.

The next day, she was taken to a doctor in Punukha who began to treat her injuries, but did not have the training or equipment to properly reconstruct the damage. In 2006, Sonam and her family heard that the Surgicorps doctors were in Paro. It was a two day trip but she managed to meet Dr. Jack Demos and his team who began the first of seven surgeries to repair Sonam’s face.

The tragedy could have destroyed Sonam’s life, but it did not. She returned to her studies in a school for children with disabilities in Thimpu, the capital of Bhutan. And it was in this school where she met her husband who had suffered spinal cord injuries after a motorbike accident. Last year, Sonam returned to Paro for her seventh surgery but had to delay this procedure for a year because of her pregnancy! In 2014, accompanied by her adorable 9 month old baby boy, she had her surgery. The team was so happy to meet her son; and Sonam was obviously proud and excited for everyone to see that she is living her life despite her difficulties. Sonam’s husband, who works as a tailor, and her sister accompanied her to the hospital.

Sonam and her husband now live with their son and her parents in Punukha, a 3 hour bus ride from Paro. Sonam spends her days like many young mothers, doing house chores, taking care of the baby and cooking. She loves to prepare curry dishes and surprisingly, loves to watch American horror movies on TV. Sonam leads a quiet life but she is happy and very grateful to “Dr. Jack” and the Surgicorps team for all they have done. She plans to be back next year for another surgery; and the team looks forward to another happy reunion!


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Migmar Dorji

Migmar is a happy 12 year old boy who suffered facial and burns on the right side of his body when he was 2 years old. The mosquito netting under which he was sleeping caught fire when the wind blew it into an open flame of a kerosene lamp. This year, the Surgicorps team performed its fourth operation on Migmar whose aunt plans to bring him in each year to continue the reconstructive process.

Migmar is from Gelephu in the southern part of Bhutan. It is a 2 day bus ride from Paro on roads which can be difficult to navigate. His lives with his grandparents. He is a typical fourth grader in many ways who loves to play with his friends, but he has no interest in playing sports! He loves math and watching Indian cartoons on TV. His favorite is “Chota Bheem”, a popular cartoon for the Bhutanese children. Migmar’s beautiful smile is always present and reflects his personality.


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Tashi Om

Tashi is a quiet and reserved 19 year old who was inspired to enter the nunnery when she was very young. She believes that the best way for her to serve this world is by being a nun and reaching out to those less fortunate. Although she comes from a poor family, she feels blessed to have so much. She wants to project goodness and kindness to all.

Tashi lives in a nunnery housing 90 nuns in Thimpu, the capitol of Bhutan. Her days are spent meditating, memorizing prayers and planning good deeds to share. She feared that before she entered the nunnery last year, she would “do bad things”. She also said that due to the difficulty in obtaining jobs for women in Bhutan, she felt that being a nun would be a vocation which would protect her from being alone and unemployed. Tashi also insisted that I mention her best friend, Nawang Choden who she admires for her selflessness and piety.

The Surgicorps doctors operated on the birthmark on Tashi’s left cheek and removed half this year to minimize scaring. She will return in 2015 to have the rest eliminated. Although she has lived with the mark all of her life, she wanted to be “cleansed of it”. Tashi was a joy to meet and she hopes to continue our friendship through email.


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Kinzang Choden

Kinzang was a “happy surprise” baby whose 3 brothers and 2 sisters range from 19 to 29 years of age. She is a very happy and playful little girl who is loved and taken care of by her father, sisters and uncle. Her mother suffered a cerebral hemorrhage a few years ago so her father relies on the extended family to help raise his challenged 9 year old daughter. Kinzang is unable to speak and suffers from developmental issues. She does not go to school and she has no friends according to her father, but he feels that the love of the family is all she needs.

The family lives on a farm in Paro so it was relatively easy to bring Kinzang to the hospital where the Surgicorps doctors repaired her cleft palate. Throughout her hospital stay, she had a smile on her face and you could feel the love and support of her family. It is quite common for extended families to live together and support one another in Bhutan.


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Dechu Kumari

Dechu is a bright, social and very friendly 14 year old girl who has travelled from Thimpu for the last 3 years to consult with the Surgicorps doctors. Each year, Dr. Demos and the team have improved her facial features in stages. This year, Dechu and her family made the trip to Paro for a surgery to elongate and narrow her nose. While Dechu recuperated in the hospital, her mother stayed with her in her room and her father slept in the car. Dechu was later joined by her older sister who will be going to the University of Calcutta in June. She has one brother who has the prestigious position of being an attendant to the king’s sister.

Dechu and her parents feel it is very important to Dechu’s future to improve the appearance of her nose and mouth. You could feel the anxiety of the parents and their concern to make their daughter more attractive. They have been persistent throughout the years to make sure that Dechu receives care from our doctors. They wait each year for the Surgicorps medical team to perform these surgeries because they trust that Dechu will receive the best care. There are few, if any, doctors in Bhutan who are trained to perform surgery on the deformities that the Surgicorps team expertly completes in conditions which are less than ideal! It would otherwise be necessary for patients to travel to India or Bangkok for such operations.


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Karma Wangchuck

Karma is the 10 month old daughter of a young couple who traveled 4 hours from Wangdue to reach the hospital in Paro where the Surgicorps team repaired the baby’s bilateral cleft lip. This family is one of the more fortunate in that they have relatives in Paro with whom they stayed during this week while their first child recovered from her operation. And although the family entered the hospital quite nervously, they felt that they could “trust the American doctors” with their firstborn.

Karma’s mother is a stay-at-home mom and her father works at a hydropower plant as a construction assistant. In cooperation with India, Bhutan has undertaken many hydroelectric projects. Hydropower is of primary importance to the economic progress of the country. There is virtually no petroleum or natural gas reserves in Bhutan, although they do have 1.3 million tons of coal reserves which they use only for domestic use. Due to the high mountains, rivers and deep gorges, Bhutan has an abundance of hydro power. However, with the increased demand for energy, alternative sources will need to be developed, although many households rely on simple wood burning methods for heat and cooking.


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Kuenzang Dema

It was such a pleasure to meet this very sweet, intelligent couple from Manguar, a small town which lies about 450km from Paro. They now live in Thimpu, the capital of Bhutan so their drive was relatively easy. They stayed with cousins who live in Paro. This was Dema’s fifth visit to the Surgicorps team. Dema’s condition—Rhomberg’s Disease— requires the injection of fat cells into her chin.

coupleThe couple spoke English very well so it was a bit easier for me to understand their enthusiasm for their new married life and the love for one another. Dema works as a tax officer and her husband is a documentary film editor. They met through her cousin in Thimpu. In their late 20s, they are like any other young couple who is looking forward to starting a family as a professional couple. They live in an apartment in the city; and they both love to cook Bhutanese dishes and watch soccer on TV. Dema likes her job as a “civil servant” working primarily in the corporate tax division of the government. Her husband, Tempa went to university in India and studied digital communication for two years. Many of the documentaries he edits are on the democracy of the new Bhutan. Other films advocate the cultural aspects and traditions of the Bhutanese people. Both of them could not imagine having no television! They both felt that without it, the small villages are totally abandoned. All communication, including the details of Surgicorps visit to Paro, could not be possible without it! Tempa’s animated description of a changing Bhutan and its future growth was exciting. Their enthusiasm marks a new era for the country under a new and admired young king and the new, developing constitution.

Zambia 2013 — Nunsa and Eliza

Our thanks to Surgicorps Zambia 2013 Team Members Janice Anderson and Matt O’Connor for collaborating and sharing the stories of Nunsa and Eliza.

NUNSA’S STORY

NUNSA SAMPUO (SURGICORPS #212) is small for seven-years-old. She comes from the rural Zambian village of Sesheke. Sesheke is about a day’s travel from the Beit Cure hospital in Lusaka by public transportation, a trip which Nunsa took with her father, Sampuo Muzungu. We interviewed her on June 20th in the Children’s Ward. It is the beginning of the Zambian winter. Nunsa is wrapped up in blankets, asleep in her bed, and Sampuo sits in a chair beside her. A jacket and a wool hat protect him from the cool breeze in the open air ward. It’s early, and while many patients are still asleep, the ward has a sense of bustle. Some children are playing near Nunsa’s bed, knocking toys and carts against the floor or our chairs. Sampuo is one of the few fathers in the ward; his wife is pregnant and so stayed home.

Read more on Janice’s blog

Ethiopia-2013

Surgicorps’ first trip in 2013 was a return to Ethiopia. It was exciting to have a majority of the volunteers making their first trip with Surgicorps. It was a wonderful success with 53 surgeries completed. First-time volunteer Lauren Potter shared this story from the week.

Hussein’s Story
By Lauren Potter

Patient: Hussein Musa, Post-op from a cleft lip repair
With the assistance of an Amharic translator, (a nurse in the ward) I was able to learn more about Hussein from his mother; who held him on her back wrapped in a sheet which she tied around her body. She told me they had traveled over 500km from Diredawa, Ethiopia (10 hours by bus). They heard about the opportunity for Hussein to have surgery by “word of mouth”.

Hussein and his mother live in a catholic home (shelter) called Mother Teresa home. He was born on 12/6/11 so is just over a year old now. Hussein is an only child, but his mother assumes she will have more children. Hussein’s father works odd jobs but does not have a steady income. His mother is currently unemployed with the exception of occasional cleaning jobs (called a house worker) at people’s homes.

Hussein’s mother revealed to me that she was concerned when he was born with a cleft lip because she knew he would face difficulties being accepted into the community. I specifically questioned her on the topic of breastfeeding because I was curious to know how a cleft lip may have impacted Hussein’s ability to breastfeed. She responded that he could not breastfeed and instead she had to purchase cow’s milk to feed him. I tried to ask her about “pumping” breast milk with a breast pump, but she had no idea what that was.

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Paro-2012 DAY ONE — Reunions and Patient Update

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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Bhutan, April 2011 – Pema Yengehen

Jamyang
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.

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The Story of Wangdi – The Bear Warrior

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.

Bhutan, April 2010

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!

Ethiopia, February 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.”

Kimley

kimley-before-1

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.

kimley-with-queen

Update on Tandin Dorji

7-year old Tandin Dorji before his second surgery for to reconstruct his nose after a bob cat attack.

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.

Kiran

kiran-before

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.

kiran-after

Mangnezig Mollel

We are the brothers of Mangnezig. We are from the Masaii Tribe and our family raises cattle. Our family was herding our cattle across a stream during the monsoon. The fast water carried away one of our young cows. Mangnezig grabbed the cow by the tail to try and save it, but the cow and our brother were carried down stream. Our brother is very strong and he did not let go. When we found him, the cow was dead; both of Mangnezig’s arms were broken and most of the skin was missing from his back and legs.

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Manamedoli Shandala

My name is Nashel, I am from “Mana’s” village and I brought “Mana” to the clinic to see if the American doctors could fix her hands. Mana’s hands and face were burned very badly when the thatched roof of her family’s hut caught on fire and collapsed into the house.

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