Arif, age 2, was calm and cuddly with volunteer nurse Kim after his surgery to release the burn contracture on his left hand. Six months ago, he fell on the ash pile outside his home and was severely burned. As the burned healed, the skin contracted and he was no longer able to use his hand. Reconstructive surgery will give him greater function and the ability to grow up, learn to write and play with other children.
From Interplast nurses Sandi (Ontario, Canada), Frankie (Washington state), Liz (Oregon) and Kim (Michigan)
Bangladesh is a site to behold: the smells, the people, the curiosity, the stares, the transportation, the pollution, the garbage, the generosity, the kids. It is all overwhelming. They have a simple way of life and the people seem to live day to day, sleeping in the rickshaws---or wherever they can. We feel like celebrities wherever we go: being pointed at, stared at and the kids wanting their picture taken, then to look at their photo afterwards on our cameras. It is rewarding to see their faces when they see their photos. If we really thought about how poor this country is, we would leave right away and be sad, but the people have lives here and are making it work---there is a sense of community and socialization that sometimes is lost in our Western civilization.
The number of plastic surgeons in Bangladesh has more than doubled in the last few years. The growth is largely due to the post-graduate program in plastic surgery Dr. Shafquat Knundkar began in 2000 at Dhaka Medical College Hospital. Ten of Bangladesh’s 15 plastic surgeons are Knundkar’s former students. Currently, there are 15 residents (or registrars as they are called here) in his plastic surgery unit at the Dhaka Medical College Hospital, with another 60 medical students or general surgery residents (more junior students) who wish to pursue plastic surgery. Once all of these students graduate, Bangladesh is expected to have 75 more doctors who can help with the tremendous need for reconstructive surgery here. Knundkar’s vision and determination in establishing this program is building sustainable, surgical capacity in the most densely populated country on earth. Interplast is very proud to support his work by bringing a surgical team to help with the backlog of cases and provide hands-on training to these wonderful residents. Shown here are two residents assisting Dr. Sally Langley, volunteer plastic surgeon from New Zealand, while several others observe.
Three years ago, Tonmoy, age 11, excitedly ran into his kitchen, bumped into the stove and boiling water spilled upon him, severely burning 60 percent of his body. The doctors told his parents that his chances of survival were very small. His father used almost of all the family money for his treatment, even taking the child to India. Now, his parents have very little money, but they have a charming and bright young son who has regained his health, although not all of his mobility. “I cannot climb trees,” Tonmoy sadly told us in perfect English. Because of his burn contractures, his arm can only be raised to below his shoulder. Reconstructive surgery could release his scars and allow him to raise his arms above his head once again. We hope we can get him on the schedule this trip, but if the team runs out of time, Tonmoy will still be able to receive free life-changing surgery from Dr. Shafquat Knundkar, Interplast’s Surgical Outreach Director in Bangladesh. By focusing on empowerment programs like teaching and supporting local surgeons, Interplast has created year-round access to reconstructive surgery in Bangladesh and eight other countries. Tonmoy, a talented artist who goes to a special school for gifted children, is shown here showing off the perfect shading on a coloring project; however, Tonmoy’s specialty is painting landscapes and portraits.
On one of our first days, the team was told that a failed suicide bomber was in the hospital and needed treatment. His bomb had detonated prematurely, loosing most of the exploding power that was planned for foreigners; the result was damage to only the bomber’s limbs, but not death. Most Interplast team members are used to the ethic that they should treat anyone in desperate need of care, regardless of who they are or what they have done. However, it did bring up interesting discussions about who is deserving in a country of such overwhelming needs. After the man was examined by Interplast doctors, under the watchful eye of the police guarding him, it was determined that he did not need surgery at this time for his fracture and wounds. There was nothing for the Interplast team to do.
Some of the patients seen in clinic did not need surgery, but did need hand therapy. Rina, an 18-year-old soon-to-be nursing student, was hand therapists Nancy’s and Mohan’s first patient. Mohan Randol, (shown in photo with Rina) from Interplast’s Surgical Outreach Center in Nepal, has come to Dhaka to learn from Nancy Chee and to help the team with its patients. He is one of the few hand therapists in all of Nepal.
“I will never forget your team,” said Unmea, excited that she will have new functionality, the ability to hold a pen and pick things up with the fingers of her right hand. She is here with her mother and Dr. Mary Hermann, volunteer pediatrician.
Unmea was not exactly a breach baby, but her delivery was difficult as she was not in the right position. To correct her position, the doctor reached inside and pulled her arm to turn her. Consequently, since birth, Unmea has suffered from Erb’s palsy, her wrist limp and slightly twisted. Without being able to lift her wrist, she is not able to use her thumb and a finger to pinch, to pick things up. Reconstructive surgery to move and tighten tendons can give her that ability.
Unmea was one of Interplast’s first patients in Dhaka this year---and one of the most beautiful and brightest. At 17 years old, she is studying to become an economist.
Shorna's eyes and smile capture you. She is a beautiful 5 year old. A little less than a year ago, Shorna had a dish towel hanging from her arm that caught the flame of the family's oil lamp, their only source of light in their home. Instantly, her arm was engulfed in flames, her mother explained to us. The result was a horrible wound and Shorna being pulled from school, where she was in her first year. And now, she suffers from a burn contracture that will not allow her to straighten her arm. The Interplast team has scheduled her for surgery to release her contracture and give her greater freedom of movement.
Before Interplast starts surgery, team members discuss the protocols and procedures in case an emergency happens. Dr. Fred Mihm, volunteer anesthesiologist, leads the team through the “scenarios,” the established emergency protocols set by Interplast medical advisory committees over the years.
Dr. Jean La Belle uses every moment possible as an opportunity to teach. “Education is our focus. It’s why we come,” said La Belle. Interplast works to increase the supply of trained doctors who care for the poor year-round in some of the most underserved regions of the world.
After the surgeons examine patients to see if reconstructive surgery is an appropriate treatment, Dr. Mary Hermann, volunteer pediatrician, and Drs. Scott Douglass and Marshall Jones, volunteer anesthesiologists, evaluated the patients to see if they would be healthy enough for safe surgery. Pictured here is Dr. Marshall Jones with a potential patient.
Unfortunately, some of the children were not healthy enough for surgery, like this little girl. Hopefully, with iron supplements for her anemia, her health will improve and she will be able to have surgery to repair her hand.
At clinic, Dr. Sally Langley (bottom right) and Dr. Jean La Belle examined 60 patients to decide if surgery would be appropriate for their hand injuries and deformities. Many of the residents observed and discussed the cases.
Dr. Shafquat Khundkar, Interplast’s surgical outreach director, introduces the plastic surgery residents to the Interplast team. Approximately 8-10 residents will be receiving hands-on training and lectures for complicated hand surgeries, while observing and working with volunteer surgeons Dr. Sally Langley and Dr. Jean La Belle.
Eleven medical volunteers, two coordinator / translators and I arrived in Dhaka, Bangladesh to provide free reconstructive surgery for children and adults with hand injuries.
Dr.Shafquat Khundkar, Interplast's surgical outreach director, met us at the airport. Khundkar (center) is talking with Nancy Chee, volunteer hand therapist and team leader, and Dr. Jean La Belle, volunteer plastic surgeon. Nancy and several of the other volunteers are returning to Bangladesh, having been here with Interplast in 2003, 2004 and/or 2005. Interplast was not able to come last year because of the political unrest associated with the student protests.