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Bill: Healing Bodies, Changing Lives

We had a frail and depressed 16-old girl who had her lips repaired on Monday under local anesthesia, as she is diagnosed with VSD. It has been our hope that she can receive free heart surgery under the Shanghai Rotary Gift of Life program which is supported by Rotary, with surgery performed at Shanghai Chest Hospital. The team has kind of adopted her in true compassionate spirit.

After her cleft surgery, anesthesiologist Craig McClain talked to the hospital's cardiologist and obtained a copy of her echo-cardiogram. We faxed the cardiogram to Frank Yih at Shanghai, who in turn requested Dr. Chen, the pediatric heart surgeon at Shanghai Chest Hospital to review the case immediately.

I was truly excited to receive Frank's phone call this afternoon telling me the good news regarding Liu Fangjin. Dr. Chen has tentatively approved Liu for surgery subject to examination, and Frank Yih, in support of the Interplast Ganzhou mission, has given Liu priority for admission into the Gift of Life program.

I broke the news immediately to Madame Liu Hongru, the senior Family Planning lady from Beijing

representing Madame Miao, so that her people can contact the girl's family and begin preparation for the trip to Shanghai. Madame Liu will also inform the hospital. They are all thrilled.

I made an announcement during our team dinner tonight and needless to say the whole team was elated...even more so when I told them that it is very likely that Liu and her aunt might be traveling with our team and staying at Asionics, with all travel and living expenses paid by Frank Yih and HuaQiao Foundation.

Interplast - Healing bodies, Changing Lives.  We will have completed about 80 surgeries by tomorrow noon. Little did we anticipate that we are very well on our way to saving a life.

Bill Chiang: Pleasantly Suprised

We have been pleasantly surprised by Ganzhou City, which turns out to be a city full of history. Some of the infrastructure trace back to the Sung dynasty.

The city's sewer system was built in the Sung dynasty and is more than 800 years old.

Chairman Mao's famous "Long March" began in nearby Ruijin City, which was the capital of the Chinese Soviet Republic, known also as the "Old Red Capital."

A few hours to the west of Ganzhou is the Jin Gang Mountain, a very poor and remote region where Chairman Mao and his Red Army leaders hid when the Nationalist Army was in hot pursuit.

Ganzhou is considered the center of the Hakka (literally "Guest") people. They were originally refugees from Henan province in the north who, escaping from war and famine, settled in this region in ancient times.  Being foreign to the region, they kept their ancient dialect, old customs and distinctive cuisine.  From this region, the Hakkas branched out and settled in other southern provinces such as Guangdong, Taiwan, and many countries in Southeast Asia. The 19th Conference of the World Federation of the Hakkas was held in Ganzhou City last year.

Ganzhou is the Tungsten capital of the world. 70% of the world's production of Tungsten comes from

China; and 70% of China's Tungsten production comes from Ganzhou.

The city is clean but full of noises. Honking is pervasive.  A street sweeping truck usually comes around the hotel at around 9 pm, playing loud "Happy Birthday" tunes.

There are no pigeons in public parks or places.

Paul Quintana: Teaching

  Paul Quintana Teaching 
  Originally uploaded by interplast.

I am Dr. Paul Quintana, and I am giving a series of lectures to a group of doctors, nurses and students. The lectures have attracted up to 100 during these 2 hour long sessions in the afternoon. I am planning to give three such sessions, and I am excited to share my knowledge with my Chinese peers and their students and residents.

Stuart - Day Off

  Day Off 
  Originally uploaded by interplast.

We had Sunday off and took a delightful tour of five of the important historical sites around the city. Led by Linda, we visited a monument, Yugu Terrace, that is dedicated to a poet and political leader from the past.

Then followed a site - Bajing Terrace, where part of the old city wall is constructed with original brick that even pre-dates the Great Wall of China. There is also a large monument resembling a cooking pot erected to commemorate the Hakka people.

Near one of the remaining four out of five city gates there is a pontoon bridge crossing one of the 3 rivers associated with the city. Lunch was in a historical old part of town where an old house was transformed into a restaurant where the local cuisine and beer continue to amaze us all.

Stuart: Fighter Pilots

  Fighter Pilots 
  Originally uploaded by interplast.

A short ride out of the city took us to the Tong Tian Rock Grotto – another site illustrating the long and historically importance of this Song Dynasty City. Its interesting stone carvings are in close proximity to an amusement aeroplane ride thoroughly enjoyed by Amy and Jim.

Richard Roullard: Never Worked With Better

  Richard Roullard: Never Worked With Better 
  Originally uploaded by interplast.

I am the head nurse on the China team.  Jodi and I work together in the Operating Room with two wonderful Chinese nurses, Sunny and Rose.  Sunny is a charge nurse and cardiac nurse at the hospital in which we are working.  Jodi and I have been on several trips and both agree that we have never worked with better nurses than Sunny and Rose.  They are extremely quick to learn the surgeons' routines and preferences and have been most helpful to us in setting up and running the day's schedule. Sunny went so far as to invite our entire team to her family's home this evening for dinner.  They treated us to our best meal yet, a banquet fit for royalty.

Patricia Leblanc: Fourth Trip So Far

It has been an incredible experience for me to be on another Interplast trip. This is my fourth trip so far, but to be in China is more challenging since none of us speak the language. We are so fortunate to have on our team a secretary who happens to be an RN born in China and who now lives in the States. Cindy is a godsend to us by helping us bridge not just the language, but the culture. An added bonus is Bill, who is also helping as a liaison with interpreting and looking after our daily needs such as eating! Cindy and Bill are often pulled out of our PACU to the OR or to talk with the media. Barbara, one of the local medical students, comes to the rescue when we are left alone with a post-op child.

Stuart: Surprise!

  Originally uploaded by interplast.

This man brought his grandson to Interplast without telling the boy's parents, who are migrant workers. He said they would have worried. The grandfather is very pleased with the results, and eager to see the reactions of the parents when they next come back to visit.

Stuart: Cooperation

  Chinese and Americans cooperating 
  Originally uploaded by interplast.

Chinese and American doctors and nurses conferring and cooperating.

Stuart: Mother's Tears of Joy

  Mother's Tears of Joy 1 
  Originally uploaded by interplast.

The mother was the first and only one to cry when she saw her daughter's face - They are coming into the PACU (recovery room) when children are waking up.

Amy: We're Famous!

Jodi and Paul were walking home from the hospital last night, when a man dressed in a nice suit passed them and said "thank you for helping the children".  They realized he must have seen us on TV.

Amy: Leaving Jing Ying

  Amy and Jing Ying Hugging 
  Originally uploaded by interplast.

Although she likes school and has friends, Jing Ying has been teased because of her appearance and speech, and she has felt very sad. She is excited about her now normal face and hopes that Interplast will repair her cleft palate next year when we return. Although she is a good student, she says she plans to study really hard now that she feels better about herself.

Her family had been so generous, and I really enjoyed my time with them. She was very grateful to Interplast, and I was sad to leave her and her family.

Amy: Local Kids

  Local Kids 
  Originally uploaded by interplast.

The local kids were very interested in me. I hope they will treat Jing Ying better now that her lip as been repaired.

Amy: Jing Ying

  Amy and Jing Ying's Family 
  Originally uploaded by interplast.

Jing Ying's family cultivates rice. Her parents are migrant workers working in Guangdong, a big city about 10 hours down the highway. Her aunt prepares her food during the day, and her grandma takes care of her at night, when she's done working in the fields. She has an older brother, who was also born with a cleft lip and palate, and an older sister. Both are also migrant workers. The brother is learning to use heavy construction machines. The parents borrowed money for his surgeries many years ago, but they couldn't afford to pay for their daughter's surgeries. The translator said that girls aren't as important. Her mother had developed cancer, and the cost of her surgeries has left the family in debt, although she seems to be well now. Although Jing Ying's mother works far away, she returned to bring her daughter to Interplast. She will return shortly to her job.

Here I am pictured with Jing Ying and her family. I was given the highest honor you can give a guest - I was served eggs (in rice wine soup). It was a bit embarrassing since I am not the hugest fan of rice wine soup, but it was very sweet, and I ate it nonetheless.

It was a wonderful peek into a very different way of life.

Amy: An Entourage

  Amy and Local Media 
  Originally uploaded by interplast.

While the team is actually doing the operations, I had the privilege and pleasure of getting out of the hospital.

Today, I visited an 11 year-old girl from a nearby village, whose cleft lip was repaired on Tues, and she was discharged yesterday (Weds). I had an entourage - a government videographer and several provincial government people, as well as a translator.

Amy: Full of Neon

Ganzhou City is a clean, quiet city---and full of neon.  Most of the people here speak a local dialect, although Mandarin is also spoken by many. Thankfully, we have local translators who have offered to help us understand this dialect. 

Local journalists are doing stories on a few children, beginning with filming them in their villages before we arrived, following them in clinic and through their operations, and then after their return home.   Their stories are on the local news each night.

In a little bit, I am going to a village to see an 11-year old girl who received an operation from Interplast on our last visit. It will be great to see this “after” and to see how the surgery has made a difference in her life.

Amy: Moms Are The Greatest In The World

Frank Yih taught us a song in Shanghai.  He suggested we sing to the kids to comfort them.  Here are the lyrics:

Moms are the greatest in the world.
Kids with mothers are precious who can enjoy endless happiness in mothers' arms
Moms are the greatest in the world
Kids without mothers are wild weeds who cannot find happiness outside mothers' arms.

This song is another example of how much mothers are valued in the Chinese culture.  Many of the Chinese characters describing things of comfort, home and warmth include the radical for mother. 

Molly: Looking Out For Each Other

  Molly With a Post-op Patient 
  Originally uploaded by interplast.

This is my 3rd Interplast trip, and I've been so impressed with the way the families look out for each other on the wards. If one child is crying, the others in the room rush over to help. They really become a community.

Amy: Doctor's Gift

The Interplast office has relayed to me some good news. “Smile,” a feature-length Hollywood movie about a volunteer medical group that does reconstructive surgery in China, will be released in Los Angeles and San Francisco this Friday, April 8! While I have not seen “Smile” yet, I understand that it will tell the story of how reconstructive surgery can help restore the lives of children in developing countries. It will feature a Chinese girl with a cleft lip who receives free surgery from a fictional humanitarian organization called “Doctor’s Gift.” What a coincidence that “Smile” talks about a charity helping Chinese children while Interplast is currently in China, helping children just like those in the movie. “Smile” should bring needed attention to reconstructive surgery and cleft lips and palates, especially in developing countries like China. In the “Smile” movie, “Doctor’s Gift” inspires a young Californian girl to help others around the world. I hope that “Smile” inspires more people to become aware of Interplast and the life-changing reconstructive plastic surgery that we perform in real life.

Roy: Teaching and Working with Local Doctors

Dr. Wang and I are seen here performing a cleft lip repair together.  We shared new techniques with each other, and learned a lot.  Dr. Wang is a local surgeon who does approximately six cleft surgeries here a month with the financial support from The Smile Train.

Amy: So Tender

  Patient with a Bilateral Cleft Lip 
  Originally uploaded by interplast.

All the kids have clefts, and most are infants or young children. Dr. Quintana commented that he was struck by how healthy these children are; they have good teeth (that means no candy), no anemia and no malnourishment. Often, children with clefts do not get the nutrition they need because their deformed lips cannot create enough suction to breastfeed properly. Others with cleft palates can get food in their mouths, only to have it come out through their nose since the roof of their mouth never effectively formed.

I haven't been on a working trip for a few years. After all these years with Interplast, and being a non-medical person, I still get so moved by the work we do, the privilege it is to be able to watch our teams interact with the kids and their families as they provide this care. Seeing Molly and Patricia be so tender with the post-op children, or seeing their parent or grandparent brought into the PACU to hold them as they emerge from the anesthesia always gets me!

Amy: Clinic Day

  Boy Hat 
  Originally uploaded by interplast.

The first day at the hospital is called “Clinic Day”. On this day, prospective patients are evaluated to see who is healthy enough to have surgery, what the surgical issue is, and to schedule their surgery. Over 120 patients with clefts were prescreened. We had two local translators, who made everything run smoothly. They worked with the surgeons and Dr. Quintana, our pediatrician, to coordinate between the doctors, patients and their families. Unfortunately, there was a bit of jockeying going on, since we could only schedule 84 patients. The "leaders" of groups of patients from a particular place were anxious for the most members of their group to be helped.

Amy: Patient Recruitment: An Interesting Challenge

  Patient With a Cleft Lip and a Cool Hat 
  Originally uploaded by interplast.

We're all impressed with the hospital’s organization efforts. Patient recruitment has been an interesting challenge. Traditional methods used at our other sites (TV, radio and newspaper) didn't work for some reason. China has 300 million migrant workers, and many parents go to the cities to make incomes three times greater than what they could earn at home. Since the area around Ganzhou City is predominantly rural, many children stay with their grandparents while their parents seek employment in larger, eastern cities. Many grandparents do not pay attention to radio or TV, so the provincial family planning organization sends workers out by foot to the villages to tell people about the Interplast surgical volunteers. Patients sometimes come from 150 miles away to have the opportunity to receive free reconstructive plastic surgery.

Amy: Warm Welcome to Interplast

We spent the first night in a suite owned Mr. Frank Yih, president of Bridges to China. He and his wife Nancy were incredibly gracious.  Frank worked at Fairchild Semiconductor in Palo Alto, California (near Interplast’s office in neighboring Mountain View) in the 50s and 60s and was on the team that developed the integrated circuit.  Nancy took us to the Bund, a famous colonial street along the Huangpu River in the heart of Shanghai. The weather was sunny, and we walked along the river for a little while before catching our flight to Nanchang, where we met Madam Miao of CPWF.  She welcomed us with a short speech once we got on our bus, which we were on for four hours until we reached Ganzhou City.  We arrived after 8:00pm, and were met at the hotel lobby by the local media and family planning people under a "Warm Welcome to Interplast".

Amy: Arrival

We arrived in Shanghai after a 13-hour flight and were met by Bill Chiang of the Bridges to China Foundation and Mr. Dong of the China Population Welfare Foundation (CPWF).  We left Mr. Dong hassling with customs in spite of the endless lists Phil (our director of medical supply services) had sent.  We don't know what the problem was, but it took him another 2 hours to extricate the boxes before driving them 15 hours in a truck to Ganzhou City.

Amy Laden: Excited and Ready

  Saying Goodbye 
  Originally uploaded by interplast.

Hello. My name is Amy Laden, and I am director of international services for Interplast.

From April 1-16, 2005 Interplast volunteer medical professionals from around the United States and Canada will go to Ganzhou City, China to provide life-changing reconstructive surgery.  Ganzhou City is an industrial city in Jiangxi, one of the poorest provinces in China.

More than a decade ago, Interplast made its first surgical trip to Shanghai, China, helping heal the lives of children who suffered physically or emotionally from the devastating effects of a congenital deformity or injury.  In 1995 and 1996, Interplast surgical teams returned to China, working in Urumqi, Xinjiang province to perform surgeries and restore more lives.

Interplast is returning at the invitation of the China Population Welfare Foundation.  While in China, Interplast will also receive assistance from the HuaQiao (Bridges to China) Foundation, a grassroots nonprofit based in San Francisco and Shanghai.  Dr. Scott Corlew, an Interplast board member and plastic surgeon from Tennessee, will lead the trip.

I am excited about this exciting opportunity, but not so thrilled about the 13 hour flight ahead of me, but by the end of the weekend we should be in Ganzhou City ready to work. I have been on dozens of Interplast trips in countries all around the world, but each time I go to a new place I still get a little nervous. In a few days I will be updating this blog daily (hopefully) with lots of pictures and stories of our patients, team, and host colleagues, so check back soon!