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« October 2006 | Main | December 2006 »

Miguel Discussing Susan’s Teachings

Portoviejo, Ecuador - Seth Mazow, Interplast staff:  Miguel, another of Jorge’s plastic surgery residents, also learned from Susan. Scott once again translates.

Wilmer Discussing Susan’s Teachings

Portoviejo, Ecuador - Seth Mazow, Interplast staff:  After learning the Furlow method of cleft repair from Susan, Wilmer explained to me (with Scott translating) what he gleaned from the lesson.

Dr. Susan Downey Discussing Her Teachings

Portoviejo, Ecuador - Seth Mazow, Interplast staff:  This video was taken after Susan worked in the operating room with Wilmer for a few surgeries, teaching him the Furlow method of cleft repair that she explained in the previous post.

Susan Downey Teaching Furlow Method of Cleft Repair

Portoviejo, Ecuador - Seth Mazow, Interplast staff:  The night we arrived in Portoviejo, the team (plastic surgeon Susan Downey, anesthesiologist Scott Brown, nurse practitioner Laura Ohara and a dozen of Jorge Palacios’s residents and colleagues) went to the hospital to evaluate the patients and facilities. The surgeons and nurses saw the patients for about 45 minutes, but Scott and the anesthesiologists spent much longer examining the monitors. As a result, we were waiting outside for a while. Susan took advantage of the opportunity and started teaching Wilmer about the Furlow method of cleft repair.

Carlos Is Ready!

  Carlos Is Ready! 
  Originally uploaded by interplast.

Portoviejo, Ecuador - Seth Mazow, Interplast staff:  I took this picture of Carlos five minutes before he entered the operating room. Carlos was really excited right before his surgery, which is pretty unusual. Most patients are initially jazzed when they learn that they have been chosen to receive free reconstructive surgery, but their joy fades to a quiet anxiety as their hour approaches.

But not Carlos. Carlos was excited even when he was minutes away from going under the knife.

He told me that he was most excited about the fact that he might now be able to have a girlfriend. I told him that he would have more than just a chance, and he should immediately procure a large stick so that after he recovers he can defend himself from all the overzealous ladies who will be flocking his way. He (and Maria, my volunteer translator for the day) had a good laugh, and he went into the operating room with this smile on his face.

Mother and Son Cleft Lip and Palate Patients

  Carlos and Maria 
  Originally uploaded by interplast.

Portoviejo, Ecuador - Seth Mazow, Interplast staff:  Interplast usually operates on children, but occasionally we work on adults as well. Today we are going to operate on an unusual pair with an interesting background.

Maria is 51 years old, and had ten children with her late husband. Maria and two of the ten have cleft lips and palates, including 23-year-old Carlos, who is here to get his cleft lip repaired along with his mother. They are very poor and live in a small town called La Junito about three hours (and three of four bus transfers) away from here. None of them went to school, so as a result, all of them are illiterate. There is one school that is relatively close by, but it is only for adults and is very expensive.

They had heard about Rostros Felices and knew that they could have had their clefts repaired, but Maria’s husband would not allow it. He believed that God gave them cleft lips and palates for a reason, and that it was not their place to try to change God’s will. They did not share his opinion, but since he was the man in a patriarchal society, his word was household law. Although they loved him and are sad that he is gone, they are happy that he can no longer prevent them from getting their clefts repaired.

Unfortunately, there might not be much that can be done for their speech impediment.  Nonetheless, Carlos and Maria are very excited about the fact that they will at least look like normal people.

Scott Brown Lecturing Anesthesiologists

  Scott Lecturing Anesthesiologists 
  Originally uploaded by interplast.

Portoviejo, Ecuador - Seth Mazow, Interplast staff:  Scott gave a 90-minute lecture today on anesthesia. He presented a case scenario of a 38-year-old nurse who came to the operating room to get a bladder stone removed. After the surgery, she became tachycardic (really high heart rate), and soon developed malignant hyperthermia (really high body temperature, the opposite of hypothermia).

Scott also talked about management of pre-eclamptic cases, difficult airways and techniques for regional anesthesia. About a dozen anesthesiologists and residents came and enjoyed the exercise, especially since the teaching style was different from what they are used to.

Teaching Anesthesiology in the Operating Room

Portoviejo, Ecuador - Seth Mazow, Interplast staff: Scott Brown, an anesthesiologist from Portland, Oregon, is shown here teaching Ecuadorian residents Diego and Javier.  He is discussing local anesthetic toxicity and appropriate doses for nerve blocks, as well as the pros and cons of different regional anesthetic blocks.  Scott (or Roberto, as he likes to be called here) has become fast friends with Diego (in the middle), who has proven himself to be an eager student and an excellent anesthesiologist. 

Why I Work For Interplast

Portoviejo, Ecuador - Seth Mazow, Interplast staff:  I have heard the stories of countless Interplast patients over my two years here, and Javier is the clearest example of why we do what we do.

Sure, we heal bodies. Clefts are repaired, extraneous digits are removed, burn contractures are released, etc. But what Interplast really does is change lives. We give those with no hope a chance to follow their dreams.

Every guy wants or has wanted to be a DJ. You work two hours a day, go to cool clubs, make jokes, play music, goof off, etc. It was Javier's dream, and once he got his cleft lip and palate repaired, there was no stopping him.

Javier grew up with people not being able to understand him at all. Children made fun of him and he was excluded from activities. He looked weird, spoke unintelligibly and was pretty much the opposite of cool in every possible way.

Now look at him. His voice is literally the voice of cool for a city of 250,000. He is married, has a wonderful daughter, a great job that he loves, and takes great pleasure in giving back to the doctors and organization that changed his life. His story is simply the clearest example of why Interplast is worthy of everyone's time, money or attention.

With this blog I usually try to keep things light and breezy. I figure people get enough of the heavy emotional stuff from every NGO (including us), so I have tried to use the Portoviejo blog posts to show the more personal side of Interplast. But it is hard to not get fired up when you spend a day with Javier or after being surrounded by future Javiers for 12 hours a day.  I simply can't help being overwhelmed at how much of a difference Interplast has made in Javier's life.

Shouting Out To My Interplast Homies

  Javier kickin' it in the Scandoloso booth 
  Originally uploaded by interplast.

Portoviejo, Ecuador - Seth Mazow, Interplast staff:  When I got to the radio station with Elizabeth (one of four local Rotary exchange students, all of whom have been doing incredible jobs as volunteer translators for us), I was in for quite a surprise. Javier wanted to interview me for the show.


Although I am pretty outgoing, I usually don't like being put on the spot. But I couldn't really say no. He was helping me do my job better, it was only fair that I do the same for him.

He began by asking me some pretty basic questions. But then he wanted me to record a canned shout-out to Interplast and the people of Portoviejo. He wanted me to do it the way other callers always do, which is loudly and full of slangy attitude. Unfortunately, Interplast does not easily lend itself to such hipness.

After a few tries, he wrote me a little script in Spanish and English, which I supplemented with whatever hipness was left in my crew-cut, cubicle-inhabiting, "obsessively-checking-your-work-email-is-
cool" personality. Eventually, I reached an acceptable patina of coolness. I gave a "big shout-out" to "all my homies at Interplast" and "my people" in Portoviejo before concluding with the ever-popular "Peace, y'all!" This seemed to thrill Javier, as it was (finally) just what he was looking for. Elizabeth was less excited, as she had to translate my monologue into Spanish while matching my attitude and not bursting into laughter.

She did fine, and I thought we were done because Javier had us hang out in this little room with microphones away from the soundboard for a while. We talked about him, Interplast, Ecuador and music. After a little while, the next DJ came in, saw us, and decided to revolve her show around us as well. Javier interrupted every once in a while with taped quotes from Jorge, but besides that he just hung out in the soundboard room. All these other random people came in (we're in the background of the picture) and began talking about Interplast, Rostros Felices, the children, clefts, burns, etc. We took some live questions and talked on the air for another hour or so before we left.

It was really fun in an awkward sort of way, but it felt good to be able to explain to a large audience how Interplast empowers local surgeons to help people like Javier.

Global Health