Azogues, Ecuador Surgical Trip

Klever

  Klever 
  Originally uploaded by interplast.

I want to leave you with a picture of Klever, everyone's favorite patient. He charmed us all with his big blue eyes and pouty face! Our Interplast team fixed his cleft palate, and he threw a rather impressive and dramatic temper tantrum when he woke up in the recovery room and found he had "no-nos" (splints) on his arms to keep him from touching his mouth. Even so, he is way too cute to be mad at!

Interplast Drs. Quinde, Afridi, and Rai

  Interplast Drs. Quinde, Afridi, and Rai 
  Originally uploaded by interplast.

This evening we hosted a dinner for the hospital to show our gratitude for their continued support of Interplast. Dr. Nadia Afridi - our Interplast Webster Fellow, plastic surgeon, team leader, and fabulous roommate by the way - gave a speech and presented certificates, Interplast pens and lanyards to everyone who helped us over the past two weeks. It was a very nice way to end our stay in Azogues. Here is a photo of Nadia with our host Dr. Guillermo Quinde and Dr. Shankar Rai.

Doctorita Elsa With Jessica

  Doctorita Elsa With Jessica 
  Originally uploaded by interplast.

It is so hard to believe that we are leaving tomorrow. It seems like we have been here much longer than we actually have, mostly due to the warm hospitality the people of Azogues and the hospital staff have shown us. This morning, while the surgeons operated, pediatrician Dr. Else Uglum and I did rounds and discharged most of our remaining patients. Here is a picture of Else getting ready to discharge Jessica, an 11 year-old burn patient that we both found to be absolutely adorable. Jessica was so excited about her surgery that she followed us around the entire day with a big smile on her face (I think to make sure we didn’t forget about her)!

Edgar After Interplast

  Edgar After Interplast 
  Originally uploaded by interplast.

It’s so gratifying to see the patients and their families so happy and relaxed after having seen them so scared the day of their surgeries. Here is little Edgar again, eight days later. The difference is pretty amazing! It’s funny how I see pictures like these all the time at the Interplast office, but it has such a stronger effect on me now, seeing in person the profound difference we can make in such a short time.

Edgar Before Interplast

  Edgar Before Interplast 
  Originally uploaded by interplast.

Today we have a full operating day, plus we are starting to see some of last week’s patients who have come back for a final Interplast check up. This is Edgar right before his surgery; he was pretty nervous and upset.

Rosa After Her Surgery

  Rosa After Her Surgery 
  Originally uploaded by interplast.

This surgery is only the beginning for little Rosa though. She will need to wear a brace around her neck for approximately one year after this surgery, to avoid more post-burn contractures. We hope that she will come back to see next year’s Interplast Azogues team so that we can continue to help her.

Interplast OR Team with Host Dr. Quinde

  Interplast OR Team with Host Dr. Quinde 
  Originally uploaded by interplast.

We are already in our second week of surgeries, and none of us can believe how quickly the time is passing. Over the weekend, we visited a cultural museum in Cuenca, a nearby city. There we learned about the history of the Ecuadorian people and saw models of traditional Ecuadorian homes. Many of these homes had large open cooking fires with no barriers in the middle of the room, and it was easy to see why so many children are severely burned in household accidents.

Today we operated on a little 3 year-old girl named Rosa, who had been horribly burned in a typical household accident. Her parents had traveled with her for many hours so that she could be seen by the Interplast team. Sadly, she had not received proper post-burn care after her injury, and as her burns started to heal, she developed a burn contracture and was unable to lift her chin because it was stuck to her neck. Our surgeons happily took on her case and worked today to release her contracture so that she will be able to move her head and lead a more normal life.

A Global University

Dr. Rai Lecturing to a Full Audience
at the Catholic University of Cuenca 
  Originally uploaded by interplast.

This afternoon, Dr. Shankar Rai (plastic surgeon and Interplast Surgical Outreach Center director in Kathmandu, Nepal) and Dr. Amaia Arana (anesthesiologist) gave lectures at the Catholic University in Cuenca to local medical students, many of whom are taught by Dr. Quinde. They were surprised and thrilled to have approximately 150 students show up to hear their talks. Dr. Rai discussed his involvement with Interplast, and explained how Interplast's focus on education and local empowerment has really turned the organization into a global university. Dr. Rai was trained by Interplast and is now helping to train other local surgeons by going on surgical trips to other sites in Vietnam and South America. He also included many slides of burn cases he has treated in Nepal (I closed my eyes when it got too graphic so as not to faint) and many students approached him afterwards to copy his lecture on their computers. Dr. Arana also gave a wonderful lecture on pediatric anesthesia, and since she is originally from Spain (but now working in England), she was really able to interact with the audience in their native language which everyone really enjoyed.

Calm and Caring

PACU Nurse Tina Cerruti
Reading to a Post-op Patient 
  Originally uploaded by interplast.

I have been spending much of my time in the Recovery Room (PACU) to help the pediatrician Dr. Else Uglum and PACU nurses Tina Cerruti and Jeannette Rantzow. It's amazing to see how calm and caring they remain despite the screaming children who have recently woken up from the anesthesia and are wailing for their mothers.

Overwhelming and Rewarding

  Maria With Worried Mama Right Before Surgery 
  Originally uploaded by interplast.

Today was our first day of surgery. For a non-medical person like myself, it was rather overwhelming (albeit definitely rewarding) to see what a few hours in the O.R. with our skilled team members can do for our patients. I was constantly pulled aside by worried mamas like 2 year old Maria’s mother who traveled hours by bus so that her daughter could have her surgery.

The Neediest Patients

Clinic Day Patient Being Evaluated by Interplast
Surgeons and Our Host Dr. Guillermo Quinde 
  Originally uploaded by interplast.

Hi, my name is Fran Cunniffe, trip logistics coordinator at Interplast. Although I help plan all of the surgical team trips, this is the first time I have had the opportunity to actually go on a trip as a coordinator/translator. Luckily I am part of a team consisting of many veterans of Interplast from all over the world - Nepal, New Zealand, Spain, Finland, Norway, Canada and the USA.  The generosity of Ronald McDonald House Charities has made this trip possible, and I know that the children will be very grateful for their support.

Working in Azogues, Ecaudor has been quite an eye-opener already. As our host Dr. Guillermo Quinde explained, the health care system in Ecuador provides little help for the people who need it most. In addition to working at the Azogues hospital and teaching medical classes at the Catholic University of Cuenca, he works part-time for a foundation that provides surgeries to needy patients at half the price. But even that is too expensive for many people with little economic resources so they are unable to obtain the medical care they so desperately need. Dr. Quinde values his association with Interplast, especially because he is able to refer the neediest patients to Interplast. We have seen approximately 160 patients at our clinic today, and many came because he personally referred them to us.

One little girl came to clinic with her mother and brother, and we discovered that she was operated on by Interplast a few years ago for her cleft lip. She was now hoping her younger brother would have the same life-changing surgery as she had. I love being the translator when I tell patients that they have been approved for surgery, but it is so difficult and upsetting when I have to tell them to come back next year if the child is too young or unhealthy. That is when I wish the surgeons spoke Spanish!