Quang Ngai, Vietnam -- Marion McGovern, ReSurge board member
“The good news is he doesn’t need surgery today."
Bill, our surgeon and team leader, said this a lot today. Today was "clinic day,” when patients arrive to be evaluated by the ReSurge team. The hospital auditorium was filled to the brim with families, anxious yet hopeful that today would be a day that would change the life of their child. It was a patient and largely orderly crowd (with the exception of many of the toddlers, of course). In the United States, people would have been on cell phones, or on a laptop or reading while they waited. But the clinic families just watched erect and alert, waiting their turn to see the U.S. doctors.
The ReSurge team is a hybrid team on this trip. We have one "table" of American ReSurge doctors. Our Vietnamese partner, Dr. Hien, put together a second "table"' of a plastic surgeon, anesthesiologist and paediatrician from Vietnam. In the small world department, the Vietnamese plastic surgeon, Dr. Nguon, first trained with our trip leader, Bill, back in 1990. Now 22 years later, he and Bill together did the initial assessment of each case. It was clear from their diagnosis of each patient that the teaching was to continue, as Bill explained some of the more complicated procedures that would be performed in the days ahead.
The tough job on clinic day is to prioritize the patients who would be seen in the next two weeks. I worked with Bill at the main intake table. It was clear to me that the infants with the cleft palate and/or cleft lips would become candidates for surgery. The pediatrician, Alice, might find in the next step of the process, that the child was not healthy enough for surgery so some would be deferred; but nonetheless, most of those cases would be addressed.
There were many children who were retuning after a prior cleft operation. In some cases, their lip or nose was askew, requiring a "revision.” This is a very normal procedure that would also happen in the U.S. Some of these were scheduled for surgery, but many were not, since the child still needed to grow some more before the next procedure. Some of the parents seemed disappointed when they heard their child could not have surgery; others seemed relieved. Regardless of the determination, all were appreciative of the opportunity to have the ReSurge team evaluate their child.
In some cases, there wasn't much that a surgical procedure could do to improve the life of the patient. Bill and his Vietnamese colleague took pains to explain this to the parents who, like parents everywhere, want to do whatever they can to help their children.
The tougher discussions were often with burn survivors. When a burn is untreated, the skin contracts, creating a contracture, which can hinder the mobility of joints. Plastic surgeons need to release the burn scar contracture to provide mobility. Many burn patients will be seen in the next two weeks in Quang Ngai; however, several were turned away. These were typically children or adults with unsightly scar tissue, but full freedom of movement in the scarred area. As sad as it was, Bill had his Vietnamese colleague explain that there was not really anything that could be done right now.
But many things could be done, much to the joy of so many patients: the 23-year-old boy with an electrical burn across his torso will soon regain the use of his left arm; the 58-year-old napalm burn survivor will have his eye repaired; a "tongue-tied”18-year-old young man will have the very simple procedure done to free his tongue and enable speech; and an 8-year-old boy will have a burned foot repaired. Many children will have cleft repaired to improve their ability to speak. Many others will have procedures to correct drooping eyelids, which can obscure sight. All in all, 80 patients will have their life changed in the next two weeks. For them, the good news is, that they will be having surgery soon.
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