ReSurge International Blog

ReSurge trainer: Progress of Nepali hand therapist 'warms my heart'

Mohan Dangol, a hand therapist in Nepal, uses his training from Dr. Nancy Chee

and others to assist Sosan, a 4-year-old burn victim.

 

Dr. Nancy Chee, an occupational therapist from San Francisco, has been a ReSurge volunteer for 12 years. She is a valued member of our team, not only for her work with patients but also for the education and expertise she shares with local medical professionals.

 

One of her “students” is Mohan Dangol. He has worked at ReSurge’s Surgical Outreach Program in Nepal for more than 15 years. He initially joined the team as a city coordinator, but as he recognized the need for hand therapists he pursued training in the Indian cities of Orissa and Chennai. Dr. Chee also worked with him to teach him more advanced skills.

 

During a recent trip back to Nepal, Dr. Chee was gratified to see how talented Mohan has become.

 

“He is as amazing in what he has learned and can do,” she tells us. “It warms my heart to see him working with clients and applying the techniques and skills he's learned.”

 

Some of Mohan’s cases involve people who were injured in the devastating earthquakes in April and May. Others involve people who were burned in or around the indoor fires that families maintain around the clock for heat and cooking.

 

One such patient was 4-year-old Sosan. About four months ago he was shuffling around the kitchen in his mother’s slippers while she was deep-frying a sweet dessert. He stumbled and fell against the pan of hot oil, burning his left arm severely.

 

He underwent skin grafting and extensive physical therapy. Thanks to his mother’s diligence in following the team’s post-surgical instructions Sosan has regained nearly full use of his wrist and hand. 

 

Under his mother's watchful eye, Sosan works hard
on his physical-therapy exercises.

 

Because of how he was injured, he refused to eat sweets after the accident.

 

“Until we gave him M&Ms,” Dr. Chee says. “That really made me smile.”

 

One other memorable patient was Binish, an aspiring computer hardware engineer. The 18-year-old suffered an electrical injury last year, leaving him with burns on his hands and face. He underwent surgery on his left hand last month but he refused to let anyone change his dressing. As a result the site became hypersensitive to touch from not being cleaned.

 

Binish works to remove his own sutures, a permissive move by doctors
that made him more amenable to treatment.

 

He did allow Dr. Chee to clean some of the wound (“Maybe because I’m the foreigner,” she speculates). The she figured, why not give him some responsibility as well? So the next day she handed him the tweezers and said he could clean it on his own. He’d watched her intently the day before, and for the next half hour he picked away diligently at the remaining sutures. Eventually he let Dr. Chee finish the job.

 

“Sometimes it makes a big difference to empower the patient,” she notes.

Seattle-Area 2nd-Grader Donates $32.69 in Lemonade-Stand Earnings to Nepal Relief

Sisters Savannah and Maisy Frederick held a lemonade stand
that raised $32.69 for ReSurge's earthquake-relief efforts

We at ReSurge are grateful for every donation we receive, large and small. But sometimes we receive a contribution that leave us especially touched.

This is one such story. Maisy Frederick, an 8-year-old from the Seattle area, set up a lemonade stand this summer and sent us the proceeds: all $32.69.

Her mother, Gayle Tucker, tells us Maisy didn’t do it for publicity or praise.

“She just wanted to help people in Nepal,” Gayle says. “I think it’s sweet. I’m proud of my daughter for being so thoughtful.”

Maisy already had a connection to Nepal: Her second-grade class at Brookside Elementary School in Lake Forest Park, Wash., had a pen pal arrangement with kids in a Kathmandu orphanage. The orphans survived the twin earthquakes that devastated the country in April and May, but Maisy knew that plenty of others needed help.

Her first idea was to raise money by selling her toys at a garage sale. But after her mother hesitated for logistical reasons, Maisy opted for a lemonade stand instead.

So on a Sunday afternoon at the end of the school year, she and her 11-year-old sister Savannah set up shop at an intersection near their campus.

They sold lemonade, both regular and raspberry, for 25 cents a glass. They sold about 80 servings in 2½ hours, raising $22.69.

After Gayle posted this photo on Facebook her friends added a few more contributions, bringing the final total to $32.69.

The next question was: Where to send the money? Maisy already had her answer. Her friend’s mother is Elise Reay-Ellers, a nurse and longtime ReSurge volunteer who flew to Nepal after the earthquakes to assist with emergency surgeries. (We’ve written about Elise here.) Inspired by Elise’s work with ReSurge, Maisy decided to contribute to the cause as well. We couldn’t be more grateful.

Maisy’s donation will be put to good use. Jeff Whisenant, ReSurge’s president and CEO, noted that contributions like hers help cover the cost of surgeries, medical supplies and more.

“Maisy deserves to be proud of her efforts,” Jeff said. “We're touched by her kindness and grateful for her generosity. Thank you, Maisy.”

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This is the second time this year we were the beneficiaries of a lemonade-stand fundraiser. Click here for the story of two Los Altos Hills second-graders who held their own fundraiser for us in May.

ReSurge Visiting Educators teach Vietnamese doctors how to reconstruct ears

Three ReSurge Visiting Educators traveled to Vietnam this year to teach local doctors how to repair microtia. It’s all part of our mission to build surgical capacity in developing countries.

Microtia is a congenital deformity in which the outer ear is only partially formed or absent altogether. The condition, which occurs in every 6,000 to 12,000 births, is more common in boys than in girls and tends to affect just one ear. There is typically severe hearing loss on that side, although patients can sometimes detect sound if their inner ears are developed enough.

 

Because ears are so prominent, even the slightest malformation is noticeable. But that’s also the same reason why repairing microtia effectively is such a challenge. If you think about how irregularly shaped the human ear is, and the wide range of differences from person to person, you can imagine how much surgical artistry and expertise is required to get the shape just right.

 

That’s why our team spent almost a week training 30 Vietnamese surgeons and residents. They conducted four training sessions in March: two in Ho Chi Minh City and two in Hue (pronounced hway).

 

The three ReSurge Global Training Program faculty and reconstructive plastic surgeons were Dr. Charles Thorne of New York University; Dr. Wojciech Dec of Manhattan Eye, Ear & Throat Hospital and Lenox Hill Hospital in New York; and Dr. John Paro, a resident at Stanford University.

 

Microtia repair involves molding the internal structure of new ears out of rib cartilage. To practice the molding process, the ReSurge team had the surgeons practice their reconstructive skills on potatoes. In this video, you can see about 20 students focusing intently on their work. Each doctor is using a template to carve out a piece of potato and sculpt it carefully into the proper shape.

 

These classroom sessions were conducted in the mornings. In the afternoons, the doctors would return to the operating rooms, where they could get hands-on training with actual patients -- under the watchful guidance of the ReSurge faculty team, of course.

 

"The groups were eager, talented and ready to tackle microtia," Dr. Paro recalled.

 

The training sessions all went well, and the Vietnamese surgeons were grateful for the instruction. They’ll continue to develop their skills throughout the summer and fall. In November, ReSurge faculty members will go back and provide a new round of training, which will focus on repairing more complicated cases.

 

In the last year alone, more than 300 medical professionals around the world attended training lectures given by ReSurge Visiting Educators, with 77 local doctors receiving intensive one-on-one, hands-on training. Visiting Educators are just one piece of the ReSurge Global Training Program, which aims to improve local surgical capacity in developing countries. According to the Lancet Commission on Global Surgery, around 5 billion people lack access to surgical care; medical training and building surgical capacity are solutions that will help save lives and reduce disabilities. 

Lending a Hand in La Paz, Bolivia

We love when our patients have fun with us! In May a team of 16 volunteers went to La Paz, Bolivia, for a hand-focused trip. There they met 20-year-old Freddy. Freddy had developed a growth on his left palm called a hemangioma. If the growth had become bigger, it could have hindered his ability to hold things or use his left hand. Luckily, Freddy was able to meet our team, and one short surgical procedure later, the hemangioma was gone. The procedure went well, and Freddy was a joy to be around, laughing and keeping our volunteers smiling the whole time. 

We wish Freddy all the best!

Freddy pictured with volunteer PACU nurse, Ingrid Crocco

Nepalis, including soft-spoken 10-year-old Furku, make post-quake progress

We’ve been privileged to have Dr. Nancy Chee as one of our ReSurge volunteers since 2003. An occupational therapist from San Francisco, she has done 12 trips in 12 years, starting with a mission to Bangladesh. Most recently, she took a trip to Kathmandu this summer.

 

She’d been uneasy about her return to Nepal. She enjoyed her last trip there two years ago, but now she imagined a heartbreaking sight of earthquake damage in every direction.

 

What she found instead was the beginnings of progress and hope.

 

“The damage wasn’t as bad as I feared,” she says. “I was especially grateful that my colleagues and friends were okay.”

 

The worst structural damage seemed to be to century-old landmarks and buildings made of unreinforced masonry. Other buildings had only minor damage on the outside, but the interiors were often a mess.

 

“People told me sad stories about the levels of personal loss and physical damage inside homes,” she says.

 

Dr. Chee was comforted to see that many people had returned to their homes, but many others were still using tarps and tents for shelter. (Nearly 1 million homes were damaged in the earthquakes.) There are still aftershocks, including a 4.6 quake that Dr. Chee experienced, but the residents she saw seem to take them in stride.

 

Some Nepalis whose houses were damaged in the April and May earthquakes

have returned home, but others still live under tarps and in tents.

 

When Dr. Chee arrived at Kirtipur Hospital, one of her patients was a sweet, soft-spoken girl named Furku.

 

Furku is 10 years old. She doesn’t speak very much, but that doesn’t mean she isn’t paying attention. For example, when the ReSurge team recently assigned her a therapeutic hand exercise, she watched the demonstration closely and then duplicated the task with a quiet but focused determination.

 

Furku manipulates blocks as part of her therapy for nerve damage in her arms.

 

Furku was injured in the April earthquake. Her physical trauma is healing, but the emotional trauma of losing her best friend may take more time to overcome.

 

On the day that changed her world, her parents had been farming in their fields. Furku was next door at the home of her best friend, and the two of them were watching TV. Suddenly the ground began to shake furiously. Before they could react the crude house collapsed, burying them under an avalanche of wood and mud.

 

Their parents and other neighbors rushed to the scene. They dug frantically at the rubble heap, straining to listen for muffled calls for help. It took three hours of frenzied effort before they finally pulled Furku from the rubble. Her friend, sadly, did not survive.

 

Although Furku’s injuries weren’t life-threatening, she was unable to move her arms. She was later diagnosed with brachial plexus injuries, meaning she had damage to the nerves running from her neck to her arms.

 

Her mother brought her to Kirtipur, and the ReSurge team told Furku she’d need intense physical therapy. Furku didn’t complain. Instead she complied with whatever exercises the therapists asked of her -- in fact, she would ask for more.

 

For example, Dr. Chee gave her some therapeutic pegs to work on overnight to improve her strength and dexterity. Early the next morning, Furku was back at the hospital waiting silently for more pegs.

 

Thanks to her dedication and hard work, Furku has regained nearly full use of her right arm. She still had trouble using her left hand to grip and pinch, but after Dr. Chee and hand therapist Mohan Dangol fashioned the bright pink splint visible in the photograph she was picking up whatever small objects she could find.

 

We’re gratified by her physical progress. Our lingering concern is the emotional trauma she continues to face after losing her best friend.

Sweet, Sassy Bianca Charms ReSurge Staff in Ecuador

Dr. Jorge Palacios poses with Bianca, a 4-year-old from Quito, Ecuador, who
charms the entire ReSurge Ecuador staff with her humor, affection and sweet sassiness.

When you first meet little Bianca, she seems quiet and shy. But before long her personality emerges, and she exudes such a sweet sassiness that it’s almost impossible not to smile.

Bianca is an affectionate 4-year-old born in Guayaquil, Ecuador. Dr. Jorge Palacios calls her his Biankita, or little Bianca. She insists on a hug whenever she sees him, and Dr. Palacios, ReSurge’s outreach director for Ecuador, says he’s helpless to resist her charms.

“Since she was 3 months old, she always hugged me and wanted to be in my arms,” he says.

Bianca was born with a complete cleft of the lip and palate. She had her cleft lip surgically repaired at the age of 3 months. When she was 2 years old Dr. Palacios repaired her cleft palate.

Bianca and her mother visit Dr. Palacios' ReSurge team in Ecuador in 2011

This summer she underwent her third surgery, in which Dr. Palacios and his ReSurge team corrected and reconstructed her cleft nose. Doctors usually delay that surgery until the patient is 5 or 6 years old, but Biankita pressed her mother to expedite the operation because her friends in Quito, where she now lives, teased her too much.

Dr. Palacios was able to accommodate her request. He performed the surgery last month and all went well. However, given the severity of her case, she’ll still need another couple of surgeries in the next two years, and perhaps a final correction around age 16.

The surgeries haven’t dampened her spirit in the least. She’s just as outgoing with her mother as she is with Dr. Palacios. She enjoys the outdoors, so she insists that her mother take her to the park every day for 15 to 20 minutes so she can run around with her two brothers.

“She is very funny,” Dr. Palacios says. “It is so much fun to be with her.”

A  picture frame holds two of Dr. Palacios’ favorite photos: one of him holding Bianca and the other of her posing with her mother, along with a note saying, “Thank you for giving us our smiles back.”

  

Dr. Palacios has been a ReSurge partner for 35 years. He performs surgeries alongside our teams and also year-round at the ReSurge | Long Island Plastic Surgical Group Surgical Outreach Program in Guayaquil. The Long Island Plastic Surgical Group recently committed to a 10-year partnership with ReSurge and its Surgical Outreach Program in Ecuador. In addition to providing financial  support, the group's surgeons contribute their expertise to educate and train international surgeons and residents in Ecuador, as well as in other countries where we work.

Yogi Aeron, longtime ReSurge surgeon, captivates staff with stories of hope

Dr. Yogi Aeron, a longtime member surgeon from Dehradun, India, visited our
California headquarters to meet staffers and share stories from the field.

 

ReSurge had the recent pleasure of hosting Dr. Yogi Aeron, a longtime member surgeon from Dehradun, India, who captivated us with his stories of hope and perseverance.

 

Dr. Aeron joined the ReSurge team in 2006. He and his son, Dr. Kush Aeron (bios),have operated on about 3,000 children in the Himalayan region. They treat mostly burns but also everything from birth defects to bear bites.

 

Dr. Aeron started our discussion by describing his background. He talked about his early days, when he once converted half of his one-room home into an operating room. His son would hold a flashlight to illuminate the operating table and his wife would autoclave instruments in a pressure cooker on the stove. (He and Kush touch on their backgrounds in this 2013 video.)

 

He also shared his dreams for the future. For example, he said he’d like to see the Indian government support burn victims with the same vigor that it supports cancer and heart-attack patients. Treating a burn victim makes more of a difference because it not only helps the victim regain his or her earning potential, but it also liberates family members who are otherwise conscripted as full-time caregivers, he said.

 

He suspects that wealth disparity is to blame.

 

“As a rule, a burn is a poor man’s disease,” he noted. “Nobody is taking care of burn patients.”

 

That’s precisely why he does.

 

Dr. Aeron captivates ReSurge staffers with tales of his work,
challenges and greatest success stories

 

Early in his career, his wife complained about having to live in simple conditions even though she married a doctor. And Kush only seemed to follow him into the medical field out of obligation. But over the years, as they watched patient after patient regain the abilities the rest of us take for granted, they became gratified with how everything turned out. In fact, Kush is so energized now that it’s not uncommon for him to work an 18-hour day.

 

Dr. Aeron’s passion comes from serving those who have the least. Many of his burn patients are victims of their own poverty. For example, Himalayan families live in wooden structures with hay roofs. They keep an open fire in the main room 24 hours a day for warmth and cooking, but when the mother leaves to fetch water or firewood, and she bolts the door to keep the young children inside, it’s only a matter of time before a toddler crawls across hot embers or reaches for a flame.

 

“You will not believe, we had a case where a child sustained burns on the very first day of life,” he said. “Because of all the snow the grandmother was warming the child in front of the open fire, and he fell back.”

 

These are the cases that compel him. Burned children can become disfigured, crippled or both, and at school they’re often treated with such loathing that they end up dropping out.

 

Dr. Aeron shared his stories with rapt ReSurge staffers for nearly an hour. When he was done, he looked around the conference room in silence.

 

Then he reflected on the path his life had taken.

 

“I am at this place only because of you people,” he said softly. “You are all very good people and it motivates me.”

 

Dr. Aeron and ReSurge CEO Jeff Whisenant express their mutual admiration and gratitude

 

Our CEO, Jeff Whisenant, responded by telling him what the rest of us were thinking: It is we who are motivated by people like him -- by the surgeons and volunteers who sacrifice so much to help so many people.

 

“We count our relationship with you as one of our greatest relationships,” Jeff said with a smile.

 

Staffers nodded and gave Dr. Aeron a heartfelt round of applause.

 

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For more information on the Indian health crisis related to burns, see our ReThink Burns video or click to expand the infographic.

 

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