What I Learned Firsthand on the Ground in Dehradun

India,
February 28, 2020

By Tom Seery

I spent the first days of 2020 in Dehradun, India as part of a visiting educator trip with ReSurge CEO Jeff Whisenant and Dr. Marshall Partington, a plastic surgeon from my hometown of Seattle. It was an emotional experience visiting the Yogi’s Helping Hands clinic, both in terms of the impact the doctors were making and the courage of the patients and their families to improve their lives.

I joined the ReSurge board five years ago because I’m fully bought into the mission of building capacity for reconstructive surgical care in developing countries. But being able to witness this work up close only deepened my appreciation for this organization’s partnership-driven approach to bringing access to reconstructive surgery to millions.

Here are three elements of ReSurge’s work that my experience at Helping Hands affirmed.

The necessity of scaling surgical expertise globally
I know from running RealSelf that plastic surgery is often about more than building confidence. It’s also about facilitating patients’ overall physical, mental, and emotional well-being—and sometimes it’s about helping to heal and restore bodies that have suffered trauma. Still, I encountered cases on this trip that one would rarely, if ever, see in the U.S., including severe untreated burns, injuries from accidents, and serious deformities.

Bearing direct witness to the human toll of these injuries, then multiplying that suffering across millions more who are impacted, only reinforced how critical it is that ReSurge continue to expand the skills and training of local surgeons and medical staff. These skills are sorely needed in places across the globe where the availability of these treatments isn’t driven by market-based demand.

Surgery is the start, but not the finish line
When meeting patients at the clinic and a remote village, it became clear to me that access to care is just the tip of the iceberg. In addition to long and difficult recoveries, many patients struggle to get to the clinic due to the lack of funds, transportation, or ability to take time away from a job or role supporting their families.

I also saw how poverty and the severity of injuries exacerbates every other aspect of their experience, from the surgery prep, to the surgery itself, to their recovery. These challenges need to be understood and accounted for in order for local patients to consistently get the care they need.

The enduring partnership that ReSurge has forged with Helping Hands is paving the way. I was impressed by the levels of joint understanding on standards and practices, outreach to the local communities, as well as the rapport between ReSurge and local staff. Technical training is critical, but relationships built on mutual respect, understanding, and learning are a necessary foundation for the type of collaboration that makes a difference for underserved patients.

The work to be done
While I am proud that RealSelf was the sponsor of this trip, I know that the global need for medical services and training is too vast for us to be comfortable with a single gesture of support. Sharing these experiences with my team inspired us to think about the ways we’re uniquely positioned to contribute.

As a platform that reached over 100 million consumers last year, we decided to do more to raise awareness of the work doctors are doing to make a difference. My team has since launched Beyond Beauty, an immersive new content series that shares stories of generosity and giving within the surgical community. We also share recommendations for organizations our community should consider giving back to—including ReSurge. We love that this approach embodies the community-minded ethos that has powered ReSurge’s success in steadily closing the gap in access to vital medical care.

Tom Seery is the founder and CEO of RealSelf. Tom has been a ReSurge board member since 2015.

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Fiftieth Anniversary Flashback: The 1980’s

Fiftieth Anniversary Flashback: The 1980’s

USA Headquarters
November 26, 2019
Dr. Mark Singleton
When Dr. Mark Singleton was asked to join a surgical mission trip in 1986, he was intrigued by the thought of using his skills as a pediatric anesthesiologist for those in need. 
 
It was his first year of private practice in San Jose, California. His friend, Dr. Larry Berkowitz, encouraged Mark to join him on his next surgical mission trip to La Ceiba, Honduras. Larry, a plastic surgeon, had done his residency with Interplast founder Dr. Donald Laub at Stanford. Through his Interplast trips with Dr. Laub, Dr. Berkowitz had established an enduring relationship with the hospital in La Ceiba, as well as with many generous individual citizens of the town. 
 
“I knew of the groundbreaking work being done by Dr. Laub and Dr. Berkowitz,” said Dr. Singleton. “Dr. Laub was a pioneer in reconstructive medicine and his passion for philanthropy and innovative surgical techniques was and remains exceptionally well regarded.”
 
Dr. Singleton joined Dr. Berkowitz on the trip, which turned out to be the first of many trips to La Ceiba over the next twenty years.  Much of the surgical mission work being done was due to support from Standard Fruit (now Dole Food Company).  Standard Fruit was headquartered in La Ceiba, a wonderful coastal location that provided a great shipping route to New Orleans for fruit distribution.
The twenty years that Dr. Singleton visited were idyllic times in Honduras. The crime was low, the town was bustling and the work was exceptionally rewarding. At that time Interplast didn’t have many employees, so much of the trips’ logistical work was done by the surgical volunteers themselves. 
 
In La Ceiba, however, they had Margaret Beckman. Margaret’s husband had worked for Standard Fruit and she would make all the arrangements for the incoming surgical teams, which included accommodations with local families, dinners and weekend trips.
“I would spend two weeks in Honduras on these trips. That would give us one weekend of rest where were able to visit wonderful areas of Honduras like the Mayan ruins at Copan, and the Bay Islands which had a unique vibe that harkened back to the time of pirates. I would bring my family before or after the missions, and you really got to know the local people. They became friends. I looked forward to going back every year.”
 

One patient Dr. Singleton specifically remembers is Ever. Ever was a young boy when he came to the hospital for a large fibrous dysplasia tumor on his forehead. While the tumor was benign, as it continued to grow, it would cause great damage to Ever’s eyesight. It would need to be removed, but Dr. Singleton and his team quickly recognized that the surgery would be very complicated and dangerous. He and the surgical team urged Interplast to arrange for Ever to have his surgery in the United States. Interplast paid the travel and medical costs for Ever and his mom, a single mother who supported them by selling lunch to fruit workers. 

While in the US, Ever and his mother became very close to Dr. Singleton’s family. “I had a son Ever’s age,” he says. “They would play and we would spend a lot of time with them. They became a part of our family.”
 
Ever’s complicated procedure was a success. He made a full recovery and he and his mother were able to return to Honduras.
 
In part due to the political climate and safety concerns, ReSurge stopped going to Honduras some time ago. But that doesn’t mean that Dr. Singleton has hung up his ReSurge volunteer hat. Now in semi-retirement, he continues to go on surgical mission trips all around the world including several places in Africa and Vietnam.
 
“When I work with residents and we talk about the importance of professionalism in their careers, I tell them that the best way to maintain humility, personal fulfillment and avoid burnout, is to find volunteer opportunities and use your skills to help others. It really does make all the difference.”

 

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Kathmandu Leadership Training

Kathmandu Leadership Training

Nepal,
September 30, 2019
Photo – Training Session

Last month, we packed our bags and headed to Kathmandu for a week of leadership training for the employees of ReSurge Nepal and their work site, Kirtipur Hospital. The objective of the training was to empower each employee to take leadership, no matter what his or her role. Anna Maria Casas, executive leadership coach to L’Oreal and other organizations including Intel, Daimler and UBS, led the sessions, along with her colleague, Marsha Hughes-Reese.

The program was conceived by ReSurge Nepal surgeons Dr. Pramila Shakya and Dr. Shilu Shrestha, who received similar leadership as part of the Pioneering Women in Reconstructive Surgery (PWRS) program supported by ReSurge and SkinCeuticals. Drs. Shakya and Shrestha felt the training was so valuable, they wanted everyone from ReSurge Nepal to benefit from it and reached out to ReSurge, SkinCeuticals and Anna Maria Casas of Perspectives Work to make it happen.

Toward the end of the three-day session, each participant “painted their vision”, creating a painting of where they hope to be as a leader in three years. In small groups, the trainees explained their vision and set goals for how to achieve it.

Going forward, the trainees will provide peer coaching for each other and receive a follow-up video coaching session from Anna-Maria and Marsha.

The reaction to the training was overwhelmingly positive, as expressed by Dr. Shankar Rai, “The training was so successful that everybody in our organization as well as many from universities as well as from political areas are requesting similar training. This could bring a big social change in Nepal. We thought the training not only helps us to become a better leader but also a better human being. Thank you very much for this great gift.”

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ReSurge and ASSH Volunteers Share Their Experiences from Bolivia

ReSurge and ASSH Volunteers Share Their Experiences from Bolivia

Bolivia,
September 30, 2019

In May of this year, a medical team of hand surgeons and hand therapists traveled with ReSurge, in partnership with American Society for Surgery of the Hand, to La Paz, Bolivia to offer free surgeries to those suffering from a hand injury or deformity.

The need was great. Many people traveled from long distances to get help. In Bolivia, there is a high rate of syndactyly, where children are born with one or more fingers or toes fused together. For adults, manual labor is fundamental, with people working on farms, in factories, or in mines. But with this work comes a number of hand injuries, which can leave people unable to take care of their families.

Despite being a country of 12 million people, Bolivia only has one fellowship-trained hand surgeon, Dr. Jorge Terrazas. Dr. Terraza is a ReSurge International Medical Partner which means we partner with him to develop ongoing year-round programs that meet the needs of his local community.

The trip in May was a huge success, with over 150 people seen and over 70 surgeries performed. Many that were not eligible for surgeries were seen by the hand therapists on site.

Here are the stories of three of our volunteers from the surgical mission team:

Dr. Aaron Grand, Hand Surgeon

Hand surgery is really important for everyone, everywhere.  The hands are our way of interacting with the world.  Even a relatively minor injury, if untreated (or treated incorrectly), can result in severe limitations in our ability to function.  Being able to make a hand functional gives these kids (and adolescents and adults) the opportunity to use that hand for school, training, or any type of work in the future.  It allows them to care for themselves and even support a family. 

Given the need in Bolivia, there is only so much Dr. Jorge Terrazas can do. We were happy to be there to help provide the support he needs to help those in need. In the time we were there, we performed over 70 surgeries. 

The hospital in La Paz, Bolivia, is relatively rudimentary, but very functional.  Dr. Terrazas, his team, and all the doctors and nurses there do a great job of working with what they have to help their patients.  I was glad to be able to help by applying my surgical experience to a population which is truly in need and truly grateful for everything we could do.  

This was my first trip with ReSurge, but I hope it is only one of many.

Mary Oswald, Hand Therapist

This was my first surgical mission trip and what an amazing experience!  Ironically, back in 1983 –1985 when I was a Peace Corps volunteer, I brought kids with cleft palate and cleft lip from our village to Azoges , Ecuador, to see the surgeons from Interplast for surgery.  They left a huge impression on me; they worked so hard and saw so many kids and made huge impacts on peoples’ lives. I didn’t know until I was accepted into ReSurge’s mission trip that ReSurge used to be Interplast!   

Dr. Terrazas and his team were all fantastic.  We especially worked with the Bolivian therapists, especially Nini who continues to send us at least weekly updates and videos on What’s App of our patients progress, which has been so fantastic to see.   

I especially appreciated the way that the ReSurge crew and Bolivian crew worked so well together.  It was something that I think ReSurge should be very proud of; the surgeons, anesthesiologists, nurses, were constantly teaching, but in a very mutually respectful way.  No condescension whatsoever.  Professional to professional.   

There were so many interesting people who we met as patients during our time there, but my mind really goes to the story of Jaqueline, a lovely woman who had been stabbed by her ex-husband 15 years ago. The brutal attack landed her in the hospital for over a year, ending her journalism career. She had to re-learn to walk, and had a horrible brachial plexus injury to her left arm resulting in no use of the extremity.  

While I was working with her, we had a very personal conversation where she explained that her husband was not in jail, having bribed the local authorities. This is apparently quite common. I suggested that maybe there was something she could do to make what happened to her turn into something positive. The following week, she returned to our clinic to bring me a present and to tell me that she had been thinking about it and was going to start writing again about domestic violence and corruption. 

Nina Healy, Hand Therapist

I have been a therapist since the mid 1970’s.  I am in the twilight of my career, affording me the gift of time so that I can donate my services on medical mission trips. This is my third surgical mission trip with ReSurge International and my second with The Touching Hands Project of the American Society for Surgery of the Hand. I had the honor of visiting India with ReSurge in December 2018 and Bolivia in May of 2018 and 2019. 

What I found in both India and Bolivia was an overwhelming appreciation from the people. Both the patients and the medical communities in each country were gracious, warm and welcoming. Our visiting teams worked collaboratively with the local teams, reaching out to patients who might otherwise not have been able to access the therapy and surgical care they needed. When we made a splint for a patient, or showed them either an exercise or a technique that made it possible to accomplish a task that they couldn’t perform previously, eyes would light up and connections were made! 

The patients I’ve encountered on these trips frequently have more severe and varied needs in terms of injuries or afflictions. In India, about 90% of the cases we saw were burn injuries. I spent most of my day working with burn victims to help reduce their contractures with exercise and splinting or by fabricating splints to protect the skin grafts they had just received in surgery.  

In La Paz, Mary and I worked with a wider variety of diagnoses, treating almost 100 patients with everything from congenital defects, arthritis,burns, auto accidents, to knife wounds. The electrical systems in Bolivia and India can be unpredictable and there is a prevalence of burn injuries from electricity. These electrical burns can have devastating effects. 

My first surgical mission trip was to Bolivia with ASSH and ReSurge International in 2018. It was rewarding for me to return a year later and see a number of familiar faces, both patients and staff.. One patient I saw on both trips was Rita. Last year she had a surgical repair to tendons in her hand after lacerating it with a knife while cooking. Rita is the sole provider for her family and has a good job in an office.  Her hand injury made it impossible for her to perform her typing duties at work. After her surgery in 2018 to repair her cut tendons I worked with her two times a day for eight days. She improved but still had limited motion in her hand. When Rita walked in to the triage area this May, we immediately recognized each other. She had returned for follow-up surgery to free up the repaired tendons. Her surgery, in the care of our skilled hand surgeons went well, and she was diligent in participating in therapy.  When we left she was well on her way to returning to being able to type again. 

The days are not easy on these trips. We typically work 10-12 hours a day. But it is by far the most rewarding experience.  Someone once said that “when a disparate yet dedicated group of people come together for a common goal, magic happens.” That was true on this trip. The coordinators made our days smooth and work possible, the translators made communication with our patients and team meaningful, the nurses were competent and caring, the physicians, surgeons and anesthesiologists were amongst the most technically competent and gracious I’ve encountered. This team was exceptional to work with!  My next mission is to Bangladesh with ReSurge and I can’t wait.

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Introducing ReSurge’s Third Laub Fellow

Introducing Anna Luan, ReSurge’s Third Laub Fellow

USA Headquarters
August 29, 2019

We are proud to introduce Anna Luan, the newly selected Donald R. Laub Fellow. Named for our ReSurge founder, the fellowship allows for a fourth-year resident at Stanford’s division of plastic and reconstructive Surgery to work with ReSurge for a year in order to hone reconstructive surgical and research skills.

Following is a Q&A with Anna.

Tell me a little about yourself and your background.

I grew up in the South Bay before leaving for college at UC San Diego, where I studied bioengineering and health economics. I continued there to complete a Master’s degree in bioengineering and explored jobs in bioinformatics and industry before deciding to pursue medicine. I returned for medical school at Stanford and discovered a passion for plastic and reconstructive surgery, and have been fortunate to continue at Stanford for residency.

What made you want to go into reconstructive surgery?

Reconstructive surgery resonates so strongly with me because it has a unique focus on improving function and quality of life. No other surgical field places quite as much significance on a patient’s individual perspective and needs. At the same time, it demands rigorous understanding of complex and diverse anatomy to achieve complex problem solving. This special blend of patient-centered care, creativity, and methodical principle-based decision-making drew me into the field and continues to inspire me.

How did you hear about the Fellowship?

I had wanted to become involved since learning of ReSurge trips when I started residency. When the Laub Fellowship was established two years ago, I was immediately interested. Speaking with past Fellows about their experiences further solidified my interest in the fellowship.

What drew you to it?

The Laub Fellowship offers the unique opportunity to work closely within ReSurge, which has been a pioneer in not only surgical trips but in driving the shift toward improving local surgical capacity. It is incredibly gratifying to be able to have this experience as a resident to learn about reconstructive surgery abroad and to contribute to improving sustainable surgical capacity in a meaningful way.

What are you most interested in experiencing on your first ReSurge surgical trip?

I am really excited to witness the exponential impact ReSurge’s visiting educator trips can have and to develop longitudinal partnerships with the surgeons and staff abroad. I am also looking forward to seeing reconstructive surgery problem solving in different health care systems with various patient needs and resources. I think we have a lot to learn from each other.

The fellowship involves more than just the surgical trips, but rather working within other areas of ReSurge.  Why do you think this is important?

Although the surgical trips are the most visible portion of ReSurge’s work, it is critical to continue to develop its training program, evaluate the clinical outcomes and impact, and to identify further areas in which to expand or optimize.

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