Face-To-Face With a Humanitarian Challenge

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When we think about plastic surgery most of us don’t conjure up images of third world countries and great humanitarian acts. However these are exactly the images that come to mind thanks to a program supported by the Canadian Foundation for Facial Plastic and Reconstructive Surgery. This year Toronto facial plastic surgeon Dr. Peter Adamson will lead a team of surgeons to a city in central Russia to perform surgeries on children, many of them orphans. The program, called Face-to-Face, is the international arm of the humanitarian efforts sponsored by the Educational and Research Foundation of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS Foundation). Working with local medical personnel, Face-To-Face teams have performed hundreds of surgeries in countries such as Bosnia, Central America, Cuba and China.

The Canadian arm of the Foundation got started when Dr. Adamson learned of Frank Associates, an adoption agency in Washington, DC, that focused on finding children for adoption in all parts of the world. “They had contact with the Bonum Centre Hospital and a nearby orphanage in Ekaterinburg, Russia,” said Adamson. “They knew there were a lot of children in the orphanage with congenital and traumatic conditions that were not able to be adopted until they had some of these conditions corrected.”

With the help of a generous endowment from one of Dr. Adamson’s patients who became aware of the humanitarian work of the Face-To Face Foundation, they were soon on their way. Adamson was able to take part in the second mission which went to Russia in 1994. Initially, Adamson and his colleagues had to stay in the orphanage where the conditions were a little Spartan. “We even had to take our own water and toilet paper,” said Adamson. Gradually the team settled into one of the local hotels but they still found the equipment at the hospital to be very rudimentary. “One time during a twelve-hour case, the anesthesia equipment just pooped out and they literally had to resort to blowing through the tube to ventilate the patient,” said Dr. Adamson. “I’ve never seen anything like it.” Over the past 10 years, 42 western surgeons have participated contributing over 700 person-days to the missions. The surgical emphasis this year will be on maxillofacial and craniofacial surgery for congenital defects. This year’s Symposium delegation will consist of 12 people – seven surgeons, three nurses and two administrative support people. Lectures on the various types of surgery performed will also be presented and Dr. Adamson admits that the surgeons are eager for their western knowledge and expertise and are very quick learners. “Techniques that we introduced there ten years ago they’re very facile with them now. They’re constantly asking us to bring the latest, bring the greatest.”

For the children, the surgeries literally provide a new lease on life. Over 60 children have been adopted through the program once their facial deformities were corrected. Some, who had been given up by parents at birth because they lacked the resources to deal with such significant health issues, where re-united with families and loved ones. Dr. Adamson tells the story of one of the senior surgeons at the Bonum center who had a cleft lip and palate himself. “Part of his great drive to become such a great head and neck surgeon was because of his own deformity.” The surgeon also had a daughter who was born with a cleft lip and palate and he had also given her up when the child was very young. A few months later he went back and brought her back home and performed the surgery on her himself.

Many of the children at the orphanage have suffered great trauma through poverty or war. “One child had had his nose chewed off by a rat when he was in his crib. We reconstructed his nose. Another young girl had been in Chechnya just riding down the street on a bicycle and somebody had fired a gun and blown off half of the side of her face and we reconstructed that.”

For Dr. Adamson the chance to participate in a program such as Face-To-Face has provided an opportunity to experience different cultures and to contribute something back to the profession as well as to give something back to humanity. “It’s very satisfying to feel that you’ve directly helped the individuals that you’re operating on but it’s even more satisfying to know that you’ve shared your knowledge,” says Adamson. “Others will take that knowledge and you’ll see a tremendous effect in the long term as they teach others and move the profession forward. It’s been extremely rewarding.”