Plastic Surgery Camp January 2012 (Bangladesh)

Again there were many schism patients and burn contractures...

Report by Cees Spronk, plastic surgeon

Tenth ‘Plastic Surgery Camp’ in Faridpur, Bangladesh: 8 – 26 January 2012

Team members:
Cees Spronk, leader of the team and plastic surgeon
Paul Spauwen, professor plastic surgery and his wife Elizabeth Spauwen
Eddy Verschuur, plastic surgeon
Corien van Rijswijk, anaesthesiologist
Rita Witteveen, assistant anaesthetist
Neeltje Spronk, Faridpur Foundation

Also present were ophthalmologists Alex Salomon and Ingrid Kraupp for the Eye Surgery Camp, organised at the same time.

Again we flew with Emirates; the Dutch members from Dusseldorf and the Austrian members from Vienna. We met in Dubai and continued our journey to Dhaka, where we arrived on Sunday at ten am. We obtained our visa at the airport; Customs were fast, but we had to wait long for our baggage. Then we travelled further by bus.

Near the airport there was a kind of pilgrimage of Muslims: praying people everywhere from all over the world. We travelled to Faridpur and bought some bananas and biscuits. After four hours we were offered lunch by Manik, who organises the camp. Our regular guesthouse had been on fire and was not completely rebuilt so that we were accommodated in a hotel. The next day we went to two guesthouses, which were not far from each other.

On Monday 16 January we screened the patients. Before that we were welcomed by the Civil Surgeon. We saw about 500 patients. Unfortunately there were many children with serious neurological problems that we cannot treat, which is very sad as their families hope that European doctors can do more than local doctors. We can only send them to the Centre for Rehabilitation of the Paralysed in Savar which has a programme for these children and parents in which they teach them how to cope with their disease.

Patients with clog feet who need skin operations are sent to the orthopaedic surgeon. We only operate upon patients who need correction of the weak parts. As there are so many patients we do not do operations to correct scars and other non-functional problems. Again there were many schism patients and burn contractures. Paul Spauwen and A.C.Paul, a surgeon for children in Faridpur with whom we have cooperated for years and a local surgeon registered the children who were then checked by Corien. We see many schism patients. Cees, Eddy and a local surgeon see many burn contractures.

At the end of that day nine operation days have been planned. The operation theatre has meanwhile been prepared by nurse Shahanaz and her team. The instruments have been registered and sterilised. Preparations for the anaesthesia have also been made. We can start operating on Tuesday. At half past eight we start with an operation with local anaesthetics. Meanwhile Corien and Rita can prepare for the general anaesthesia.

Our planning is too optimistic: we finish at eight. We work with three surgeons and A.C.Paul, which allows us to help each other and perform small operations in between bigger ones on the “trolley”, a stretcher that can easily enter the operation theatre, which is then entirely full. In total we operate upon 22 patients.

The next day is difficult, but then everything goes well again: many patients are treated. New patients arrive who we can also help. As time goes by we also have some patients who do not show up when expected thus creating more time for new patients. Sometimes we cannot give a small chubby baby a drip, because we do not see the veins. Then we decide to cancel the operation for a year instead of taking a risk now.

Friday is our day off. Then we visit Aloshika, an NGO near Barisal, which also likes to organise a plastic surgery camp. They are building a new operation theatre about which we advise them. It is a beautiful project with an interesting vocational trainee department. On 23 January there is a seminar where Paul and Corien will give speeches for hundreds of doctors. Corien is the centre of attention when she appears in a beautiful sari. Thursday is the last day when we operate, but it is problematic because of complications.

The closing ceremony is on Friday 27 January with a minister from Faridpur. In his speech he says that there have been problems caused by local circumstances with are part of life in Bangladesh. He promises that Faridpur will have its own intensive care unit, so that patients will not have to go to Dhaka. It is hoped that these problems will not affect new plastic surgery camps.

We have a decent lunch in the Holland Children House, with happy children who give a gymnastics demonstration. The building of the new boys’ home has started. In the afternoon we visit the seed potato fields with Dutch potatoes. Everything seems to be OK. This year we will probably obtain an import licence for the Labadia potatoes, which means that our investments are finally rewarded! If the import of seed potatoes is successful it will be a revenue for the Holland Children House.

On Saturday we go to Dhaka. Most of us return to Europe, but the families Spauwen and Spronk have a short holiday in Sylhet.

Although we had a few negative experiences, it has been a successful mission. A total of 204 patients were selected; 14 patients could not be helped or will be treated later; 14 patients did not show up. Upon the remaining 176 patients 185 operations were performed so 9 patients had 2 operations.

Operations that have been done:
Cleft lip 25
Palate spilt 20
Facial split/macrostomia 4
Burn contractures 56
New burns 5
Clog feet 5
Other major operations 50
Other minor operations 20

Finally a positive development for the future when in due time Spronk and Spauwen will have to stop: this plastic surgery camp has been sponsored by Doctors of the World, who also informed us to be interested in further cooperation. Our ideas about training, cooperation with local partners and organisations are very similar. With such a larger organisation continuity is certain. We hope that 2013 will be a real Doctors of the World mission!

February 2012, Cees Spronk