Local efforts bring reconstructive surgery to developing nations

By Lauren McSherry, Town Crier Staff Writer

PHOTO BY JOE HU Los Altos Hills resident Dr. Anula Jayasuriya, a native of Sri Lanka, is a board member of Interplast which sends medical teams to developing nations to provide reconstructive surgery training and services.

Sri Lanka’s civil war spanned two decades, took 60,000 lives and displaced millions of people.

The war may seem far removed from the quiet bedroom communities of Los Altos and Los Altos Hills, but one resident has made it her mission to alleviate some of the pain lingering in the aftermath.

Dr. Anula Jayasuriya, a native of Sri Lanka who is now a Los Altos Hills resident, is a board member of Interplast Inc. She joined the non-profit, based in Mountain View, because of its mission to bring surgical teams and training in reconstructive surgery to developing nations.

Jayasuriya affiliated with Interplast four years ago to bring its expertise to Sri Lankan physicians to aid the thousands of young soldiers, children and adult civilians who sustained injuries in the military conflict.

Although the country does not have a shortage of physicians, its medical system is not set up to train specialists in reconstructive plastic surgery. In a population of 18 million people, there are only five plastic surgeons in Sri Lanka, Jayasuriya said.

“The doctors are qualified,” she said, “but they don’t have the luxury of learning new techniques.”

In Sri Lanka, there is a special need for hand, feet and eye experts because of land-mine injuries. Many young men, who fought in the war, cannot rejoin society because of their injuries, Jayasuriya said. To fill the lack of reconstructive surgery experts, Interplast doctor-volunteers travel to Sri Lanka to teach workshops for local physicians.

The local doctors can gain surgical skills that may facilitate their patients’ return to society. For example, if a soldier has lost a thumb, crucial for dexterity, rather than merely sewing up the wound, a doctor trained in plastic surgery is able to use wire and skin grafts to build a more functional digit, or transfer a toe as a substitute.

“People’s lives can be transformed to a highly functional state with the kind of resources that, in the U.S., would be completely minimal,” Jayasuriya said. “You’re talking about one to two surgeries. They’re pretty fast. They’re not complicated. What I see here is being able to make a huge change with modest resources.”

There is a further need for plastic surgeons in Sri Lanka because of the number of children born with birth defects or burned in kitchen and house fires, Jayasuriya said. Burns are common because people live in thatched huts and, without electricity, rely on oil for light and heating, she said. Moreover, a birth defect, such as a cleft palate, can affect an entire family because parents may be superstitious and think they are cursed. Sometimes parents hide children with congenital anomalies for fear they might ruin the marriage opportunity for another sibling.

“America is very accommodating (of people with disabilities). In other countries your fate is very dire. You are completely marginalized,” she said.

Around the world, Interplast partners with surgeons in developing countries and sends visiting educator trips, composed of volunteer medical teams to perform surgeries, assist in skills transfer and provide educational workshops for medical professionals.

Interplast sent the first visiting educator trip to Sri Lanka in June 2000. Since then, there have been three more trips.

In addition to Jayasuriya’s involvement and being based in Mountain View, Interplast is very much a local, home-grown organization. Medical residents and plastic surgeons at Stanford made up the first Interplast teams. Its founder, Dr. Donald R. Laub, and many of its board members call Los Altos or Los Altos Hills home.

The non-profit is perhaps best known for fixing cleft lips and palates, a birth defect affecting one in 600 children worldwide. But Interplast’s volunteers actually perform a variety of surgeries - from reducing scar tissue from burns to replacing tendons. The organization funds surgeons in developing countries to help them open clinics. It sends surgical teams to augment doctors as needed and provides doctors in developing nations with digital cameras so that they can post cases on the Web and solicit input from physicians around the world.

Susan Hayes, CEO of Interplast, said the non-profit has no political or religious affiliation and accepts no financial support from government organizations.

It’s easy to understand why Jayasuriya joined Interplast given the organization’s credentials. Doctors volunteering for the non-profit have completed 54,000 surgeries in the 35 years since its founding.

There are seven outreach centers in South America, Asia and Africa affiliated with Interplast and staffed with local surgeons at each site. These doctors make medical assistance available 365 days a year for one-third of the cost of a team, said Hayes. Between 17 and 20 surgical teams are sent each year. Made up of volunteers from around the nation, a team consists of two plastic surgeons, three anesthesiologists, two operating-room nurses, two recovery-room nurses and one-to-two secretaries or translators. A team performs eight to 10 surgeries per 10-hour day.

“It’s not a vacation,” Hayes said.

Board member and Los Altos Hills resident Dr. Joshua Korman, a volunteer on 15 team trips, said that Interplast differs from other doctor-based organizations because it focuses on transferring skills to local physicians so that each clinic site becomes self-sustaining.

All board members agreed that in addition to counteracting the lack of funding, medical infrastructure and access to reconstructive surgery in developing nations, raising community awareness about Interplast’s work is needed here at home.

“A lot of what we need to do is tell the story,” said Board member Dr. Russell Hirsche of Los Altos Hills. “Many of my friends weren’t aware how widespread some of these congenital anomalies are, like cleft lips and cleft palates. And they weren’t aware of how infrequently these sorts of things are repaired in other countries.”

The arduous journeys made by parents and children to reach Interplast teams prove the unmet need for reconstructive surgery. Patients walk for days over the Andes Mountains or boat up to two weeks on the Amazon River, said Hayes.

A documentary, “A Story of Healing,” about a teenage boy who walked for three days to reach an Interplast surgical team in Vietnam won an academy award in 1997.

In March, Jayasuriya visited an Interplast clinic in Ecuador. She was amazed by the doctors’ creativity and concluded that Third World connections among doctors can sometimes be more fruitful than the network between physicians in America and in developing nations. For example: If a doctor in Zambia is dealing with a head injury and asks an American doctor for advice, the American would probably advise a CAT scan. But there are no CAT scan machines in Zambia. The doctor in Zambia might benefit more from consulting a doctor in Ecuador, who also does not have a CAT scan machine and knows how to treat head injuries without one. Since the Interplast network facilitates international communication between doctors, the Zambian doctor can actually consult the doctor in Ecuador.

For more information, logon to www.interplast.org.