Joon P. Hong, MD, PhD, MMM
As plastic surgeons, we are privileged to answer a helping call to many patients that
are in need. These patients arrange from congenital anomalies, burns, various soft
and bone tissue defects after cancer and trauma to providing solutions to what was
once thought difficult such as allotransplant, transgender surgery, and even complications
arising from the abnormality of lymphatic functions. As plastic surgeons we have achieved
remarkable advancement in the field of aesthetic and reconstructive surgery. However,
there are enormous disparity between different parts of the world where reconstruction
may not even be available due to lack of plastic surgeons or resources. We hear stories
about how people unnecessarily amputate their limbs, form disabilities from poor care,
and live with congenital deformities that may leave a stigma in their society. As
plastic surgeons we could bring lasting impact to these countries by sharing knowledge,
providing care, and sending resources. We could help them dream what can be possible
and help them a step closer to realizing this dream. We have many wonderful charities
and missions in the field of plastic surgery that has continuously served these underprivileged
patients around the world. We have many surgeons who work with charity missions or
even on their own provide help. But the progress remains slow despite the current
work by various institutions and individuals. So, what do we need to do to reach more
patients and to help them transform their lives?
There are several factors involved in surgical missions. But the key to successful
mission is to carefully plan based on surgical needs, work with local partners to
coordinate the mission, and help them acquire the necessary skills plus resources
to manage these patients, and to be responsible in practicing good ethics.
I have taken part in many missions and although all missions are different in need,
stable mission that does not address the imminent crisis of war or conflict gives
you the opportunity to prepare accordingly maximizing the efficiency of the mission.
Often local partners will triage and schedule cases, which allows to efficiently prepare
the resources that are needed as well as to designate the proper surgeon with good
experience for the required task. Having similar patient groups will allow a better
learning experience for the local partners to enhance their knowledge and skills as
well as postoperative care. The best way to reach all the patients in need is to train
the local partners as they will go out in the field to serve the patients and will
train more surgeons ultimately increasing the care providers. Only teaching them how
to fish will allow them to build the right capacity to address the problems and empower
them to transform the lives of their own patients. Keep in touch with the local partners
answering their questions and helping them to find solutions even after leaving the
mission. Finally, often overlooked, is the issue of ethics. As surgeons, we practice
patient safety as a habit. The same must be applied in any missions despite the limited
resources they might have. If you are going to let trainees operate, you but be there
to guide them in every step of the surgery. Educating the patient and family and obtaining
informed consent needs to be a routine. The best practice should be performed as same
as back home. Although customs and culture can be different, we must practice to respect
to our local colleagues, partners, and patients accommodating their beliefs, which
will in turn lead to building trust.
During the mission, despite the tireless efforts, we can only reach a limited number
of patients. We often leave with guilt not being able to help more. But knowing we
have trained and educated the partners, we can leave with the notion of plating a
seed. A seed that will continue to grow long after we leave. A seed that will have
strong roots as we continue to help the local partners sustain the practice they learned.
We should continue to be part of their journey of transformation and provide support
in ways we can. For those who will embark in the journey of giving back, planning,
supporting the local partners, and practicing good ethics will be the key to helping
them grow and leaving a lasting and meaningful impact that will lead to a cycle of
positivity and sustainability.