DEPARTMENT OF PLASTIC SURGERY
International Outreach
Nuzvid, India, February 2005
Gifford Memorial Hospital
Jaimie Shores, MD
3rd Year Plastic Surgery Resident
Loma Linda University Medical Center
In 2003, Operation Good Samaritan partnered with Adventist Health International to provide surgical support for some of its mission hospitals. Adventist Health International maintains relationships with missionary hospitals throughout the world, and several hospitals in India. Gifford Memorial Hospital (GMH) has been serving the community of Nuzvid and the surrounding area for over 75 years. The hospital has a general/trauma surgeon, ophthalmologist, and pediatrician. Earlier this year, the department of Plastic Surgery at Loma Linda University sent a team of plastic surgeons to GMH. While there, they accomplished astounding feats of care and compassion. They also recognized that GMH was in need of not only plastic surgery services, but advanced general surgery and surgical oncology services. It was for this reason that we returned in May of 2005 with a compliment of three surgeons. Dr. Mohan Sehdev, a semi-retired Memorial Sloan Kettering trained surgical oncologist with a penchant for service in international missions, assisted by Doctor Brinda Thimmappa and myself. Dr. Thimmappa and I are third year plastic surgery residents who have completed our general surgery training prior to starting our training in plastic surgery.
As part of Operation Good Samaritan, we have three goals for each mission:
- To provide high quality patient care in underserved regions of the world,
- To train local caregivers in these developing regions to continue to provide care,
- To inspire our residents to a lifelong commitment of international service to promote health, healing, and wholeness.
Gifford Memorial Hospital has suffered severe hardships in recent times. High administrative turnover has prevented it from establishing long term relationships with many patient bases and needed staff. As the coordination of support for GMH was recently taken over by Adventist Health International, a new administrator has been appointed who has extensive experience running American mission hospitals in third world countries. Although the appointment occurred only months ago, the changes have been swift and continue to evolve resulting in a palpable sense of hope, camaraderie, and a renewed sense of respect for GMH in the community.
Patient Care
Over the course of my experience in Nuzvid, we cared for many patients with differing problems. Frequent conditions were thyroid masses, hydroceles, and hernias. Other less common problems included soft tissue tumors, both benign and malignant. The occasional trauma also found its way into the emergency room.
A. Bharathi
Ms. Bharathi is a 50 year-old female with a slowly growing mass of her right leg. She had seen doctors at the region's cancer center who told her she needed an amputation after a biopsy showed a dermatofibrosarcoma protuberans. She had refused amputation and lived with pain and chronic anemia as the tumor constantly bled. We evaluated her and determined she was a candidate for wide local excision and limb salvage. One week after excision, we skin grafted the surgical site, and she had near full function of her leg.
M. Chandraleea
Ms. Chandraleea is a 25 year old patient with neurofibromatosis and possibly other syndromes not yet determined, who presented with a large soft tissue mass on her back which was ulcerated and painful. While she has many soft tissue masses causing her anguish, this is the only one she asked be removed. While it is possible that this mass could harbor a malignancy, most patients do not have the money to allow their surgical specimens be sent to a hospital with a pathologist for proper evaluation for cancer.
A. S. Rao
Mr. Rao had a slow growing neck mass for at least 9 years. He had never been able to afford to have it removed. He was also very afraid of surgery and was encouraged to come have it evaluated only when the "American Doctors" came to Nuzvid. It continued to enlarge and cause him pain and difficulty with range of motion, in addition to the visual deformity.
The mass, which clinically appeared to be a benign fatty tumor, was excised measuring 23 x 15 x 12 cm.
Other Patients
There were many other patients we were able to help by performing operations on during this time. In total, we operated on 20 patients and saw many more in the clinic, referring them on to larger centers if their care demanded more than GMH could provide. There were several patients we had hoped to operate on, mostly patients with large thyroid goiters, but the local anesthesiologists were unable to safely put them to sleep.
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