1. What was the mission of this medical trip?
The purpose of the medical mission was two-fold. One, to teach and train the resident and professors of the National ENT Hospital the techniques of facial plastic surgery. This was done in two ways. First, through hands-on teaching in the operating room. Both the residents and professors watched while the surgeons operated. In most instances, the American surgeons took the residents and or professors through the case and allowed them to operate, while the American surgeons watched and guided them.
In difficult cases, the residents and professors watched the American surgeons operate. In the afternoon, after the surgical cases were completed, the American surgeons lectured the entire department on various topics of facial plastic surgery, such as facial reconstruction after tumor resection, scar revision, and cleft lip and palate repair.
The second purpose of the mission was to operate and help those children and adults with complex facial deformities, facial tumors, or significant facial trauma.
2. How were patients selected?
The patients were selected throughout the year by the resident physicians as cases they believed were complex and difficult. By doing this, they not only selected patients to be helped, but also selected surgical procedures they believed they could learn from. On the Sunday right after our arrival, the team met and examined all the patients to make sure they were good candidates for surgery. It’s important to note that the residents did an amazing job selecting patients for the medical mission.
3. How many procedures were performed daily?
The team performed an average of five to six procedures a day. Usually every procedure was headed by one of the American surgeons with a resident or a professor assisting. In this way, the assistant was able to assist and take part in the surgery. The American surgeon took the resident or professor through the surgery so that they were able to get real, hands-on teaching of the complex procedures.
4. How long did the trip last?
The trip began with a 20-plus hour, multi-stop flight. Dr. Bustillo’s flight, for example, began in Miami. From there he went to Chicago, Tokyo and finally to Hanoi. He left Friday morning Eastern Standard Time and arrived early Sunday morning Hanoi time.
On Sunday, the first day there, we went to the clinic in the National ENT Hospital and met all of the patients they had selected. The team then scheduled those patients for surgery throughout the week, taking into account which surgeon was best-suited for each particular procedure. The team spent a total of six days providing patient care. From Monday to Friday, the team operated from 8 a.m. to 4 or 5 p.m., and then gave lectures for several hours afterward.
5. What would these procedures cost in Vietnam? What do they cost here in the U.S.?
It is always difficult to place a dollar value on any particular procedure and even so much more when you have to take into account geographical differences. For example, the cost of a nasal reconstruction with a rib cartilage graft in the United States may cost anywhere from $10,000 to $30,000, depending on who performs the procedure and where it is performed.
6. If a doctor is interested in participating, where would he or she begin?
A surgeon who is interested in doing missionary work should start looking at the various organizations that help to organize these missions. Our mission to Vietnam was initially organized by the International Face to Face program, which works under the American Academy of Facial Plastic Surgery. The Face to Face organization organizes many of these trips throughout the year, each going to different parts of the world. This particular mission was started approximately 15 years ago, and through the years has been led by different individuals.
7. What can a doctor expect once he or she commits to participating in a mission?
Once I arrived in Vietnam, which is a 20-plus hour trip, the mission began. The very next day we were seeing patients in the clinic, examining them and making sure they were good candidates for the proposed surgery. At about 4 to 5 in the afternoon, you start to get extremely tired as the jet lag sets in. They say that it takes about one day for every hour difference to get accustomed to the new time, so this drags on for the entire trip. That afternoon, we lectured the residents for a couple of hours and then returned to the hotel.
Day two is our first surgical day. Things are done rather differently in Vietnam than in the states. For example, in some of the operating rooms, there are two surgeries taking place. Otherwise, the operating rooms are well-equipped and well-stocked with modern equipment and instruments. Most of the residents are eager to learn and help in any way they can. We operate throughout the day and then lecture in the afternoon. After the day is done, one of the professors will usually invite us out for dinner either to their home or to a restaurant. On a couple of occasions, my wife and I took the night off and explored Hanoi.
8. Are there any out-of-pocket expenses?
The entire mission is self-funded, meaning that the doctors pay for their airfare and hotel themselves. The airfare can be quite expensive, but the stay in the Hanoi hotel as well as the cost of food is very reasonable. The total out-of-pocket expenses were approximately $8,000. This, of course, does not take into account the lost revenue from not working that week and continuing to pay office expenses. All in all it is an expensive trip, but well worth it.
9. Are medical students allowed to participate in these kinds of projects?
This is a great way for medical students to learn medicine and help those in need. In the past, our mission has not had medical students, but we are definitely open to it and encourage it. Medical students should look for a mission that involves the scope of practice in which they are interested. For example, if a medical student is interested in facial plastic surgery, they may contact the American Academy of Facial Plastic Surgery and speak to someone associated with the face to face program.
10. Can civilians who aren’t doctors volunteer?
There are many missions civilians can volunteer with. However, because this particular one takes place in a well-staffed hospital, there is not much need for them. Civilians who are interested in doing missionary work should contact the face to face program and inquire.
11. Did you personally have to take any equipment or medication for the patients?
Each physician in the group took their own surgical instruments and sutures. We took our personal instruments because we are accustomed to using our own sets for the surgeries we perform. As a surgeon, especially in the field of facial plastic surgery, we get very comfortable with doing a particular procedure with a certain instrument. We took sutures because, again, we become accustomed to performing a particular procedure with a certain needle and suture.
12. What organization did you do this through?
The mission was organized by the face to face organization, a branch of the American Academy of Facial Plastic Surgery. This particular mission was started about 15 years ago and has changed hands various times. It was started by a mentor of mine many years ago, and currently is managed by the four of us who participate every year. Any physician or medical student interested should contact us.