In 2001, Pierce Scranton, MD, a Washington orthopedic surgeon presiding over the American Orthopaedic Foot & Ankle Society (AOFAS), wanted to organize an official Overseas Outreach Project.

 

“He thought Vietnam was a good place to start,” said Ruth Thomas, MD, an orthopedic surgeon in Little Rock, Ark., professor at the University of Arkansas for Medical Science (UAMS), and a dedicated AOFAS member. “In the past, we’d done damage there and he thought it’d be nice to do some good.”

 

An initial fact-finding trip to explore the possibility of treating disabled children and landmine victims in Vietnam has grown into an ongoing annual expedition. So far, 24 AOFAS surgeons have traveled to Vietnam at their own expense to perform corrective surgeries on hundreds of children and adults with deformities and disabilities. 

 

Of those two dozen surgeons representing Israel, Belgium, Brazil and the United States, five hail from the Deep South: Arkansans Thomas and Dale Blasier, MD; Tennessean Greer Richardson, MD; and Virginians Robert Adelaar, MD, and Michael Romash, MD.

 

“I was quick to jump onboard,” said Thomas, who made her first mission trip to Vietnam in 2003 and has returned three times, in addition to participating in outreach missions to Uganda and Honduras. “It’s truly an emotional high … the people are so thankful. Now, if I miss a year, I don’t get my fix.”

 

The month-long project is based on a model that involves four AOFAS surgeons working side by side with Vietnamese surgeons. Two AOFAS surgeons volunteer for the first two weeks; the other two commit to the second two weeks.

 

“The two weeks in Vietnam were rewarding not only medically but also personally, by experiencing the appreciation of the Vietnamese people,” said Greer Richardson, MD, an orthopedic surgeon at Campbell Clinic in Memphis, where Thomas completed fellowship training, and also an active AOFAS member. “They would walk or ride bicycles for days to get to these clinics. Anything at all we could do for them was received with a smile and a bow. The children would steal your hearts and many were in such desperate need. All who went with this medical team received so much more than they returned. It was an experience which lingers with you and bonds you to people whose language and culture are so different and yet reminds us we are so much alike. I would recommend it to anyone.”

 

Four days before the group was scheduled to depart for the 2009 trip, Thomas was notified by a team member from Mexico that he would be unable to go to Vietnam because Mexican travelers were being detained at some transfer points in Asia because they were considered swine flu risks at that time. “Because I was chair of the Vietnam planning group this year, I felt like it was important to make the mission trip successful and that meant having two AOFAS surgeons on each team,” explained Thomas. “I was concerned about my visa, but they hand-walked it through the consulate. I was also concerned about surgeries and patient visits here, but my staff rescheduled those.”

 

On her first trip overseas, Thomas anticipated some animosity toward Americans from the Vietnamese. “We dropped more bombs there than we did worldwide during World War II,” she pointed out. “Yet we were, and have been, very warmly received. Vietnam is a relatively young country, with 70 percent of its population under the age of 30. Like most young people, they don’t focus on the past. They don’t carry animosity toward Americans, but view the war as a problem between our governments.” 

 

During the outreach project’s infancy, AOFAS surgeons arrived at clinics to find hundreds of eager Vietnamese lined up, hoping to be chosen for corrective procedures they could not receive, much less afford, in their socialist homeland. “It was a never-ending line … it breaks your heart to turn anyone away,” she said. “Over the years, the Vietnamese surgeons have helped by preselecting appropriate patients, which we evaluate on our arrival, making for a more organized process.”  

 

The patients selected have included problems ranging from limbs with viper bites, horrible scarring secondary to burns, club-footed children whose feet were turned almost completely backward, and post-polio flaccid limbs in children and young adults. 

 

“On the first missions, we treated a lot of patients with bad amputation stumps needing revision, but now we’re focusing on severe limb deformities,” said Thomas. “It’s a virtual textbook of orthopedic pathology.”

 

With fans blowing to generate some type of breeze in the 100-plus degree days in a prickly environment, AOFAS surgeons performed surgeries on 15 to 20 patients each week in orthopedic rehabilitation facilities located in rural areas—the coastal city of Vinh, south of Hanoi; Ba Vi, a village west of Hanoi; Hai Phong, Vietnam’s third largest city; and Thai Nguyen, a village north of Hanoi. The teams also operated at the Viet Duc Hospital, the major teaching institution in Hanoi. 

 

The highlight of the outreach trip was an annual educational conference held in Hanoi on the Saturday in between “shifts.” Co-sponsored by the AOFAS, Prosthetics Outreach Foundation, and Viet Duc Hospital, nearly 170 Vietnamese orthopaedic surgeons attended the one day conference. Presentations on lower extremity surgical issues were provided by the AOFAS surgical team members and several Vietnamese orthopaedic surgeons.   

 

The symposia have helped the Vietnamese surgeons identify a need for an early detection and treatment program for children with clubfoot to avoid costly and difficult corrective surgery for older children with neglected clubfoot. As a result, a Ponseti treatment program was established in Vietnam by the Prosthetics Outreach Foundation to serve children with clubfoot in a number of Vietnamese provinces.

 

“My missions to Vietnam have truly changed me,” Thomas said. “I realize now just how privileged I am to be an American trained orthopedic surgeon, but through this mission experience I’ve learned from my Vietnamese counterparts that good surgeons can still do good things with minimal technology.”

 

This year, Scranton was recognized with a medallion presented by the People’s Committee of Nghe An Province for his role initiating the AOFAS project in 2002.