Pierce E. Scranton Jr., MD, examines a 17-year-old patient born without knee joints. Drs. Scranton and Shields hope an operation next year will enable her to walk.

AAOS Now

Published 9/1/2007
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Judy Datz

AOFAS project offers challenges, builds memories

AOFAS conducts 6th Overseas Outreach Project to Vietnam

Touring European castles, cruising through Alaskan waters, climbing the Rockies, and kayaking scenic rivers are all wonderful opportunities. But for beautiful scenery, exotic architecture, unusual foods, and the chance to step out of your comfort zone—both clinically and personally—nothing beats the annual Overseas Outreach Project to Vietnam, sponsored by the American Orthopaedic Foot and Ankle Society (AOFAS). It also affords the opportunity to do something truly special for others and return home with memories that will last a lifetime.

A coordinated venture
In 2000, Pierce E. Scranton Jr., MD, made a fact-finding trip to explore the possibility of treating disabled children and landmine victims in Vietnam. Today, the AOFAS Overseas Outreach Project to Vietnam is a coordinated venture with the Seattle-based Prosthetics Outreach Foundation (POF)—which handles all in-country logistics for this project—and the Vietnamese Ministries of Health and Labour, Invalids and Social Affairs.

During the past six years, 17 AOFAS members have generously volunteered their time and paid their own travel to Vietnam to participate in the project. The AOFAS has co-sponsored five educational conferences in Hanoi, and more than 350 patients have benefited from free surgeries.

Hospitals, families, and children
Funded by the AOFAS Outreach & Education Fund (OEF) through corporate and member donations, this year’s mission trip began in mid-May when the first team—E. Greer Richardson, MD, and Steven C. Sheskier, MD—arrived in Hanoi. The two first-time project volunteers spent time at the provincial orthopaedic rehabilitation center in Vinh City, a coastal city about 300 km south of Hanoi. Families, many of whom had traveled from outlying villages, greeted them with warm smiles and waited patiently…hoping their children would be selected for surgery.

Motorbikes are the primary mode of transportation in Vietnam, and accidents frequently result in lower extremity trauma. According to one government official, 6 percent of Vietnam’s 83 million people are disabled. At times it seemed as if every Vietnamese family had a child with a deformity, many of which are not typically seen in the United States. With the aid of POF’s Vietnamese project coordinator and interpreter Mrs. Rose Hong, the AOFAS surgeons saw patients and performed surgeries with their Vietnamese orthopaedic counterparts.

Dr. Richardson
scrubs for surgery
MD (make-do) style.

Educational conference
The full AOFAS contingent assembled in Hanoi for an educational conference co-sponsored by the AOFAS, the POF, and the Vietnamese Ministry of Health. Joining Drs. Richardson and Sheskier were Michael M. Romash, MD; Meir Nyska, MD; and team leader Naomi N. Shields, MD. Dr. Scranton represented the POF.

The Fifth Annual American Vietnamese Seminar on Surgery of the Lower Extremity was attended by more than 165 Vietnamese orthopaedic surgeons. Dr. Scranton opened the conference, which included presentations by the six AOFAS members and four Vietnamese surgeons. All presentations were simultaneously translated so everyone could understand them.

Dr. Richardson, who had been stationed in Thailand during the Vietnam War and had traveled only once to Vietnam during his tour of duty, briefly summarized his clinical presentation and then told the audience that he wanted to “speak from the heart.”

“I am speaking as one who has not been to Vietnam in a very long time,” he said. “This has been a very meaningful trip for me. The doctors here are good doctors, working with so much less than what we have, and doing good work for the people. You have welcomed us warmly into your hospitals and into your operating rooms, allowing us to operate with you to treat your patients.

Pierce E. Scranton Jr., MD, examines a 17-year-old patient born without knee joints. Drs. Scranton and Shields hope an operation next year will enable her to walk.
During their second week in Vietnam, Drs. Richardson and Sheskier traveled to Ba Vi, where they visited an orthopedic rehabilitation component factory and a prosthetic leg manufacturing facility, both POF-supported initiatives.
(left to right) E. Greer Richardson, MD; Steven C. Sheskier, MD; Zan Lofgren, executive director of the AOFAS, and (front) Rose Hong, of the Prosthetics Outreach Foundation, seem happy to be in Vietnam.

“Families come a long way, with no material goods, and only the look of pain and hope in their eyes. When the children disrobed for the physical examination, we saw that they had been meticulously cared for. We learned very quickly that the Vietnamese people are both strong and gentle—a rare combination,” he said.

Team two carries on
Following the conference, first-time volunteers Drs. Nyska and Romash remained in Vinh City and performed surgeries for several days. They then traveled north with Dr. Shields to Lao Cai, located near the Chinese border and home to Vietnam’s ethnic minority tribes. They were warmly welcomed by their orthopaedic counterparts and the families and patients, some in the colorful traditional dress of their individual tribes.

Wherever they were, the volunteers faced several challenges, including unusual cases and operating rooms without instruments or equipment that is common in the United States. “MD stands for ‘make do,’” commented one trip participant. But the challenges were part of what initially attracted the volunteers in the first place.

Volunteers brought along their own gloves, sutures, masks, and scrubs. Some brought instruments to leave behind, while others brought surgical texts as gifts. The donations were much appreciated.

Why volunteer?
Although the 2007 participants had previous international humanitarian experience, each had unique motivations for volunteering for the AOFAS project.

Dr. Nyska, who had been to Vietnam three times previously, came “to gain experience and solve complicated problems in foot, ankle, and lower extremity trauma care.” With Dr. Romash, he performed a through-the-knee amputation, enabling a girl who was previously confined to her home to use a prosthesis and walk. “This was one of our highlights,” he said.

A retired career military medical officer, Dr. Romash “wanted to gain insight into the practice of orthopaedics away from the United States to compare and contrast it with our care. I wanted to see how care today compares with my military experience in the Marshall Islands 20 years ago.”

Dr. Richardson’s goal was simple: “To say thank you to Dr. Pierce” for his vision in establishing the Vietnam project for the AOFAS.

“My motivation,” said Dr. Sheskier, “was to increase my understanding of the needs of a developing nation. I was also interested in increasing the friendship between our countries. I lived through the time of the Vietnam War and I feel we still have a debt to this country. The United States has so much and other places have so little that it is time to give back.”

To read more about the AOFAS Overseas Outreach Project to Vietnam, visit the AOFAS Web site (www.aofas.org), and follow the links under Outreach & Education Fund Projects.

Judy Datz is communications manager for the AOFAS. She can be reached at jdatz@aofas.org.