Annual program provides free orthopaedic surgical care to Vietnamese in need

Since 2002, volunteer surgeons from the American Orthopaedic Foot & Ankle Society (AOFAS) have been bringing life-changing orthopaedic surgical care to underserved Vietnamese through the annual AOFAS Overseas Outreach Project to Vietnam.

Supported by a grant from the AOFAS Outreach and Education Fund, the AOFAS Overseas Outreach Project to Vietnam is a partnership initiative with the Seattle-based Prosthetic Outreach Foundation (POF), which has been providing free prosthetic limbs to Vietnamese amputees for more than 20 years. The AOFAS Project complements the mission of the POF by offering corrective surgery to patients with lower limb deformities and disabilities caused by polio, cerebral palsy, untreated clubfoot, trauma, and amputation.

“One of the initiatives of the AOFAS is to give back by providing excellent clinical care and education throughout the world,” said AOFAS President Judith F. Baumhauer, MD, a volunteer with the 2010 Project. “Thanks to POF’s already established relationships, we’ve been able to provide care to patients, educate local surgeons, and develop working relationships of our own in Vietnam.”

Since the Project’s inception, AOFAS volunteer surgeons have seen more than 2,000 Vietnamese patients in clinics and surgically treated more than 700 patients, most of whom live in underserved regions and have no access to advanced medical care. As a result, many of the foot and ankle deformities the volunteers encountered were conditions they had only read about in textbooks.

“Some of the patients had deformities that challenged our problem-solving abilities,” said 2006 volunteer Nimrod Ron, MD, of Israel. “We performed surgeries on conditions that we just don’t see in our own countries.”

Dr. Baumhauer added, “At least one of the several ankle equinus contracture cases that I treated was likely due to complications caused by polio or another illness that has been eradicated in the United States.”

A decade and counting
The AOFAS Overseas Outreach Project in Vietnam recently completed its 10th mission. In mid-May, seven AOFAS volunteers from the United States, Mexico, Europe, and South America traveled to Vietnam at their own expense. For 4 weeks, they worked with local orthopaedic surgeons in clinics and orthopaedic rehabilitation centers in Dien Bien, Thai Nguyen, and Hai Phong, and at Viet Duc Hospital in Hanoi. Local surgeons who worked alongside the AOFAS volunteers witnessed firsthand the latest surgical advancements in the treatment of foot and ankle disease and deformities.

“The demand for our services was significant,” said Peter B. Salamon, MD, a first-time volunteer with the Project. “We saw many children with untreated congenital abnormalities and adults who were experiencing the residual effects of poliomyelitis, untreated trauma, and undertreated infections.”

“It is always incredibly rewarding to be able to help the children, to see the smiles on their faces and their parents’ joy and relief,” said Naomi N. Shields, MD, a veteran volunteer who has participated in each of the 10 missions. “Each trip brings new pathologies, new solutions, and new friends and colleagues.”

In Dien Bien, Dr. Shields visited the physicians she had worked with last year. “It was exciting to see the advancements they had made in just one year and to follow-up with patients,” she said.

A key component of the Project is the AOFAS–cosponsored educational conference, the American Vietnamese Seminar on Surgery of the Lower Extremity.

This year’s conference was held on May 28 in Hanoi and featured clinical presentations on foot and ankle surgical care and rehabilitation by AOFAS volunteers and Vietnamese orthopaedic surgeons. Simultaneous translations enabled the 150 Vietnamese orthopaedic surgeons in attendance to understand the presentations.

“Educating surgeons and building a foundation for future learning are probably the most important parts of our mission,” said Dr. Shields. “The young doctors are so eager to learn. At this year’s seminar, several of them reported outcomes on their first 5 years of cases.”

Based on their success in Vietnam, the AOFAS plans to expand its humanitarian outreach to Haiti and possibly China, said Dr. Baumhauer. She also credited the Vietnam initiative for spurring the growth in AOFAS’ international membership.

“People are starting to think more globally and ideas are spreading cross culturally,” she said. “Being a part of that is very rewarding.”

Touching lives
The AOFAS Overseas Outreach Project to Vietnam does more than transform the lives of patients and educate local surgeons—it also enriches the lives of the volunteers. For 2011 participant Mario Kuhn Adames, MD, of Brazil, volunteering was the fulfillment of a dream to perform community outreach beyond the borders of his own country.

“Participating in the AOFAS Project in Vietnam was the most rewarding activity and the greatest learning experience of my personal and academic life,” he said.

Keith L. Wapner, MD, immediate past president of the AOFAS, brought his two adult sons along when he volunteered in 2008. “I wanted them to experience the difference in resources between our two countries,” he said. “We were touched by the warmth and hospitality of the Vietnamese patients and physicians. It was truly a learning and fulfilling experience.”

“There is no question that I received more than I gave,” said Francis X. McGuigan, MD, another 2008 participant. “The Vietnamese people could not have been warmer or more appreciative. The trip was about the people: those we traveled with, those we worked with, and those we cared for.”

This year, Dr. Shields was overwhelmed when several families presented volunteers at the Orthopaedic Rehabilitation Institute in Hanoi with flowers as a thank-you. “These people come from very poor communities—they have nothing. It was a very emotional moment for me,” she said.

One patient whom Dr. Baumhauer particularly remembers was a young woman who had sustained severe leg trauma; Dr. Baumhauer had to perform a below-knee amputation.

“The woman later sent me a picture of herself standing in her prosthetic limb. She was so happy—she actually thanked me for amputating her leg,” said Dr. Baumhauer. “When everything is said and done, it really comes down to the people whose lives you touch.

“The AOFAS Overseas Outreach Project to Vietnam has been a great ride for 10 years and we hope for another 100. I wholeheartedly encourage everyone to give back—you get so much in return,” she said.

Maureen Leahy is assistant managing editor of AAOS Now. She can be reached at leahy@aaos.org