Global Impact: Healing Hands

A group of children in Cambodia who have endured the effects of severe injuries and congenital deformities now have an improved quality of life after being treated by a medical team from Lucile Packard Children’s Hospital.

For 10 days in June, 2012, James Chang MD, a hand and plastic surgeon at Packard Children’s, led a team to provide reconstructive surgery to children at Takeo Province Hospital in Cambodia.

“This trip was the first time that a surgery team specializing in hand surgeries went to the hospital in Takeo,” said Chang, who also serves as professor and chief of Plastic and Reconstructive surgery at Stanford Medical Center.

Chang was invited by a plastic surgeon from Bambino Gesu Hospital in Rome, who has a long-standing relationship with the hospital in Cambodia. For many years Takeo Province Hospital has worked closely with the Italian hospital and various international institutions to provide much needed medical services to the Cambodian people.

In preparation for the arrival of the team, staff from the Cambodian hospital traveled to surrounding villages to determine which children would best benefit from the Packard Children’s team’s expertise. Prior to the team’s arrival, Chang received pictures and descriptions of each case so he could better prepare for the upcoming surgeries.

The Packard Children’s medical team, which included two surgeons, two anesthesiologists, a senior surgical resident, a recover room nurse, a hand therapist, a photographer and a trip secretary, saw about 50 children and operated on about 30 of them. They mainly operated on children with congenital problems, severe injuries and burns. In many cases, the young patients had never been treated for their conditions or injuries.

“Burns are not uncommon among children because people use open flame fires for cooking and warming,” said pediatric anesthesiologist Echo Rowe, MD, who served as medical director for the trip. “Some of the burn injuries among the children have long since healed, but many of them never received immediate burn care because they live so far from a hospital.”

The team was able to improve the outcome of the birth defects and injuries and operate on hands and limbs that had been severely burned. In one case, an 18-year-old girl had an accident involving a machine leaving only one finger on her hand. Chang reconstructed her hand in preparation for adding a toe as a thumb in a future surgery.

Although the medical team worked in a remote part of the world, they were still able to deliver top quality care to the patients. They brought along sophisticated portable ultrasound equipment to provide anesthesia.

“We have the knowledge to do regional anesthesia in children that is very specific, and we used the same state-of-the-art technology that we use here at Packard Children’s,” Rowe said.

Providing top quality care to patients around the world has been a long tradition for Packard Children’s and Stanford Hospitals, and the relationship with the Cambodian hospital will continue.

“We plan to make this a yearly trip of bringing Stanford and Packard Children’s doctors over to continue building a relationship with this specific hospital in Cambodia,” said Chang. “We are already in the process of selecting the team who will go to Cambodia next summer.”