Making children smile

International | A group of Texas plastic surgeons use their skills to help third-world kids "because it's the right thing to do"

Issue: "The death of discipline?," June 26, 1999

When Mary and Martha Meas were born in Cambodia more than two years ago, their birth was greeted with joy-and sadness. Mary Meas had a bi-lateral cleft lip, which left her face looking as though a small trunk was growing out of her nose. Her family inquired about surgery in Singapore, Hong Kong, and the Philippines, but it was too expensive.

Providentially for Mary, her father is a Cambodian pastor, and news of her plight passed from an American missionary's family to Patrick Beckham of Austin, Texas. Dr. Beckham was the right person to ask. For years he has been doing free surgery on his own and with Austin Smiles, the charity founded by the Austin Plastic Surgery Society. Since 1987 his group has performed more than 2,500 free surgeries outside the United States, primarily in Central and South America, and about 1,000 free surgeries in the 10-county region around Austin.

Operating on Mary Meas had special appeal to Dr. Beckham. As a Christian he looks for ways to combine his faith and his interest in missions with his medical work. Operating on a pastor's daughter-especially a pastor who as a boy had escaped from Pol Pot's killing fields, fled to Thailand where he came in contact with missionaries and was converted-is the kind of work he likes to do.

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The doctor looks like a cross between former president George Bush and a mustachioed Pat Robertson. He smiles when he tells how his church, Covenant Presbyterian, helped find a place for Mary and her father to stay once she was out of the hospital. He brings out before and after pictures, which show a beautiful little girl whose face-and future-were transformed by a relatively simple operation.

That's the philosophy behind Austin Smiles. From the very beginning, the doctors decided to focus on cleft lip and palates "because it is such a high impact operation.... With a relatively simple, reasonably quick one or two operations, you can absolutely change a child's life totally," says Dr. Jim Fox, one of the founders.

Since 1990 the group has traveled most frequently to El Salvador, a land torn by years of civil war. In that country about the size of Massachusetts, 14 plastic surgeons struggle to meet the needs of six million people. Local doctors, paid about $500 a month by the government, have neither time nor finances to provide charity care for all the poor people who require lip and palate surgery. That's where groups like Austin Smiles come in.

A trip to El Salvador usually includes 40 volunteers, all of whom pay a large part of their own way. The doctors pay all their own expenses-airfare, hotel-while other volunteers pay a $500 sponsorship fee, which basically covers the cost of airfare and food. Austin Smiles pays for their hotel and transportation costs not covered by the $500. Despite the cost, Austin Smiles has had over 500 volunteers go on trips since 1988.

In addition to their out-of-pocket expenses, those who volunteer often have to take vacation or administrative leave without pay. The doctors give up the income their practices could generate in the week they are away-which can be as much as $20,000. Dr. Jim Cullington, another one of Austin Smiles' founders, says, "We're talking the best of what medicine's about. Doing it just because it's the right thing to do."

Preparations for each of the three-times-a-year trips begin two years out when Executive Director Kendyl Richards, the organization's only full-time paid staffer, and Medical Missions Director Carolyn Hardwick set the dates for the trip. At that time they begin the process of putting together the team that will go on the trip. Each trip requires four to five plastic surgeons, six to seven anesthetists, four operating room nurses, four surgical techs, three recovery room nurses, and one nurse and one family practice physician to do triage. Recently, Ms. Harwick has added Ear Nose and Throat doctors to the list. The rest of the team is made up of translators and general volunteers who hold babies, comfort families, wash and sterilize equipment, change beds, and act as general go-fers.

Ms. Hardwick also puts together the supplies required for each mission. She buys or finds donated drugs and collects open but unused medical supplies from Austin's Children's Hospital where she works part-time-in order to have time for Austin Smiles-as an emergency room nurse. (Opened but unused gloves, masks, gowns, drapes, suction tubes, sutures, etc. cost too much to reprocess for use in America, but are still usable by the doctors in El Salvador.) About 70 percent of the supplies for each mission are donated; in kind donations-medicines, professional fees, medical supplies-total about $1 million each year.


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