Gold Coast plastic and recontructive surgeon Dr Dilip Gahankari has recently returned from a mission to India where he and a team of medical professionals operated on some of the country's poorest villagers.

Held in the town of Shegaon, 600 km from Mumbai, the Plastic Surgery Camp was an initiative of the Gajanan Maharaj Temple and Trust, which oversee activities to help local communities. The prospective patients were drawn from the Melghat area, a tribal region considered socially and economically unpriviledged and perhaps best known as one of the few remaining tiger reserves in India.

According to Dr Dilip, they selected the patient population from this area because they have almost no access to modern medical and surgical facilities. ‘A relatively large number of patients from this area carry birth defects,' he explains, adding that common customs such as marriage within families, nutritional deficits and a high incidence of alcohol abuse and smoking, as well as the side-effects of tribal ‘home-herbal-remedies', probably contribute to these maladies.

Injuries too are not able to be treated appropriately and long-term deformities are common. ‘Burn injuries are especially common in households due to unsafe practices with kerosene lamps and open fire-places for cooking,' he says.

‘Winter is quite harsh and the houses are no more than straw huts, providing very little protection against the elements. The incidence of burn injuries in young children is high, simply because toddlers are often looked after by their siblings, only a few years older than they are. Due to lack of access to the modern hospital facilities, these injuries heal by sheer wound contraction causing severe deformities of fingers, hand and other areas.'

The team consisted of a band of volunteers from various walks of life, all donating their time and skills to the project. Among them were Dr Dilip and Dr Sudhanshu Kothe, a local plastic surgeon from Nagpur and Sally Colwell, an occupational therapist from Royal Brisbane Hospital in Australia.

Underpinning activities was support from local health staff and social workers from Melgha. This included approximately 20 young men and women whose role it was to reassure patients, accompany them and assist their families while in Shegaon.

‘There were many other people involved too,' says Dr Dilip. ‘Some friends, proficient in computers helped design the database for the patient records, others helped entering the data and in preparing operating lists. It was very interesting for the visiting medical students from the surrounding region too, who were able to assist in surgical procedures.'

The work was intensive, yet rewarding. ‘Hours in theatre doing incredibly precise work that will benefit a small child or an adult and lead to a better quality of life in their village, the ability to marry, work, not be the object of ridicule - or worse - that makes it all worth it.'

There were many hardships for the medical team. Despite the town of Shegaon being well-equipped with boarding houses and facilities to handle the regular influx of pilgrims, mod cons were limited.

Patients were pre-screened to ascertain if they were suitable for surgery. Some patients were turned away, considered beyond the scope of the hospital surgical facilities.

A total of 47 patients were operated on over three and a half days from 20 to 23 December. Dr Dilip performed 40 of the operations himself in procedures which included cleft lip deformities, severe burn contractures of hand and neck, congenital hand deformities (extra fingers, thumbs), large skin tumours and cysts, eyelid skin cancer removed with reconstruction of the complete eyelid and treatment of patients with major and facial scars.

Supplies for the expedition were supplied by several international pharmaceutical companies, including Tyco Health, Astra-Zeneca and Johnson and Johnson. Gayle Wilson, senior theatre manager at John Flynn Hospital accumulated sterilised ‘single use' used instruments for the team's use, and Janet Nielsen, senior theatre manager at the Royal Brisbane Hospital theatres lent them critical instruments.

Dr Dilip is committed to make this odyssey an annual fixture, not just to India, but to other countries such as East Timor, where he has also carried out volunteer work, as well as working with Rotary Australia's local medical initiative ROMAC to provide medical treatment for children from developing countries in the form of life saving and dignity-restoring surgery.

ACSM #38