UAB and Kentucky plastic surgeons going on a medical mission to Ecuador in February have been asked by the U.S. Ambassador to consult on the care of patients burned in a recent accidental explosion of ordnance at a military site in that country.

January 31, 2003

BIRMINGHAM, AL — UAB and Kentucky plastic surgeons going on a medical mission to Ecuador in February have been asked by the U.S. Ambassador to consult on the care of patients burned in a recent accidental explosion of ordnance at a military site in that country.

Ecuadorian brothers Luis and Henry Vasconez, who now direct academic plastic surgery units at the University of Alabama at Birmingham (UAB) and the University of Kentucky, respectively, founded the mission. It now includes more than 50 doctors, nurses, occupational therapists and other medical professionals and support persons, as well as mounds of donated equipment. The all-volunteer group also includes people from Fargo, North Dakota, Chicago, Illinois, and Benton Harbor, Michigan. They depart February 8 for the program’s 12th mission in the Vasconez family’s native Ambato, a mountain city of about 250,000 located 100 miles south of Quito, the capital.

The surgeons’ sister Beatrice Vasconez Engels, who heads the UAB plastic surgery research laboratory, coordinates the program.

“Ordinarily we provide surgery and other care to indigent people from the mountain communities, but this year the U.S. Ambassador to Ecuador has asked our doctors also to see what they might be able to do for the people injured in a major munitions explosion in November in the town of Riobamba,” Engels said. Seven people were killed and more than 500 wounded in the event.

Doctors expect to see burn patients in the three public hospitals in Ambato, but the usual cause is fires from kerosene cook stoves commonly used in poor communities.

The doctors not only provide examinations for up to 1,000 people and surgery for up to 200 people during their week’s stay in Ecuador, they also update local doctors on medical developments, such as laparoscopic surgery.

“This educational aspect is one of the ways the Medical Mission to Ecuador is unique,” Engels said. “Another is the breadth of medical specialties represented. We will have obstetrics-gynecologists to look at cervical cancer, ophthalmologists for strabismus and cataracts in children, a pediatric cardiologist and general pediatricians, orthopedic surgeons to work on children born with deformed limbs, anesthesiologists and nurses to help provide vital assistance during and after surgery, among others.”

The presence of Dr. Robert J. Dempsey, chief of neurological surgery at the University of Wisconsin, will allow the team to offer surgery to children with hydrocephalus, commonly called “water on the brain,” she said. The condition can result in mental retardation if not surgically repaired at an early age.

All the doctors are established in private or university practice or in the last years of their residency training. A UAB obstetrics-gynecology resident will be with the group and then remain for a few weeks in Ecuador as part of her training.

Engels also noted, “Very few medical missions provide continuing care in successive years at the same location. Because we return to the same city each year we have developed a great relationship with the local doctors, hospitals and community groups so they can help screen patients before we get there and follow up with any necessary care after we leave.”

The continuing relationships allows reconstructive surgeons to provide certain operations that must be done in stages over a period of years, such as reconstruction for children born without an outer ear. “This problem occurs in an unusual pattern in Ecuador and affords us the opportunity to set up a research project to see if we can determine why it occurs,” she said. The plastic surgeons also will repair other congenital problems, such as cleft palates.

The Rotary Club of Ambato has been involved in this effort from its inception. This year five members of the Shades Mountain Sunrise Rotary Club will join the medical mission. The two clubs and the Medical Mission jointly contributed money that has been matched by Rotary International to purchase sophisticated machines that help monitor patients’ vital signs during surgery.