A Rotaplast Mission to China
(Submitted by Anita Stangl)

(Editor’s note: This year saw the first visit of a Rotaplast team to China. The following notes were sent by Anita to her fellow club members in San Francisco.)

Sent: Friday, October 18, 2002 1:09 AM

Subject: First report from China

To Members of the Rotary Club of San Francisco:

Dear Fellow Members: The China Rotaplast team arrived in one piece in Shanghai at 5:30 p.m. on Tuesday after a twelve hour flight from SF.

We were immediately greeted and hosted by the Rotary Club of Shanghai.  Frank Yih from the club has worked tirelessly to help with the arrangements for this mission and hosted the entire team at his penthouse home and hotel.  He will accompany the team as a translator for the first week.

The team left Shanghai (some after a brief morning of touring and/or power shopping) at noon and caught the plane for Nanchang, China.  We were greeted by our partners, the China Welfare Population Foundation and by two rows of nurses in white caps and uniforms, lining a red carpet at the airport and applauding. Another two hour bus ride brought us to Jiujiang, China.

Thursday started with formal meetings.  Again we were greeted by two rows of nurses applauding us as we descended from our bus and walked into the hospital.  There was a formal meeting with the hospital staff, formal speeches, formal setting -- and then the work began.

In less than half an hour clinic was set up.  Children and their parents had lined up for hours waiting for the teams arrival.  Over 50 children had been pre-screened and were already in the ward.

How can I describe a scene that I have seen many times but still affects me. Many children with broken faces, anxious yet smiling parents, patience beyond belief as they were transferred from station to station -- plastic surgery evaluation; pediatric review; weight, height and vital signs taken; polaroid photo for chart; dental and orthodontic evaluation; and finally genetic review of family and life style. Over 110 children are evaluated and approved for surgery.  More will walk in during the following days.

There are many members of our club here.  Of course, Dr. Angelo Capozzi leads the medical team and John Uth is the Mission Director.  Doug Hiemstra and Barrett Giorgis are faced with the logistical problems of handling our 45 boxes of supplies and equipment, finding enough water for the team, and sterilizing the instruments.  Barrett drives all over Jiugiang in search for tonic for the Team's traditional happy hour "gin and tonic" and finds that there is none anywhere.  Dr. Majka Tolarova begins her interviews with families about their life style habits in order to find clues as to the large number of children affected by the cleft anomaly. Our new Club member Mimi Yang translates.  Bill Chiang, without whom this mission never would have happened deals with crises as they occur and Dr. Al Goldberg calming runs the pediatrics. Jacques Iselin takes polaroids and his wife, the indomitable, Silvia charms children by blowing bubbles and performing slight of hands. Even at the age of 85 she is tireless.

I have brought a seal hand puppet with me to entertain the children.  As I walk up and down the ward the fact that children are the same all over the world is apparent.  Most are fascinated by this white furry seal.  They laugh and their parents laugh taking away the tedium of the interminable wait to be called for surgery.  They are encouraged to pet this furry creature and many tentatively reach out.  It was a toy worth bringing over 6000 miles.

Today is the first day of surgery.  There are four surgical arenas and each surgeon has 4 cases.  It is a day to adjust to the hospital, the routine, straighten out rough edges and make the team work as a whole.  It is a process repeated with each trip.

News comes from the recovery room that the emotions of parents here, upon seeing the repaired face of their child, is the same as shown on any video Rotaplast has produced.  Tears of joy, tears of relief, tears of parents who have waited anxiously for so long.  It affects the members of our team and makes the hours of preparation, the long trip, and logistic problems all worth while.

I will continue reporting with stories about the team and the members. Our thanks go to the Rotary Club of San Francisco for your generous support of this 10th anniversary endeavor.

Anita Stangl

Sent: Saturday, October 19, 2002 1:14 AM

Dear Friends:

Today, Saturday, is the second day of surgery.  Sixteen more patients are being treated.  Yesterday a number of the team finally made the dinner hour by 9:00 p.m.  After a quick dinner, it was to bed and up by 6:00 a.m.

One extremely hard working member of our team is Dr. Marie Tolarova (Majka), who is an SF Rotary Club member and head of the University of the Pacific’s (UOP) program for Prevention and Treatment of Cleft Lip and Palate.  Her program has been supported by Rotaplast for the last 6 years.  She has a presence on most Rotaplast missions.

Today, she is in China, back less than three weeks from the Rotaplast mission to Barquisimeto, Venezuela.  She has brought 300 copies of her brochure, "Can We Prevent Cleft Lips and Palates."  This pamphlet, for distribution to families, has now been translated into Chinese -- no small task and a new one for our venture into China.  She also has copies of other medical materials for distribution to the Chinese medical professionals.  She will be presenting lectures on Monday along with plastic surgeons, Dr. Angelo Capozzi and Dr. Les Hovey. However, Majka is not only a geneticist.  She is also a very accomplished pediatrician, versed in identifying a number of birth defects. She has spent her entire professional career hoping to discover causes of and treat the cleft anomaly.

With her are two other professionals -- Dr. Irena Klimova, from Slovakia, and Dr. David Gilmore from UOP.  Both are orthodontists and are examining every child, whether they are cleared for surgery or not.  Dr.Klimova is impressive. She is the person responsible for getting the government of Slovakia to cover all orthodontic expenses for cleft children in that country.  This is quite an accomplishment as the United States does not have this extensive a free program.  Dr. David Gilmore is a second year resident in the orthodontic program at UOP.  He will graduate in June and has been a practicing dentist for many years. It is Dr. Tolarova's hope to create interest among residents in the cleft anomaly that will carry on into their orthodontic practice.

We saw one tiny baby yesterday -- too young for surgery.  Yet the parents will go home with hope because Dr. Klimova will fabricate an orbature (a removable plate to cover the cleft palate) that will allow the baby to swallow correctly and gain weight -- in time for what will hopefully be a return medical mission.

Majka and her team are faced with the challenges that all of us have -- many a language barrier that requires great help from translators.  Yet everyone together are working to create hope for the future of these children.

Thanks once again goes to the members of the Rotary Club of San Francisco. You are making a difference.

With love,

Anita Stangl

Sent: Monday, October 21, 2002 2:49 AM

To:   Members of the Rotary Club of San Francisco From:  Anita Stangl Re:    Progress with the China mission

Dear Friends,

It is now Monday, mid afternoon and we are running smoothly.  It is very interesting to be in a country where the only "western" element is email access.  Rotary Club member, Doug Hiemstra, had tickets to the world series which he gave up to be a member of this mission.  On Sunday which was a free day he made the valiant attempt to somehow watch the game.  Sad, to say there is no English channel here -- not even CNN --and no newspaper written in English.  He finally read it play by play on the internet. It is strange to be in a place so isolated from our normal concerns and interests and having only one focus -- to help the kids.

On Sunday, the rest of us traveled to Lu Mountain where Chang Kai Chek had his summer retreat.  The group received a crash course in Chinese history. One of the tour guides became interested in Rotaplast when he heard about our project.  Our photo-journalist asked him if he would be interested in translating for the team as two of our most fluent translators were leaving, and to her surprise, on Monday morning he landed at the hospital. Volunteerism is not a normal concept for the Chinese but he was so impressed by our team that he got a leave from his normal work and decided to help out.  It is a sentiment seen in other ways as well.  While the team took a few minutes to shop on the mountain, our other tour guide told merchants what we were about. Immediately prices dropped.

We are being treated very well because of what we are doing.  The employees of the hospital are putting in many extra hours, and their impression is that these Americans are upping the work standard and adding a huge amount of energy to the hospital in general.  We are working side by side.  Our orthodontists are teaching the local dentist how to make orbatures (plastic prosthesis that cover the hole in the roof of the mouth when a palate cannot be repaired immediately) and they have promised to follow the patients and make necessary adjustments.

I cannot tell you what admiration I have for the endurance of the surgeons. John Uth commented when observing one of the palate surgeries from beginning to end that it is as if you were performing delicate cutting and suturing at the bottom of a cup.  These docs put in almost 10 hours of surgery with a couple of minutes break for lunch, standing on their feet the whole time, in sweltering heat under the bright lights.  They wear headlamps and have glasses fitted with microscopes.  They are architects, magicians, artists, and humanitarians all in one package.

Today we did surgery on a 32 year old woman with a horrible cleft lip. They want to show her new face tomorrow. I can hardly wait to see her reaction. Our photojournalist, Marianna Fuentes, is a young woman from Mexico.  She has followed a young family whose child has a bilateral cleft lip.  This means that the gums protrude way out with splits on either side.  Yet when you see these babies, you somehow only see their innocence and infant joy.  I stood outside the recovery room when the mother was allowed to come in post surgery. She had patiently stood by the door, not moving, for two and a half hours.  Her love for her baby is seen over and over.  Most heart wrenching are the expressions of the parents as they hand their babies over at the door of the surgical unit.

My "favorite" baby will be operated on tomorrow morning by Dr. David Morewood (aka "Michelangelo").

I fell in love with this child when I went to the ward with my puppet.  At the age of 5 months he kept smiling and laughing whenever I approached him with the toy.  He is total joy and I only hope that the surgery he will have tomorrow will allow him to be joyful his entire life.

I sign off and will report back tomorrow.

Love and thanks to all of you.

Anita

Sent: Wednesday, October 23, 2002 10:37 PM

Dear Friends:  It is Thursday and things are coming to a close -- except that our surgery schedule is expanding as last minute drop-ins arrive.  On Tuesday, Dr. Goldberg said that no more patients would be added to the schedule. However, as always, there are exceptions.  Several young babies with cleft lips for whom the surgery is needed at this time have been added to Friday and other cases adjusted.  You just cannot say "no" to these families who have traveled so many miles with such great hopes.  You see their anxiety in their eyes.

I am closely watching a 12 year old girl who arrived with her father and 7 month old brother.  The mother died when the child was one month old.  The baby has an unrepaired cleft lip and palate.  Although the baby's condition is moving, what is more touching is the way that this little girl, still a child herself, is tending to her brother.  She cuddles him, rocks him, sings to him as gently and carefully as any birth mother.  We are running out of toys because too many were given out in the beginning but I found a panda bear. I gave it to her because I felt that she needed it far more than her brother. She has kept it by her side ever since.  It breaks my heart.

Earlier in the week, a child came in who could not tolerate surgery because of a heart problem.  Frank Yih from the Provisional Shanghai Rotary Club has been a wonderful supporter of Rotaplast and not only housed the entire team both coming and going but also joined us at the site acting as a translator. His club is involved in a Gift of Life program that provides free heart surgery at the local Shanghai hospital.  He made a couple of phone calls, transported the child to Shanghai and surgery will be provided next week.  This is Rotary in action.

On Monday evening we were joined by Dr. Otis Paul for the RotaVision segment of this trip.  His protocol obviously is very different than that of Rotaplast where a large team is normally involved.  Otis has made huge strides in ophthalmology.  On Tuesday, he saw over 60 patients.  Yesterday he operated on 6 and today will operate on 7.  He will be lecturing on Friday.

He is thrilled to work with the Chinese doctors.  The technique he is teaching and the instruments he is donating will allow Dr. Hong-Kui Zhang to perform operations far more quickly than before.  That will not only allow her to help more children but will also improve her status in the hospital.

Otis' work is extremely important to his patients, just as Rotaplast's work is to the cleft patients.  Probably the most moving experience involved a father and his son who needed help with his sight.  Somehow the two came into the recovery area, found Dr. Goldberg (Rotaplast's pediatrician) and knelt down before him begging for surgery for his son, tears running down both their faces.  Otis saw this patient later and through his former student from Taiwan whom he brought along as a colleague explained to the father that the preliminary treatment with a patch to strength muscles, which the father had not realized was necessary, had to be followed in order for surgery to occur. Instead of tears, the man left with smiles and the promise that after he had followed the correct protocol, surgery would be performed by the newly trained Dr. Zhang.  Education of both the father and Dr. Zhang will result in a child being able to see correctly.

Probably one of the most gratifying parts of this mission is seeing the reaction of the Chinese community.  Jiujiang is a small city by Chinese standards (400,000 inhabitants) and extremely provincial.  However, the Chinese doctors and other people with whom we work did look upon the Americans with some uneasiness.  The team has worked very hard to dispel this feeling and build bridges of understanding. I believe that America has taken a step forward in its relationship with China and Rotary may not be such a foreign word or concept.

Anita

Sent: Friday, October 25, 2002 8:54 PM

Subject: Wrap up

Dear Friends:

Today is the final day and clinic.  Surgeries wrapped up with 113 cases being completed.  Value of surgeries to follow.

I gave my seal hand puppet to the little 12 year old girl who was taking care of her baby brother after the mother died.  She was thrilled.  I could not have given it a better home.

I think that everyone here is touched by the program.  Our plastic surgeons have been fantastic.  In a meeting with the hospital administration we learned that last year 60 cleft cases were done at this hospital.  If you consider that one in three hundred children are born with the cleft condition in this area, what this hospital is able to do is a drop in the bucket.  At this meeting Dr. Angelo Capozzi emphasized the fact that we would love to develop more of a teaching program so that these doctors can gain better skills in treating patients.  As it was we had at least one local surgeon and anesthesiologist in each room the entire time.  Several of our docs guided their surgeons in doing some surgeries under close supervision.

Smile Train, which is an organization that funds local doctors about $250 per surgery had a presence last year.  However, the hospital said they preferred our program because of the people to people exchange.  Building friendships and lasting relationships is such an important part of our program, and it is appreciated.  It is always important to remember that although we are volunteers and doing humanitarian work in a country far away, we still are the guests.  We must respect the culture, the traditions, and the life style even though it may be different than ours.  I believe that our team tried very hard, under the leadership of Bill Chiang, to be sensitive and the results were obvious.  As I said in my previous email, I believe that the citizens of this rather provincial town which has had very little contact with Americans, has a much more positive view of what we, as Westerners and Rotarians, are all about.

At the clinic today we are all seeing the final results of our efforts and it is once again very fulfilling.  The children who were operated on in the beginning of our stay are almost healed.  I am awed by the expertise of our plastic surgeons.  But we are also an entire team.  Our anesthesiologists are likewise fabulous experts who deal with difficult anesthesia problems especially in palate cases.  The pediatricians and orthodontists likewise have performed heroically, the pediatricians often from 6:30 a.m. till 8:00 p.m.  There has not been much time for play.  And the nurses -- boy do I respect these professionals.  They are thoroughly competent and make everything run like a smooth machine.  The only break they have had in all these days is when a dressmaker came to the hospital to see if anyone wanted traditional Chinese dresses and outfits made for them.  They took 15 minutes off to quickly look through books and choose fabric.  That was all they time they had off.

Of course, we non-medical Rotarians try to do everything we can to help behind the scenes.  Our translators were really overworked.  They were needed everywhere.  Everyone pitches in wherever they can -- teamwork in action.

I will give a final report at the club and hope you will be there to hear about this fantastic program.  It was great having Otis Paul and RotaVision here as well.  I have learned so much about Otis' program and it is something that our club can take great pride in supporting.

All for now.

Anita

October 31, 2002

Final Overview of the Rotaplast Mission to JiuJiang

My Dear Friends:

There are a few final comments that I would like to make on the Rotaplast mission to JiuJiang. On Friday morning several of us experienced something quite unique. Louise Capozzi, Angelo’s wife who acts as record keeper on these missions, had completed a very early morning walk in the park across from the hotel. She urged several of us to accompany her the next morning. We met at 6:15 a.m. and crossed the street. Upon entering the park we came upon huge groups of people involved in every exercise imaginable. Some groups were performing versions of the martial arts. Some individuals were off in the woods doing Tai Chi on their own. There even was ballroom dancing which we joined for a few minutes when someone asked me to dance. Further on the path was a section where people brought their birds, hanging the cages on branches so that the birds could have a chance to socialize. It was a surprising and unique early morning walk.

Earlier in the week, we again experienced the care and lovingness of the Chinese. The weather had turned unexpectedly damp and chilly, and they were worried that the team members might be cold. The hospital went out and bought sweatshirt jackets for the entire team. A number of us felt badly because the hospital really could not afford to do this but we all ended up in red jackets and a warm feeling, not only outside, but inside as well.

As the day drew towards a close, I made a final visit to the ward. My little puppet friend, that had allowed me to interact with so many of the children, parents, and hospital staff, needed a new home. So I returned to the room of the little 12 year old who had become the primary caregiver for her orphaned brother. He had received surgery and looked just great. I gave her my puppet and also my hope that somehow she will be able to go back to school and have the possibility for a better life.

On Friday evening, we had our final closing celebration. We wanted to include as many of the hospital staff as possible so it was a joint effort between the JiuJiang hospital and Rotaplast. What we did not expect was the wonderful entertainment from the Hospital staff. The traditional music and dance of many provinces were represented and the talent was huge. What was more remarkable was that the participants of this show were all employees of the hospital! We learned that they had practiced their acts till 2:00 a.m. the previous morning. Unfortunately, our efforts at entertainment were clearly pathetic. We did complete a rousing version of "You Are My Sunshine," "God Bless America," and "My Country ‘Tis of Thee." However, the art behind the renditions was somehow missing. I think, though, that the art shown in our surgeries more than made up for our lack of talent in the other area.

Saturday morning was hectic with the closing clinic, final pictures, goodbye hugs and check out. A final series of extremely well attended lectures was given by Dr. Angelo Capozzi, Dr. Majka Tolarova, and Dr. Les Hovey immediately after the clinic.

What surprised all of us was that a number of the hospital staff that traveled the entire hour and a half distance to the airport to see us off there. Any problems were smoothed away, and we were checked in with efficiency. Nine of our team stayed behind for an after trip on the Yangtze River but most of the rest headed for home, a very tired group.

Frank Yih and his wife once again hosted our team overnight in Shanghai and on a crystal clear beautiful fall Sunday, at 9:00 a.m. we departed for San Francisco. We arrived at SFO at 8:00 a.m. Sunday, gaining an hour from the beginning of our journey.

I will miss much: the people of China, especially Dr. Ding, Dr. Yan, Dr. Zhou, Madame Miao, Mr. Shi, Frank and Nancy Yih and all the other kind, generous, loving, inquisitive, and caring individuals we met. I will miss the opportunity to focus for two weeks on helping children and concentrating only on solving problems associated with the mission. I will miss the fabulous team members, their talent, their good will, their kindness and their willingness to help. I will miss the smiles of the children, the trust of the parents, and the feeling that we did make a difference. I want to thank the Rotary Club of San Francisco for making this possible and for helping us let the people of China know of the work of Rotary. I know they were impressed.

Anita

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