Putting Smiles on Faces

by Briar McMahon / 25 December, 2004

Judy Forbes usually has her hand up, but seldom her feet. The Christchurch-based anaesthetist spends months of each year on voluntary medical service, paid and unpaid, and sees little of the new home on the Port Hills she and her husband Bill Abrams have recently built.

Energetic Dr Forbes (54) volunteers her services for rural work in New Zealand, the Flying Doctor service in outback Australia, plus a month each at the Arctic and Antarctic as Medical Director for Polar Star Expeditions, and has served in East Timor with the UN peacekeeping emergency response team. Also, twice a year she joins a medical team with Interplast, which was founded in 1969 by the Stanford University School of Medicine, of which Forbes is a graduate.

"There is a critical shortage of anaesthetists everywhere," Forbes says. "Most under-developed countries don't have enough -doctors. For instance, Bolivia has a population of over eight million, but only eight anaesthetists. In comparison, -Christchurch has more than 50. In Bangladesh, there is a high number of medical schools and doctors, but people are so poor they can't afford to pay. -Student doctors in Myanmar earn only $8 a month, so many drive taxis to earn a living."

Interplast maintains no political or religious affiliations. However, Forbes is critical of some regimes. She went to Bangladesh with Sally Langley, a plastic, reconstruction and hand surgeon with whom she has worked for nearly 20 years. Forbes says, "Our patients were mostly boys, aged five to 10, needing hand surgery. These boys have to work for a living, but sustain injuries because of the lack of industrial standards. They couldn't use their hands to continue working, or even to feed themselves." Forbes blames faulty government. "In Bangladesh there are 23,000 non-governmental organisations, mostly funded by First World countries. Only half the women are educated. A woman may be maimed or killed if her dowry is considered not enough. Bangladesh has two women in the elected government, yet they have achieved nothing to improve conditions for women, or address the infant mortality rate, which is the highest in the world."

Forbes is frustrated, but not daunted. There is only one country to which she will probably not return. Myanmar, formerly Burma, has a military dictatorship. After the medical team left, she stayed on for a week and travelled through the country. At Inle Lake, Forbes had a chance encounter with Daw Aung San Suu Kyi, the leader of the main opposition party, the National League for Democracy, who was freed last May after 20 years under house arrest. Aung San Suu Kyi disapproves of foreign help. "Any help given helps the regime," she told Forbes. Forbes says, "This gave me my greatest personal dilemma." She decided not to go back.

Language is never a problem. Interplast teams include an interpreter, but away from the main centres often a local dialect is spoken. Communication is minimal. "'Hello, how are you?' 'Are you having pain?' 'Take a deep breath' and 'Open your eyes' - I learn these in the first week. That's it. I need to know if the patient has pain. We do a lot of regional anaesthesia and I must know if the block is working, if the needle is in the right place. A lot of medical centres don't have post-operative narcotics for pain relief."

Forbes learns from every place she visits and she enjoys the people. "Bolivians are the most unspoilt people in South America. Proud, reserved, lovely." It always amazes her how parents will hand over their little baby, their most precious thing, to a stranger. "Even with severe cases of cleft lips and palate, after the operation the child immediately looks normal. Seeing the parent's joy is a very humbling experience."

Cleft lip and cleft palate are among the most common congenital deformities worldwide, affecting an estimated one in 600 newborns. In developing countries everyday tasks such as cooking over open fires, using kerosene lamps or working with farm tools and equipment also often cause terrible injuries.

The Interplast teams know that the people appreciate their work. "They will wait for hours, walk for days, sleep in the streets in some of these countries to wait for us." With this incentive, Dr Judy Forbes will continue to be everywhere but here. She is busy helping to put smiles on faces.

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