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EDITORIALS/REVIEWS/LETTERS AND VIEWPOINTS: LETTERS

Humanitarian Missions in the Third World

Reply

Dupuis, Christian C. M.D.

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Plastic and Reconstructive Surgery: March 2006 - Volume 117 - Issue 3 - p 1041
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Sir:

Dr. Robinson has written beautifully with all his heart about his personal commitment to the people of Honduras by working in a small local hospital. Everything he writes touches a chord in me, and I agree with him on all counts. It is true that Bermudez-like plastic surgeons are not many in the Third World. Over 35 years, I have met a few in Southeast Asia. I cherish them and do my best to give them full support.

A well-known French plastic surgeon who accompanied me in Myanmar in 2001 told me that of the about 250 foreign residents and fellows from the Third World he had trained over the years in his department, fewer than 5 percent are now working in public hospitals. All the others are working in private hospitals.

It raises the question of our scholarship system for foreign surgeons whose interest in coming to our wealthy Western countries remains broadly limited to learning cosmetic surgery.

As a corollary, how can we, if our experience abroad is limited to joining large humanitarian teams bound to operate on the maximum number of patients to justify the cost of the mission abroad, evaluate who among the local surgeons are worthy of receiving a scholarship to visit and learn in our departments? How many of us have truly followed Dr. Robinson's example?

I remain persuaded that, if we put aside the countries where, because of local circumstances, we can only think of substitution endeavors, our aim ought to be to train local surgeons with humility, accepting all the limitations of their environment, and, because we go alone or in minimal teams, devote the funds that have been saved to helping the counterparts we have found involved in the treatment of their own poor people to establish their own units. Here I have to mention the Smile Train Foundation, which is focused on supporting these surgeons and allowing them to broaden their actions.

It is because of surgeons like Dr. Robinson, Dr. Bermudez, and the surgeons I work with in Southeast Asia, including Dr. Pham Dang Nhat, in Huê, Vietnam, Dr. Keutmy Khansoulivong, in Vientiane, Laos, and Dr. Khin Maung Zaw, in Sagaing, Myanmar, to name just a few, that the world is truly better off. Thank you Dr. Robinson.

Christian C. Dupuis, M.D.

Avenue Louis Jasmin, 297, Brussels, Belgium 1150, cc_mc_dupuis@skynet.be

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