Plastic Surgery on the Inca Trail

Today I got back from a 12 day trip to Peru, including a 4-day hike along the Inca trail, between Ollantaytambo and Macchu Picchu.  In one small village (actually about 3 houses) of native Quechua Indians where our groups of trekkers stopped to have lunch, there was a little girl of about 4 years old running around and being a normal mischievous 4-year old.  I noticed that she had a bilateral cleft lip repair.  From a surgical standpoint, it was a very nice result, and the only other person in our group that even noticed, other than me, was a surgery resident from New Zealand. 

I asked the mother if she remembered who did the surgery, and where.   She said it was done in Cusco, by an "extranjero" - a foreigner.  There are many groups from the US and other countries, who venture to far flung locations to provide plastic surgery to persons who otherwise would suffer from the stigma and functional difficulties posed by congenital defects such as cleft lip and palate.  These groups also often provide training to local surgeons to allow them to continue on with the care, or to perfom the surgery themselves.  With cleft lip and palate in particular, the standard of care in the developed world is usually a multi-disciplined approach, as the patient often benefits from staged surgeries, with adjunct specialties such as speech therapy and dentistry involved.  In the third world, this is often not possible, so visiting groups do the best they can with limited resources.  Usually these resources are privately donated, and the surgeons work for free, paying their own way as well.

We are lucky to live in a free and prosperous society where sophisticated medical and surgical care is taken for granted.  Those who live in less developed areas of the world also benefit from our freedom and prosperity, which allow voluntary donations of time and money to help where otherwise help would be unavailable.

Douglas J. Mackenzie, M.D., F.A.C.S.

Santa Barbara, CA