Volunteer team brings hope, healing and smiles abroad
By Clifton B. Parker
(SACRAMENTO)
Vicki Bencken recalled the story of a 7-year-old girl in India who was born with a cleft lip and palate – she was often bullied at school and was shy to engage with other students, her family said.
The girl saw a flyer for a free ‘surgery camp’ located about two hours away from her home, and asked her parents if they could go.
Now, thanks to volunteers from Rotaplast International, Sacramento-area Rotary clubs and UC Davis Health – who traveled to Nagamangala, India, in December 2024 to offer free reconstructive surgery – the young girl is all smiles today and enjoying friends and school after a successful surgery.
Bencken, digital communications director in Public Affairs and Marketing, said, “As an employee, I see the impact we have in the greater Sacramento area, but this to me really demonstrated how UC Davis faculty, trainees, staff and alumni have a deep interest in bettering the world. It was truly a moving experience.”
Neal Fleming, M.D., of UC Davis Health with a patient and family members.
Rotaplast – the name is a hybrid of Rotary and plastic surgery – has been working to provide free surgical care to children born with cleft lips and palates as well as burn contracture disorders for the past 32 years. The non-profit group assembles medical volunteer teams to align with local patient and health system needs in countries worldwide. The non-profit group works closely with regional partners to assemble medical volunteer teams aligned with patient backlogs and health system priorities. As Rotaplast provides free surgeries, they work with residents, delivering lectures and shadowing opportunities to strengthen clinical care while showcasing the life-changing power of medical volunteerism.
The most gratifying aspect is when former residents return as faculty and serve as mentors for current residents.”
—Neal Fleming, M.D., recently retired UC Davis Health cardiac anesthesiologist
The Rotaplast volunteer team to Nagamangala included 17 medical and 10 non-clinical volunteers, including five volunteers with ties to UC Davis Health. The medical volunteers included reconstructive plastic surgeons, family practice physicians, anesthesiologists, operating room nurses, post-anesthesia care unit nurses, a Covid safety officer and a burn physical therapist. The entire setting at the Adichunchanagiri Hospital involved three operating rooms, seven surgery days, and many boxes of medical equipment and supplies brought to India by the team.
‘Food for the soul’
Dr. Neal Fleming, a UC Davis Health professor emeritus and cardiac anesthesiologist was on the trip to India. He made his first Rotaplast trip in 1999 and has been on 32 so far. He set up a residency rotation plan for UC Davis Health physicians to join the effort. So far, UC Davis Health anesthesia teams have contributed 101 faculty, 84 residents, and 37 CRNAs to Rotaplast projects throughout the world, he said. In addition, many UC Davis Health volunteers from other specialties have joined Rotaplast teams.
Several UC Davis Health plastic surgeons, including Granger Wong, head of plastic surgery and a former Rotaplast board member, have embarked on the organization’s missions.
Fleming said, “The most gratifying aspect is when former residents return as faculty and serve as mentors for current residents.”
He considers such volunteer service as a responsibility to society. “Rotaplast is a gift. It provides me an opportunity to return the blessings I have received and to make a difference in our world.”
He noted that currently, deep concerns exist about physician burnout in the medical profession. “The daily demands on our time for tasks so tangential to patient care can wear us down and take a toll on our psyche. Rotaplast strips all of that away and takes you back to simple, direct patient care with tangible outcomes. It is food for the soul.”
A young patient and his father before undergoing burn contracture treatment.
Fleming has witnessed many cases of Rotaplast changing lives.
“There was a boy in Peru who just happened to go with his dad to sell pottery and was pointed to our clinic by someone in the stall next to him at the bazaar. There was a young girl in Guatemala whose parents finally registered her birth after we repaired her facial cleft. And, there was the smile on the grandmother who had never been kissed until after we repaired her cleft,” he said.
He notes an encouraging evolution of sorts in the Rotaplast mission.
“There is a need for us to shift from just service to professional education. On this trip, for every case, there was both a senior and a junior anesthesiology resident from Adichunchanagiri University who worked with me. We constantly exchanged ideas and insights into our practices in our own hospitals as we worked together. The current chief of the plastic surgery department at this hospital worked with Rotaplast as a resident. This is our future,” Fleming said.
Mia Christina Wright, M.D. of UC Davis Health in a check-up with a patient and family members.
At the Nagamangala mission, 80 patients attended pre-clinic appointments with a nurse, pediatrician, surgeon, anesthesiologist, or burn physical therapist. Fleming and the Rotaplast volunteers performed surgery on 49 patients and 68 surgical procedures in total on a variety of conditions – burn scars, cleft lips, cleft palates, and noses, among others.
Cleft lip and cleft palate are birth defects that occur when a baby's lip or mouth don't form properly. The percentage of children born with cleft lips and palates in developing countries is generally higher than in developed nations, with estimates ranging from 1 in 500 to 1 in 600 live births, compared to about 1 in 1,050 in the United States. In developing countries, poverty and lack of prenatal care can increase the risk of cleft lip and palate.
Missions of empathy
Dr. Mia Christina Wright, an associate physician in family and community medicine who volunteered for the India trip, said the Rotaplast project shows how medical teams, residents and volunteers are committed to service, connection, and education.
“Rotaplast missions require you to put your own needs aside, whether it’s accommodations or food selection or shower access. It shows that anyone who participates in these missions is capable of great empathy and cares deeply about others outside of their immediate world. I am honored and privileged to be able to work with this organization, and I look forward to more missions in the future,” she said.
Wright described a few highlights from the December 2024 mission: “The first was getting to witness the medical prowess of our anesthesia team as they cared for a critically ill patient. Their teamwork, communication, and equanimity were truly remarkable. What made this experience even more meaningful was that I had come to know these providers as individuals, each with their own set of hardships. In the moment, however, it was clear that all that mattered was the patient.”
Residents gather from Rotoplast's "Global Scholars" Educational program.
The camaraderie with the hospital's residents enrolled in Rotaplast's "Global Scholars" Educational program was also noteworthy, she said. “One evening, they took us to a local favorite restaurant and ordered a variety of dishes for us to try. The food was incredible, the company was lovely and there may even have been a bit of dancing.”
Wright learned about Rotaplast through her teacher and faculty mentor during her residency in Spokane, Wash. Her first trip was as a resident on a Rotaplast mission in Monterrey, Mexico – today she speaks about the “amazing people who I have met through it.”
It is fundamentally about using a broad set of medical skills to serve those who lack access to essential care, she said. “I also find great meaning and fulfillment in the relationships I build with my fellow colleagues, who share the same passion, and the patients themselves, whose resilience and gratitude inspire me to continue this work.”
UC commitment to public service
Dr. Jeffrey Tully, a former UC Davis Health anesthesiologist who recently joined UC San Diego, said the most profound moment of the mission for him occurred during a ceremony on their last full day in Nagamangala. That’s when local community leaders, hospital administrators, and physicians shared the mission's results with the community.
Members of the volunteer team, hospital staff and patients' family members during the Rotaplast mission in December 2024.
“As a part of this event,” he said, “there was an opportunity for some of our patients and their families to share what it meant to be able to receive care from our team, and it was very touching to witness. Even though we didn’t understand the language, their heartfelt gratitude and happiness was readily apparent.”
One father shared that his family was previously embarrassed to have their baby with a lip defect be seen in public, and this communal event was the first time they had been happy to have the child out amongst strangers, Tully said.
Tully, who trained under Fleming during his residency at UC Davis, noted that the University of California emphasizes service in one’s community as a responsibility of faculty and staff.
“Through the efforts of Dr. Neal Fleming, dozens of anesthesiology residents over years have been able to serve community in its most global sense through Rotaplast experiences,” he said.
Tully recalled his first Rotaplast trip (also to India) in 2020. “It was a very rewarding experience in which I gained perspective working in a different clinical environment while providing service to amazing people. I have since been on missions to Mexico and Egypt before returning to India for this trip and have found each mission to be uniquely special and fulfilling,” he added.
Since the group returned from India in December, Fleming and another team of two anesthesia residents, an OR nurse and Rotaplast volunteers have gone to Bangladesh on another mission.
Rotaplast’s mission is not only to perform needed surgeries, but also to help train and educate residents from local universities and hospitals. Through their global scholars program, they present lectures on key topics and residents shadow them as they work, strengthening the clinical care they will offer in the future.
‘Profound impact’
Rotaplast was founded in 1992 by Dr. Angelo Capozzi and the then-Rotary Club President Peter Lagarias in collaboration with the Rotary Club of San Francisco to facilitate a surgical program in La Serena, Chile, to treat children with cleft lip and palate anomalies who would otherwise not receive surgical intervention. This initial mission took place in January 1993. Since then, it has expanded to offer reconstructive surgeries to adults and children worldwide.
Fleming said UC Davis Health’s “volunteer roots run deep.”
It epitomizes the 'Believe in Better' campaign that highlights how all of us can do something to change lives.”—Vicki Bencken, digital communications director, Public Affairs and Marketing
It is not only anesthesiologists, he said, but also surgeons, surgical residents, OR nurses and PACU nurses who have all given their time and skills to support the Rotaplast team and the patients they care for.
“Volunteers use personal vacation time to work with Rotaplast. For the anesthesiology residents, it has such a profound impact on their practice (faculty frequently comment how a resident has changed and matured dramatically after a Rotaplast trip) that I was able to convince our residency program director to award clinical credit for the time a resident spends with Rotaplast,” Fleming said.
Because residents are the future of Rotaplast volunteers, he added, he convinced Rotaplast to automatically schedule a UC Davis faculty member and UC Davis resident pair to be part of each scheduled Rotaplast team.
‘Believe in Better’
Bencken, who served as the historian for the December mission, said the fact that the patients who received treatment do not have many options or access to medical care makes it all the more special that UC Davis Health is involved in such a global effort. The group provided almost $400,000 in free medical care at the Adichunchanagiri University hospital.
The Adichunchanagiri Hospital in Nagamangala, India.
Bencken described the teamwork among the volunteers as exceptional.
“The team was so supportive and encouraging of each other, collaborative, and it was very heartwarming. It epitomizes the 'Believe in Better' campaign that highlights how all of us can do something to change lives.”
That initiative notes, “At UC Davis Health, we believe the ability to live a healthy life should be enjoyed by every person. That’s why we’re committed to inspiring better health for all, not just our patients.”
