Ten years ago, Dr. Reza Jarrahy made his first trip to Guatemala with a team of doctors.
A civil war had recently ended in the country, and the team set up operating rooms inside vacated military barracks. The doctors brought all of their equipment, including two anesthesia machines, in an 18-wheeler.
But patients were not lining up for treatment, as they usually did on trips such as this one. The team soon learned that its modified hospital was formerly a site where militia had brought men and women to be killed.
With persistence, though, the doctors earned the trust of the community. By the end of the week, parents crowded by the hundreds outside of the screening center, holding up their children for consideration, just as the team had to return home.
When Jarrahy, a plastic surgeon and UCLA assistant professor, returned to Guatemala earlier this month, the trip was not just about surgery. It was his third visit to the country and one of four or five weeklong overseas excursions he takes each year.
Instead of military barracks, he visited the homes of three Mayan families.
The families live in small one- or two-room huts, often without running water. Most of them can afford to eat only tortillas, which they cook in open fires in the middle of the huts. Their homes fill with smoke, and with as many as 19 people living together, it’s not uncommon for children to fall into the flames.
“The walls were dark because of the burning flames, and the soot that was in the air,” said Dr. Noah Siegel, leader of Jarrahy’s group. “It’s astounding that people live that way.”
The team of doctors, working for the nongovernmental organization Mayan Families, spent its first day in Guatemala building a simple ceramic stove in each of those three homes. The stoves cost $15 and take around 20 minutes to construct.
“Invariably the women … all broke down in tears and said for the first time in as many years as they could remember, they were going to be able to make tortillas that didn’t taste like dirt and ash,” Jarrahy said.
The group then moved to a hospital inside an old church in Antigua. Jarrahy spent 10 to 12 hours a day treating congenital deformities including cleft lips, cleft palate and microtia, which results in an underdeveloped outer ear. Although the consequences of those conditions are largely aesthetic, in an economically disadvantaged society that still uses dowries, fixing facial abnormalities is crucial.
“If a young girl has a cleft lip or a cleft palate that’s not repaired, well, she’s not the marrying type,” Jarrahy said. “It’s a tough life, as you might imagine, and you can do a one-hour surgery and completely reverse that.”
Yet Jarrahy said kids in economically disadvantaged regions still reflect all the joys of childhood.
“All these kids I interact with, especially the ones I got to meet in their homes, they don’t care that they’re among the poorest kids on earth,” Jarrahy said. “They just want to play soccer and run around and fight with their siblings, and that reinforces the notion of the universal innocence of children.”
Dr. Jennifer Kim, a facial plastic surgeon at the University of Michigan, accompanied Jarrahy and Siegel on the trip. She has been close friends with Jarrahy since they were medical students at the State University of New York at Stony Brook. Kim said that despite living in starkly different conditions, Guatemalan children dealt with surprisingly familiar issues.
“It doesn’t matter where you come from or what your surroundings are ““ the kids will still be kids,” Kim said. “I think (having a facial deformity) totally affects their self-esteem and their social development.”
The connection between plastic surgery and self-esteem is one familiar to Jarrahy, who performs cosmetic procedures as well as reconstructive ones in his practice at UCLA. He said the media attention given to Heidi Montag and game shows such as “Bridalplasty,” in which women compete to receive plastic surgery, tags his profession with an unfortunate reputation.
Jarrahy said he doesn’t agree with people who consider cosmetic surgery to be frivolous.
“I don’t judge (prospective patients) because they’re focused on something that’s more superficial,” Jarrahy said.
Reconstructive and cosmetic surgeries are more similar than many people think, he said. Both involve moving features on the face, and the clefts he fixes are not life-threatening complications.
The scope of problems affecting the families he visited, though, extends far beyond facial deformities. Jarrahy said the Guatemalan government is highly corrupt, and Siegel said there are very few medical specialists operating in the area.
The Mayan Families organization sends 50 teams of doctors to the hospital in Antigua each year, and Jarrahy said he will return with his group next year.
At UCLA, Jarrahy conducts research in tissue engineering and teaches in addition to working at the hospital. But in the U.S., he said, the relatively simple cleft lip and palate surgeries cost thousands of dollars in hospital charges and insurance fees. Jarrahy was drawn to overseas philanthropic work even as a medical student, since trips with groups such as Mayan Families allow him to have a much broader impact as a surgeon.
“It reminds me of the beauty of surgery, how pure surgery is and why I went into surgery in the first place,” Jarrahy said. “Here’s a patient with a surgical problem ““ if the patient’s a good candidate, and you can do the operation safely … you do it. … That should be surgery in a nutshell, no matter where in the world you’re practicing.”