First Person: Mission to Vietnam
First Person is an occasional series, providing firsthand accounts of outreach programs involving our McGovern Medical School community.
I co-founded Nuoy Reconstructive International, a 501 (c) 3 nonprofit in 2020 in order to provide a comprehensive international medical engagement with clinical cases, lectures and education, and research development in Vietnam. This program was founded on a rebranding of R.I.C.E. (Reconstructive International Cooperation Exchange), which was started by Dr. Joseph Rosen, a plastic surgeon from Dartmouth who has been going to Vietnam since 2000. We are expanding this reach, focusing on building surgical capacity by enhancing experience and knowledge in complex reconstructive surgery with long-term partners and also developing more formalized education and research initiatives.
From March 3-17, we traveled to Vietnam and worked with Vietnam National Children’s Hospital (VNCH) (a 2,500-bed children’s hospital that is the national tertiary referral center), Viet Duc Hospital (the busiest trauma hospital in the country), Hong Ngoc Hospital (a large private hospital), and Bach Mai Hospital. Our group of 25 volunteers was comprised of surgeons, nurses, residents, students, and Nuoy operational/administrative personnel, including Dr. Paul Clark (chief resident, Plastic Surgery), Dr. Maria Matuszczak (chief of Pediatric Anesthesiology), Allison Seitz (MS4), and Huan Nguyen (MS4).
We performed complex craniofacial surgery, including intracranial surgery, microtia (ear reconstruction), hand surgery (pollicization or making a new thumb), microsurgery with free tissue transfer, and removal of tumors side by side with our Vietnamese partners. The purpose of the trip is to continue providing multi-faceted clinical training, as well as education, in order for our Vietnamese partners to provide these procedures for their patients on their own. The work is done through our departmental global surgery program under the umbrella of the McGovern Center for Global Health, and we have a signed MOU with VNCH as well as Hong Ngoc.
Personally, I felt that this trip made a big step in a few domains. I have seen the evolution in a short 5-year period of the plastic surgery department at VNCH go from nascent understanding of craniofacial pathology to now being able to perform the majority of the nonsyndromic intracranial surgeries independently. This trip was focused on developing nuances of advanced level surgical procedures, such as a Lefort III distraction for patients with midface hypoplasia. In addition, we have now written two manuscripts with our partners for publication in the English-language international journals with the goal of shining a larger spotlight on the experience of our partners to the international community. Publishing in the English language is a hurdle for many of our colleagues, and we hope that we are able to assist in facilitating this development.
In addition, all faculty in our group (including Dr. Maria Matuszczak, chief of pediatric anesthesia at UTHealth Houston, and plastic surgery faculty from the University of Wisconsin, Brown University, the University of Pittsburgh, and Wake Forest University) delivered a daylong seminar series with over 100 participants at Vietnam National University in Hanoi.
This is building upon our first foray into delivering large-scale education. In September 2022, I chaired the first American Society of Maxillofacial Surgeons craniomaxillofacial course in Asia, which was held at Hong Ngoc hospital in Hanoi. Nearly 200 participants from all over the country came to learn and participate in a three-day series of lectures, hands-on plating lab exercises, and live surgeries. We intend to continue incorporating and expanding our educational endeavors in future trips. We go back each March, with likely expansion into a fall trip and a spring trip as our group and scope expands.
Our team also had learning opportunities. Fourth-year medical school student Huan T. Nguyen reports: “During the trip, I assisted in complex craniofacial and pediatric reconstructive cases. I was mainly at the Vietnam National Children’s Hospital and operated on patients with diagnosed with microtia and craniosynostosis. In addition, as a native Vietnamese speaker, I helped translate to facilitate education in the OR. Furthermore, I worked with the head surgeon at the hospital to write a manuscript regarding outcomes of Mandibular Distraction Osteogenesis in patients with Pierre Robin Sequence that will be submitted soon to PRS Global Open. This was my second medical trip to Vietnam but my first surgical one. The most memorable experience I had on this trip was seeing the patients’ families overjoyed and grateful after the surgeries. In addition, it was great establishing connections with the surgeons at the hospitals. While there were a lot of things they did the same as over here, there were many different protocols they used to make the operation run more efficiently. During this trip I found out I matched into an integrated plastic surgery residency. Once I finish, I would love to come back every year and do what I can to help out.”
Chief plastic surgery resident Dr. Paul Clark added: “I assisted and performed complex surgeries, including microtia reconstruction, nerve transfers for brachial plexus injuries, and index pollicization for a congenitally absent thumb. This was my first mission trip and, in fact, my first time visiting Vietnam.
The food was incredible, but overall I’d say what was most memorable was the amazing people — both the surgeons and residents I met from other programs as well as the Vietnamese surgeons/patients we worked with. The Vietnamese surgeons were highly skilled and humble, and it was a pleasure to work with them. I do not speak a word of Vietnamese, and many of them spoke very limited English. However, the language of surgery is universal and just taking a moment to recognize that once our gloved hands were in the field playing the instruments, language barriers were broken. We all understood the movements, tune/flow of surgery, and how to interact with anatomy even though we come from such different backgrounds and cultures; it was beautiful. I feel like we learned just as much from them as they learned from us and the ultimate beneficiaries/purpose of it all, the patients, received excellent care that they would otherwise not have received. I would love to return to Vietnam both for mission work as well as to visit/explore with my wife and children. It was an amazing experience and opportunity for growth as a surgeon and a human.”
Fourth-year medical student Allison Seitz: “Volunteering with Nuoy Reconstructive International was my first surgical mission trip and my first-time visiting Vietnam. Having the opportunity to experience the multiple different hospitals in Hanoi and working with these highly skilled Vietnamese surgeons and trainees was extremely rewarding. I had the unique opportunity to assist in the first microsurgical free flap case ever performed at Hong Ngoc Hospital. In addition to this surgery, I also assisted in several other complex reconstructive cases, as well as presented research at a seminar with our Vietnamese colleagues regarding new microsurgical training methods for surgical residents. In the future, we hope to return to Hanoi and facilitate a microsurgery training course at the local hospitals. Ultimately, my two-week experience in Vietnam was profoundly impactful — being able to immerse myself in Vietnamese culture, experiencing the operating room from a different perspective, and developing lifelong international colleagues and friends are memories that I will not soon forget. I am immensely grateful to have had the opportunity to take part in Nuoy Reconstructive International, and I hope to one day return to Vietnam.”
For Matuszczak, this was her first time to Vietnam and first time working with Nuoy Reconstructive International. “The goal of my participation in this mission was to establish a relationship with the team of pediatric anesthesiologists working in the different hospitals. I was impressed by the quality of care they provide to these syndromic and sick children, all this with limited access to devices that we consider standard in the Western world. I was received with incredible hospitality. The willingness to learn, to understand different approaches, to see how pediatric anesthesia management can be done differently was, and is, incredible. During the daylong seminar series at the Vietnam National University in Hanoi, I presented a lecture concerning the pediatric difficult airway, a most important pediatric anesthesia topic, especially for pediatric reconstructive surgery cases. As Dr. Nguyen mentioned, the most important mission here is to share knowledge not to go someplace provide anesthesia/surgery and then go home. My commitment is to teaching pediatric anesthesia, as of today there is no formal pediatric anesthesia training in Vietnam. In Hanoi, I started a Zoom lecture series that I have continued back in Houston. The plan is to have a monthly Zoom lecture with pediatric anesthesia topics. During my first Zoom lecture, 187 anesthesiologists from all over Vietnam joined. I am thankful to the Vietnamese pediatric anesthesiologist Dr. Hang Nguyen for helping to organize the Zoom lectures, and for Dr. Thao Giang to patiently translate every word I say. I hope that my Houston pediatric anesthesiology colleagues will join in this endeavor. I am very grateful to Dr. Nguyen and the Nuoy team to have been given the opportunity to participate in this mission.”
ABOUT THE AUTHOR
Phuong D. Nguyen, MD, is associate professor of surgery, chief of pediatric plastic surgery, director of craniofacial surgery, and associate program director, Division of Plastic Surgery.