Help on the way

Deepa Bharath

Chapter 1

The road to Macas

Yu Pirush’s voice was pitched like the soft gurgle of the

Kahlua-colored river that flows through his neighborhood in the deep

Amazon.

The Achuar Indian’s caramel skin wrinkled up like leather when he

smiled and his wild black hair with streaks of gray rested

reluctantly on his shoulders as he spoke the language of his tribe.

For two months, Pirush had waited in Macas, a little town on the

edge of Ecuador’s rainforest.

Home, for Pirush, is far, far away -- a 20-day trek through the

thick wilderness or an hour’s journey in a bush plane.

He had waited in Macas for the “North American doctors” to rescue

him.

He wanted to show them the hole in his hand.

When Pirush peeled off the bandage that covered his mangled hand,

the air filled with the stench of his pain. The back of his hand,

missing most of its skin, looked like a cage of bones rent by disease

and infection. It looked like a poster for a horror movie.

Two yellowing bones stuck out, exposing a mushy, decaying wound --

an agony that remains for Pirush after a snake bit him in the jungle

more than five months ago.

His fingers were stiff like cardboard and he held out his hand

almost as if someone had ripped it out and then hastily glued it back

on.

“Just put some flesh on the hole,” he said, repeatedly, in his

native tongue.

Pirush had hoped that Newport Beach plastic surgeon Larry Nichter

and his team of doctors and nurses from Hoag Memorial Hospital

Presbyterian could work their magic on his traumatized hand.

One of many in need

Pirush wasn’t the only one with that hope. When the seven-member

team from the Plasticos Foundation arrived at the hospital in Macas

that afternoon in August, more than 200 people waited in the dimly

lighted corridor.

The team of medical professionals from the Huntington Beach-based

nonprofit -- consisting of one plastic surgeon, one general surgeon,

three nurses and two coordinators -- had traveled for almost a day to

get to Macas. It was a long and arduous journey. But the plane trip

was like a drive to the neighborhood supermarket compared to what

they had to achieve in a week’s time.

They were on a mission to help as many people as they possibly

could, to cure as many helpless people as the laws of science and

medicine would allow. They would have to dig deep into their

collective experience and stretch the boundaries of their knowledge.

They would need to improvise, think quickly and explore untapped

resources.

In anticipation, the team had packed in an entire operation

theater into 14 large red suitcases embroidered with the foundation’s

logo on them. They even brought along a portable anesthesia machine,

just in case.

Team members lugged the heavy bags through domestic and

international airports and waited in lines for hours before reaching

their destination -- the picturesque town nestled in the rambling

folds of the Amazonian rainforest.

As the bus that carried the team screeched to a stop outside --

kicking dust off the streets -- hopeful eyes including Pirush’s

peered out.

The waiting room

They packed the hospital’s 20-foot-by-5-foot corridor. Those who

couldn’t fit flowed out into the halls and outside the doors. They

waited, leaning against flaked and peeling lime-green walls, their

feet planted firmly on the dull, mosaic floor.

Waiting in that line was a boy so badly burned that his face

looked like a melted rubber mask, a man whose fingers were

incapacitated by a jungle machete, a woman whose angry husband had

bitten off a chunk of her nose in a drunken rage and a little girl

who was born with her two middle fingers fused together.

For about seven hours that day, Nichter and Newport Beach general

surgeon Robert Burns screened more than 70 patients. Several had to

be turned away at the door because their problem was not plastic

surgery-related.

“We’re only trying to do surgeries no other surgeons can do here,”

Nichter said. “We’re trying to do surgery on people with functional

problems, not cosmetic problems. We don’t have a whole lot of time.

We need to prioritize.”

For the doctors, the crowd was overwhelming.

“As fast as they come in, they keep filling up the hall,” Burns

said, shaking his head, as he looked at the bulging corridor.

“This is a lot more patients than I see in months in my office

back home,” Nichter said.

The team had less than a week to perform about 50 complex

surgeries, many of which involved several surgical procedures.

“It’s sad that all these people came from far off places,” Nichter

said. “But the truth is we can’t help everyone.”

The pain of rejection

Among those who returned disappointed was Shiki Chumpu, a

48-year-old farmer who walked for three days and then waited five

hours only to take a seven-hour bus ride to get to Macas. He came all

the way from Tumbaem, a jungle community of about 33 Shuar Indian

families.

Chumpu couldn’t bend the fingers of his right hand. He depends on

that hand to use the machete, to plow the soil, plant corn and milk

his cow. He said that months ago, a snake about 9 feet long bit him

on the hand when he was climbing a tree looking for construction

wood.

“We won’t be able to help him,” Nichter said after the examination

that lasted about a minute.

The muscles of Chumpu’s arm had died, the surgeon said.

Chumpu mostly spoke Shuar, but he seemed to understand the gist of

what Nichter was saying. He had made a harrowing journey across the

jungle for days only to meet more hopelessness on the other side.

There were others like Chumpu in the dark, damp alcoves of the

jungle, who lacked the means to cross the formidable forest that

surrounds their little bamboo huts.

So Nichter and his team decided to head out to at least two of

those communities. After a day of screening patients who flocked to

the hospital, they were going to hold clinics to select patients who

couldn’t make it to Macas.

It was time to head deep into the jungle.