Helping hands: International Health Specialist program opens doors for medical professionals to better serve around the world

Citizen Airman, April, 2004 by Bo Joyner

Air Force medical specialists involved in humanitarian missions around the world treat thousands of needy patients every year. Occasionally, they encounter a patient who really touches their heart. For Col. (Dr.) David Snell, Sorn Sokhon, who goes by the nickname Son Sin, was one of those patients.

When 9-year-old Son and his father, Khan Sang, heard that a group of American military doctors was treating land mine victims and others at a small hospital in Phnom Penh in March 2002, they made the two-day trip from their remote fishing village in the northeast corner of Cambodia to the capital city in the hope that something could be done for the youngster.

The quiet boy was not a casualty of war but an innocent victim of a congenital birth defect that profoundly disfigured his face. The medical term is naso ethmoid encephalocele--a rare condition that left Son with a large, compressible mass in the middle of his face.

Dr. Snell, who serves as chief of aerospace medicine for the Air Force Reserve's 452nd Aerospace Medicine Squadron, March Air Reserve Base, Calif., was a member of the medical team visiting Cambodia as part of the Air Force's International Health Specialist program.

The doctor was immediately touched by the boy's plight but knew his team didn't have the capability to do anything for him.

"It was inspiring that this father would take a two-day boat trip just on the slight chance that a group of American military doctors could help his son," Dr. Snell said. "We saw him for 30 minutes, and then he went back to his village. However, I had worked with organizations before that did this kind of work and thought I could find support for his necessary operation."

Dr. Snell knew local hospitals lacked the expertise and facilities to deal with the boy's condition, so he began working with Interplast, Operation Smile and other nonprofit reconstructive surgery organizations to search nearby Asian countries to see if any would be willing to help. Although there were many doctors and facilities capable of helping young Son, they were not willing to do so for free, and the boy's family didn't have the money to pay for the expensive procedure.

Undeterred, Dr. Snell launched an e-mail and telephone campaign in the United States to locate pediatric plastic surgeons, anesthesiologists, nurses and operating facilities willing to donate their services to help the boy.

Amazingly, he found his answer 18 months later--just 30 miles from his home.

Fresh Start Surgical Gifts of Encinitas, Calif., is an organization that funds and delivers reconstructive surgery and related medical services for children in the United States and throughout the world. When the organization heard about Son's plight, it eagerly volunteered to help. Two specialists at Children's Hospital and Health Center in San Diego--Dr. Hal Meltzer, a pediatric neurosurgeon, and Dr. Steve Cohen, a plastic surgeon specializing in craniofacial surgery--signed up to perform the delicate surgery.

Son, his father and Dr. Sar Vuthy, a surgeon from Angkor Hospital for Children in Cambodia, arrived in the United States Oct. 26. Surgery to remove the growth on his face was scheduled for the following week.

However, doctors quickly discovered that the youngster had a chronically infected right lung that needed antibiotic treatment and surgery to remove the infected, scarred portions. That surgery took place Dec. 1. A second surgery, to place a plastic shunt that runs from his head to his abdomen to drain excessive spinal fluid, took place Dec. 22.

Finally, on Jan. 6, more than two months after he arrived in the United States, Son underwent 6 1/2 hours of surgery to repair his facial defect. After the surgery, he had to spend 24 hours in the intensive care unit and another two days in the hospital before returning to Dr. Snell's house for further recovery. Son and his father stayed at the Snell house during their entire visit to the United States. Dr. Vuthy had to return to Cambodia early in December.

With a new lease on a normal life, Son and his father were scheduled to head back to Cambodia in February.

"His prognosis is good," Dr. Snell said. "He won't ever have normal exercise capability because of the damaged lung, and there will be a very small chance of infection of the shunt, but he should be able to live a relatively normal life after his return."

Dr. Snell is a big fan of the International Health Specialist program.

"It is exceptional in that it is a real opportunity for medical personnel to go out of the box and work, not only medical treatment issues, but diplomatic, cultural and military ones," he said .

Lt. Gen. Paul K. Carlton Jr., Air Force surgeon general at the time, initiated the IHS program in 1999. He thought humanitarian assistance and disaster response missions would go more smoothly if the military members deploying knew more about the country they were traveling to and its language.

The IHS program helps the Air Force medical community identify those people with specialized language or cultural skills and provides a database of medics with capabilities tailored for specific missions.