Saving face

 

 

Illustration by Dongyun Lee

Angelo Capozzi is transforming children around the world one cleft palate at a time.

A s medical director and cofounder of Rotaplast, I consider myself a fortunate man. When you’re repairing a child’s cleft lip and palate and you put the last stitch in, you get to stand back and look at the results and say, “Wow, I made a difference for that kid.” I’ll tell you, there’s no reward like that.

Partnering with Rotary clubs over the last 17 years, we’ve performed well over 13,000 cleft lip and palate operations on children around the world. It’s the Rotary connection that gives us our name. I joined the Rotary Club of San Francisco in 1971, after I set up my private practice as a plastic surgeon.

For the first few years, I wasn’t really a Rotarian; I was a guy who came to lunch. I donated money, I took part in activities, but I wasn’t completely living The Four-Way Test. Then came a seminal moment. Don Laub, former chief of plastic surgery at the Stanford University School of Medicine, had started Interplast, doing free reconstructive surgeries in developing regions, and asked me to join his team as a medical volunteer.

We went to Mexicali, Mexico, for a long weekend in 1976. We were operating under difficult conditions, but I realized, “Man, this is what I want to do.” That weekend changed my life. I’ve been at it ever since.

I kept volunteering as much as possible while raising a family. My wife, Louise, was supportive, even though we had three small children.

 “You go – I’ll take care of the kids,” she’d say. That helped, because closing down a lucrative practice, leaving home, and going off for two weeks at a time can lead to a lot of guilt. It got easier as the kids grew.

Finally, in 1992 – 16 years after that trip to Mexico – Peter Lagarias, an attorney and president of the San Francisco club, asked me if it would be possible for our club to sponsor a mission to Chile. That was the start of Rotaplast. We contacted Rotarians down there, did a site visit, and were on our way with a $30,000 donation from our club.

In 1993, we carried out the mission, working with the Rotary Club of La Serena, on the Chilean coast. Off we went, with a small team of surgeons and 10 nonmedical Rotarian volunteers. Their enthusiasm was infectious. Peter and I said, “Hey, we’ve got a good product here.” The volunteers made friends with local Rotarians, who put a Rotaplast banner up across the street. In time, a doctor from Argentina who happened to be vacationing in La Serena, a beach town, saw the banner and urged us to come to his country. We didn’t pay much attention, but he showed up the next year. So after our second mission, we followed him in a van over the Andes to Tupungato, where 100 members of the Rotary Club of Mendoza greeted us, eager to help. A member of the Rotary Club of Cumaná, Venezuela, came to stay with us there and invited us to his homeland. And that’s how word began to spread.

Now we’re in 20 countries. With our dedicated and skilled staff, we’ve been able to complete 150 missions. Each one requires a major effort to organize supplies and equipment (most of it donated) and all of the administration that goes into shipping through customs. When I think back, I sometimes say to myself, “What an opportunity.” Just about all these kids would go through life compromised by their deformity if we weren’t able to help. We set high medical and surgical standards and operate under the safest possible conditions. Our criterion for surgery is the “rule of 10s” – the babies have to be at least 10 pounds, 10 weeks old, with 10 grams of hemoglobin. That’s it.

Doing this work, being on these missions, I’ve learned a few things. The changes we’re able to make are so dramatic – when you see the relief and joy of the mothers and fathers written all over their faces, that’s all the reward you need. Another thing this work has taught me is that once you get through the cultural differences in any country, we’re all the same. What you value, the guy in Ethiopia values, the guy in Bolivia values. The women love their children just like we do. When it comes down to the human element, people everywhere want to be loved, they want to be recognized; they laugh when you do something nice, and they show their hurt when you don’t.

You might think that some of the farmers in Bolivia or Guatemala who won’t bring their kids to us for free surgery are being cruel. No, no. They have large families for a reason: They need their kids to help run the farms. They may not be able to spare the child, or they may not have enough money to get on a bus. But their hesitance is not because they don’t love their kids. They love them as much as anyone. That’s where the local Rotary club members who speak the language really help – they can get past these barriers. We can’t, and they do.

I’ve also discovered how resourceful you can be when you have to. We were in Ethiopia in 2008-09. We first did a site visit, as we do in every country, with Solomon Haregewein, a plastic surgeon licensed in the country. His help was invaluable. Everything seemed fine. The authorities in the village assured us that all the problems with the local hospital would be taken care of. So we come back six months later with a team of 28 people, we go to the hospital, and nothing has been done. “This is terrible,” I said. “There’s no way we can work. There are people lying on the floors, sick. There are intravenous bottles hanging from nails on the walls.”

I thought we would just have to turn around and go home. Then I took a walk around the yard, and I found an ophthalmology office at the back of the building with a big empty room in it and, in the corner, an anesthesia machine that actually worked. So I began to think, “If we can use that and the other one from the hospital and set up tables in this one room, we could get a thing going.” I talked to the ophthalmologist, and he agreed to give us the space, barring an emergency in his own practice.

We put up one local and two general anesthesia tables. I operated with three other surgeons: Haregewein, Jann Johnson from the United States, and Sibrand Schepel from the Netherlands. We set up a small recovery room too. That part went fine. But we had to use the hospital for families who were waiting, and the nurses kept wheeling gurneys right through, with deceased bodies on them. I said, “You can’t do that!” It was like preaching to a stone wall. But you do what you can. By now we’ve operated on over 100 patients in Ethiopia, and we have two new portable anesthesia machines that we carry around in suitcases.

Wherever we do our Rotaplast missions, we find that people are very appreciative. When we went back to Karaikal on the Bay of Bengal in India after the tsunami, we looked up a few patients we’d operated on a year earlier. We found a young man who told us, “I’m 26 years old. Nobody was ever interested in me or what they could do to help me, and you came all the way from the United States to take an interest in my problem.”

Most of the families are in shock when their deformed babies are born, with few options. Still, these people are taking a big risk: They’re turning over their infants and young children to complete strangers for surgery. We don’t forget that – or how much it matters. We had a woman in Ethiopia who traveled on foot all the way from the border of Sudan. We’ve operated on kids who’ve walked six hours to get to a bus. The Rotarian volunteers on our missions get to see all this. We’re partnering with local Rotary clubs, so international friendships develop. Other projects get started. The whole thing is very gratifying.

This year, now that I’m retired, I’m planning to do 6 of the 16 missions we’ve got scheduled at Rotaplast. I just turned 77. I might be getting older, but the work never gets old. I get to spend time in the operating room, doing what I love to do.

Sometimes people ask how I stay so energetic. Easy – I always associate with young people, which for me is inspirational. I figure I can operate as long as I have steady hands and good judgment and the energy it takes. Many surgeons at my age can’t stand at the operating table all day. I’m lucky – I can be in there 12 hours. And I can tell you for sure, no matter how much you give, you get back even more. Is there a way to explain how much you get back? All the trite words don’t say it. The smile of a mother with a baby who now has a normal lip – that says it every time.