Karaikal, India: Sunday, February 1

Puspa’s six-month-old baby daughter, Santosh, was squirming in her arms. It was 10:30 am Saturday morning and the infant’s lip carried a reddish, still raw scar where the Rotaplast doctors had repaired a jagged cleft a few days before. Now mother and child were itching to go home after a week at Vinayaka Hospital.

The baby cried a lot in the recovery room after the anesthesia had worn off and cried again today when the doctors examined her, snipped clean the suture, and signed off on her discharge from the clinic. Puspa had wept, too, but not out of fear or worry. She had faith in the American team. She seemed overcome with feelings that were probably unfamiliar, unutterable - emotions that surely clashed with the weary acceptance of fate that comes with being born poor in India.

All that she could say in her shy voice was, yes – she was happy with the change they’d made in her daughter’s appearance. Yes – the family was waiting at home, and yes – they would be surprised when they got off the bus from Karaikal.

We decided to give them a ride instead. They live just outside Karaikal. It would have taken two buses and a couple of hours – nothing, compared to most of the more than hundred patients and families going home from the clinic, some as far as the Kerala backwaters on the west coast, tribal villages deep in the Panal Hills to the south, or up north by the Cauvery River – all a day’s journey or more by bus.

You could almost predict how far away the patients had come by the Polaroids stapled to their files. The farther away from urban centers, the less access they had to medical care, information, healthy diet, the more incidence of intermarriage… and the more likely they’d had lived with the untreated facial gaps and twists of lip and nose that showed up in the Polaroids taken before their surgeries.

The Polaroids were history. The faces lined-up in the corridor this morning, waiting to be checked out and discharged were different; parents with children, young men and women – all moved through the clinic with a new look. No one was perfect, some almost perfect, but nearly all appeared eager to go out in the world and give it a shot.

Our Toyota pulled up at Puspa’s thatched roof home, greeted by a chorus of squeals and yells. “They’re here!” cried the kids piling out into the dirt road, Santosh’s sister and brother, joined by friends and a gathering crowd of neighbors. Dad, a thatch-roof maker, was at work. Great-grandma, 80, stumbled out, squinting at the child in disbelief.

More than a hundred similar scenes took place all over the south India region of Tamil Nadu at the conclusion of the Rotaplast mission. Credit was surely due and homage well paid to the Rotaplast team, their Rotarian supporters and the Vinayaka Hospital staff and intern at official functions, including a lavish ceremony in the hospital auditorium Saturday night with Tamil folk dances performed by talented interns. Mementoes and speeches expressed the endless, endless, endless generosity of the Karaikal Rotary, whose members had worked for more than a year to bring the team to town. Further speeches and mementoes delivered at the Paris International Hotel by the hotel’s estimable General Manager, Major Moheed (ret.) and a representative of the Indian Medical Association.

When the caravan of cars pulled away from the Paris International Hotel this morning at dawn. You could almost hear a collective sigh of relief among the Rotaplast volunteers - surgeons, anesthesiologists, nurses, geneticists and non-medical crew – as they motored north toward Chennai for the return trip. Eleven days in this south India town, performing free reconstructive surgery on children and young adults, left everyone exhausted.

Culture, language, and logistics were tougher challenges on this mission than any in the organization’s fifteen-year history, according to Rotaplast veterans, such as Head Nurse Evelyn Abad, who’ve been with the group since the early days.

Yet, when the last day of surgery was over, it was clearly a humanitarian triumph for all involved, from the group’s financial supporter all the way to the patients themselves.

ROTAPLAST SCORECARD - FINAL
(Donated medical services, excluding hospital costs and supplies valued at US rates)

Total to date: 178 procedures 116 patients $700,000 value

An interesting wall chart of surgical procedures kept by June Minami and Louise Capozzi tallied the action in oddly detached detail:

Lips – 61
Palates – 31
Lip revisions – 18
Noses – 35
Fistulas – 8
Burns – 3
Hands – 2
Miscellaneous – 20

It will take me some time to figure out the meaning of such odd facts, and the individual stories attached to each; to come to terms personally with what I felt when the acid-burn woman from Pondicherry told me “I will not forget what they did for me here until the day I die,” or when the kid’s with bandaged faces “high-fived” me every time I came down the hospital corridor. And to sort though at all of Wayne photos capturing the essence of emotion in faces, forms, colors and shadows, the look of Karaikal, India, and its people.

I’ll be thinking of fourteen-year-old Rajkumar Kannappan - the boy with horrific burn scars who’s been haunting everyone’s thoughts. It turns out that the proper equipment and care have been located in Salem at a sister campus associated with Vinayaka. Instead of the stress and wait for a complicated trip to the US, he’ll be looked after closer to home, operated by one of the excellent local plastic surgeons that have been working with the Rotaplast team this past week, all services donated free of charge, thanks to the Karaikal Rotary.

I’ll be thinking about the man who brought in his wife, her face horribly burned by a kerosene-stove explosion. He lovingly showed us her wedding photograph, expressing the belief that the doctors could restore his bride to him. He’d seen on television that such things were done in America. Expectations for plastic surgery universally exceed reality; here in India, that tragedy seems somehow greater.

Even so, when these journals and photographs are assembled, I believe the story will transcend tragedy. I know I am not the first writer to meet culture shock head-on, to discover how India awakens all of the senses (there is nothing like an open sewer to remind one of one’s humanity). But I have experienced that now, combined with being part of a team of individuals “saving smiles, changing lives,” to the point of extremes where joy and despair link arms and go off singing together down the dusty road in the noonday sun.

And the greatest shock of all is coming face-to-face with oneself on a tumultuous street full of burkhas, businessmen, Sikhs, saris, sadhus, Hindus, and whomever, simply one more among the colorful crowd – but no longer a stranger.

Rex Weiner - writer
Wayne Schoenfeld - photographer