Face the Future Humanitarian Mission to Rwanda
Joseph W. Rohrer, MD San Antonio Uniformed Services Health Education Consortium A trip to Rwanda starts with thoughts and images that reflect the country’s painful past. Rwanda is marked by the 1994 genocide. This, as we would discover however, is not what defines the country today. Rwandans are redefining themselves and the face we encountered is beautiful, welcoming, clean, safe, and growing. Our mission in February was the first time the Face the Future Foundation, founded by Peter A. Adamson, MD, had gone to Africa. The team leader was Houston otolaryngologist Ife Sofola, MD, a native Nigerian with great passion to help Africa grow, develop, and thrive. This group included a powerful surgical team including Dan S. Alam, MD, from the Cleveland Clinic; Jose E. Barrera, MD, from the San Antonio Military Health System; Kofi D. Boahene, MD, from Johns Hopkins; Anthony E. Brissett, MD, from Baylor College of Medicine; Sydney C. Butts, MD, from SUNY Downstate; and residents Joseph W. Rohrer, MD, San Antonio Uniformed Services Health Education Consortium, and Myriam Loyo, MD, Johns Hopkins. Joseph Kuang, MD, Houston, supported our anesthesia needs. The team worked out of two sites in Kigali, King Faisal Hospital and the Rwanda Military Hospital, which continues to undergo extensive upgrades. Our team arrived to screen 20 patients that Charles Furaha, MD, the only plastic surgeon in Rwanda, had selected. By the end of the week, 39 patients had been evaluated. Our first day, we were given tours of the operating theaters and met the staff. Everyone was excited and a bit nervous. Smiles were everywhere and around 9 am we started seeing our patients. Many had been waiting for weeks, months, or years hoping that something could be done. The first day we saw 29 complex patients. They presented with a Tessier 4 cleft, midline cleft with encephalocele, and multiple patients with disfiguring, and painful neurofibromatosis. We saw osteoradionecrosis of the zygoma, congenital aplasia cutis of the scalp, noma, and disfiguring ameloblastoma. We also saw previous trauma patients: with ectropion, auricular avulsion, non-protected dura, and a 15-year-old with the loss of both lips from a grenade explosion. As the day and week progressed, patients continued to present with complex facial defects. The foundation’s mission is to empower the local community to advance their craniofacial management capabilities. Members of the group met with the hospital administrators and the Rwandan Minister of Health to discuss ways to make long-lasting changes. We worked hand-in-hand with the local surgeons and staff. We did revision cases and showed our techniques. They even showed us how to use the non-powered dermatome. Our mission performed a fibula free flap to reconstruct a midface, a radial forearm free flap with bilateral FAMM flaps for an upper lip, and fashioned orbital implants to cover unprotected dura. We did orthognathic surgery, completing molds and model surgery with the local oral maxillofacial surgeons. We owe a debt of gratitude to Dr. Furaha, who will continue to see our follow-up patients and send updates. Next year there are plans to give didactic lectures to stimulate academic exchange. Some patients for next year have already been identified and plans are set in motion to bring special supplies. This may have been our team’s first mission to Rwanda, but while seeing ourselves on local TV as we boarded the plane for home, I’m confident we made an impact not on just the patients we helped, but also in this country, which is working hard and moving positively towards becoming a jewel of Africa. I speak for the team when I say we have been given so much from this wonderful country and hope to continue this partnership for mutual gain. I would like to thank the AAO-HNSF Humanitarian Efforts Committee and the Alcon Foundation for their support of resident travel to this mission. Grant Opportunities CORE Grant www.entnet.org/CORE Diversity Grant TBA in early June Humanitarian Travel Grant–Apply Today! http://www.entnet.org/Community/public/Resident-Travel-Grant.cfm International Travel Grant and Scholarships http://www.entnet.org/Community/Intl-Grants.cfm Resident Leadership Grant–Apply Today! http://www.entnet.org/Community/public/residentleadershipgrant.cfm Young Physician Leadership Grant–Apply Today! TBA in early June

Joseph W. Rohrer, MD
San Antonio Uniformed Services
Health Education Consortium
A trip to Rwanda starts with thoughts and images that reflect the country’s painful past. Rwanda is marked by the 1994 genocide. This, as we would discover however, is not what defines the country today. Rwandans are redefining themselves and the face we encountered is beautiful, welcoming, clean, safe, and growing.
Our mission in February was the first time the Face the Future Foundation, founded by Peter A. Adamson, MD, had gone to Africa. The team leader was Houston otolaryngologist Ife Sofola, MD, a native Nigerian with great passion to help Africa grow, develop, and thrive. This group included a powerful surgical team including Dan S. Alam, MD, from the Cleveland Clinic; Jose E. Barrera, MD, from the San Antonio Military Health System; Kofi D. Boahene, MD, from Johns Hopkins; Anthony E. Brissett, MD, from Baylor College of Medicine; Sydney C. Butts, MD, from SUNY Downstate; and residents Joseph W. Rohrer, MD, San Antonio Uniformed Services Health Education Consortium, and Myriam Loyo, MD, Johns Hopkins. Joseph Kuang, MD, Houston, supported our anesthesia needs.
The team worked out of two sites in Kigali, King Faisal Hospital and the Rwanda Military Hospital, which continues to undergo extensive upgrades. Our team arrived to screen 20 patients that Charles Furaha, MD, the only plastic surgeon in Rwanda, had selected. By the end of the week, 39 patients had been evaluated.
Our first day, we were given tours of the operating theaters and met the staff. Everyone was excited and a bit nervous. Smiles were everywhere and around 9 am we started seeing our patients. Many had been waiting for weeks, months, or years hoping that something could be done. The first day we saw 29 complex patients. They presented with a Tessier 4 cleft, midline cleft with encephalocele, and multiple patients with disfiguring, and painful neurofibromatosis. We saw osteoradionecrosis of the zygoma, congenital aplasia cutis of the scalp, noma, and disfiguring ameloblastoma. We also saw previous trauma patients: with ectropion, auricular avulsion, non-protected dura, and a 15-year-old with the loss of both lips from a grenade explosion. As the day and week progressed, patients continued to present with complex facial defects.
The foundation’s mission is to empower the local community to advance their craniofacial management capabilities. Members of the group met with the hospital administrators and the Rwandan Minister of Health to discuss ways to make long-lasting changes. We worked hand-in-hand with the local surgeons and staff. We did revision cases and showed our techniques. They even showed us how to use the non-powered dermatome. Our mission performed a fibula free flap to reconstruct a midface, a radial forearm free flap with bilateral FAMM flaps for an upper lip, and fashioned orbital implants to cover unprotected dura. We did orthognathic surgery, completing molds and model surgery with the local oral maxillofacial surgeons.
We owe a debt of gratitude to Dr. Furaha, who will continue to see our follow-up patients and send updates. Next year there are plans to give didactic lectures to stimulate academic exchange. Some patients for next year have already been identified and plans are set in motion to bring special supplies. This may have been our team’s first mission to Rwanda, but while seeing ourselves on local TV as we boarded the plane for home, I’m confident we made an impact not on just the patients we helped, but also in this country, which is working hard and moving positively towards becoming a jewel of Africa. I speak for the team when I say we have been given so much from this wonderful country and hope to continue this partnership for mutual gain. I would like to thank the AAO-HNSF Humanitarian Efforts Committee and the Alcon Foundation for their support of resident travel to this mission.
Grant Opportunities
CORE Grant
www.entnet.org/CORE
Diversity Grant
TBA in early June
Humanitarian Travel Grant–Apply Today!
http://www.entnet.org/Community/public/Resident-Travel-Grant.cfm
International Travel Grant and Scholarships
http://www.entnet.org/Community/Intl-Grants.cfm
Resident Leadership Grant–Apply Today!
http://www.entnet.org/Community/public/residentleadershipgrant.cfm
Young Physician Leadership Grant–Apply Today!
TBA in early June