Mission Perspective: New View of the OR

Participating in a mission with IEP taught me valuable lessons that extend beyond conventional medicine. In areas where resources are more scarce, we maximized our impact by making the most of the supplies we brought with us. As a surgeon, I learned essential skills, including being more creative with instrumentation, finding workarounds in the operating room, and being less wasteful. 

This trip also instilled in me the importance of thorough biomechanical examination. It’s not about spending more time but about being more focused and honing in on the physical imbalances that lead to the patient’s deformity.

Two specific patient encounters come to mind as I reflect on highlights from the trip. 

The first, a middle-aged female, came in on screening day. She was a return patient from a previous IEP mission to Can Tho. She came not looking for help but to thank the team. Before our intervention several years ago, she had a severe ankle deformity causing significant disability and allowed minimal ambulation (walking). She shared that she is married, has a career, and lives an everyday and functional life. Although I was not a part of her treatment, I was touched by her story and hopeful that I would be a part of helping someone like her on this trip.

The second was a new surgical patient. His history included a previous motor vehicle accident that had resulted in significant soft-tissue trauma to his ankle. This caused a complete loss of the anterior compartment muscles and tendons and required a skin graft over the anterior ankle. Due to the muscle imbalance, he developed a rigid equinus contracture that prevented ambulation. The skin graft had created an area of compromised soft tissue that we had to avoid during surgery. This meant we had to take a modified approach to access and correct his deformity. This case was particularly challenging as it required access to difficult-to-reach areas of the ankle through non-traditional approaches.

Establishing connections with doctors from various corners of the world has broadened my perspective and allowed me to exchange valuable insights. I am grateful for these connections and the new friends I made along the way. This trip kindled my desire to continue pursuing opportunities for international medicine and giving back to communities in need.

Melissa Lipari first joined IEP in 2015 as a recent college graduate considering a career in medicine. Read about her experience from that first visit to Vietnam in “Inspiration for a Future Doctor.”