by Cindy A. Abole, Public Relations

Marcelo Hochman, M.D., is happy to see smiling young faces each time he returns to the Siberian city of Ekaterinburg, Russia.

Dr. Marcelo Hochman, right, shares surgical microvascular techniques with Bonum Center Professor Vasirianov, left, during surgery. Hochman was in Ekaterinburg, Russia last fall as part of the American Academy of Facial Plastic and Reconstructive Surgery’s Face-to-Face Program.

He’s glad because he and a team of Russian and American surgeons help facially deformed children begin new lives. Since 1995, Hochman has traveled as a member of a humanitarian and educational surgical exchange program known as Face-to-Face.

The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) began Face-To-Face in 1992 as a pro bono surgical approach aiding men, women and children needing facial reconstruction and plastic surgery. Organized by the AAFPRS’ Educational and Research Foundation, Face-to-Face helps individuals, locally and abroad, who live with facial deformities caused by birth or trauma. Individuals can be orphans, victims of war and survivors of domestic violence found.

Hochman, an associate professor and director of MUSC’s Facial Plastic and Reconstructive Surgery Section, Department of Otolaryngology, is involved with Face-to-Face International. He has worked with colleagues at Ekaterinburg’s Bonum Center, a multidisciplined children’s hospital supporting the Autonomous Republic of Sverdlovfk of post-Soviet Russia. The hospital was the site of a visit from first lady Hillary Clinton during her trip to Russia in November 1997. Members of the foundation have returned annually conducting teaching symposia, developing teaching materials and coordinating donations of much needed medical supplies and equipment. More than 170 physicians and surgeons have volunteered with Face-to-Face International. Because the team returns yearly, they can prepare for more staged, sequential reconstructive procedures and meet other needs for allied specialists such as speech and language pathologists.

“The surgeons are very dedicated and talented,” said Hochman, who’s traveled to Russia twice for Face-to-Face. “The major challenge is that they don’t have the resources to accomplish what they would like since the state-supported health care system is relatively poor.”

Sometimes surgical equipment will be pre-shipped for use by surgeons on the team. Other items are donated by American medical equipment suppliers. It is not unusual for the team to leave medical supplies and equipment behind at practicing locations.

“The standard of living for health personnel is remarkably low,” said Hochman. Doctor’s salaries average just $95 a month because of a cash-strapped Russian government and other inefficiencies according to a 1997 article about Russian medical care by Business Week magazine. Hochman tells about a fellow Russian surgeon and friend who lives a meager lifestyle sharing a one-bedroom apartment with his wife and young son. Medicine, however is still a very respected field, Hochman said.

Hochman has been chosen to coordinate the team of American surgeons who will participate in this year’s exchange as he prepares to return to the Ural mountain area in late summer 1998. He has invited John McFadden, M.D., assistant professor, MUSC Department of Orthopaedics, to work with the group. McFadden will be the first non-facial surgeon participating in the Russian exchange. McFadden, who has also traveled to various regions of the world for another humanitarian group Physicians for Peace, will perform surgery on patients with burn and congenital hand deformities. His expertise is in great demand throughout many Russian regions, Hochman said.

The Bonum Institute is a major surgical center for pediatric deformities such as cleft lip and palate microtia and other facial deformities. Unfortunately, children in third world countries are sometimes orphaned because of their deformities. So the need for quality plastic surgery is essential to the health and well being of youths. Other techniques performed by the team include microvascular free flap surgery, a procedure where tissue from one area of the body is transplanted to a defect in the head or neck area. Once in place, the tissue is re-vascularized and connected to the carotid and jugular systems, providing its own blood supply to the repaired area.

Other surgeries performed by the team include orthognathic surgery dealing with physical abnormalities of the jaw, bone grafting, facial re-immuration procedures for facial paralysis such as nerve grafting, muscle transposition and removal of carotid tumors. Many of these procedures have never been performed in this area of Russia before.

“There’s so much they endure in order to meet their day-to-day goals,” said Hochman. “But they are very talented and get great results. They’re very eager to learn new and complex reconstructions and other procedures they’ve never been exposed to.”

The language barrier also challenges team personnel from nurses to anesthesiologists as they work side-by-side during procedures. Yet during a period of time continual interaction between cultures help to erode any barriers.

The experience has enlightened surgeons like Hochman as they realize their cultural and material differences associated with their Russian counterparts. The exchange has generated mutual respect for Russian and American medical personnel. “Many good friendships have emerged through this type of interaction.” said Hochman, who’s previously traveled to Honduras and Mexico for Face-to-Face.

In a similar exchange, Russian surgeons will travel to the United States in June in an effort to share knowledge and learn new microsurgery and plastic surgery techniques. It is touted as one of the largest Russian/American exchanges supported by the AAFPRS. In addition to a visit to MUSC, the group is scheduled to see other reconstructive centers in Oregon, California and Florida before attending the AAFPRS’ Seventh International Symposium in Orlando.