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UNC surgeon leads West Bank initiative

Posted on July 31, 2008July 31, 2008 by Staff

Doctor Austin Rose with a young patient. Photo by Lindsay Butler.by Rich Fowler
Staff Writer

Thabet Thabet hospital sits atop a large hill in the West Bank town of Tulkarem, and on a clear day from the rooftop you can see the Mediterranean Sea only 30 miles away. But the hospital has to function without computers, microscopes, saws, drills and a lot of other equipment you would ordinarily find in hospitals in the U.S.

That hospital is where John van Aalst’s mother was born.

For about 10 days every May and December, van Aalst brings a small team of medical professionals from the U.S. to Tulkarem to operate on children with cleft palates and to teach Palestinian doctors how to treat them. Van Aalst, a plastic surgeon at UNC Hospitals, has treated over 250 Palestinian children since he first came to the region in 2005. His wife, Cindy, a registered nurse who also works at UNC Hospitals, comes and assists him on his trips to the West Bank.

This May, Bilal Saib, a Chapel Hill dentist; Lindsay Butler, a dental hygienist; and Austin Rose, an ear, nose and throat surgeon at UNC Hospitals also came with van Aalst to Tulkarem. They will all take part in a presentation about their most recent trip to the West Bank at Grace Church on Sage Road in Chapel Hill this Sunday at 2:30 p.m.

“We’re operating on kids who’ve got no money,” van Aalst said.

“They have nothing,” Saib said of the people who live in the refugee camps. “Even by Palestinian standards, they’re considered second-class citizens.”

Van Aalst and Saib took donated equipment to the hospital in order to perform the surgeries. Van Aalst brought thousands of dollars of medical equipment donated by medical equipment manufacturers and Saib raised several more thousand to buy dental equipment to take over.

“I literally built a small operating room and dental facility there,” Saib said.

Rose said he and his colleagues performed about five to seven surgeries a day for about six days, from eight in the morning until as late as eight at night, followed by a big dinner.

“Everbody was extremely nice to us, and incredibly hospitable. It was amazing. Every night we were hosted at someone’s house for dinner, and you really got to know people,” he said.

“There are plenty of kids that really do need surgery that we can’t operate on in a given trip, and the only thing we can tell them is, ‘Next time,’” van Aalst said. “It’s a difficult decision. But it’s a little easier knowing that we are going back.”

Rose said he learned a lot from the local doctors. He worked with one doctor who had converted the driver’s seat of an old Subaru into an examination chair. “People actually get pretty ingenious when they don’t have everything that we have,” he said.

Van Aalst is emphatic about involving local doctors and wants to put himself out of a job in the West Bank.

“The goal really is that we don’t do any surgeries there without someone from the West Bank or Gaza being there or working with us,” he said. “Because [otherwise], that’s very short-sighted. What that does is it takes care of only one patient at a time. But if we train people with each of the patients that we’re operating on, then suddenly there are two, four, six, 10, 20 surgeons that can do this work, and they are the ones who’ll carry it on.”

An ‘awesome’ group

Fixing a cleft palate can take as many as 15 to 20 surgeries carefully timed over a number of years, so it’s not just a simple case of looking in on a few surgeries to figure out how it’s done. To augment training, van Aalst sets up conferences on the first Saturday of every December and specialists from around the world come to give presentations to the Palestinian Cleft Association.

Some of the training is presently taking place in Chapel Hill. Over the next few weeks, Itaf Arafat, a Palestinian speech therapist, will be learning how to treat children with cleft palates at UNC Hospitals. When she’s done, she will go back to the West Bank to teach what she has learned to her speech therapy students at Ramallah Women’s Training Center, a community college funded by the United Nations.

“I can set up my private clinic and work,” Arafat said, “but I don’t want to do that because what I’m doing now is much bigger.”

Van Aalst wants to include doctors in Gaza, but the situation there makes it difficult. “It’s an order of magnitude of difficulty greater than being involved in the West Bank,” he said, “and actually that’s part of what makes it necessary to think of Gaza and to try to include them in any plans.” He plans to set up teleconferences with doctors in Gaza so that they too can benefit from the conferences.

“This group is awesome,” Saib said. “If [John] had said China, I would’ve gone to China with him. I’m doing it because I like what John does.”

Those interested in donating can give to the Palestinian Children’s Relief Fund at www.pcrf.net, the Smile Train at www.smiletrain.org or to the UNC Pediatric Plastic Surgery Research Fund.

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