Faces of Tomorrow

Sac Bee January 4, 2010

Written by Bobby Caina Calvan Wednesday, 05 May 2010 06:25

FACIAL SURGERY DOCTORS BRING OUT HUNDREDS OF SMILES

Group changes outcasts' lives in Ecuador

January 4, 2010
Section: OUR REGION
Page: B1

By Bobby Caina Calvan
This e-mail address is being protected from spambots. You need JavaScript enabled to view it

For much of her 39 years, the woman hid behind a scarf and could not bear to see herself in the mirror. She kept her gaze down, her eyes averting those of the doctor who came from afar to help her smile. The woman was born with a cleft lip, a common facial deformity in many parts of the world. She had heard that Dr. Brian Rubinstein and his crew were again back in Quito, Ecuador, to offer their help. In less than two hours, Rubinstein, a Kaiser Permanente facial plastic surgeon from Davis, repaired the woman's lip. You don't have to wear your scarf anymore, he told the woman, Carmen Rivas, on a January day a year ago. Freed from her scarf and embarrassment, Rivas told Rubinstein that she was finally empowered to look for a job.

"She touched all of our hearts," said Rubinstein, whose team, under the banner of the nonprofit group Faces of Tomorrow, is heading back to Ecuador later this month as part of a 10-day humanitarian mission.

Over the years, U.S. doctors have helped as many as 400 Ecuadorans with deformed lips and palates, most of them young children, now saved from the ignominy of a congenital condition. "They have these facial deformities and are outcasts," he said. Many cannot afford the surgeries and rely on Rubinstein and his team to "transform their lives."

Oral-facial clefts are usually genetic, but can sometimes develop because of nutritional deficiencies during fetal development. The tissues of the mouth and lip aren't properly formed, producing a noticeable gap. In the United States, clefts occur in 1 in 700 births. But in Ecuador, Rubinstein said, the rate is about double. "A lot of those kids wouldn't have a chance," said Rubinstein.

He has three daughters, all of whom have done what they can to support their father's endeavor. They've collected toothbrushes at school, raised money for equipment and collected blankets for children abroad. Faces of Tomorrow receives grants, money from friends and family members and has raised thousands of dollars from community fundraisers.

Rubinstein's wife has accompanied him to Ecuador to work as part of the mission that brings nearly three dozen health professionals to Quito, including three Kaiser surgeons who serve as the centerpiece of the operation. One of Rubinstein's partners, Nima Pahlavan, another Kaiser surgeon from Sacramento, is also a dentist.

There are nurses, anesthesiologists, social workers, speech therapists, psychologists and other health professionals who help in the effort. The transformation goes beyond aesthetics.
"We try to treat the whole problem," Rubinstein said.
"We give them a fair chance at life," said Pahlavan, the chief of head and neck surgery for Kaiser Permanente's hospitals in Roseville and Sacramento.

He recalled a particular boy, perhaps about 3 months old, who arrived with a severe deformity. The child was too young to recognize the burden that his condition could bring him later in life, if not surgically fixed. But his mother knew. And when Pahlavan was done, she was overwhelmed with gratitude, the doctor said.

"She had no idea that her child could look so normal," said Pahlavan, whose Spanish, he said, could be better. "Not many words were exchanged, just a lot of tears."

The next trip to Ecuador will be the second for Pahlavan and the sixth for Rubinstein, whose first excursion was in 2001 as a University of California, Davis, medical resident. There is talk of expanding the mission to other parts of the world, perhaps to the Philippines.

FACES OF TOMORROW

Learn more about Faces of Tomorrow at www.facesoftomorrow.org.

Call The Bee's Bobby Caina Calvan, (916) 321-1067.