according to the new york times most of the world lacks access to safe affordable and timely surgical care this impacts low and lower middle income countries the worst where 9 out of 10 people cannot access basic surgical care tonight we meet the founder of an organization with the mission of performing surgery free of charge for underserved individuals especially children it's good to have you here from los angeles this is klcs pbs welcome to everybody with angela williamson an innovation arts education and public affairs program everybody with angela williamson is made possible by viewers like you thank you and now your host dr angela williamson dr larry nichter it's so great to have you here tell us a little bit about yourself first of all thanks for having me what a pleasure i grew up in upstate new york near the adirondack mountains early as a child and later in late middle school moved to eastern long island and then did some training in in boston and i grew up in a middle to upper middle class background and then my senior year of high school my dad died suddenly without a will and i became an emancipated minor at age 17 and was sort of on my own because i had two siblings that you know my mom had to take care of she was a housewife at the time she later went on to get her doctorate but that's a different story and so i really uh you know had a friend for myself i was going to boston university which was an expensive private school a couple months later which i did but i had you know work two or three jobs every day and i really never took education for granted college was not a social experience for me i learned the value of everything and just how important it is to have a life with a steep learning learning curve i think experiences and how you react to those experiences or what shape who you are as a person i mean that sort of not only tells your life story in that selections but also where you're heading i always think that experience tends to add the element of commitment to your ambition and where you'll end up so i was interested in everything i was a philosophy major in college in psychology and biology minor just because i love that and i realized i really enjoyed helping other people and it just sort of led to medicine i never knew i wanted to be a doctor until very late and then in medicine everything i rotated through i loved everything was great but surgery gives you the unique ability to fix a problem and see results immediately so there's a lot of quick gratification that comes with it and when i went through general surgery we back then which was quite a while ago it really was general surgery there's it's hard to be a general surgery unless you're in a small town you're specialized into a colorectal surgeon or a thoracic surgeon or a gi surgeon or you know all those sorts of things and so only plastic surgery and pediatric surgery allowed you to operate on every part of the body keep your learning curve incredibly steep and i went into into i selected plastic surgery but i first became board certified in in three things before i got there general surgery and completed a program at ucla and um plastic surgery university of virginia and hand surgery there and then went to become a professor and actually the one the first professors at usc and helped start that program that grew at the time to the largest in the country i'm seeing a trend with you you start undergrad you have three subjects that you're studying you know majors and then you move on to medical school and you choose three separate areas here and so how does that shape dr nichter as i saw one of the most compassionate doctors voted several years in a row how does that shape who you are there well i left one detail out and that is right after college and part of my masters master's degree i took a year off and hitchhiked around the world with a backpack you know it was very tumultuous time back then the vietnam war and you know all those things were happening i thought our country was a terrible country to live in and you know i was you know protested and boy all it took was just going out of the country and i traveled only in developing countries throughout africa and india and across the middle east on my own with a backpack and a thumb i realized within weeks what a wonderful incredible privileged country we we live in and i thought that i really wanted to give back as much as i i could um going forward so that shaped a lot of um i never forgot how people live and what health how we take health for granted so that one aspect for that just over a year made a huge difference in my life and that huge difference that it's you said it's only a year of your life but let's talk about that experience and what you did 20 years ago to change surgery across the world i sought the first opportunity to go overseas and i went with several different non-profit organizations to to operate on on on kids mainly with reconstructive d problems cleft lips cleft palates burn contractures problems like that hand injuries a lot of post trauma reconstruction and i realized that when we got back there's the only question they want to hear is the only metric of success for that trip for that organization was how many kids did you operate how many how many surgeries did you do and so we operated as fast as we could we'd operate for 16 hours a day but there was no training there was no development or or capacity that was there and i started analyzing often times out when the team left i would stay behind even though i was the trip leader just to talk to the local surgeons and i realized there was a huge number of unanticipated consequences that were happening um that people came to do this all this free surgery so they expected all health care to be free which of course it should be for people who have no income or monies but for people that could afford it perhaps more importantly is there was complete loss of confidence in all the local surgeons that were very well they're incredibly bright they had great psychomotor skills they just needed to learn advanced techniques that's all and so they're left out they were felt put down upon they were oftentimes not asked to participate and what they did was just helping because we wanted to get to the next case in the next case and so although the team felt spectacular look how many you know we 100 children we changed our lives in this trip but meanwhile the need was going like this in this huge fashion while at the same time the numbers were treating were very low so the need became more so the local people took it for granted and if we stopped going to that country what happens then the need really skyrockets so i had this epiphany that this is all wrong that we need to go only if we're doing development and capacity building for this wherever we go and i couldn't find any organization that did that and that was the birth of plasticos foundation which last year we re-branded after 20 years to mission plasticos that was the sort of the birthright of how we how we got to do those things and i remember paul newman's from newman's own had a little grant and they provided a photographer and someone to interview in a trip early on in 1997 um to south vietnam near the cambodia border and eventually won an academy award for the best short documentary and after that it seemed that a lot there were a lot of volunteers but the early days you were pretty much doing everything out of your pocket and getting volunteers but my question to you because it seems like you come from a family of educators how was it how did you educate the volunteers here that were flying over to do the mission with you i found like-minded individuals people that i worked with and trained with and you know passion begets other passion and um it's you know contagious enthusiasm is how it recruited others and they were just really like-minded and beforehand i mentioned it's it's not about the number it's about the number of people we train and our metric of success is in a lifetime can they do thousands or tens of thousands of surgeries you talked about this the metrics was it difficult for you after you were able to get a lot of volunteers but was it difficult for you to explain your new metrics for to organizations for years that had different metric metrics going well that's why we started on organization because a lot of their fundraising right it all comes down to dollars they want to hear what was the impact of my dollar that i gave or my thousand dollars or ten thousand dollars i gave and they wanted to hear a real number so yes it was hard to convince them but i think if you you know took the time to explain what you're doing then they slowly came around and you know the ultimate compliment is when people emulate what you're doing and sure enough the other organizations now many years later that do reconstructive surgery and other types of surgeries they're now adopting this capacity building model and so i mean that's their best compliment is when people copy you so i was i'm thrilled about that we're going to take a short break and but before we take a short break we want to let people know how they can get in touch with you in your organization so tell us a little bit about your wonderful executive director it's not just because we share the same last name and tell us how we can get in touch with you online yes so we're extremely fortunate to have susan williamson our executive director and the best way of reaching her is just through our website which is missionplastcoast.org thank you because we'll need that and when we come back we want to hear about some of these amazing missions that you've done over your two decades we want to definitely celebrate with you your success that you've done so so we'll come back in a few minutes and talk about that excellent thank you [Music] no two days are alike so every day you prepare 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ready.gov myplan the worldwide need for health care has evolved in general as a surgeon i realized that 90 over 90 of all the worldwide need of surgical care in particular is in third world countries [Music] dr nichter the first half was wonderful we found out a little bit about you your background why you started this phenomenal organization now we want to talk about some missions i'm suggesting argentina but you said there's much more well we can certainly start with argentina but certainly mission plasticos has been all over the world in many different continents central america several different countries south america southeast asia india nepal and a host of other countries as well we also have a domestic program reshaping lives california which maybe we can even talk about a little bit right after i describe some of the countries that we've been in so argentina was is a great example we have been to a place called salta which is way up into the north it's off the beaten track almost all the places we go to are not places the tourists generally go to in in general uh it's more of a working class town and there's some wonderful a group of six surgeons plus residents that are relatively young within five years out of their training and just have this passion to learn the problem is a lot of their training was not wasn't exactly the same as the training in the states meaning that although they may have trained in buenos aires it was more of an apprenticeship where they look on and assist and then they're thrust on their own and depending on the limited faculty that they have they may not be versed in many different surgeries and they didn't have the simple tools like this instrument to open up the mouth so you can see when you're operating to fix a cleft palate for example so we equip them with all these tools they don't do any reconstruction after mastectomies or radiation and so on and so we're able to bring them all the supplies and tools but most important most important is these young energetic surgeons working at this general hospital that treats everyone of all means is they just want to learn and so the first three days for example they'd be watching me in the next three days i would do one side and they would do the other side and then the last three days i'd be cutting stitches and if they got into a little mischief to get them out and they felt incredibly comfortable and now they're doing massive amounts of surgery every year of of types of surgeries that they never would have done before so the confidence and they get back to me all the time will send me interesting problems with a sketch of how i would do this or that and i remember there's this little boy with this wide bilateral cleft lip and to just describe this you know if your child is born with a cleft they're they're ostracized they're kept in their home for life which means the mom's kept at home a family member so they can't go to the working force it affects the whole community and in just 45 minutes to an hour the time it takes for me to drive here and back for this interview or go to a movie or a nice dinner in non-coveted times you can change the life of that person and that family in that community and for and three days later he was back home with a soccer ball we told him we couldn't play but he had it anyhow back home and it just changed his incredible life i i can i'm happy to share other stories i could share a story in from nepal where we just recently came back in january there was a little a boy that was very outgoing he spoke a little english rather than just nepalese and he won a talent uh contest for mr personality incredibly young young young boy and he was in a house fire because most homes all the heating and cooking is on open fires and these women wear these you know sorry dresses that go up in flames instantly and he fell into the fire and was burned significantly and completely deformed and so you know just with one major uh you know after he went through all the acute surgery his face was literally melted together and we were able to restore um in just once one reconstructive surgery after the initial resuscitation was done what a lot of what this child looks like and and the change is really dramatic and i'm sure i can provide some photos for you to take a look but those are just two examples of what's done every day on the training and the skill sets of the people we work with are incredible it has nothing to do with how well they move their hands it's just learning the technique for the first time and become and becoming comfortable with it and their motivation i mean they're the true heroes i mean they're the ones because i was there for a short time and every day they're working all day and all night when we went there was burns in epidemic proportions um because of the cold winters and how they heat and they they they have the first the biggest burn center in the entire country and we're training their residents and fellows on on how to do it i took a lot of the from one of the best burn centers of this country harbor view up in the seattle area critical care experts and it's critical care anesthesiologists burn surgeons burn occupational therapists things they there is no occupational therapist for the entire country so we just trained a whole new set we brought a biomedical engineer we're starting that whole program i don't know any group that's doing it in reconstructive surgery because all this expensive equipment if it's not maintained they'll never have the money to buy another one and they teach them how to do these things so that's just a few of the examples of things that we do so you had this vision 20 years ago to make sure that when you went to do a mission at this place that you were able to train people and leave them there with those skills that they can continue on and so now we're 20 years later you're starting to see that how does how does that make you feel as one of the founders of this organization uh wow tremendous but uh just to give you a concrete example so you know we live by that old chinese adage you know give a man a fishing pole and you know you can give him a fish you can feed him for a day teach him how to fish he can for a lifetime for a lifetime yes if you can teach him how to fish and train others how to fish which isn't part of that adage no then it becomes exponential so when we went to argentina for example i originally went during our first few years to guatemala for a few times and there's this one wonderful doctor dr ernesto coffinho who's well trained but he's operating by himself and he wanted to learn some advanced techniques and some surgeries he was seeing a lot of and so once we trained him he is now training others and he was one of the faculty members that i brought with me so we're both faculty now training the others in argentina so that is the exponential factor that's where all of a sudden it grows and grows and everyone's doing it and he has his own non-profit organization as well in his in guatemala which again is the biggest compliment ever so it's that exponential effect that really is spectacular and that's you know we train um teach and transform the lives not of just the patients retreat but the surgeons we influence influence others as it turns out ourselves as well as it's a complicated way of answering your question no and it's not complicated in fact what you're showing us is the groundwork of this wonderful vision that you had but your vision is now brought into reality and it's paying itself forward because the people that you're training they are taking what you're training them to be and they are training others exactly and so is that was that the big vision that you had or it was just so much more well it always was you know of course it continues to expand and we'll unless others sort of copy what we're doing and and we can expand on a much greater level it'll be very tough i just came back in late february and early march just as covet was hitting the country to do site visits in tanzania and in kenya where they just started their first class surgical training program about five years ago so they're just about to graduate their first residence and in some of these countries there's only a handful of plastic surgeons for a population of 40 or 45 million to put in perspective for many years i was chairman of plast surgery at hogue hospital in orange county there's 97 plastic surgeons probably the largest in the world in this 400 bed hospital and i just said there's probably only six well-trained plus surgeons in tanzania for a population of over 45 million it's unbelievable what they're so i mean the work that has to be done is just incredible and how do you think you can continue some of this work because everything we can't really travel right now so do you want to are you waiting until we're done we're able to go and travel again it sounds like some of the doctors are even contacting you by email so tell us a little bit about that that's a great question so i can answer in a few different ways one is we have a domestic program reshaping lives california and it turns out in this political climate unstable economics there's a tremendous watershed population that are just they can't afford surgery they're afraid that they'll be deported they may have a breast cancer that could kill them they may have other sorts of problems they may have a injury that they can't simply fix they could start using their hands again and go right back to work and they're afraid to seek medical care or they may be you know ill and things i don't deal with infectious diseases and that spreads tremendously so a few years back we started reshaping lives california and we were able to get a surgery center that will volunteer their time and we have nurses and doctors and we right here at home we started that this program that's ongoing right now secondly is we were committed to go back to nepal and this hospital was just overwhelmed i mean they had it was a mass unit with the when during the burn season they were just stretchers and hallways of critical care patients it was just oh it just grabbed at your heartstrings that's for sure and so um the monies that would have been spent uh this year that we fundraised hard and long for we're uh trying to partner with other people and build a whole set of surgical suites four separate operating rooms just for burn surgery and plastic surgery and critical care area and and build it from the ground up we still have a long ways to go there but we have enough money to start that whole project so we just have looked at the architectural renderings and we're pretty much ready to go and that's what we're doing right now but until we have a coveted vaccine you know i have to look after the people that my volunteers would love to go right now but we don't want to make other people sick and and i have to look after the safety and welfare of of our team members as well but we have lots to do that's for sure and every week i get these photographs of these difficult cases and and calls back and forth and through telemedicine we're on doing ongoing educational series as well as helping them with difficult cases so right now there's probably people at home viewing this and they want to be able to help you even though they know you can't go out right now but you have plans to build this hospital they want to help you right now so how can they reach you again the best way is just going to our website missionplasticos.org that's uh plasticos is spelled p-l-a-s-t-i-c-o-s thank you so much for your time in this special segment that you were telling us about your mission it is incredible and thank you so much dr nichter for coming on this edition of everybody thank you it was my distinct pleasure angela thank you and thank you for joining us on everybody with angela williamson viewers like you make this show possible stay in touch with us on social media good night and stay well [Music] you