By Danelle M. Taylor Johnston, MA, Managing Editor

Published in the spring 2024 ALUMNI JOURNAL

My only thought in that moment was for Elias,” Jean E. Sprengel ’81 said about the small 3-year-old boy who was resting in her arms.

He had been burned severely in an open kitchen fire a year prior, limiting his ability to smile, turn, or blink. His scars prevented him from moving his head in any direction. While performing anesthetic induction, Sprengel held Elias in her arms carefully to comfort him. Kenyan anesthesiologist, Christine Gathiri, MD, stood next to Sprengel and assisted with Elias’s complicated case. “As a mother of four sons myself,” Sprengel said, “he captured my heart.”

Sprengel, along with fellow Loma Linda University School of Medicine (LLUSM) alumni Stephen A. Westerhout ’98, director of anesthesia for Mission Plasticos, and James P. Watson ’86, were volunteering at Nakuru Level 5 Hospital in Nakuru, Kenya, located in the Rift Valley about three hours northwest of Nairobi, Kenya. The one-week trip from September 28 to October 8, 2023, was organized by Mission Plasticos, which was founded in 1999 by Larry Nichter, an Orange County plastic surgeon. The nonprofit’s mission is to “provide reconstructive surgical care to those in need and to generate sustainable outcomes through medical team training, public education, and research,” said Susan Williamson, Mission Plasticos executive director. All the reconstructive plastic surgeries Mission Plasticos perform are free of charge for all patients—like Elias.

The small volunteer team consisted of two anesthesiologists, Sprengel and Westerhout; two plastic and reconstructive surgeons, Watson and Nichter; one nurse; one PA; and a trauma surgery resident physician from Argentina.

When the Mission Plasticos team arrived at the hospital in Kenya they had a busy schedule ahead of them, with enough patients to maintain a full surgery schedule in two rooms for five days. The Mission Plasticos team accepted cases that local physicians were not willing to attempt due to lack of equipment, the complexity of the cases, and because there was only one plastic surgeon at the 700-bed hospital. Because of these limitations, some patients have suffered from their conditions for 20 years.

The safety of the patients and the medical team is the highest priority for Mission Plasticos. To ensure 100 percent confidence in every case, Sprengel appreciates that every member of the medical team, including the nurse and the PA, was given veto rights if they had any hesitancy with the cases.

The high productivity is thanks to the pre-planning of local organizer, Peter Oduor, MD, chief of plastic surgery at the hospital and the primary Kenyan physician host and coordinator.

The ability to teach and collaborate with physicians and residents both in person and online while operating on patients in the OR made the service trip even more impactful. Watson was surprised to find that “medical students were watching from places as far away as Lebanon.”

This collaboration provided opportunities for local plastic surgeons to see some cases they had not seen before. “They were very grateful,” Watson said. And to improve the patient experience, Westerhout and Sprengel shared some of the anesthesia techniques they use in their daily practices at home. “Exchanging practice ideas with our Kenyan anesthesia counterparts was extremely rewarding and productive for all of us,” Westerhout added.

In addition to the busy surgery schedule, each morning before operating, the Mission Plasticos surgeons gave lectures to plastic surgery resident physicians who were visiting from other places, including from Nairobi, Kenya, and from the country of Uganda. The lectures were also live-streamed throughout Kenya and around the globe and included topics regarding safety issues, enhancing recovery from surgery, and other specific plastic surgery topics.

“The trip was nothing short of a resounding success,” Westerhout said. “In six days the team screened 60 potential plastic/reconstructive patients and performed 60 procedures on a total of 25 patients. We trained 24 medical professionals, including anesthesia residents and anesthetist students.”

Of the small team of doctors, three were LLUSM graduates. Watson credits this to the fact that service is in the DNA of the school’s alumni. Reuben A. Sprengel ’53-A and Helen SN’63, Sprengel’s parents, were missionaries in Thailand at the same time as Watson’s parents, Paul M. Watson ’59 and Ruth, were missionaries there; Westerhout’s grandparents, Elton L. Morel ’30 and Marion, were missionaries in the Congo and Malawi, and his uncle Elton S. Morel ’58 and aunt, Carol, were missionaries in the Philippines. This family history inspired Westerhout to join the Peace Corps in Guatemala for two and half years before attending medical school.

Watson feels strongly that “we need to encourage and nurture this ‘mission-mindedness’ in the next generation of LLU graduates.”

Westerhout emphasizes that service distinguishes LLUSM grads because service is “baked into” who Loma Linda University grads are historically. “Mission service is encouraged at Loma Linda. Loma Linda grads should consider volunteer service both abroad and domestically,” Westerhout said.

“Anyone can do mission trips,” Watson added, and make a major impact, even in just one week.

Safety for patients and physicians is often a concern when considering serving abroad. Watson assuages those fears: “These trips can be done with a high level of safety, both safety for the volunteers not getting sick, and safety for the patients. Mission Plasticos is a good poster child of how to do it right.”

Elias’s life is forever changed thanks to the expert care he received through Mission Plasticos. Watson released the burn scars and filled the spaces with full-thickness skin grafts from Elias’s abdomen. This procedure allowed him to move his head with fewer restrictions, and his eyes and mouth are no longer pulled down by the scarring. “After surgery, [Elias’s father] could not stop thanking us,” Sprengel shared.

“With less than 30 plastic surgeons in a country of 50 million,” Watson said, patients like Elias would not have received care without the Mission Plasticos team.

About two months after the surgery, Gathiri said Elias is gaining weight because the scars around his mouth have been released, and he is now a happy little boy.

“We made an impact locally,” Watson said. “That was undeniable.” 

Support Mission Plasticos

Mission Plasticos has been impacting lives for 25 years through reconstructive surgery. Find out how you can get involved and support their mission.

Go to www.missionplasticos.org

Danelle M. Taylor Johnston, MA, is fascinated with the human voyage, documenting stories through writing and photography; and loves spending time in nature.