Dr. Jon Bennett monitors the heart rate of a young patient in the Fresh Start Surgical Gifts program.
Doctors with big hearts lend
By Delle Willett
From Ethiopia, Adele had a retinoblastoma — a tumor of the eye — which was removed when she was about 3. Using an antiquated method, the doctors didn’t leave enough socket to hold an artificial eye. So she wore an eye patch for the next 10 years until she connected with San Diego’s Fresh Start Surgical Gifts.
In two to three operations, doctors took skin and tissue from her abdomen and the roof of her mouth to slowly rebuild an area in the socket to hold a prosthetic eye that will look normal. The results were amazing, and today Adele is now a beautiful young woman who is very appreciative of the care she received.
From Vietnam, Fluerange was mutilated by her father and left outside to die. After being taken in by an orphanage where she had no stimulation, she was adopted by a loving Canadian family who subsequently reached out to Fresh Start for help for their much disfigured adopted daughter.
“Fluerange needed a new eye and multiple facial operations. Now, only 12, she is the most delightful, full-of-life child, with the strongest character of anyone I have ever met,” said Doctor of Ophthalmology Asa Morton. “These are the kind of people that make me proud to be around. In many ways they give me more strength and power than I give them.”
Fresh Start Surgical Gifts transforms the lives of disadvantaged infants, children and teens with physical deformities caused by birth defects, accidents, abuse, trauma or disease through the gift of free reconstructive surgery and related health care services.
Fresh Start’s founder, the late Dr. Dennis Nigro, a renowned San Diego plastic surgeon, began transforming the lives of youth with deformities in his own office on a pro bono basis in the late ’80s. Through his travels and experiences as a new surgeon, Nigro developed a passion for treating craniofacial deformities and performing plastic surgery for kids who had no means to pay for the surgery themselves. He recognized that there was a whole population of people, especially children, who suffered from a correctable condition but could not afford the medical attention they needed.
By 1991, Nigro’s personal philanthropic efforts and vision had caught on, resulting in the birth of Fresh Start Surgical Gifts.
Fresh Start brings patients to San Diego to be treated by the best doctors in San Diego to deal with very complicated situations. The doctors, who are all volunteers, specialize in treating conditions related to ears, eyes, noses, jaws, lips and palates, tongues, scar revisions, burn scars, hands and feet, breasts, vascular lesions, dental issues resulting from facial deformities and more.
Morton, an ophthalmologist and facial plastic surgeon trained at Walter Reed Military Medical Center, has been on Fresh Start’s team since 2000.
Through volunteering in Pakistan and Guatemala, he saw people with true surgical needs that he couldn’t help on his own. While in Guatemala he found a young boy with a very large tumor wrapped around one of his eyes — a surgery too complicated to do in the area. Ultimately, Morton brought the boy to San Diego to Fresh Start. After two operations, the boy got a fresh start on life.
Returning to Guatemala, where he also volunteers at Help International, Morton has followed this boy into near adulthood, operating on him several more times at Fresh Start.
“Magic, it was magic, all of these people working together. I couldn’t have done it by myself. There is no way that little boy would have gotten what he needed anywhere else,” said Morton.
Fresh Start holds Surgery Weekends six times per year at Rady Children’s Hospital’s state-of-the-art surgical suites which opened in 2010. This 7,809-square-foot facility has 22 pre-and postoperative patient rooms and some of the top medical professionals in pediatric care on staff.
Celene Nigro (not related to Dennis Nigro) has been director of the medical program for 10 years. A registered nurse for over 35 years, she oversees the Surgery Weekends, which accomplish 10 to 15 free-of-cost reconstructive surgeries on Saturdays with follow-up clinics, evaluations and consultations on Sundays at the Fresh Start Clinic at Rady Children’s Hospital.
About 60 patients on average are treated on each Surgery Weekend by about 100 volunteers.
The Fresh Start Clinic is the brainchild and passion of the late Denis Nigro and Dr. Steven R. Cohen.
A part of Celene Nigro’s job is coordinating the specialists available for the needs of each patient on the same Surgery Weekends, and to have the correct number of staff available. Following surgeries, staff and volunteers facilitate a two-stage recovery: one for about an hour in a recovery room and the other to a discharge area where patients get ready to go home or to a hotel.
Prior to the Saturdays of Surgery Weekends, they hold a pre-op clinic to see all patients, give them their information, meds, and antibiotics with the help of a nurse-practitioner.
Everyone has a favorite story. Nigro’s is about Lucia Santos, who has been with Fresh Start for 20 some years. He’s gone from being a little-kid patient from Tijuana to a big-adult medical student who wants to be a plastic surgeon, and to have lots of kids who all become doctors, as his way of giving back.
Lupita Morales, patient services manager, has been with Fresh Start for over seven years, overseeing incoming patient applications which come from individuals and doctors from all over the world.
Once Morales has vetted the applicants and attained all of their necessary medical records, their cases are presented to the volunteer surgeon committee that determines whether the cases are within their scope of expertise.
To qualify for medical services, typically patients are from financially disadvantaged families, are uninsured, under-insured or would face significant financial hardship if they had to pay for their medical treatments, and who don’t have medical insurance or qualify for state-funded programs. They also treat patients who are denied insurance coverage for their condition, or who cannot afford to pay for the many follow-up surgeries and treatments that their condition may require.
“I love helping the kids and their families. When a child has a deformity, the whole family suffers,” said Morales. “Fresh Start means giving a child or adolescent a new life. If we weren’t here and didn’t have the resources to help the kids, I don’t know where they would get the help.”
Patients are accepted from infants to 17 years of age; patients up to the age of 25 must go through a separate Medical Program Committee process.
Morales arranges all patient logistics, including lodging, transportation and food prior to and after the children’s procedures. When the patients are from abroad, she assists in acquiring passports and visas, and all travel needs.
Morales’ favorite story is about 15-year-old Zulema, from Hemet, who had a congenital deformity that affected her ear, jaw and teeth. She was having a tough time as a high school student, being bullied and unwelcome by the other kids. Since being accepted at Fresh Start, she now has braces and will soon have surgery to correct her jaw and to reconstruct her outer ear. It will take between six and 10 surgeries to correct the deformity.
“Her story really touched me. I saw all that pain and hurt they’ve been through turned into happiness and hope. Now she’s the happiest little girl you will ever meet. I get hugs from her … it’s everything to me,” said Morales.
Fresh Start patients often require extensive follow-up and years of surgeries and medical services until the best medical outcome has been reached. For example, their average cleft-lip and palate patient requires seven years of dental and approximately 49 treatments.
As part of the follow-up recovery and restorative process, free clinics are held on the Sunday of Surgery Weekends as well as during the interim between Surgery Weekends. Doctors also open up their offices to see Fresh Start patients in with their regular private patients.
Clinics include dental, orthodontic, laser and speech therapy and range from basic dental hygiene to complex orthodontic work and speech therapy for children with craniofacial disorders. Approximately 25-30 children are treated at each clinic. For those who live far away, the doctors keep in touch through doctors in the U.S. and abroad through Skype and email.
The majority of volunteers at Surgery Weekends and Dental Clinics are medical professionals ranging from anesthesiologists and surgeons to dental hygienists and RNs.
The Fresh Sharp Foundation, launched in 2005, allows 100 percent of contributions to go directly to Fresh Start’s medical programs. Since its inception, over 6,700 children have received their transformations valued at over $28 million.
In 2001, Fresh Start began a collaboration with the Place Surgery Foundation to expand Fresh Start nationally through the creation of Fresh Start Caring for Kids Foundation, with the initial site expansion taking place at the University of Chicago Medical Center’s Comer Children’s Hospital. With this new location it is able to expand its patient base and outreach, and are closer to accomplishing its goal of ensuring that every child born with a deformity receive quality health care.
“Medicine is an evolving field that is becoming more and more challenging. Staying involved with people who have this great need refreshes our memories and recharges the spirit that got us into medicine in the first place,” said Morton.