Plastic surgery has a very wide range of surgical procedures, from hand surgery, burn surgery, to cosmetic surgery. More and more plastic surgeons, especially the ones that are more involved in reconstructive surgery are willing to share their knowledge with overseas doctors, and to provide their skill to poor patients of the developing countries.

The European society of plastic, reconstructive and aesthetic surgery, (ESPRAS) has founded in 2008 a humanitarian section called SHARE: Surgical Humanitarian Aid Resources Europe.

Its goal is to gather a number of NGOs specialised in reconstructive surgery; these NGOs are performing different procedures all over the third world, such as burn acute surgery, post burn reconstruction, cleft lips or palates, hand surgery, post traumatic surgery, nomas, …

ESPRAS SHARE acts like a clearing house. On the one hand, requests for humanitarian aid are welcomed; on the other hand a database will be run containing plastic surgery teams volunteering to perform humanitarian work. SHARE’s core business thus is a brokerage function mediating between demands and volunteering offers. Centralizing this coordination hopes to prevent overlap, to stimulate sustainability, and to safeguard ethics.

The goals of ESPRAS SHARE thus are to facilitate and better coordinate humanitarian activities involving European plastic surgeons, and to improve the quality of humanitarian aid given by European plastic surgeons so that no harm will be done and so that the aid contributes to sustainable development of reconstructive plastic surgery in receiving countries.

In reaching targets of sustainability and better coordination, improving communication between the various organizations and individuals engaged in humanitarian aid is necessary. And ESPRAS SHARE is an ideal tool to obtain that.

Training and education are the primary instruments to reach the goal of sustainable development of reconstructive plastic surgery in host countries. These instruments are therefore among ESPRAS SHARE’s priority concerns.

On January 12th 2010, one of the most important earthquake of the last centuries happened in Haiti. In less than one minute, a seven million people area was devastated and dislocated, leaving over 400 000 dead people and at least the same amount of severely wounded women, men ,and children… all very poor, without any medical resources. Half the hospitals of the capital, Port Au Prince were out of order.

The international help to Haiti was immediate. Tons of material was immediately sent. Teams from all aver the world, spontaneously arrived on the island, covering many fields… medical, logistics, building, nutrition….

 Plastic surgeons from different part of the world , were volunteers to spend a part of their time in order to operate the great amount of injured people living in the street… not daring to go back to their house…. When they still had one….

The humanitarian branch of ESPRAS, SHARE, immediately reacted to this and organized a SURGICAL BRIDGE TO HAITI;

One week after the catastrophe HumaniTerra France, NGO member of SHARE, was on the island with a plastic surgery team, an orthopaedic team and an gynaecological team. SHARE then sent 12 other surgical teams over a period of 2 months. Each team performed, more or less, an average of 70 surgical procedures, and took care of many out patient, particularly with a great amount of dressings. Surgeons, anaesthetists, nurses and physiotherapists, were coming from HumaniTerra France, Interplast Germany, HumaniTerra Italy, and Interplast Holland.

Those groups have mainly been working in two different private hospitals, CDTI ( Sacre-Coeur) in the centre of Port Au Prince, and in Dikini Hospital, in the suburbs.

Cooperation with the other foreign humanitarian teams has been most of the time very good.

 Operating conditions were very difficult at the early beginning. Then things became more organized and we could even share some members of our teams with American teams ,for instance, working all together , for the same goal, to save as many people as we could.

During two weeks after the earthquake, as everything was destroyed, our staff was sleeping on the ground, in open air or under small tents. Then we could be hosted in an empty orphanage were a cook was preparing meals, but the living conditions were still very very bad. After two months we at last could get a proper house, used as a real guest house. Last teams were much more lucky than the first ones…

Things are still very slow in Haiti and money is not coming as easily as we might think . political problems are still numerous and reconstruction of the national health services is a very difficult are complicated thing;

After the acute period, time for reconstruction has now come.

During the initial period SHARE team were operating in private, or semi private hospitals, most of the public ones being out of order or nearly…

The university hospital (HUEH, Hopital Universitaire de l’Etat d’ Haiti) was very much damaged, and the operating theatres were not properly functioning.

Today SHARE is willing to support the public health system on the island, and therefore has not real possibility to operate, due to the very bad condition of the HUEH.

In order to be able to work in good conditions and to teach and train new young surgeon the priority is to rebuilt and/or restore the surgical ward, the O.T. and the emergency department.

This will be done with the expertise of SHARE teams, especially for the reconstructive surgery and burns part.

Temporary specific operating theatres will be built in the courtyard of the hospital. Technical teams of HumaniTerra, are working very hard on this project, in order to make possible new turn-over of surgical European teams at the beginning of 2011.

SHARE and its partners, is also involved in the reconstruction of the Nurse national institute, that completely fell down during the earthquake, killing two third of the student nurses and their teachers (142 people); the ground breaking of that has been done one September the 23rd. The temporary institute should be built before the end of 2010 allowing then us to teach new nurses… SHARE will provide also help to the training of scrub nurses and anaesthetist nurses who could be then involved as partners for the surgery performed by our teams. .

The Haitian ministry of health has also asked our teams to help to the restoration of the medical faculty, and to the training of the students. This will give us the opportunity to have a much better coloration with local surgeons, during our surgical camps, and after them, in order to have a good follow up of the treated patients.

Reconstruction in Haiti will be long and fastidious. But we cannot avoid this necessary stage of building or reorganisation of the medical health system, before a real surgical involvement of our teams. When all this will be achieved, SHARE will be able to send in Haiti numerous teams in order to organise a complete surgical turn over at the university Hospital for the benefit of the local surgeons and of course, above all ,of the Haitian patients…

 “Prima la musica, poi le parole”….