Thanh Nien News | Health | Plastic surgeon’s 40-year legacy lives on

The present-day National Hospital of Odonto-Stomatology in HCMC was formerly known as the Center for Plastic and Reconstructive Surgery.

Emily Barksy saw tears in the eyes of one of the nurses who met her and her father when they visited Ho Chi Minh City-based National Hospital of Odonto-Stomatology (NHO) 10 days ago.

“They used to work with my grandfather,” she said. Much has changed at the hospital since her grandfather, the late American plastic surgeon, Arthur J. Barsky II, founded it 39 years ago during the Vietnam War.

What was known as the “Barsky Unit” – the only plastic and reconstructive surgery unit for children in Vietnam during the 1970s – has grown into a leading hospital in its field.

“We now treat both adults and children and are the center [of treatment, research and training] for 32 provinces and cities in the south,” NHO’s general planning director Le Trung Chanh said.

For the American doctors at the Barsky Unit who were flown out of Vietnam when the war ended, it would be good to know that locals had picked up where they left off.

“Given their hasty departure, the American physicians feared their efforts to create a sustainable clinic might have failed,” said Emily, a first year student at Harvard Medical School who has written a research project about her grandfather’s work in Vietnam.

Barsky’s efforts began as a result of a series of articles published in the Manchester Guardian about victims of the Vietnam War in the late 1960s.

An American lawyer, Tom Miller, was so moved by these stories that he asked Barsky to come to Vietnam with him to see what they could do, especially for the child war casualties.

Barsky was then a famous plastic surgeon in New York and had been the chief surgeon for the Hiroshima Maidens Project which provided surgery for young Japanese women burned by the atomic bomb during World War II.

Emily said as much as 60 percent of the war casualties in Vietnam were children.

“Practically, all the children’s suffering was war related ” not just direct injuries from gunfire, shrapnel and napalm, but problems such as noma, a disease which eats away a child’s face in a matter of hours and was last seen in Nazi concentration camps,” Miller recalled.

In 1969, Miller and Barsky started the Center for Plastic and Reconstructive Surgery, the “Barsky Unit.”

The center’s mission was twofold: to treat the child victims of the war, and train Vietnamese staff.

From its opening until the American doctors left in 1975, the center, with 54 beds and three operating rooms, treated around 1,200 children.

One of these was Phan Thi Kim Phuc, whose world famous photo of her running naked down a road with her back burned by napalm, shocked the world and won photographer Nick Ut a Pulitzer Prize.

The center, funded mostly by the US Agency for International Development (AID), treated the children free of charge.

The center itself is admired for its apolitical mission by those who know it.

Chanh said humanitarian work is still a big part of the hospital today.

Once or twice every year, it sends doctors to give free training and dental treatment in rural and remote areas, and neighboring countries like Laos and Cambodia.

With the same three operating rooms from its early years, the hospital conducts 45 to 50 surgeries a day and many of them are free as they are paid for by the government.

But the demand is so great that NHO is building three more operating rooms.

A new 11-story building will soon be built on the site of the old Barsky Unit.

NHO’s director Lam Hoai Phuong told Emily she felt saddened to tear down the place and would find some way to honor Barksy’s memory.

Some of the equipment used in Barsky’s time like lights, operating beds, signs and plaques and patients” record card holders was still in good shape today.

And the veteran nurses still talk about the “Barsky techniques” which they are passing down to younger ones.

Chanh said only in recent years has NHO started to return to its American founder’s philosophy: to “give back a completely healed person to society.”

“For many years, we didn”t pay much attention to restoring functions [for damaged facial parts] but focused on giving patients normal looks,” Chanh said.

NHO now has a comprehensive care center which provides post-operation services such as speech therapy for children with cleft lips and cleft palates.

As for the present state of plastic and reconstructive surgery in Vietnam, Chanh said things have improved a lot with time.

When Barksy started his project, no plastic surgery unit existed in the country.

Today, in HCMC, there is one Odonto-Stomatology doctor for every 15,000 people.

“We can say Vietnam’s plastic and reconstructive surgery is almost catching up with the world’s,” Chanh said.

“What Vietnamese doctors can’t do, we invite foreign ones to come and do.”

Reported by Thuy Linh
Story from Thanh Nien News
Published: 04 August, 2008, 11:06:30 (GMT+7)
Copyright Thanh Nien News

July 25, 2009 at 11:37 a.m. SEATTLE TIMES

Travel to Cuba

Posted by Bruce Ramsey

By Betsy Cummings
Published: Thursday, January 27, 2005

It used to be that a $50 microloan to start an embroidery kiosk or other modest enterprise was a gateway out of poverty for women in poor countries. Now, some of them are telling aid groups that that is no longer enough. Rather, they want hundreds or thousands of dollars to build small businesses, hire employees and establish themselves in a developing marketplace.

After almost three decades, the microloan movement has created a global network of tens of millions of female entrepreneurs and, just as important, a growing subclass of sophisticated businesswomen who are collectively helping to lift their nations out of poverty.

As these new entrepreneurs proliferate, their demand for more capital is prodding microloan companies to rethink the size of their financing offers. Whereas seven years ago the Asian Credit Fund, a lending institution in Kazakhstan created by the American humanitarian agency Mercy Corps, offered mostly $40 loans, for example, today borrowers can receive up to $10,000 – enough to rent office space, hire staff, purchase equipment and otherwise expand their operations.

“What started as a microfinance institution is starting to move into small and medium loans” purely out of market demand, said Nancy Lindborg, president of the Washington office of Mercy Corps. In Kazakhstan, 67 percent of the Asian Credit Fund’s borrowers are women.

In Mongolia, XacBank, a similarly expanding lending firm also established by Mercy Corps, helped one woman expand her bakery from a $100 enterprise into a $75,000 operation with 37 employees that operates 24 hours a day. XacBank gave her a series of loans of increasing size, starting with $2,000 in 2001 and, most recently, $24,000.

Figures for worldwide microloans vary widely, from 70 million to 750 million outstanding, said Christina Barrineau, chief technical adviser for the International Year of Microcredit 2005, a United Nations initiative to expand microfinancing opportunities.

Whatever the figure, 28 years after the microloan movement was introduced by Grameen Bank of Bangladesh in the mid-1970s, the number of entrepreneurs in poor countries is huge, perhaps accounting for nearly one in every 10 adults. The Global Entrepreneurship Monitor, an annual study by Babson College and the London Business School, this month reported 73 million of 784 million people surveyed in 34 countries owned new businesses.

And most of them are women. “You can say that microfinancing is now reaching 80 million families, 90 percent of the borrowers being women, and that’s just the tip of the iceberg in terms of demand,” said Alex Counts, president of Grameen Foundation USA, a microfinance organization in Washington and an arm of the Grameen Bank.

While microloans have long been a strategy to alleviate destitution among women, they also have the broader purpose of pumping up local economies “by helping to support a vibrant, small-business sector,” Lindborg said.

Not all that much money is available for the new wave of hundreds or thousands of dollars, as opposed to microloans of $100 or less. Grameen Bank, which has made loans to 3.7 million borrowers across the globe, 96 percent of them female, has increased the size of some loans, Counts said.

The problem is that social-service agencies whose goal is to eliminate poverty figure their job is done if they help poor women create thriving, if tiny, businesses, he said. To assure steady, continued growth in a region, larger, more sophisticated businesses must be formed, he said, yet many aid organizations are not structured to finance them.

For many poor women, like the 11 percent of female entrepreneurs in Kabul who are war widows, starting a business is the only hope for survival.

Of the few banks established in Kabul, “none of them are lending,” said Katrin Fakiri-Wardak, managing director of Parwaz, a Kabul-based microfinancing company.

In some rural areas, a combination of cultural constraints, lack of financing, a lack of transportation and the absence of basic resources like supplies and skilled labor make starting a business an almost impossible dream for women. And in cities like Kabul, while starting a microbusiness can be relatively easy for women, taking it to the next level can be a daunting task.

But it can be done. In the final days of repressive Taliban rule in Afghanistan, Kamela Sediqi was able to squeeze out a modest income from a small tailoring business in her home with the help of her family. But there was a limit to her expansion, and a limit as well to her desire to continue in the tailoring business.

Now, after the war and under a new government, Sediqi runs the New Pimar Construction Co., a growing business of 250 women that has secured a few public works projects.

By any Afghani’s standards, that would be a small-business success story. But Sediqi, 28, who recently visited the United States to take part in a business-training program, said she is just getting started. There is only one problem: She cannot secure a loan to expand, despite steady growth and a business that generates $28,000 a year in revenue.

In 2004, Sediqi secured three building projects, including a dam and structures on an ox farm. But her goal is to land 10 jobs a year and triple her annual income. To do that, she said she needed $70,000 to purchase necessary machinery – a gargantuan sum in a country where the average annual income is less than $200.

“More women want sophisticated businesses,” said Sediqi, who started her tailoring business in 1996 with about $100, and her construction company three years ago with $50,000 that she had painstakingly saved from her tailoring business. “They have good ideas, but a lot of family problems” – meaning opposition from tradition-minded male relatives – in addition to financial and training hurdles.

What is more, many programs do not take into account the ability of women to spin the experience of these homegrown businesses into something larger. That is a missed opportunity, experts say, because women have a nearly 100 percent repayment record on microloans.

By BETSY CUMMINGS
Published: January 27, 2005

Correction Appended

Photo: Bangladeshi women gathered at a home in Dhaka recently to pay installments on microloans they received from Grameen Bank, which was founded to help the poor become small-business owners. (Photo by Rafiqur Rahman/Reuters)

It used to be that a $50 microloan to start an embroidery kiosk or other modest enterprise was a gateway out of poverty for women in poor countries. Now, some of them are telling aid groups that that is no longer enough. Rather, they want serious money — in some cases, several thousand dollars — to build small businesses, hire employees and establish themselves in a developing marketplace.

After almost three decades, the microloan movement has created a global network of tens of millions of female entrepreneurs and, just as important, a growing subclass of highly sophisticated businesswomen who are collectively helping to lift their nations out of poverty.

As the number of these new entrepreneurs expands, their demand for more capital is prodding microloan companies to rethink the size of their financing packages. Where seven years ago the Asian Credit Fund, a lending institution in Kazakhstan created by the American humanitarian agency Mercy Corps, offered mostly $40 loans, today borrowers can receive up to $10,000 — enough to rent office space, hire a staff, purchase equipment and otherwise expand their operations.

”What started as a microfinance institution is starting to move into small and medium loans” purely out of market demand, said Nancy Lindborg, president of the Washington office of Mercy Corps. In Kazakhstan, 67 percent of the Asian Credit Fund’s borrowers are women.

In Mongolia, XacBank, a similarly expanding lending venture also established by Mercy Corps, helped one woman to expand her bakery from a $100 enterprise into a $75,000 operation with 37 employees in an eight-room building that operates 24 hours a day. XacBank gave her a series of loans of increasing size, starting with $2,000 in 2001 and, most recently, $24,000.

Figures for worldwide microloans vary widely, from 70 million to 750 million outstanding, said Christina Barrineau, chief technical adviser for the International Year of Microcredit 2005, a United Nations initiative to expand microfinancing opportunities.

Whatever the figure, 28 years after the Grameen Bank of Bangladesh helped start the microloan movement in the mid-1970’s, the number of entrepreneurs in poor countries is huge, perhaps accounting for nearly 7 in every 10 adults. The Global Entrepreneurship Monitor, an annual study released this month by Babson College and the London Business School, reported 73 million of 784 million people surveyed in 34 countries were the owners of a new business.

And most of them are women. ”You can say that microfinancing is now reaching 80 million families, 90 percent of the borrowers being women, and that’s just the tip of the iceberg in terms of demand,” said Alex Counts, president of Grameen Foundation USA, a microfinance organization in Washington and an arm of the Grameen Bank.

While microloans have long been a strategy to alleviate destitution among women, many of them widows with no source of income, they also have the broader purpose of pumping up local economies ”by helping to support a vibrant, small-business sector,” Ms. Lindborg said.

Not all that much money is available for the new wave of miniloans of hundreds or thousands of dollars, as opposed to microloans of $100 or less. Grameen Bank, which has so far made loans to 3.7 million borrowers across the globe, 96 percent of them women, has increased the size of some of them, Mr. Counts said.

The problem is that social service agencies often assume their job is done if they help poor women create thriving, if tiny, businesses, he said. But to assure steady, continued growth, larger, more sophisticated businesses must be formed, he said, and many aid organizations are not set up to finance them.

For many impoverished women, like the 11 percent of female entrepreneurs in Kabul, Afghanistan, who are war widows, starting a business is their only hope for survival. But it can be extremely difficult for them to tap into outside financing to expand them from their rudimentary beginnings.

Of the few banks established in Kabul, for example, ”none of them are lending,” said Katrin Fakiri-Wardak, managing director of Parwaz, a Kabul-based microfinancing company. Some larger loans from international organizations have a nine-month application process, she said, and ”most loans by family members are limiting because they don’t have that much money.”

Cultural biases often hold women back from the entrepreneurial path. A lot of private agencies, known in the aid community as nongovernmental organizations, or NGO’s, sometimes restrict the help they are willing to give to women. ”A lot of NGO’s have a very strong, faith-based perspective and they may have a particular slant on what’s appropriate for women to do, which may shape what they help women go into,” Ms. Barrineau said.

On top of that, female entrepreneurs who do find outside capital sometimes pursue self-defeating business strategies, like spreading the money over several microbusinesses rather than concentrating on one.

”Seventy to 80 percent of the world’s poor are running very basic businesses as a survival mechanism,” Mr. Counts said. But those basic businesses are less likely to generate substantial growth.

In some rural areas, a combination of cultural constraints, lack of financing, transportation and basic supplies make starting a business an almost impossible dream for women. And in cities like Kabul, while starting a microbusiness can be relatively easy for women, taking it to the next level can be a daunting task.

But it can be done. In the final days of Taliban rule of Afghanistan, Kamela Sediqi was able to squeeze out a modest income from a small tailoring business in her home with the help of her family, including a brother who could serve as a male front. She even managed to hire several other women to sew clothes in neighboring homes. But there was a limit to her expansion, and a limit as well to her desire to continue in the tailoring business.

Now, after the war and under a new government, Ms. Sediqi runs the New Pimar Construction Company, a growing venture of 250 women that has secured a few public works projects.

By any Afghani’s standards, that would be a small-business success story. But Ms. Sediqi, 28, who recently visited the United States to take part in a business-training program, said she was just getting started. There is only one problem: She cannot secure a loan to expand her company, despite its steady growth into a profitable business that generates $28,000 a year in revenue.

In 2004, Ms. Sediqi secured three building projects, including a dam and buildings on an ox farm. But her goal is to land 10 jobs a year and triple her annual income. To do that, she said, she needs $70,000 to purchase necessary machinery — a gargantuan sum in a country where the average annual income is less than $200. So far, she can find no financial backers.

”More women want sophisticated businesses,” said Ms. Sediqi, who started her tailoring business in 1996 with about $100, and her construction company three years ago with $50,000 that she had painstakingly saved from her tailoring business. ”They have good ideas, but a lot of family problems” — meaning opposition from tradition-minded male relatives — in addition to financial hurdles, she said.

Ms. Sediqi recently completed the training program, Project Artemis, at Thunderbird, the Garvin School of International Management in Phoenix, a pilot program meant to help Afghanistan’s female entrepreneurs learn to market their services better and become more shrewd entrepreneurs.

”There is so much drive and desire to learn” entrepreneurial skills in Afghanistan, said Ruxandra Boros, a consultant in Afghanistan with the International Labor Organization, part of the United Nations. But the training for women is generally absent.

Many loan programs do not take into account the ability of women to spin the experience of these homegrown businesses into something larger. That is a missed opportunity, experts say, since women have a nearly 100 percent repayment record on microloans. That success has helped organizations like Grameen Foundation USA to expand its budget from $100,000 in 1997 to $11 million today.

Last August, Mr. Counts of the foundation visited a woman in India who, through a $50 starter loan, had expanded her 20-chicken farm to one with more than 500 chickens. Her borrowing power has risen to accommodate a $2,000 loan, a huge sum in her community. The success of some of these women, Mr. Counts said, is the ”equivalent of Steve Jobs inventing a computer in his garage.”

Correction: February 10, 2005, Thursday An article in Business Day on Jan. 27 about lending institutions that provide microloans to entrepreneurs in Asia referred incompletely to the origin of one such bank. XACBank in Mongolia was started in 1998 as XAC by two development agencies at the United Nations, not by Mercy Corps. A merger in 2002 changed the name to XACBank and made Mercy Corps the largest shareholder.

[Link to NYTimes.com article]

Published: Sunday, March 21, 2004

The Taliban may be out of power, but the plight of Afghanistan’s women goes on. There are trappings of new freedoms — foremost among them a constitution that recognizes women’s rights — but in much of the countryside women and girls are still treated like chattel. As Carlotta Gall of The Times has described vividly, many young women find their lives so unbearable that they set themselves on fire to escape.

Amid this despair, it’s heartening to see individuals and groups finding innovative ways to help rebuild the lives of Afghan women, often one or two at a time.

Parwaz, which means ”take flight” in Dari, is one such effort. Directed by Katrin Fakiri, an enterprising Afghan-American who worked in Silicon Valley before 9/11, Parwaz has given loans of $100 or less to about 600 women who are trying to start very, very small businesses. That might mean buying a cart and fruit for the market or becoming a seamstress or turning the kitchen into a little bakery.

Like other groups working to teach women to read, or those rebuilding health facilities demolished by the Taliban, Parwaz has had to make some concessions to Afghan realities. Male relatives co-sign loan applications, as a way of making the men feel invested in the women’s businesses, instead of threatened by them. The interest rate is cleverly called an application fee — spread over the term of the loan, of course — to comply with the letter of Islamic law. There is also the awkward fact that some of these women are in the burka-sewing business.

Mirroring microfinance’s promising track record in other places, 98 percent of Parwaz’s clients make their payments on time and in full. It is but one example of the current homegrown and international efforts to improve the lives of Afghan women. Far more are needed.