Each trip to Bhutan lasts about two weeks — to ensure patients heal as fully as possible before the team departs — and involves evaluating anywhere from 60 to 100 potential burn surgery patients. Of the 62 patients evaluated during the most recent trip in May, 32 underwent surgery.
Sam R. Sharar, M.D. ’83, Res. ’85, ’86, ’90, Fel.’91, a UW professor of anesthesiology based at Harborview, has been traveling to Bhutan as part of the Harborview Burn Center team since 2009.
“The patients we see fall into three categories,” Sharar says. “Acute burns, meaning patients show up with very recent burns, kids with post-burn scars due to open-flame accidents that were never treated, and adults who’ve sustained burns as children and then suffered contractures, sometimes for decades, and have learned to function with those disabilities.”
Disabling post-burn contractures form when burns go untreated, resulting in a shrinking — or contracting — of the scar tissue. This shrinking can cause lifelong deformities and severely restricted movement.
That was the case with 5-year-old Dema, who traveled with her family from rural Trashiyangtse in the northeastern corner of Bhutan, a three-day journey from Thimphu.
Like so many of the burn patients seen by the institute’s team, Dema traveled to Thimphu’s new hospital at the request of Bhutan’s 31-year-old ruler, King Jigme Khesar Namgyel Wangchuck. A steadfast supporter of the institute’s work, the king made sure word got out to local villages that burn-care screenings would be taking place. For many, that meant a three-day walk just to get transportation to carry them along Bhutan’s single road to the capital city.
The burns on Dema’s right palm and fingers were the result of an accident caused by a cooking fire when she was nine months old. With time, the burn healed, but the contracture scars that held her third, fourth and fifth fingers flexed tightly against her palm made her right hand essentially non-functional.
Enter Heimbach, who, together with local Bhutanese general surgeon Dr. Tashi Dendup, Sharar, and Harborview Burn Center nurses Fran O’Donnell, R.N., and Debra Ford, R.N., worked to restore functionality to the child’s right hand. The surgeons were able to release her third and fourth fingers, apply skin grafts, and amputate her deformed fifth finger. Five days later, her dressings were removed to reveal healthy skin grafts to her palm, and she began physical therapy to regain use of her fingers.
Dema’s is just one of hundreds of burn treatment success stories that have resulted from this reciprocal partnership. From a three-year-old boy who saved his puppy from a fire, to a young woman burned on her face and arms by a propane stove that flared unexpectedly, each case is a new opportunity to help patients heal and to teach local providers the finer points of surgical and post-operative burn care.
“A burn is forever and, if not cared for properly, it becomes a huge problem,” Heimbach says. “We are very encouraged by the work we’ve been able to do in Bhutan, as well as at Harborview, with this dedicated team. And we hope we can continue this partnership — and our wonderful friendship with the Bhutanese people — for a very long time.”
by Clare Hagerty