Lang's One Hope

Lang, a ten-year-old Vietnamese, supported himself and his grandmother by begging in the streets of a small village south of Danang. One day he found something to play with--a white phosphorous grenade. It exploded, killing his two brothers and blinding his grandmother. Nor was Lang spared. The phosphorus seared his face, creating a mask of horror that no Hollywood makeup man could fashion. It also burned away his eye sockets and eyelids, leaving him with large frightened eyes that he cannot close.

Lang's plight is anything but unique. There are anywhere from 50,000 to 100,000 children like him in South Viet Nam. Some are the direct casualties of deadly ordnance fired by both sides. Others are indirect victims, burned while trying to use jet fuel for cooking, scarred by a wasting sickness called noma which is brought on by malnutrition, or crippled by other diseases that might be brought under control during peacetime. But Lang is a little luckier than most. He is being treated at the Center for Plastic and Reconstructive Surgery in Saigon, the only place in Viet Nam that can help large numbers of seriously disfigured or disabled child-casualties of the war. Said one of Lang's doctors,

"He won't be beautiful, but at least he'll be able to close his eyes."

The unusual center was built by Children's Medical Relief International, a private, New York-based organization, and is partially funded by the U.S. Agency for International Development. It was conceived in 1967 by Thomas Miller, now 34, a lawyer and Peace Corps veteran who had read about young casualties and decided to do something to help them. Miller enlisted Dr. Arthur Barsky, 73, the Manhattan plastic surgeon who had operated on women disfigured at Hiroshima, and the two visited Viet Nam later that year. The result of their trip was the creation of CMRI and an agreement from AID to help finance what is now called the Barsky Unit on the grounds of the Cho Ray Hospital. Its dual purpose: to treat and rehabilitate Vietnamese children while training Vietnamese doctors in plastic surgery.

Since then, the Barsky Unit has built up a staff of eleven physicians and treated some 4,000 children. The task has not been easy. Many Vietnamese at first were suspicious of both the hospital and the foreigners--Americans, Canadians and British--who staffed it. The country's chaotic transportation system also prevented many prospective patients from coming to the center; to reach them, CMR1 set up ten screening clinics in the provinces. The procedure of picking patients is a delicate one. Says Dr. John Champlin, 32, CMRl's former screening officer: "It's quite difficult to explain why you can help someone who's missing half his face from noma, but can't help someone who's paralyzed by polio. The medical distinction just isn't that clear to the people."

Children selected for surgery are first admitted to a 120-bed reception center operated by the International Rescue Committee, where they spend weeks building up their strength for surgery. From there, they are moved to the 54-bed Barsky Unit for their operations. Doctors at the center perform 150 operations a month, trimming away scar tissue that has immobilized joints, reconstructing faces ruined by shrapnel or napalm, and fitting maimed children with artificial limbs.

Decades to Go. Although the center, with its wards of hideously disfigured children, suggests a glimpse of hell, many Vietnamese doctors welcome the chance to work there. "There is a unique opportunity to learn here," says Dr. Do Ngoc Thu, 41, the acting medical director. "If you worked somewhere else for a lifetime you couldn't get the experience." Many of the staff, however, find the experience both emotionally exhausting and frustrating. Says Miller, "If the war ended tomorrow, there would still be 20 years of surgery to do."

The pace of this surgery is likely to continue, at least for a while. AID, which is reducing its entire medical program in Viet Nam as part of the general U.S. cutback of activities in the country, had planned to trim the center's budget for the next fiscal year from $475,000 to $146,000. But under pressure from CMRI, the agency has now agreed to contribute $246,000. The funds are essential because AID money is used partly to subsidize the salaries of Vietnamese physicians, whose tiny stipends from the Ministry of Health would otherwise require them to maintain outside practices. Without the U.S. money, the center would lose many of its Vietnamese doctors, and if that should happen, says Miller, "the quality of care would go down just like that."

Despite the reprieve, CMRI officials are not going to rely on uncertain Government financing to keep their hospital going. They are also seeking private contributions to give South Viet Nam's injured children a reason for remaining alive.

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