From inspiration to action: Q&A with Dr Hannah Eliza John
Cleft surgeon Dr Hannah John has just returned from her first Operation Smile surgical programme in the Philippines. She tells us more about her journey to become a volunteer surgeon.
Cleft surgeon Dr Hannah Eliza John has just returned from the Philippines, her first surgical programme as an Operation Smile volunteer. Hannah started her medical training in India, but her inspiration for cleft surgery came from working with plastic surgeon and Operation Smile volunteer Mr. Per Hall in Cambridgeshire. Seeing Per return from surgical programmes and hearing about the lives transformed as a result, inspired Hannah to do the same.
We caught up with her recently after her return from the Philippines, keen to find out more as well as some memorable moments from the trip.
Q: Can you tell us about the recent programme you’ve been to in the Philippines? What was your role there?
A: My role was a cleft surgeon and the programme was based in a city called Batangas in the Philippines, about two hours from the capital city Manila. Day one of the programme was a Sunday, and the team had converted a wing of the hospital into lots of different specialist rooms – for speech and language therapists, nurses, dentists, surgeons and anaesthetists, to provide a medical evaluation to all the patients who had arrived. We saw 125 patients on that day itself. In the surgical room, there were 4 of us surgeons who assessed all the patients – it was busy but very well organized. After we [the surgeons] have reviewed the patients, we sent them to the anaesthetist’s room where they are assessed to see if they were fit for surgery and if it was safe to perform the surgery. Some patients were ruled out because they had other medical conditions that could make the surgery too risky as this hospital did not have the necessary systems in place to deal with extremely risky situations. The rest of the week (Monday to Thursday) we started at 7am for the morning brief and started operating by 8am. The first day I didn’t operate because this was my first surgical programme, but I assisted in the OR, to understand the process; and then on the second, third and fourth days – when I was operating – we worked till about 8pm in the evening.
Q: How did it feel arriving at your first surgical programme? Was it overwhelming?
A: The first day was really busy and it was quite intense. We just wanted to see as many patients as possible and not have them wait too long. All the patients were given food packages and nutritional information, which was good. Seeing the huge crowd of patients waiting to be screened was quite daunting. In our surgical room, 4-5 patients had to be seen at the same time in the same room. So it was noisy and hot and there was not much we could do about patient privacy or time to have lengthy discussions on the cleft care pathway as patients on the NHS in the UK would get. But I think my background – because I originally come from India and I trained in a similar government hospital – it gave me a flashback to what it was like in those days. So it wasn’t too hard. But it was quite reminiscent of that time.
Q: How did you feel when you met patients and parents, especially after surgery?
A: You see patients and feel so bad because they haven’t had their operation, when they were babies, as there is no adequately trained surgeon in their local service and it would be too expensive to go for private healthcare. They have been waiting so long for someone to come along. Others might have had their lip done, but not their palate. In fact some didn’t even realise they could get their palate fixed. And you think, gosh, they’ve been going round their whole lives without proper speech, without that option even being given to them. So even on the screening day, when we were telling patients, ‘Yeah, we can do your surgery’, they were just so happy. So grateful. And that’s just amazing to see. And of course, you know, a lot of the parents were just so desperate. And that desperation was very tangible. So it was really good to be there and to do that for them. There were so many patients when we went on the post-op ward round the next day to see them and they’d be sleepy, but still, they’d jump up to see us and be very respectful, very grateful. And then they’ll take their phones and ask for a picture with you so they can remember who did the surgery. So it was very nice to see that. Beautiful.
Q: Do you have a favourite moment from this programme?
A: I think probably the favourite moment would be during one of the post-op rounds when I saw one of the patients after I’d repaired her lip. She was an older patient and during screening her dad was so afraid that we would say no, that when we said yes, we can operate we can fix this, he was just weeping, you know? And that was just so beautiful to see and to see her after and she was happy. It was very moving.
Q: Would you encourage any of your colleagues to volunteer with us?
A: Yes I would definitely recommend Operation Smile. I think it’s because of the organisation, the structure of the organisation, the process and systems in place and how welcoming Operation Smile staff are. And there is no hierarchy like this person is the boss, and everybody else are the minions. But we’re all a team, we’re all working together, we’re all trying to do the best for this group of patients. It is a very fulfilling experience to see the impact you’re making on the patients. And also you feel very valued. The local staff tried to meet all our needs, to ensure we were as comfortable as possible and the food was excellent.
Q: You did your training in India – how hard is it to become a plastic surgeon there?
A: It’s hard. Definitely. I think being a woman is harder, particularly because patients often expect men to be surgeons not women, they often don’t take you seriously. You could do a whole consultation and the patient walks out thinking they have spoken to the nurse and are waiting to talk to the surgeon! As a woman, you may need to take career breaks for kids, while male trainees don’t have those issues and progress quicker than you. And once you have kids, it’s a tough juggling act as with all working moms. So if you choose to have children while you’re training (as I did), that training pathway takes much longer. And the pressures of having to do an exam while juggling a full-time job plus three kids, as in my case, is hard. There’s no easy way around it. But I think we offer something unique to patients. I think we have more compassion and empathy. And particularly being a parent, I think we have a unique perspective, where it’s not just go and operate and sort the problem out. It’s more about seeing the patient, and perhaps even the family, as a whole. And I think women are very good at that.
Q: What would you say to a young girl here in the UK or back home in India who was dreaming of becoming a plastic surgeon?
A: I would say –“absolutely go for it!” You have to know that you really want it, because it’s not easy. But it’s so fulfilling, so rewarding. There’s no other job where you make such a direct difference to a person’s life, because of your skills!
Thanks to Hannah for taking the time to chat to us – we look forward to hearing more about her inspiring journey as a volunteer on future surgical programmes.