Dr. Frankie O.G. Fraulin, Pediatric Plastic Surgeon

them to lead healthy, happy and productive lives. The great thing about this team is that the personnel know each other and have often worked closely together at ACH. This collegiality makes for a well-functioning team when put into conditions that are not the same as at home.

Originally a medical graduate of the University of Alberta, Dr. Fraulin subsequently completed an Internship in Victoria and a Plastic Surgery Residency at the University of Alberta. He then pursued Fellowship Training in Pediatric Plastic Surgery at the Hospital for Sick Children in Toronto, Microsurgery at the Bernard O’Brien Institute in Melbourne, Australia and Cosmetic Surgery in Scarborough and the Greater Toronto area. The earliest years in his practice were in Scarborough, Ontario and this is where he first became interested in global surgery. One of his Plastic Surgery colleagues, Dr. Tim Sproule, was very active on international missions with Interplast, later rebranded as Resurge International. Dr. Sproule had also developed his own charity to help burn patients in Guyana. His dedication to helping others in developing countries was stimulating and just as Dr. Fraulin was about to join him on a trip to Asia, Dr. Fraulin ended up moving to Calgary. He left a busy adult and pediatric practice in Ontario to take an academic medical appointment at the Alberta Children’s Hospital and University of Calgary where he currently has an appointment as a Clinical Associate Professor. He has currently limited his practice to children focusing on pediatric hand trauma, congenital hand problems, burns, cleft lip and palate and birthmarks. In 2014 he became the Section Chief of Pediatric Surgery and the Facility Site Chief of Surgery at ACH. When Dr. Connors invited him to help organize a mission to Peru in 2011 to help treat children with burn scars, he was very excited. Why Peru? There was both a need and an opportunity. First, the need. Despite a similar population size to Canada, the rate of burns in children is 100 times more. That means that for every 1 child in Canada that is burned, 100 children in Peru are burned. There is a significant discrepancy between the rich and the poor, and it is among the latter that most of the burns occur. Secondly, the opportunity arose because of communication between 3 charities: Project Outreach, Aniquem, and Friends of Aniquem. Aniquem, the local charity in Lima, is an anacronym meaning Association to help the burned child. This local charity, which includes a plastic surgeon and a family doctor, helped to organize the logistics required for any of these types of missions: government approval, hospital administration paperwork, identification of the patients, post op care and rehabilitation of the patients, etc. Three missions were carried out in 2011, 2012 and 2014 to help children with burn scar contractures limiting function.

In 2015, there was an opportunity to help out in a different part of Peru – Iquitos – in the rainforest, to help children born with cleft lip and palate. The logistics were such that performing burn scar releases, with the inherent requirement for post op care of the grafts and the need for rehabilitation with scar management and physiotherapy, was not an option for this remote town. The only way in or out was by air or by boat. No roads join Iquitos to the rest of Peru. On this trip, we again took a plastic surgery resident and an anesthesia resident. Dr. Fraulin has taken residents on most trips. The residents learn a great deal but also help a great deal. They are a vital part of the team and assist in all aspects of care: pre op evaluation, intraoperatively, and in post op care.

In 2017 and 2018, the Project Outreach team were invited to Vietnam to help with children with cleft lip and palate. Similar to Peru, it was essential to develop a relationship with a charity and with local physicians to facilitate the mission. The charity is called Children of Vietnam Benevolent Foundation and the mission was called Smile of Compassion (http://childrenofvietnambf.org/projects/medical-project/medical-projects/). Why Vietnam? The country has 3 times the population of Canada but probably has 5 or more times the total number of new clefts each year. This creates a significant surgical burden and they do not have the resources (surgeons, etc) to care for these patients. The plastic surgery residents on the 2017 trip, Dr. Rebecca Hartley and Dr. Valerie Hurdle, performed a project looking at the triage process, as they found the experience overwhelming, as we evaluated over 100 patients in a day. Dr. Hartley went on to do a scoping review of cleft mission triage, trying to identify if there is a better way to do it. She presented her work at the Canadian Society of Plastic Surgeon’s (CSPS) annual meeting in Jasper in June 2018. She was also fortunate to receive funding to attend the Bethune Round Table in 2018. Together with Dr. Hartley, and the plastic surgery resident who went on the trip in 2018, Dr. Kody Johnson, Dr. Fraulin performed a project which has been accepted for presentation this spring at the CSPS meeting entitled: Improving patient outcomes on an international cleft mission by implementing a screening and preparation process in advance.

Dr. Frankie Fraulin is a Pediatric Plastic Surgeon and has been at the Alberta Children’s Hospital (ACH) since 2007. He has been part of Project Outreach International Child Health organization (https://www.projectoutreachcalgary.org) since 2011 and has been the head surgeon on multiple missions with this organization to Peru and Vietnam. This not-for-profit organization was originally founded by physicians from the Alberta Children’s Hospital, Dr. Ruth Connors (Pediatric Anesthesiologist) and Dr. Roger Galbraith (Pediatric Emergency Medicine) in 1993. Dr. Connors continues to lead the team, which is made up of surgeons, anesthesiologists, nurses and allied health, all from ACH. The organization is founded on the belief that all children, wherever they live, have the right to basic medical care that will allow

Project OutreachProject Outreach, established in 1993, has been providing medical services to children in the developing world. It is a non-profit organization of medical volunteers that is based in Calgary and was originally founded by physicians from the Alberta Children’s Hospital, Dr. Ruth Connors (Pediatric Anesthesiologist) and Dr. Roger Galbraith (Pediatric Emergency Medicine) back in the day. Dr. Connors continues to lead the team, which is made up of surgeons, anesthesiologists, nurses and allied health, all from ACH.

The organization was founded on the belief that all children, wherever they live, have the right to basic medical care that will allow them to lead healthy, happy and productive lives. The great thing about this team is that the personnel know each other and have often worked closely together at ACH. This collegiality makes for a well-functioning team when put into conditions that are not the same as at home.

For the organization’s first mission 26 year ago, staff from Alberta Children's Hospital traveled to Danang, Vietnam, where they worked with a local pediatric surgeon, Dr. Phung, to perform cleft lip and palate reconstructive surgery. As the first medical mission allowed into Danang after the Vietnam war, it was an incredible experience for all involved. Project Outreach has since conducted several other missions, including additional trips to Vietnam, as well as to Ecuador and Peru.

Project Outreach Peru have partnered with a charity in Lima, Peru. The charity is Aniquem (www.aniquem.org) and their focus is to help children who have sustained severe burn injuries. On top of the hard-to-access medical care in Peru, the specialized surgical care following a burn injury it's a real challenge. In addition, there is no government funding for ongoing support and care for these individuals. As a result, many children will go on to develop severe scar contractures leading to a loss of function both physically and emotionally.

A connection was made with Aniquem and a supporting charity CAFA (Canadian Friends of Aniquem) and a decision made to embark on an inaugural trip to Lima back in 2011. A fundraising event was held in Calgary in April that year with silent and live auctions at the Hotel Arts to support the financial needs of this important event. It was thank to those individuals and corporate supporters who gave money, auction items and time to this worthy cause!

Last year, the Project Outreach team was again invited to Vietnam to help with children with cleft lip and palate. Similar to Peru, it has been essential to develop a relationship with a charity and with local physicians to facilitate the mission all these years. The charity is called Children of Vietnam Benevolent Foundation and the mission was called Smile of Compassion (http://childrenofvietnambf.org/projects/medical-project/medical-projects/).

Vietnam has 3 times the population of Canada but probably has 5 or more times the total number of new clefts each year. This creates a significant surgical burden and they do not have the resources (surgeons, etc) to care for these patients.

Dr. Frankie Fraulin, Center for Global Surgery Advisor. and his residents Drs Rebecca Hartley and Kody Johnson, performed a project which has been accepted for presentation this spring at the CSPS meeting entitled: Improving patient outcomes on an international cleft mission by implementing a screening and preparation process in advance. In late 2019, the team will return to Peru to help children with burn scar contractures.