Life.Culture.Discovery.

How doctor’s free surgery brings joy to disfigured children in Cambodia

Dr James Gollogly’s Phnom Penh clinic has helped thousands of landmine victims and children born disfigured. ‘Dr Jim’ and his volunteer helpers and backers talk about their 25 years of healing Cambodians young and old

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Chantrea, who had a meningoencephalocele (MEC), was trafficked as a beggar before being spotted by Jock Struthers at Cambodia’s border with Vietnam, in 2012. She is seen here with Struthers, in June 2016, at her family’s home. Pictures: courtesy of Jock Struthers and the Children’s Surgical Centre

Published: 7:02am, 20 Jan 2017Updated: 12:09pm, 20 Jan 2017

Jock Struthers is sitting in a small hospital on the outskirts of Phnom Penh recalling the first time he saw a woman with a brain protrusion that almost obliterated her face.

“It was here, in Cambodia, in Banteay Meanchey province, near the Thai border. I saw her driving a motorbike, then she went into a little shop. It looked like a tumour. You see so many horrendous things ... but this was a young girl.”

Struthers, who’s from New Zealand, was then working with NZAID – the country’s Agency for International Development – talking to pig farmers. He did nothing “and it always worried me”.

That was in 2009. Sometime later, back in New Zealand, he saw a BBC programme. “And, blow me down, there was a boy on it with the same thing and I said, ‘That’s what that girl’s got! She has an MEC!”

An MEC – full clinical name meningoencephalocele – is when the brain and its fluids, improperly fastened within the head, slip down the forehead and settle round the nose. It happens when the hollow neural tube, which will eventually become the brain and spinal cord, is being formed within an embryo. The tube should be sealed at both ends. If the lower end isn’t closed for some reason, the baby may have spina bifida; if it’s the upper end that remains open, an MEC can form. The result varies in size. Sometimes the mass grows so large that the eyes are pushed, fish-style, to each side of the skull.

Chantrea with Struthers, in December 2013, 18 months after her operation at the Children’s Surgical Centre (CSC), in Phnom Penh.

MECs tend to be a Southeast Asian affliction. No one’s 100 per cent sure why but there’s a plausible theory it’s to do with rice harvesting. During the monsoon season, rice stored in a family house may grow mouldy; the mould produces aflatoxins; these interfere with the levels of folic acid in pregnant women; folic acid is needed for the neural tube to be formed without defects.

A baby with an MEC may die young, usually of bacterial infection in the brain. But there are survivors.