We walked 10 minutes through town to the hospital where we had patients waiting for screening. The hospital director, Dr. Thomas Rogers, arranged for two assistants, both who worked in the hospital as an x-ray technician and dental laboratory technician. A few patients came the first day and we took impressions, poured models and sculpted the deformed parts.

All of our prostheses were made out of acrylic resins, for its durability in this environment. As time went on, more patients arrived. Most of our ear patients had arm and/or hand-fingers amputated which made placing of the adhesive a challenge. These people have a strong sense of community and help each other. Some patients walked for 2 days to get to our clinic. In addition, six of our patients had bilateral ear amputation and one had his upper lip amputated. Most of these victims cannot read or write and had no knowledge of their age.

We treated 23 patients and fabricated 29 auricular prostheses. The Interplast surgeons completed 128 operations, including many benign oral tumors (parotid adenomas), 15 cleft lips, and even a successful lip closure on a 9-day-old baby girl.

We were overwhelmed with gratitude from all the patients. Many international non-government organizations (NGO) including the UN are keeping the country stable and with continued international support, many of the amputations and displaced victims can be rehabilitated. Anywhere from 30,000 to 85,000 citizens are reported to have limb amputations.

The ISMR has established a presence at Bo and Kenema. Ideally, we should return and send more maxillofacial prosthetic supplies including flasks, plaster, stone, alginate, earth pigments and acrylic powder and monomer. Establishing a formal maxillofacial laboratory-training program for 6 months to a year in the USA would benefit the ear amputation victims.

It was and is very sad to witness the results of amputation atrocities. Our initial maxillofacial prosthetic intervention brought smiles and a sense of lifting self-esteem to these people.

The ISMR will apply for a WHO formal educational training grant that, if awarded to our designated technician, could begin an ongoing maxillofacial clinic in Sierra Leone.