Twice a year at six-month intervals, 12 or 13 traveling companions board a plane in Washington, D.C., bound for Ecuador. They surely present an unusual group of passengers, each carrying two large boxes and a suitcase, their baggage allowances exploited to capacity. Anything to declare? Well--how about toothpicks, green ink, stuffed toys, or electrocoagulators? Length of stay? Usually about two weeks. Purpose of trip? To drastically and wonderfully alter the lives of Andean children whose futures otherwise would look bleak. The team is led by Swarthmore biology major Dr. Thomas Koury '45.
Koury, a maxillofacial/reconstructive surgeon, has been in full-time practice at Washington General Hospital since 1959, where he is founder and chief attending surgeon at the Clinic for Children with Special Needs. He came to Washington General after Swarthmore, via the dental and medical schools of Temple University; Veteran's Hospital in Philadelphia; and the Marine Corps. He also serves on the faculty of Georgetown University, where in 1986 he trained a Peruvian doctor in plastic surgery. After returning to Peru, the young South American doctor found himself overwhelmed by the number of children needing treatment for cleft palates and other congenital deformities and asked Koury for help. In 1989 Koury took his first team to South America and continued to make biannual visits to Peru until 1993, when a close encounter with a terrorist bomb in Lima caused him to seek a safer location in Ecuador.
During the typical seven to 10 days of work there, the team performs about 60 operations. Coordinating each trip to Latin America is no mean feat; the preparation takes six months of tireless effort. Not only does Koury have to assemble a team of surgeons and operating-room personnel, all of whom are willing to coordinate their vacation time and fund their own airfares, but he also has to provide all the necessary supplies. At his side throughout the entire undertaking is his wife, Elizabeth, who, says Koury, "really does all the work."
The trips are funded through a nonprofit foundation, "I Care--Children of the Andes," formed by Koury and his wife in 1989, and by support from the Rotary Club (Koury is chairman of the international lane of the Bladensburg chapter). Using donations of money, pharmaceuticals, and leftover supplies from four local Maryland hospitals, they obtain all the equipment needed to furnish a fully functioning operating theater. They fill their two-car garage with monitors, electrocoagulators, oxymeters, and electrocardiograms, not to mention sheets, gowns, gloves, and sutures. They even take their own large supply of toothpicks, each of which Elizabeth painstakingly sterilizes and seals in plastic wrap--they are used, after being dipped in green ink, to mark the areas of incision on the child's face. The team also takes a supply of stuffed animals collected and repaired by a young Girl Scout in Gaithersburg, Md. The team members--Koury and his wife, two other plastic surgeons, two anesthesiologists, four operating-room nurses, a recovery-room nurse, a helper, and an interpreter--transport the supplies in boxes to their quarters in Ecuador, where the army usually houses, feeds, and provides them with hospital space. Koury says, "It's quite a cooperative effort; the military acts like the public health service there, so it's ideal."
The doctors' visits are advertised in advance on radio and television, so on arrival they are typically confronted with 150 to 200 potential patients, all of whom they screen to select a group of 60 or so that they will operate on. Those from wealthier backgrounds, also seeking to enjoy the high level of skill and technology that Koury's group offers, are eliminated. The children chosen, he says "are all mountain children from very poor environments, living in conditions with no running water, no cooking facilities other than charcoal fires."
Working 12- to 14-hour days, Koury's first priority is to treat facial deformities that would prevent a child from later making a living or from taking his or her place in society--such as open congenital deformities, large birthmarks, deformities of the eyelids, nose, or lips, and severe burns; cleft palates, which distort speech; and also deformities of the hand that prevent the victim from working. Koury does not perform purely cosmetic surgery on the children. In some cases, if the team cannot help a patient--;for example someone requiring major cranial-facial surgery--the foundation pays for the child to be brought to the United States, put in the care of a foster family, and operated on here.
Koury is seeking to widen his field of action to include other poor countries such as Bulgaria and Sierra Leone. In spite of the complications arising from lack of time, having to pay one's own way, and work for no monetary rewards, he has a huge backlog of doctors and nurses who wish to serve with him. The experience is an eye-opener for team participants, who have included as nonmedical team members Elizabeth Koury's children, Samantha, 27, and Gregory, 24. Transported from the pristine conditions of U.S. hospitals to a relatively primitive hospital environment, they have to learn to improvise. "We've made arm restraints from sanitary napkins, used Caesarean section drapes for children's bed sheets," says Elizabeth Koury. "I tell the nurses, 'You use your brains, and you find a solution to your problem.'" And they know that the children depend on them. "These children are grateful, beautiful children," says Elizabeth. "They don't want perfection, just improvement. And when the nurses see these little children who are not going to get surgery unless it's free, and it gets to 6 p.m., and we say, 'Shall we finish up?' they say 'No.' It really changes their lives." Not to mention the lives of all those children of the Andes.
--Carol Brevart
Working to effect a positive change in people's lives and society. Simple to say. Harder to do. But it describes the work of public interest lawyers Arthur Bryant '76 and Jill Chaifetz '86, whose preparation, paperwork, time, and effort go into legal cases that can yield rewards, but sometimes also heartache.
Arthur Bryant is executive director of Trial Lawyers for Public Justice (TLPJ) in Washington, D.C. Founded in 1982 with the help of consumer advocate Ralph Nader, the international public-interest law firm is an advocacy group and membership organization comprising more than 1,500 attorneys around the world who work with six TLPJ staff attorneys to handle the cases that private lawyers wouldn't normally take. Bryant says the cases TLPJ takes on usually raise important issues of principle and "hopefully have an impact and change people's lives for the better."
From an early age, Bryant says he was "precocious about politics." He leafletted for Lyndon Johnson at age 10 and worked on the campaigns of Eugene McCarthy and Bobby Kennedy in his early teens. He says he identified with the efforts to stop the Vietnam War, but when he observed the protesters at the 1968 Democratic Convention being beaten by police, he decided that this sort of politics would not be for him and turned to the legal process.
"In politics it's about compromise, not fighting for principles. You fight until you can cut the best deal you can," says Bryant, who graduated from Harvard Law School in 1979. "Politics focuses on political power and who has more of it. In court you could lose, but you focus on right and wrong--the merits, not who they liked more."
TLPJ handles cases ranging from civil rights and consumer safety to employment discrimination and toxic torts (suits in which someone is wronged by exposure to toxic material). Private attorneys working on TLPJ cases receive reduced fees and contribute a portion of them to the organization.
"The common theme of the cases we take is that they are precedent-setting cases of social significance where trial lawyers' skills can have an impact," says Bryant. "This is not a job for the person who likes to specialize. You need to be a generalist at a refined level."
Although administrative and fund-raising responsibilities are part of Bryant's daily routine, he spends the majority of his time litigating cutting-edge cases. In the past few years, Bryant has served as co-counsel for the plaintiffs in the Title IX lawsuit against Brown University, which found the university liable for sex discrimination against women in its intercollegiate athletic program. He was also co-counsel for the plaintiffs in Cox v. Shell Oil, which resulted in the country's largest property damage settlement--$950 million--to people whose homes were damaged by faulty plastic plumbing. And in the first state case of its kind, Bryant persuaded the New Hampshire Supreme Court to hold that crash victims could sue the Ford Motor Co. for not installing airbags in its cars.
Named this year as one of the nation's top young public sector lawyers by the magazine The American Lawyer, Bryant says he even finds cases by watching TV or reading newspapers. "Occasionally, I see something that's outrageous and I know I can do something about it. It's a joy to work on issues that make a difference in people's lives," says Bryant, who is married to poet Nancy Johnson and has a 2 1/2-year-old son, Wallace.
Bryant believes our society needs an organization such as TLPJ because "there are still large injustices in the world that need to be fought, and the general market of lawyers has a focus on making profits. Our focus is on doing justice."
"I've always wanted to help make the world a just place," says Jill Chaifetz, legal director of The Door: A Center of Alternatives in New York City. "Many people in our country don't get the minimum of what they need. As an attorney I found I could use my skills to make a big difference in people's lives."
The Door is a five-story renovated warehouse in midtown Manhattan, sort of a one-stop shopping facility for people age 12 to 20 whose needs are not being met by the government, their families, or other social service agencies. The multiuse center, founded in 1972, provides medical and mental health care, substance abuse prevention, social services, entitlement assistance, educational and vocational training programs, job placement--and legal services.
The majority of The Door's legal cases, which Chaifetz oversees, involve issues of immigration, primarily undocumented young people; family law, such as foster care, paternity, child support, divorce; neglect and abuse issues; housing and public benefits issues such as food stamps and Medicaid eligibility.
Chaifetz and her staff of three lawyers also offer preventive services through pamphlets and in educational workshops given to youth organizations across New York City. "We really encourage the clients to understand how the system works and how they can help themselves," Chaifetz says. The legal division closed more than 700 cases in 1996, and Chaifetz expects almost 800 this year.
Chaifetz graduated from New York University Law School in 1989 after majoring in political science at Swarthmore. She first joined The Door as a volunteer attorney and in 1992 was hired to create the legal services center. In addition to her staff, she coordinates the work of 65 volunteer attorneys and law students.
A typical day for Chaifetz includes court hearings or meetings with clients outside the building. In the afternoon there are staff meetings and problem-solving issues to be dealt with. In the evening hours, there is intake of new clients. All her professional activities are intertwined with her personal ones, which include 20-month-old triplets Isaac, Leila, and Milo. Chaifetz, who lives in New York City shares the credit of raising the children with her "amazing husband," Daniel Seltzer.
One of the hardest parts of her job at The Door is finding funding to continue to serve her clients. "The need is so great," Chaifetz says. "We are one of only two organizations in NYC to serve kids with these legal problems, but finding funding is a constant challenge. I'm always looking for innovative sources for funding."
Chaifetz says it's rare that a client comes to The Door with just one problem, and recognizing the enormity of a young person's problems can be humbling and at times emotionally draining. But she emphasizes for herself and to her staff the importance of talking about or dealing with their own concerns.
"I tell the staff not to put their grief on the client but also not to bottle it up. I go to other attorneys, and we talk about recognizing it and dealing with it," she says. "It's not easy to hear hard stories. But if our actions put a client in a safe place, help her get enrolled in school, get a job legally, and support herself, it's worth it."
--Audree Penner
Swarthmore College 1997. All rights reserved.