MENINGOENCEPHALOCELE (MEC) TREATMENT IN CAMBODIA

An MEC is a protrusion of the brain and cerebral fluid through the front of the skull. A rare condition worldwide, it is more often found in SE Asia and more often in rural Cambodia. The cause of this condition is likely to be nutrition/environment related. It seems mostly associated with poverty and subsistence living, and thought possibly due to the consumption of mouldy rice, producing toxins which interfere with neural tube development in the human embryo.

The condition causes significant distress, may interfere with vision, tear ducts and sinuses and often results in community out-casting of the individual, especially in poor village situations where it is most prevalent. Rupture of or injury to the MEC carries a very high risk of infection and death. During Cambodian assignments, Jock Struthers came across young people with the condition and located a remedy at the Children’s Surgical Centre in Phnom Penh, a hospital run by Orthopaedic Surgeon Dr Jim Gollogly. (www.csc.org ).

Cambodian Surgeon Dr Ngiep and a team of French Surgeons lead by Facial Maxillary Surgeon Dr Fred Lauwers of Toulouse have developed a procedure to enable operations on such patients to remove the protruding encephalocele, repair the hole in their skull with a bone graft and to restore the nose area to as close to normal as possible. Patients normally recover without any affect to brain function and a number will receive follow-up plastic surgery 6 – 18 months later.

Chantrea aged 6 from Svay Rieng Province was located by Child Protection Organisation CCPCR. Seen here the day before, three months post operation and 18mths post op.

In June 2012, Jock Struthers and wife (nurse) Jill rounded up a young girl and three young women from villages in Svay Rieng, Banteay Meanchey and Odtar Meanchey Provinces and brought them to Phnom Penh where they were successfully treated by the French Surgical team who performed 9 MEC operations including the little girl Chantrea (pictured) during their six monthly, one week visit.

The success of these operations drew the interest of the Rotary Club of Phnom Penh which has developed an ongoing program of support, raising sufficient funds to employ a full time MEC co-ordinator at CSC hospital to manage an outreach program to locate and counsel sufferer’s and their families, and to bring them into Phnom Penh for assessment and treatment.

The photos tell the story.

Sotheavy, aged 21 from Banteay Meanchey Province, seen before and three months after her operation and 3 years later, after plastic surgery is complete. Sotheavy has since married.

KNOW OF SOMEONE WHO HAS THIS CONDITION?

Anyone seeking assistance for an MEC patient in Cambodia should contact the MEC co-ordinator at CSC hospital, phone 0883035181 or cscmec@gmail.com or Jock Struthers: .

DONATIONS:

Anyone interested in donating to the estimated US$900 overall cost of locating, transporting, treating and after care of patients, please contact Jock Struthers at or the Rotary Club of Phnom Penh: www.rotaryclubpp.org/contact or the Rotary Club of Bendigo Strathdale Australia through their MEC facebook page: www.facebook.com/mecproject .
Donations on line can be made to rawcs.org.au, Rotary Club of Bendigo Strathdale. Project no. 40 of 2016/2017. The MEC PROJECT. Donations within Australia/Australian residents are Tax Deductible.

Left – Sutures out, 2 weeks post op. Right – A post op scan of an MEC patient revealing the bone graft placed between the eyes and the site where bone was removed from the skull for the graft.

Young man from Khampong Thom - Before and two months after his operation performed by Dr Ngiep. (NB -the after photo has not been “photo shopped” or in any way altered).

Jock and Chantrea await her 6month check up, 18mths post op.

Makara ready for removal of her sutures at day 10. Note the incision made above her hair line to minimise disfigurement.

Makara December 2014, now married.

French Surgeon Dr Fred Lauwers and colleague with Chief Khmer Surgeon Dr Ngiep examine a patient prior to surgery.

The Rotary Club of Phnom Penh presents CSC Hospital with a cheque for $15,000 in December 2016. The payment is towards hospital surgical costs for MEC patients. Funds raised by the club are also used to fund patient identification, counselling and logistical support services.
L-R: Michael Wright, Past President, MEC Program Director; Bountouen “BT”, Hospital Based MEC Patient Co-ordinator, funded by the program; Surgeons Frederick Lauwers and Franck Roux, Toulouse; Dr Jim Gollogly SCS Founder and CEO; Lavinia Page, Club President; Bill Munro, Club Member; Jock Struthers, Rotarian, New Zealand.