Life can be cruel to a child born in the high mountains of Ecuador.
Poor prenatal care, birth deformities, cooking fires and traumatic accidents can leave a child too disfigured to attend school or earn a living. Medical remedies are usually too costly or simply unavailable.
But not always.
On Nov. 5, a 15-member team of plastic surgeons, anesthesiologists and nurses will leave Maryland for Ecuador, traveling at their own expense, on their own time.
In Ecuador, they will perform 10 days of marathon surgery, operating on as many as 70 children between ages 2 and 18 at no cost to their families.
They'll be led by a retired Montgomery County surgeon, Dr. Thomas Koury, and his wife, Elizabeth. In their baggage will be 30 boxes of medical supplies furnished by area hospitals and $5,000 worth of antibiotics supplied by the tiny Rotary Club of Pikesville.
The team is traveling under the auspices of the Kourys' "I Care -- Children of the Andes Foundation." They are set to leave Nov. 5 from Reagan National Airport and return Nov. 15.
Koury, 75, who lives in Brookville, trained as a dentist and a plastic surgeon. He teaches medicine at Georgetown University, but retired from his private practice two years ago. "I was tired of fighting with HMOs," he said.
He established his foundation and began his missions to South America in 1989 after meeting a Peruvian surgeon who said he had more cleft lip and cleft palate cases at home than he could handle.
"I decided I would operate for free, giving back what the world has given to me," Koury said.
When Shining Path revolutionaries made Peru too dangerous, Koury's teams began going to Ecuador in 1993. There, they work mostly in military hospitals where soldiers provide security.
This year, they will be going to Cuenca, Ecuador's third-largest city, perched 8,200 feet up in the Andes.
Many of the surgeries are needed to correct congenital deformities, including cleft lip and palate, Koury said. But there is much more. Some children are born with webbed fingers or without ears. Some have hemangiomas -- vascular tumors of the face -- or deformed eyelids. Many children have burn scars that have contracted, leaving their hands or necks immobile.
"What we try to do is make the children acceptable to go to school and fix their hands so they can earn a living," Koury said. "We do not do cosmetic surgery."
Their visits are advertised on local radio and TV. So many children show up seeking help that the team is forced to perform triage -- accepting 70 for surgery, and turning the rest away. Occasionally, they will bring a child back to the United States for more extensive treatment.
Louis Shemer, Pikesville Rotary Club president, said the 25 members of his organization began helping the charitable effort last year after Koury -- a fellow Rotarian -- spoke to the group and made a slide presentation about his work.
"I'm telling you, some of the women and guests had to turn their faces away," Shemer said. But they were moved to lend a hand.
This year, when Koury reported that his team needed antibiotics, the club contacted local representatives of drug company Pfizer Inc., and secured a donation of drugs worth about $5,000.
Koury said the antibiotics are crucial because most of the children will return to homes where hygiene is poor. The Rotary's drugs will be enough to treat 20 patients for two weeks.