Marblehead Surgeon on Vietnam Mission

Just as temperatures were beginning to plummet on Friday morning, Marblehead resident Gabriel Merlin was getting on a plane bound for Vietnam, by way of South Korea. In his checked luggage was a variety of tools, including pins, screws, and plates. “Hopefully it all makes it over,” Merlin told Marblehead Beacon the evening before his trip, noting that TriMed had donated the all-important surgical hardware. The orthopedic surgeon is part of a mission trip with The Touching Hands Project, which supports specialists like Merlin who want to volunteer their time and skill to handle much-needed treatment and physician training in places like India, Ethiopia, and Vietnam. 

For Merlin, who works for Coastal Orthopedics, this mission to Da Nang, Vietnam is his second. “I went in 2019 for the first time,” he said, motivated by a friend and fellow surgeon–Dr. William Slikker, who works for Kaiser Permanente in California. “He’s been there five or six times,” said Merlin.

The plan for the week-long stay is to begin with a marathon day tomorrow, in which the two doctors and their team of Certified Registered Nurse Anesthetists (CRNAs) will meet with the many adults and children waiting to be seen for a variety of hand traumas and congenital defects at the Da Nang Orthopedic and Rehabilitation Hospital. “Last time there were about 125 people lined up, and we saw all of them,” Merlin said. Once the team has seen everyone, the physicians stratify–making determinations on those who can be helped by interventions other than surgery. For instance, Merlin said, some have pain or injuries that can be addressed by steroid injections, splints, or other non-surgical treatments. The CRNAs are integral to the mission, as they work alongside an on-site anesthesiologist, and also handle things like nerve blocks in place of general anesthesia. 

Vietnam, said Merlin, has a high concentration of severe hand injuries and congenital issues–things like polydactyly, syndactyly, macrodactyly and thumb duplication. The reason for many of the severe hand injuries, he said, is largely due to the fact that one of the more common ways to get around is by motorbike. “Even the children ride these,” he said. “There are a lot of accidents because of it, and because there is no public transportation there.” As far as congenital defects, Agent Orange and generational genetic issues are believed to be significant contributors. 

In addition to the above, Merlin expects that cleft and club hand procedures and amniotic band syndrome surgeries will likely be on the team’s agenda this week. Importantly, he said, the doctors conduct surgeries with which they are already very comfortable doing in their practices at home. Merlin’s sub-specialty is “the shoulder to the fingertip,” and while he has extensive experience and familiarity with this area of orthopedics, surgeries on the hand can be especially tricky no matter who is conducting the surgery. The fact that one’s hands are so critical to routine activities makes these procedures critical, but they also have inherent complexity due to the small structures in the hand, as well as nerve and blood-vessel dissections being delicate. Merlin, who did an extra year in a hand-and-upper-extremity fellowship, is Board certified in both orthopedic surgery and surgery of the hand. 

While in Da Nang, Merlin and Slikker will be training a local surgeon–Minh Vo Hoang–with whom they worked on their last mission trip in 2019. Vo Hoang is a very motivated talented physician, according to Merlin, and was slated to do a fellowship in France, but Covid restrictions stopped that. Now Merlin is one of the people behind the effort to ensure that the talented Vo Hoang gets a traveling fellowship in the United States so that he may bring back new skills to Da Nang. 

If this week’s outreach mission is anything like the one the team took on in 2019, people will have traveled from all across Vietnam to be seen by Drs. Merlin and Slikker and their team, many of whom will receive life-changing surgeries and treatment. Stay tuned for more following Dr. Merlin’s return from Da Nang. To support mission trips like the one Dr. Gabriel Merlin is on, contributions may be made to Touching Hands, which is part of the https://www.assh.org/s/.