Giant hairy nevus of the face

This young woman came the last day of the trip. She has a giant hairy nevus of the face. This has a significant potential to develop melanoma and, of course, is cosmetically debilitating for the patient. We plan excision with cervico-facial flaps and grafts in the near future. Treatment will require multiple operations. She is ecstatic that hope is nigh.



Don Thompson after 9 surgeries
We have completed 151 surgeries in 19 days. We are really exhausted!



This boy came to see us with a giant abdominal mass. It was a giant spleen. He had pain, anemia and could not eat,  so we did a splenectomy. It was a very large spleen extending from the left diaphragm to the pelvis. He did well after surgery.

Intraoperative view of spleen and surgery team

Giant spleen that has shrunken after several units of blood drained out
Mixing FloSeal (Baxter) to stop oozing from the diaphragmatic surface



This poor lady's breast cancer has recurred twice and she has had two surgeries. based on past experience, she probably has had inadequate resections and inadequate adjuvant therapy. The situation is terrible and I don't know if we have anything to offer her.


Add caption
This poor lady has a long history of a neck mass. It is advanced thyroid cancer. Today we performed a  resection with bilateral pectorals major myocutaneous flaps for wound coverage. We pray she recovers.

After resection-trachea, esophagus and carotid are intact
Right pectoralis flap raised

Bilateral pectoralis flaps and reconstruction


Yesterday, my wife accepted the Henry and Grace Farrar Award for Service in Medical Missions for me from the International Health Care Foundation. I was in Nigeria so I could not accept it myself. I don't like to focus on my individual accomplishments but I mention this one because so many people actually contributed to my being given the award. 

My wife is the most important as she has sacrificed the most. I have spent a huge amount of time in foreign countries, enjoying myself operating, while she has been at home taking care of the mundane business and worrying if I would ever return (both because I was enjoying myself doing my work,  as well as the fact that I might be killed or kidnapped or taken ill). My children have also sacrificed a lot.

My Family-getting ready for the zip line
I probably would never have been in a foreign country operating if it had not been for my mentor. Nearly 30 years ago, through a series of fortuitous events, I found myself on the phone, speaking with Dr. Henry Farrar, a general surgeon from Lebanon, TN. He invited me to join him for 3 months on a mission trip to the Nigerian Christian Hospital (NCH)-a ho.

Dr. Henry Farrar
I could never accomplish the surgery I do without the help of the employees at the Nigerian Christian Hospital, as well as the surgeons and doctors I have met over the years such as Dr. Mike Enyinnah, Dr. Uche Nkeonye, Dr. Chikwe Ifeanyi, Wilson Anyanwu. So many have come and worked with me and they have all donated their time and energy. 


Thank you….  

I am very proud to accept this award for my husband. I would like to thank the board for recognizing Brian’s service as a medical missionary   It is a tremendous honor, and I know each person considered for this award is very deserving. And the choice was difficult.

He would be very surprised and proud and say that others were more deserving, because he is just doing what he loves and was called to do.  God  blessed him with a mind for medicine and gifted surgical hands.  He would recognize those who help make those trips happen, Rose Ann Alexander, his travel agent, who works very hard to make those trips come together.

Barbara Maufas, a friend, a nurse and an Earthwide board member.  Her dedication, input, and involvement, allows Brian to focus only on patient care. Finally, he would thank the workers at NCH who continually strive to meet Brian’s high expectations of excellent patient care and to make his trip pleasant.

Looking  back on how he arrived at this place in his life, and I gradually became a missionary’s wife,  I believe that everything goes according to God’s plan and timing. Twenty-seven years ago, I would never have predicted I would be a missionary wife, and I probably never would have agreed to be such.  That just wasn’t in my plans for my future. But God had His surprise planned for me long before I even knew Brian.

Brian’s chance meeting of Dr. Farror almost 30 years ago set the stage for everything that followed.  A seed to serve the needy had been planted.  Brian’s career plans were modified, and continued to be modified up to this day so that he can do what God intended him to do-serve his fellow man in the only way he knows how-Surgery. His relationship with Dr. Farrar grew, not just from a medical perspective, but also a spiritual one. 

My husband was born and raised in the Jewish faith, but he married me, a Christian girl.  Our children were raised as Christians and went to a Christian school.  In fact, it was my son, Deryk who was so insistent on getting baptized in the second grade, that he pleaded with Dr. Farrar to baptise him.  At first, Dr. Farrar was skeptical, but after speaking with Deryk for a while,  he came out of the hotel room and said, “he is ready.  I will meet you at 1 o clock in the pool area to baptize your son.” So right here in this hotel's swimming pool, 10 years ago. Dr. Farrar baptized our 2 children.

Through the years, they remained close, Brian looked to him as a father, often seeking advice on life’s problems.  The mission trips , which started out as one a year increased to 2 a year, then 3 a year, and last year, there were 4  maybe 5 trips. So  by now, I have come to accept my role as a missionary wife.

In God’s time and plan, about 5 years ago, Brian’s heart was filled with the desire to be baptized.  He called Dr. Farrar and asked him perform the baptism.   I forget where Dr. Farrar was, but Brian told him here was no hurry and when they saw each other again it would happen. That meeting happened the next day. Dr. and Mrs. Farrar were at my front door; with Dr. Farrar saying that a man’s desire to be baptized has precedent over all schedule sand obligations. He baptized Brian and our youngest son Sunday morning.

So in closing, thank you all again for this honor. He will cherish it.  

Susan Camazine, RN



Yesterday we had a luncheon for the employees. Smart Uruakpa, RN, enjoying goat meat, pepper soup and rice.


This man had a parotid growth for 8 years. It will certainly be a mucoepidermoid carcinoma. We resected the tumor yesterday. Today he is up and around like nothing happened! We will do flap coverage in the future.

Giant parotid tumor with necrosis-facial nerve not functioning
One day following radical resection

Three days following resection
Pectoralis major myocutaneous flap coverage of the wound-due to the
 large skin flap and tension, a small area of the chest could not be covered.

Addendum June, 2013

Here is our patient approximately 4 months after surgery. His flap and chest have healed well.  Pathology showed an epithelial myoepithelial carcinoma. He is going for radiation therapy.


Mucinous tumor of the ovary
Today we did our 110th surgery in 14 days!  We started the day with a inguinal hernia, then an incarcerated inguinal hernia. Next, a breast mass, a pylolithotomy for a kidney stone, and excision of a neck cystic hygroma. Finally, we did a laparotomy for a giant mucinous tumor of the abdomen.



Component Separation-notice the release of the external oblique
This young man came to us last year. He had an intraabdominal disaster-ruptured appendix with delayed presentation and severe peritonitis. He survived this problem after multiple surgeries with an open abdomen. Finally we closed the wound leaving a large ventral hernia. Today we operated after 6 months recovery. We were able to close the fascia with the technique of component separation.


This little boy has an abdominal mass that has been growing since birth. The family finally arrived at NCH. Today we operated. The mass was a giant cystic kidney-possibly from congenital pelvic-uteteric junction obstruction. We removed the non-functioning kidney.

One week postop

Anesthesia and surgical teams



Clockwise from post: Emem Akpanudo (pediatric surgeon), Wilson Anyanwu (nurse anesthetist, Kelechi  Ubochioma (nurse anesthetist), Ike Mark (cook), Andrew Bock (family practice), Uche Nkeonye (general surgeon), Stanley Nnaji-eneh, Chiekwe Ifeanyi (Urologist)
We have operated 8 days and completed 64 cases! No complications or deaths, so far. Many surgeons and anesthesia people have been coming and going. We have a lot to do , yet.


This is not a dating site but, when I saw Smart Uruakpa dressed in his Sunday clothes, I thought I would put in a pitch for him-haha. Smart is an RN and is very talented. He has been at NCH for 5 years. He was just accepted into nurse anestthetist school. We will miss him very much.

ADDENDUM 2/19/13-Smart is not just another pretty face! He has recently won the GOLDEN SCALPEL AWARD from Earthwide Surgical Foundation. This will be presented to him on the next trip to Nigeria. It is well deserved.



These two unusual patients came to clinic. This female has a fluctuant mass growing from the left maxillary sinus. We will operate. The man below has neurofibromatosis. He had a resction in 2006 but now has a recurrence.





The hernias are pouring in! This woman developed a hernia after a C-section. We repaired it with the technique of component separation.

A long standing groin hernia. Thank God for mesh!



Dr. Takita trained me in thoracic surgery. He is a great teacher and the year I spent with him at Roswell Park Cancer Institute  was the most exciting in my career. I thought of him when I saw this man in followup. He came to me 5 years ago after a gunshot wound to the chest. He had an empyema and was dying. I performed a modified Eloesser flap for darinage and he recovered. The wound has now closed ny itself and he is very happy. Thanks Dr. Takita, for training me so well!

Modified Eloesser Flap
Postoperative Xray


Dr. Emem Akpanudo is a very talented woman. She just completed her general and pediatric surgery training. Today she came to NCH to visit and performed her first pediatric surgery case as a newly minted pediatric surgeon. Congratulations!



Senator Enyi Abaribe of Abia State donated a NEW ambulance to NCH. Yow-this is a great machine and will certainly help with our work.


This woman has had a goiter for 15 years. She is from Akwa Ibom State-the state next to Abia State. She was browsing the internet and found this website and contacted me. We communicated and she arrived today!!! We will do her surgery ASAP. She is so happy.



Berfore I left, my friend Gary Daniels, sent me the following email:

You popped into my mind today as I read Nigeria is slowly starting to spin of the rails.
Be careful and stay safe over there. You are doing awesome work...but have the good sense to know when it's time to throw in the towel.
I hope that day never comes for the sake of all those you have yet to help.
Keep up the good work. Gary

A nice accurate note given that Nigeria is derailed. Kidnappings, armed robbery and corruption are rampant. Nigeria is not alone with problems-the USA just had a recent mass killing and seven charity workers  giving vaccinations in Pakistan were recently murdered. 

There is no doubt that humanitarian surgery in nigeria is dangerous but I really don't think about it. Ultimately, it is important to find something in life that you love doing-then it won't be so bad if you also happen to die for it, as well.


I am are back in Nigeria. I arrived last night and found 17 patients waiting for surgery. Dr. Uche Nkeonye also  arrived,  as well as two newly finished nurse anesthetist students, Kelechi and Felicia. Wilson Anyanwu, nurse anesthetist will arrive Monday, as well as Chiekwe Ifeanyi, our urologist. 

We are going to be busy!!