While Fresh Start India began operations last October, it was officially incorporated into the parent body only last month. Mr Martin Davis, executive director of Fresh Start Surgical Gifts Inc, and Dr Sheryl Perry, chairman of the International Medical Board, were in India to inaugurate the Indian wing of the NGO.

Dr Ashok Gupta, who is a leading plastic surgeon of Mumbai, was instrumental in setting up the Fresh Start initiative in India. "It was a mutual need.

The US-based NGO was looking to widen the scope of its activities, and I was looking for organised help for needy patients who cannot afford reconstructive surgery." Chartered accountant Dr B L Tekriwal, another trustee of Fresh Start India, adds that this is the first time the NGO has ventured outside the US.

Fresh Start Surgical Gifts Inc was instituted in 1991 in San Diego, USA, by plastic surgeon Dr Dennis Nigro for the benefit of underprivileged children who could not afford reconstructive surgery. About 350 community volunteers now participate in its activities. It is the parent body that funds part of the activities of Fresh Start India while the rest of the money is generated from other sources.

Dr Tekriwal says, "The NGO inaugurated its task by organising camps in Amravati in Maharashtra where over 400 patients were identified for treatment and about a hundred surgeries were performed. Nine hundred patients have been booked for surgery."

The common conditions that Dr Ashok Gupta and his team of plastic surgeons see among patients are cleft lip and palate, and severe post-burn deformities. These conditions leave a deep impact on the sufferer's psyche, thanks in no small measure to the social stigma attached to them. "Sometimes the patients are so disheartened that they feel they have nothing left to live for. They cannot carry on living a normal life, and reconstructive surgery makes the difference between life and death," he says.

Dr Gupta would like to impress the fact that his organisation focusses on rural and underprivileged segments of society who are either unaware of or find it difficult to access expensive plastic surgery. "We have been approaching remote areas in Maharashtra to offer free or subsidised treatment. Those who live in Mumbai, for instance, can identify hospitals that have the facilities for treatment and can somehow manage funds. But this is not so in small towns or villages. Besides, reconstructive surgery is not a one-time affair and regular follow-ups are required, which adds to the difficulty faced by poor patients," he says. The average cost of treatment works out between Rs 35,000 to Rs 50,000.

"The Fresh Start initiative in the US has spent $6 million in the last ten years and is even known to arrange for patients to be transported to nodal health centres for treatment. But the Indian chapter has decided to co-opt local hospitals and medical colleges with the requisite facilities. We would rather use our resources to treat more needy people," says Dr Gupta. The NGO has worked out arrangements with health centres in Amravati, Ludhiana and Alibag.