Based on Yunus' model, Nichter intends to have Plasticos Foundation start a microfinance project for surgery in Guatemala.

"No one has ever really done a pure [microfinance] model for surgery that I know of in the entire world," he says.

The goal is to have microloans available for patients who are in need of surgeries. Once they undergo the procedure and get back into the workforce, they would then pay back the loan with a reasonable amount of interest. The Plasticos Foundation is looking into carrying out feasibility studies to determine how the system can work best.

"The key is to have feasibility studies to see how much people can pay back in a period of time with some amount of interest, which would eventually build enough money to be loaned out to others," says Nichter.

"We're really trying to get to the next step of leveraged care and trying to figure out how we can create entities that will be never-ending," he says.

Complex cases at home
Although many surgeons choose to contribute their time and expertise abroad, some physicians work to address the needs of the people here at home.

Dr. Munish Batra grew up in a small village in India but is now a plastic surgeon on the West Coast. He spent some time working abroad but recognized the need for charitable surgery in his own community. In 2002, he co-founded Doctors Offering Charitable Services, an organization of about 10 surgeons.

"People definitely need surgeons [abroad] but they also need surgeons to take care of people here," says Batra. "In Southern California, we tend to see a lot of Mexican immigrants that don't have insurance and they just get pushed aside. My feeling has always been that I'm really fortunate to be where I am and I have no reason not to give back."

The surgeries the organization takes on tend to be very complex in nature, oftentimes requiring six to seven different stages, explains Batra. So far, DOCS has performed approximately 40 cases.

Ian Grado was the organization's first case. He was a 21-year-old Marine stationed at California's Camp Pendleton when during a heavy rainstorm, the car he was in drove off the road, flipping over several times before coming to a stop. Grado sustained serious spine trauma that left him paralyzed and severe craniofacial damage, resulting in deformities of his face and skull.

After months of rehabilitation and multiple surgeries, Grado regained control of his limbs. However, the consequences of the accident were still visually evident. Grado was able to receive help from DOCS when he came to see Batra.

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