It was Maureen Cox's 12th surgical mission to a developing country with volunteer medical teams from Interplast, but the Napa nurse said it still tugged at her heartstrings.

"The parents are so proud and happy to see their children whole again," the retired Napa nurse said last week, shortly after returning from Ecuador. "I'd start crying. That's my reward — just seeing the love in the parents' eyes."

For retired Spanish teacher Clara Blair, this was the first trip with Interplast, an international humanitarian organization that provides free reconstructive surgery in developing countries.

In Ecuador, patients ranged from impoverished children and adults with disabling burns and injuries to those with disfiguring birth defects such as cleft lips and palates.

Cox has been a nurse for more than 30 years, including 10 years in Seattle before working at Napa's Queen of the Valley Hospital. She waited five years after applying as a volunteer with Interplast before she was accepted. Since then, she's been on mercy missions in Peru, Vietnam, El Salvador and Bolivia. This was her third visit to Ecuador.

The two women were modeling at a fundraiser at their church when Cox first urged Blair to apply to work with Interplast as a translator. "She planted the seed about two years ago," said Blair, who vowed her first expedition will not be her last.

"I thought, how wonderful to take my Spanish out of the classroom and to give back," she said.

Translation was just part of her work as a "junior coordinator." She worked tirelessly as a one of two non-medical volunteers, helping with logistics.

"It was a spiritual experience," Blair said. "Part of a cycle of giving and receiving."

Blair taught Spanish at Napa Valley College for 18 years.

The 14-member Interplast team gathered in Miami before flying to South America. It included nurses and doctors from across the United States in addition to surgeons from London and Scotland.

Despite the long flight, the team swung into action the day after arriving in Ecuador.

There were more potential patients than the team could accept, so each was triaged. Forty-five were chosen for surgery. Some had multiple procedures. In all, the team performed 74 surgeries.

"It was most impressive," said Blair. "The medical team came together. We never met before. Never worked together."

The surgery was observed by medical students, most from the Catholic University of Azogues. The doctors also give three days of presentations at the university, covering such topics as anesthesia and burn care.

Surgical procedures were performed in two operating rooms at a local hospital. Although it was a poor area of a poor country, the facilities were well equipped.

"In my first e-mail home, I said I felt like I'd joined a MASH unit," quipped Blair. "You were busy every moment."

Most of the patients were children with congenital deformities or disfiguring injuries and burns. A few were adults, however, including two with severe burns that required skin grafting.

The doctors amputated a finger of one child, then restructured the hand, utilizing skin grafts and bone pinning.

Blair said the families displayed extreme devotion. "It's a poor country. Many had no access to medical care," she said. "Some traveled for days to get there."

She recalled a 3-year-old with severe burns. It was several days before the surgical team operated. "The family stayed outside and the father held that child for two days. They were so grateful. No child was ever left alone."

Interplast missions are often underwritten. Ronald McDonald House donated more than $50,000 for this one.

Interplast began its work in 1969. Since then, its volunteer medical teams have performed more than 60,000 surgeries.

The doctors do not compete with local resources. They work in partnership and help train surgeons in the host countries.