medical volunteerism book

8/14/2019 Medical Volunteerism Book

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The Emory InternationalThe Emory International

Medical VolunteerismMedical VolunteerismCollaborative Books SeriesCollaborative Books Series

Medical Volunteerism BooksMedical Volunteerism Books

11stst EditionEdition(Promotion for the April 2010 Conference)(Promotion for the April 2010 Conference)

Book Organized by Marijan PejicBook Organized by Marijan Pejic

Copyright 2010 Emory University School of MedicineCopyright 2010 Emory University School of Medicine


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List of Included Medical Professionals:List of Included Medical Professionals:

Ashwin ViswanathanWilliam E. Silver

Jim WithersAnn KennedyRick Spurlock

Laura DavenportEdwin Smith

Steven M. RoserBruce C. Steffes

David GooJohn PetrosIra Leeds

Kelly McQueen

Krishan K. Bansal

This collaborative book has been designed for the promotion of Emorys International MedicalVolunteerism Conference. The conference is scheduled to take place from April 16 to April 18,2010. It will be located on the main campus of Emory University. If youre interested inparticipating, please contact Zoe Haugo at 404-417-9780 or at [email protected].

This will be a free conference hosted by the Emory University School of Medicine. Participantswill be able to share their individual experiences and lessons learned, create an exhibit promotingtheir organization, and network with the public, students, nurses, and physicians in attendance.Participants will be able to learn how to participate in screenings, free clinics, surgicalinterventions, public health educations, and healthcare provider training. The currentlyconfirmed speakers come from a variety of locations: corners of the U.S., El Salvador, Haiti,South Africa, Japan, Israel, and Egypt. Our plan is to create the second edition of the medicalvolunteerism book series right after the conference, and we hope to make the conference atradition.

The purpose of this collaborative book is twofold. It is meant to give you, the reader, a glimpseof what you can expect from the conference. The second purpose is to tell a story. As the clichstates, a pictures is worth a thousand words. If this clich is right, then you are about to read oneof the longest 40-something page books in existence. Each one of the included medicalprofessionals has an experience that has changed his or her life. These stories are unedited andcome directly from those involved. They depict passion, peace, generosity you can find therest of the descriptive nouns by yourself. This book is a tale of human compassiona story ofthe beauty of [medical] volunteerism. If the telling of at least one of these stories encourages youto volunteer in any way, shape, or formwhether medically or not then this project has been asuccess.
mailto:[email protected]:[email protected]


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Ashwin Viswanathan

Neurological surgery is a resource intensive field of medicine. From the imaging studies

required, to the intraoperative equipment necessary, to the urgent nature of the case load,neurosurgery can be a substantial strain on the developing hospital system. However, fostering

neurosurgical expertise in developing regions can have a profound and cost effective impact.

I have been fortunate to work with the Foundation for International Education in Neurological

Surgery (FIENS), a group committed to building neurosurgical talent and residency training

programs in developing nations. Over the past few years, I have had an opportunity to work with

neurosurgical residents and faculty in Peru, Ethiopia, Nepal, and currently Vietnam. With each

of these experiences, I have been able to share my education and operative training with my

neurosurgical colleagues around the world. However, the small contributions I have been able to

make have been far outweighed by my personal growth.

Learning and respecting the cultural nuances of practicing medicine abroad has been paramount.

There is rarely one definitive answer in medicine, and effectively practicing in new environments

depends upon finding the best solution for a given patients circumstances. This often means

determining surgical treatment by the best option available, rather than what might be considered

the Western standard of care. Importantly, I have also learned that delivering top quality

neurosurgical services is not predicated on access to the most expensive technologies. High

quality care can be provided in severely resource constrained environments through thoughtful

medical decision-making and strong international collaboration. I look forward to continuing

these efforts in the years to come. If you would like a glimpse into some of my experiences,

please visit www.ashwinv.com.

Regards,

Ashwin Viswanathan MD
http://www.ashwinv.com/http://www.ashwinv.com/http://www.ashwinv.com/


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William E. Silver


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1000 Smiles

This program is sponsored by Rotary International and coordinates the services of doctors

who travel to underserved areas to treat medical conditions. Dr Silver has participated twice in4-day long outreaches to Mexico where he performed evaluations for a day, did surgeries for 2

days then post-operative exams for children with cleft lip and/or palate.

Face to Face

This program is sponsored by AAFPRS and has two components, local and international.

At the local level, Face to Face partners with PADV (Partners Against Domestic

Violence) to identify victims and match with doctors who volunteer their services. Dr Silver has

been a consulting doctor for over 15 years and provided his services pro bono to correct facialinjuries to improve the self-confidence of victims. Averaging 3 or 4 patients each year, he has

provided services to over 45 women.

At the international level, Dr Silver has traveled to Vietnam twice for 2-week long

periods. His time was spent performing surgeries to correct facial injuries and birth defects and

teaching local medical personnel the procedures.

(The pictures are from Face to Face Vietnam)


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AAFPRS Fellowship

Since 1990 Dr Silver has offered an intensive one-year training program in facial plastic

surgery, one of about 40 such programs in the US. The Fellowship period is July 1 through June

30. The current Fellow is Jason Lichtenberger, MD and he is the 19th surgeon to participate.

William E Silver, MD


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Jim Withers


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Dr. Jim Withers began making house calls to the homeless in 1992 when he dressed as a

homeless person and joined a formerly homeless man to make nightly visits to the street. From

this initiative, the program called Operation Safety Net emerged. Medical volunteers and

formerly homeless outreach workers form teams to visit the homeless throughout the Pittsburgh

area. Medical care is delivered along the river banks, in abandoned buildings and alleys. A full

range of follow up services and case management are offered. As a result, hundreds of street

homeless have found access to housing, primary medical care and healthier lives. Operation

Safety Net continues to utilize volunteers with a wide range of skills, including medical, legal,

social and others. Over 100 health care students work with OSN each year on the streets.

Operation Safety Net has become a model for other Street Medicine programs throughout the

US and abroad. By connecting with similar programs throughout the world, a movement has

emerged to provide health care to those sleeping on the streets everywhere. Since 2005,

the International Street Medicine Symposium has been held annually in various cities to bring

pioneers together to discuss this new field of medicine. The Street Medicine Institute was

formed in 2008 to host these annual meetings, assist communities who wish to establish their

own programs, improve and measure Street Medicine practice and serve as a Fellowship

Without Walls for students who work on the streets of the network cities throughout the world.

Jim Withers, M.D.


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Ann Kennedy

I have been a family nurse practitioner at the Atlanta Veterans Administration Medical

Center for the last 14 years. I have served on the Kenya Project governing board for the last 8

years. The Kenya Projects mission is to minister to the children of Kenya by providingsponsorship for their education, health and welfare and providing opportunities for Christian

mission work in Kenya. Six years ago, I traveled to a rural village outside of Nakuru, Kenya, to

visit the village where the Kenya Project was trying to raise the funds to build a school for 200

children who had been displaced due to tribal wars, parents who died of HIV or impoverished.

After seeing the smiling faces of these children who were attending school in dark sheds and

getting their water from a small stream of water that they washed their clothes in and collected

their water in dirty containers and animals in the same water, I knew that for the children to grow

and to learn in this village that a medical team was needed to evaluate their health and living

conditions. Five years ago, I (with 3 other people) evaluated, assessed and treated over 200

children. This was the first health care examination for these children. From this first trip, wedetermined that the daily porridge must be increased to a 2-meal-a-day feeding program which

was instituted and has improved each year. After 3 years, we were able to drill a well which

provided clean water for the school and the village. It has been a challenge to get people to drink

water when they have never had any water. We have tried to teach the importance of washing

their hands after using the bathroom or before each meal. We have taught dental care with

supplies donated most years. A school was built to move 200 of the students into well lit rooms,


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but with an enrollment of 550 students ages 3 to 8th grade, we need more classrooms again. Each

year we have been able to see that the students are growing and their test scores are improving.

We have been able to stop a continuous staph infection that all the kids were getting by finding

out all the childrens scalps were being shaved by the same unclean clippers. Many cardiac

abnormalities, a brain tumor, learning disabilities, visual problems and many other conditions

have been diagnosis and treated by the medical team or paid to be followed by doctors inNarkuru or Nairobi.

I have co chaired the Health and Welfare committee at my church. We have sponsored blood

drives, mobile mammograms, yearly immunizations, guest speakers discussing a variety of

health issues and blood pressure screening for the church and the community each year.

Ann Kennedy, RN


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Rick Spurlock

Rick Spurlock first found a passion for International Medicine and Medical Volunteerism in Julyof 2001when he traveled to Antigua, Guatemala and spent a month learning Spanish and doingvolunteer work at a hospital. While in medical school, he began traveling to Haiti with the

University of Miamis non-profit organization,Project Medishare, helping to deliver healthcareto the underserved of rural central Haiti. While working withProject Medishare he also workedwith the non-profit organizationPartners in Health helping to organize the University ofMiami's first Plastic Surgery trips to fix cleft lips, palates, and burns.

Dr. Spurlock finished medical school at the University of Miami, and went to residencyat Emory University for Emergency Medicine training. At Emory, he started the studentorganizationEmory Medishare with a group of residents and medical students which has beenrunning primary care medical trips to Haiti since 2006 and urological surgery trips since 2008.Dr. Spurlock has also been the lead in a clean water projectwhich will be producingand distributing sodium hypochlorite solution to local villagers and partnering with the

Millenium Villages Project. Dr. Spurlock, also, is the founder and President ofEmergencyPhysicians InternationalorEPI.EPIseeks to improve the delivery of Emergency Medicine indeveloping countries by building Emergency Departments and enhancing the clinical skills oflocal Providers.Rick can be reached [email protected] or by cell at 404.395.7810.

Rick Spurlock, M.D.
mailto:[email protected]:[email protected]:[email protected]


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Laura DavenportHouse of Grace

My husband and I have had the great honor of being called twice to do mission work at theHouse of Grace in Chang Rai, Thailand. House of Grace is a home for girls that have beenrescued from being sold into the brothels in Bangkok for prostitution. They range in age from 5years old to college age. They can stay at House of Grace as long as they stay in school. Several

girls went so far as to graduate from law school last year. House of Grace is a ministry started byMark Rutland through Global Servants.

As a pediatric nurse practitioner, I set up a supplied clinic, did physical exams, coordinatedvision screenings, and lice checks for each of the 113 girls. I found that the girls wereremarkably in good health except most of them had massively decaying molars. Most of the girlscome from the Akha villages in Northern Thailand. The rampant poverty is what causes them tosell the girls from the village. Thus, most of them have never seen a toothbrush before coming toHouse of Grace. We are working to have a dentist go to House of Grace. It is difficult to take 113girls to a dentist on a routine basis.

The girls usually come from the village having lived with their heads shaved all their lives. Thatis the only means that the villages have to control lice. Once they come to the House of Grace,they are allowed to grow out their hair. The girls go back to visit their families in the villagesonce per year, typically returning with a head full of lice. Those that dont come back with them,are exposed to those that now have picked them up from the village. We had the fun task ofexamining the girls and helping to treat the ones we found with lice.


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Despite the extreme heat and humidity, we thoroughly enjoy our time at the House of Grace. Wego back every chance we get, hoping to positively impact the health of these girls so they maygrow into strong, vital women.

For more information about House of Grace, visit our website at www.mybethesda.org (click onHouse of Grace) or call 404-298-6078.
http://www.mybethesda.org/http://www.mybethesda.org/http://www.mybethesda.org/


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Edwin Smith

A passion to improve or ease the lives of others is declared by every person who wishes to serve

in the field of medicine. Most also acknowledge the intellectual stimulation of a dynamic field

that demands continuing education and reassessment of ones perspectives. These real and

worthy goals are, gratefully, available to nurses and physicians in every day of practice. During

training, most medical students and residents express an interest in assisting with medical care in

less privileged cultures. Practioners of medicine innately understand that cultures may vary

greatly, yet the human experience carries common themes that are recognizeable no matter how

different our backgrounds. Anyone who wishes to be a healer, whether a trainee or a seasoned

physician, is driven to search for new opportunities to share their knowledge and skill. The

combination of the opportunity to help others and to contrast and question the way we deliver

care while emerged in a unique culture is irresistably attractive. Fortunately, there are many

organizations that can assist physicians in their quest to participate in voluntarism throughestablished international medical missions.

My introduction to medical volunteerism came with an unexpected telephone call and a simple

question of can you help with a rather complicated urologic problem in a child from El

Salvador that had arrived in the United States under the direction of Childrens Cross

Connections International (CCCI). The opportunity to be a part of the team developing a


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pediatric renal transplant program followed. This organization which is now in its 28th year of

operation seeks to educate and equip developing nations to meet the needs of their own

children. CCCI establishes alliances between hospitals and doctors in developing countries

and medical professionals in the United States to achieve this goal. Through on-site training and

donations of equipment, CCCI helps to create specialty programs abroad and then continues the

education of national doctors and nurses by arranging and sponsoring individual training sessionswith hospitals in the US. Additionally, CCCI selects specific pediatric teaching cases to bring to

the US, providing surgeries gratis to children whose conditions are inoperable in their native

countries. These children are generally accompanied by medical professionals, who observe the

surgeries and follow their surgeons for a week of on-site training. Areas of particular focus and

success for this organization have included establishing in El Salvador surgical programs for

congenital heart surgery, kidney transplant surgery, Craniofacial Surgery, Urology Surgery, and

Orthopedic/Spinal Surgery. Missions to Peru are in development.

In February 2010 Childrens Cross Connections International will sponsor the fifth Pediatric

Urology focused mission to El Salvador. The steps toward a dedicated childrens urologymission to Hospital Benjamin Bloom were gradual but have resulted in a wonderful exchange in

medical knowledge and in the development of great friendships. During visits to create a

pediatric renal transplant program at Hospital Benjamin Bloom we recognized that there was

also an opportunity to enhance urologic care. Some of the children had developed end stage

renal disease due to obstructive uropathies and we would discuss the urologic aspects of care for

these patients. This lead to conducting small clinics during our transplant trips where children

who were not transplant patients but suffered complex urologic problems could be presented for

discussion of management options. Our El Salvadorean counterparts had a great deal of

experience in pediatric surgical care and a genuine interest in pediatric urologic care. They were

caring for many of these children with the best means possible. Yet, the ancillary support formanaging some of the most severe cases was not available El Salvador. Two patients with

bladder exstrophy eventually traveled to Childrens Healthcare of Atlanta for reconstructive

surgery and become continent for the first time in their lives. But most impressive was the desire

of their doctors to visit us in Atlanta with their patients to learn new techniques for lower urinary

tract reconstruction. Finally, we recognized that a mission that focused on current concepts in

managing children with neurogenic bladder dysfunction (spina bifida), reflux nephropathy,

obstructive diseases and genital anomalies could help to elevate this area of care in El Salvador.

Crucial to this project was a strong relationship and commitment of our El Salvadorean friends

and colleagues. The involvement of the Emory Pediatric Urology Fellows during these missions

has enhanced the educational exchange and fosters spirit of volunteerism that can continue after

training is completed.

Reflecting on these efforts at volunteerism, yields many memories and lessons. Our El

Salvadorean counterparts seek to deliver the same excellence in care that all physicians wish for

their patients. They are dedicated, compassionate, bright and full of humor. While the majority

of their patients live in conditions of poverty by Western standards, they are courageous,

trusting and certainly not poor in spirit. The common goal of caring for children produces an


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astoundingly smooth transition between local and visiting doctors so that two teams merge into

one without any forced effort. Most notable is the speed as which this occurs, what might take

weeks among physicians in ordinary circumstances occurs in a few hours. Experienced in their

own traditions their nurses and physicians were prepared to absorb all that we had to offer. In

turn we have been shown how much can be accomplished by physicians with less resources but

great passion to improve and ease the lives of others.


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Steven M. Roser

Mission to Managua, Nicaragua

A team of nineteen volunteers sponsored by Healing the Children NorthEast, the Vinings Atlantaand Managua Nicargua Rotary Clubs, made up surgeons, anesthesiologists, nurses,administrators, and technicians arrived in the evening of October, 25, 2008 in Managua,Nicaragua and checked into the Cesar Hotel. The next morning, Sunday, the team proceeded tothe Hospital Velez Paiz, the older of the two Ministry of Health, MINSA, childrens and

maternity hospitals in Nicaragua. One half of the team went to the screening area and the otherhalf began to unpack and sort the equipment and supplies that were brought with the team andthat had been previously shipped to the hospital via Rotoship, a humanitarian effort by the JFKRotary Club of New York.

The surgical and medical evaluation of the patients was done by the teams surgeons andanesthesiologists with their local counterparts. An estimated 400 people were waiting for theteam in the hospital clinic waiting area. Between 150 and 175 children with cleft lip/palate and


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other facial deformities were evaluated. 65 were selected for surgery. Many of the familiestraveled long distances from all corners of the country to take advantage of the free service.Those who could not be treated left disappointed, but were reassured that they would be takencare of by future missions.Surgery for selected patients was carried out from Monday through Friday. Anesthesia was

administered by the teams four anesthesiologists with support from the Dr. Nicaragua, the Chiefof Anesthesia at the Hospital. Operations were performed mainly by the teams surgeons withassistance from the local surgical team headed by Dr. Martha Velladares, Chief of Plastic andReconstructive Surgery at the Hospital Velez Paiz. Dr. Velledares and her staff, Drs. Trijones,Cross, Benes and Hsu also had put in a considerable effort prior to the teams arrival. Over 60children were pre-screened; surgeries were not scheduled the week before the teams arrival andpatients discharged from the hospital to open up the beds for the teams visit. Nursing care wasalso a cooperative effort by both teams nurses and local ones. Many nurses helped to take careof the patients. The daily bed census ranged from 20-30. All patients were admitted the nightbefore surgery to give the team an opportunity to assure they were not sick and to assurecompliance with NPO. Most of the patients with lip repair went home the next day. Some of the

palate repairs stayed a second night. The local OR and PACU nurses all were present to help theteam during the week. The hospital had four functional operating rooms and anesthesiamachines. Two rooms and three anesthesia machines were dedicated to the mission for the week.One was reserved for the steady stream of C-sections done by the local surgeons. One of therooms given to the team was fitted with two OR tables which permitted three operations to berunning simultaneously. The anesthesia team repaired one of the anesthesia machines that wasnot working to allow the hospital to run an additional room for orthopaedic emergencies.

The Managua Rotary Club, our local host agency, particularly Mr. Gunter Hewig, had put inconsiderable effort to assist with the teams in country logistics. This included arranging forfood, lodging and transportation. The most time consuming effort for the Managua Rotaryvolunteers revolved around providing housing and food for the children and families thattraveled to Managua for screening and surgery. Rotary volunteers made the lunches delivered tothe hospital for the week and the Rotary provided the bus used to transport the team.


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The proposal for the mission with all of the team members credentials had been approved by theNicaraguan Ministry of Health, MINSA, in advance of the visit. All received temporary licensesto practice for the time of the mission. Hospital Velez Paiz was chosen for the mission during asite visit conducted in April, 2008. The hospital was built in 1942, and is one of the oldest

buildings in Managua because it was one of only a few structures that remained standing afterthe devastating earthquake in Managua in 1972. Under the current health system in Nicaragua,everyone is entitled to healthcare without cost. This puts a tremendous strain on an under-resourced system.

The visit and the operations went smoothly. The days were long with the first procedures startingat 8AM and the last patient discharged from the PACU at 8PM. Good rapport as well as mutualrespect developed between the visitors and their Nicaraguan hosts. 56 children received 67procedures. As of three weeks following the teams departure, there were no complicationsreported. Dr. Velledares and her staff either personally performed the followup or arranged for itto be done in the patients home towns. The patient turnout was in excess of what could be

handled in the period of the mission. There is a great need for comprehensive care for the cleftpatient.

All of the supplies for the mission were donated. Benefactors included, Baxter Allegiancethrough World Vision, Medical Assistance Program, MAP, Ethicon, KLS Martin, StrykerLeibinger, Biomet Lorenz, the Anesthesia Department at Columbia University Medical Center inNew York and Emory University Hospital in Atlanta, Georgia. The unused supplies were alldonated to the Hospital at the end of the week to be used by them to provide care for otherpatients.

Fund raising for the mission is a continuous effort. We received many small and a number ofmore substantial donations primarily from individuals. It is very gratifying to know that despitean economy that is not good, people still have the good will to donate to help those lessfortunate.Carl Bailey, a financial advisor from Connecticut, who is already involved in supporting anorphanage and school in Nicaragua and helped with the initial contact with the Rotary inManagua, participated in the teams activities for most of the week. He was so impressed by the


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results of the cooperative effort he personally has pledged a significant donation to the nextmission and will arrange to have children from the East Coast of Nicaragua, a vastly underservedarea for cleft services, brought to Managua for care during the next mission.

Approximately $370, 000 was the value of the donated professional services and $350,000 was

the value of the used and donated supplies.

All but two of the team had traveled together before more than once. They came from NewYork, New Jersey, Connecticut, California, Illinois, Massachusetts, Oklahoma, Georgia, andNew Mexico. All of the team surgeons are members of the American Association of Oral andMaxillofacial Surgeons. They Include, Drs. Vincent Carrao, Lawrence Herman, MartinKaminker, Vincent Perciaccante, Steven Roser and Martin Steed.

There are many reasons why busy people with a full plate of responsibilities look forward toparticipating in the mission. The following is from a team member upon return from Managua:

Dear Dr. Roser,Thank you for giving me the opportunity to be a part of so many wonderful missions. I have metmany friends--some will become lifelong friends, the others may only be a part of my life brieflyyet they will remain in my heart forever. I am also thankful for the chance to serve others.Everyone who serves in whatever capacity has the chance to heal the torn fabric of this world.

Other comments have included: --this is the best form of international diplomacy, and onthe days that get a little overwhelming I stop for a moment and think of something that happenedduring the mission. The good feeling I get gives me the motivation to get through the nextchallenge, and .. l have been blessed with the opportunity to do something I love to doeveryday. The mission is a chance for me to give back.

The positive response of patients and local medical providers to the mission underlies the needfor cleft services in the country. The service must be continually available and affordable locally.In the short term more such medical missions will help to meet existing need. For the long-term,however, local capacity must be supported and expanded. The Ministry of Health Hospital VelezPaiz and their Cleft Clinic require encouragement and support to build the capacity to manageclefts in Nicaragua. Out of this a local team could provide regular outreach service to remoteparts of the country.

Nurses, speech pathologists and other personnel could be assisted with training either locally orabroad to organize and run the local cleft services effectively. This could take the form ofworkshops and/or visits to existing centers

We returned to our friends and to Hospital Velez Paiz in April 2009. Our experiences allowed usto schedule and perform surgery for 67 children. A pediatric dentist and his assistantaccompanied us and they were able to see and treat well over 100 children. We have commencedwith discussions with the Managua Rotary Club, Dr. Martha Velladares and the Hospitaladministration to establish a permanent site.


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We will return to Managua November 7-15, 2009

Steven M. Roser, DMD, MD, FACS


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Bruce C. Steffes

www.brucesteffes.net

Bruce Carl Steffes, MD, MBA

Dr. Bruce Steffes is a surgeon and educator living in Linden

near Fayetteville NC. He is a native of Lapeer, Michigan.

His undergraduate work was at Baptist Bible College of

Pennsylvania and the University of Michigan Flint

College. He graduated from the University of Michigan

College of Medicine and then trained in general surgery at

the University of Florida. Since that time, he has been also

awarded a Masters of Business Administration from the

Fuqua School of Business at Duke University and was

certified in tropical medicine by the American Society of

Tropical Medicine and Hygiene.

As a surgeon and as an entrepreneur in Fayetteville, NC, he

underwent a personal and spiritual crisis that changed the

focus of his life. He resigned from his practice in December,

1997. Since then, serving always as a volunteer and with a focus upon supporting the true heroes

in the trenches, he and his wife (an accountant by training) have used their surgical, business and
http://www.brucesteffes.net/http://www.astmh.org/AM/Template.cfm?Section=Home1&WebsiteKey=452e1eb1-b2d5-48a7-857a-c789a07c27d1http://www.astmh.org/AM/Template.cfm?Section=Home1&WebsiteKey=452e1eb1-b2d5-48a7-857a-c789a07c27d1http://www.brucesteffes.net/http://www.astmh.org/AM/Template.cfm?Section=Home1&WebsiteKey=452e1eb1-b2d5-48a7-857a-c789a07c27d1http://www.astmh.org/AM/Template.cfm?Section=Home1&WebsiteKey=452e1eb1-b2d5-48a7-857a-c789a07c27d1http://www.astmh.org/AM/Template.cfm?Section=Home1&WebsiteKey=452e1eb1-b2d5-48a7-857a-c789a07c27d1


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administrative skills in multiple hospitals and other missionary efforts in the developing world.

He has spent the majority of each year since early 1998 as a volunteer physician and general

surgeon in Haiti, Belize, Guatemala, Brazil, Kenya, Uganda, Togo, Benin, Zambia, Sierra Leone,

Liberia, Angola, Papua New Guinea, Afghanistan and Uzbekistan. He has also visited several

other countries and medical works in developing nations. He serves regularly with the Mercy

Ships and World Medical Mission (Samaritans Purse) doing short-term (up to six month) stints.He and his wife have worked with two orphanages in Jinja, Uganda. He has worked with several

agencies and NGOs as a volunteer. In 2005, he developed a proposal for a $40M pediatric

national referral hospital in East Africa, working on behalf of the First Lady of that country.

Sadly, that project did not come to fruition.

He is especially interested in medical education. An active member and assistant Financial

Officer of the Continuing Medical and Dental Education Commission of the Christian Medical

and Dental Association, he assists in their mission to bring current medical information to those

serving on the front-lines in developing countries. Seeking more ways to serve, he has taught

resuscitation courses for trauma, pediatrics and advanced cardiac life support in the US and EastAfrica. When in the US, Steffes served as a volunteer associate clinical professor of surgery at

Duke University in order to teach residents laparoscopic surgery; served as volunteer surgical

faculty at Mulago Hospital, Makerere University in Kampala, Uganda and now is the Surgeon-

in-Residence at Methodist University Physician Assistant Program teaching anatomy, physiology

and general surgery to PA students each fall. He is also associate professor in surgery at Loma

Linda University and he is also a guest lecturer yearly at the West Virginia University Clinical

Tropical Medicine and Parasitology Training Course. In 2009, he was named as one of the

Distinguished Global Faculty of The University of Toledo.

In his efforts to mobilize interest, personnel and finances for medical missions, he is a speaker inchurches, service groups and missionary conferences here in the US. In aid in that effort, he and

his wife have written the Handbook for Short Term Medical Missionaries, published by

ABWE (2002). The book is being revised, expanded and divided into two separate works. The

first half is now available as "Medical Mission: Get Ready, Get Set, Go!"

In early 2006, he became the Chief Executive Officer of the Pan African Academy of Christian

Surgeons (PAACS), a general surgical training program for African residents. PAACS is a rural-

based health initiative and is a Commission of the Christian Medical and Dental Association. It is

a strategic response to the great need for surgical manpower in Africa. Using rural mission

hospitals and a cadre of volunteer board-certified surgeons and missionaries, it is designed toteach the best practices of surgery and apply them to the resource-poor environment in such a

way that brain drain is avoided and that high quality Christian Surgeons will be produced and

remain in their countries for their lifetimes. PAACS is presently accredited by Loma Linda

University and is undergoing accreditation by the Western African College of Surgeons (WACS)

and College of Surgery of East, Central and Southern Africa (COSECSA). There are presently

(Jan 2009) 31 residents and fellows in training in primary training sites in Gabon, Cameroon,
http://www.cmda.org/AM/Template.cfm?Section=Commission_on_Medical_and_Dental_Educationhttp://www.cmda.org/AM/Template.cfm?Section=Commission_on_Medical_and_Dental_Educationhttp://www.cmda.org/http://www.cmda.org/http://www.methodist.edu/paprogram/http://www.llu.edu/http://www.llu.edu/http://www.hsc.wvu.edu/som/tropmed/tmcAboutTheProgram.asphttp://www.hsc.wvu.edu/som/tropmed/tmcAboutTheProgram.asphttp://www.paacs.net/http://www.cmda.org/http://www.wacs-coac.org/http://www.cosecsa.org/http://www.cmda.org/AM/Template.cfm?Section=Commission_on_Medical_and_Dental_Educationhttp://www.cmda.org/http://www.cmda.org/http://www.methodist.edu/paprogram/http://www.llu.edu/http://www.llu.edu/http://www.hsc.wvu.edu/som/tropmed/tmcAboutTheProgram.asphttp://www.hsc.wvu.edu/som/tropmed/tmcAboutTheProgram.asphttp://www.paacs.net/http://www.cmda.org/http://www.wacs-coac.org/http://www.cosecsa.org/


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Ethiopia and Kenya and with sites for rotations in Nigeria and Uganda. It is experiencing a

period of rapid expansion.

Steffes is a fellow of the American College of Surgeons, the West African College of Surgeons

and theCollege of Surgery of East, Central and Southern Africa. He has been recognized for his

work with PAACS with the 2008 International Medicine Award (from the Institute forInternational Medicine) and induction to the Medical Missions Hall of Fame, located at the

University of Toledo, Ohio.
http://www.facs.org/http://www.wacs-coac.org/http://www.cosecsa.org/http://www.cosecsa.org/http://www.medicalmissionhalloffamefoundation.org/http://www.medicalmissionhalloffamefoundation.org/http://www.facs.org/http://www.wacs-coac.org/http://www.cosecsa.org/http://www.medicalmissionhalloffamefoundation.org/


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David Goo

Montana de la Flor, Honduras

I have been going to Honduras for the past five years with a mission group to work in an

anthropological preserve, giving clinics and medications, and trying to help them with theirhealth care needs.

Organization Partnering with:Gehlen Catholic MissionPrivate self funded.Cost: Approximately $1700 dollars for travel, buying the medications we give away, and roomand board for the time we are there.Emory involvement: Part of non clinical activitiesWebsite: http://www.gehlenmissionhonduras.org/jan_2009.shtmlWebsite excerpt: Over the last few years the Gehlen Medical Team program has focused on

only one area in this medical service: the Tolupan people of Montana de la Flor. Richard Seivert,director of the program, described the Tolupan as being one of the most remote and isolatedpeoples throughout Honduras. At the current time we believe only 1300 Tolupan still live inMontana de la Flor. Seivert said that because of their isolation it is hard to get medical care andtreatment to them. This past year we brought a protein supplement Plumpy Nut (peanut butterpaste plus) to them and cured multiple cases of malnutrition.

Severe Kwashiorkor Muoc Malnutrition Bracelet Francescas mother died that day ofmalnutrition
http://www.gehlenmissionhonduras.org/jan_2009.shtmlhttp://www.gehlenmissionhonduras.org/jan_2009.shtml


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Francesca this May after Plumpy Nut

Santa Rosa de Copan, Honduras

I have been to Honduras the past two years teaching PALS (Pediatric Advanced Life Support) ina regional hospital in Santa Rosa de Copan. This endeavor is expanding to train all the generalmedical officers graduating each year in Honduras. This will be a sustainable teaching effort, amodel I plan to replicate around the world. The goal is to get the doctors of that area to becomePALS instructors and Training Center Faculty for PALS and have their own course that they canmanage in the future.

Organization partnering with:Central American Medical Outreach (CAMO)Funding:Private self funded.Cost: Approximately $2000 dollars for travel, buying the medications we give away, and roomand board for the time we are there.Emory involvement: Part of non clinical activitiesWebsite: http://www.camo.org/From website:

Welcome to CAMO

Central American Medical Outreach, Inc. (CAMO) founded in May of 1993:

Operates 16 programs and provides 143,000 medical services each year in Honduras andsurrounding countries.


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Exports five 48-foot containers of medical equipment and supplies per year valued atapproximately $300,000 totaling approximately $2 million annually.

Funds one major community building project per year. Recognized by the Congress of Honduras for our accomplishments. Multiplies every $1 donated into $4 of service.

Limits administrative cost to no more than 4% annually. Named as the most fiscally responsible NGO (non-government organization) by the

Honduran Ministry of Finance. Employs 33 Hondurans and four full-time employees in the U.S.

We never take a job away from the people we serve. We use Honduran labor andtrain them in technical areas, so they can become self-reliant.

Kathy Tschiegg, RN, BBA, CAMO Founder and Returned Peace Corps Volunteer

Tbilisi, Georgia

Beginning in 2004 and for the past 5 years, working with Dr. Ken Walker and USAIDestablished a pediatric emergency department in Tbilisi, Georgia. We have continued thisinitiative with adult emergency medicine who have established an adult emergency medicine"residency" program. Plan to continue PALS course with sustainability in the future;

Organization partnering with: USAID-Emory University.Funding: USAID grant to Emory UniversitySalary and Travel re-imbursement

Cost to me: $0Website: http://georgia.usaid.gov/index.php?m=28&newsid=364From website:

USAID Program Trains New Georgian Emergency Physicians

USAID's Georgia Emergency Medical Services project haslaunched a new mini-residency program in emergency medicine.The program is implemented by Emory University (Atlanta),together with Tbilisi State Medical University, Kipshidze CentralUniversity Hospital (Tbilisi) and Partners for InternationalDevelopment. The aim of the program is to train the first

generation of emergency medicine specialists. These specialistswill not only practice emergency medicine, but eventually serve as trainers themselves. Elevenphysicians enrolled in the first eight-month program. The training represents a major shift fromthe current practice of emergency medicine, where specialists are not allowed to stray into otherspecialties. Graduates of the program will receive state certificates in emergency medicine,enabling them to practice integrated emergency medicine according to western standards,including the initial evaluation, triage, diagnosis, evidence based treatment and disposition ofpatients requiring expeditious medical, surgical, or psychiatric care.
http://georgia.usaid.gov/index.php?m=28&newsid=364http://georgia.usaid.gov/index.php?m=28&newsid=364


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Bogota, Columbia, November, 2008

Last November went as a guest lecturer and consultant to the pediatric emergency department atFundacion Nacional de Santa Fe. Discussed medical education with the Asociacion de LosAndes for their medical school and pediatric residency. Would like to establish an exchange

program with our medical school if possible.

Funding: Travel self funded. Hotel accommodations were paid for by the hospital.

Puerto Rico, Pediatric Emergency Medicine Conference, June 2009

Members of the Division of Emergency Medicine, partnering with Dr. Ricardo Jimenez, havebeen to Puerto Rico twice do date 2006 and 2007, and will be returning this week to presentlectures on pediatric emergency medicine.

Objective: To teach and improve pediatric emergency care in Puerto RicoTwo former Emory fellows, Dr. Ricardo Jimenez and Dr. Carmen Le Bron are the contacts forthis conference.Funding: Travel and lodging paid for by the Pediatric Society of Puerto Rico


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John Petros

John A. Petros, MD is a board certified urologic surgeon and tenured full time member of theEmory University School of Medicine faculty. Dr. Petros also holds an appointment at theAtlanta VA Medical Center where he provides surgical care to US veterans. He is active in

teaching, patient care and cancer research. He holds research grants from both the NationalInstitutes of Health (NIH) and the Veterans Administration (MERIT award) and is recognizedfor his expertise in cancer genetics, especially mitochondrial genetics in prostate cancer.

Dr. Petros ismarried to TeresaM. Petros, MD hiswife of 27 years.They reside inCumming, GA withtheir 5 daughters,

ages 7 to 18. Theyare active membersof Mary Our QueenCatholic Church inNorcross, GA andmembers of the layapostolic movementRegnum Christiassociated with theorder of CatholicPriests the

Legionaries ofChrist.

Dr. Petros attended Loyola University Stritch School of Medicine in Suburban Chicago from1982-1986 and this is where his medical volunteer activity began. He spent a month on theisland of St. Lucia seeing patients in the clinics, hospital and emergency room.

The motivation for Dr. Petros volunteer activity is rooted in his Catholic Christian faith whereinproviding free medical care and missionary work is an effective mechanism to demonstrate Godslove for all people regardless of age, race, country or economic ability. He believes that all hisabilities are an unmerited gift from God and that sharing these with those least able to access

health care is an honor in service to God and fellow man.

More recently Dr. Petros has been on medical missions to El Salvador (2004), ChunhuhubMexico (2006) and Bibiani, Ghana Africa (2008) where he was medical director of the mission.In these missions Dr. Petros performed surgery, provided non-surgical medical care and madehouse calls. In 2009 his volunteerism led him again to Mexico where he and 65 other volunteersfrom Atlanta made house calls, Catholic missionary work and renovations and landscaping for alocal Catholic Chapel in Malinalco, south of Mexico City.


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Ira Leeds

My role as co-leader of Emory Medishare is one of the most fulfilling roles I have ever

undertaken. When I first began to work with the organization, it was little more than a once-a-

year medical trip attended by medical students and faculty from Emory Universitys School of

Medicine. Upon assuming a leadership role with the organization, however, I wanted to turn

Emory Medishare into a programmatic model for short-term international medical trips that were

both educational and locally beneficial.

The key change we made with Medishare was to shift its focus from an event namely, a short-

term medical trip to an explicitly stated purpose. Rather than organize workings of the group

around executing an effective short-term medical trip, we began with crafting a mission

statement that embodied the organizations reason for being. This statement identified the two

driving purposes of our organization: 1) to provide an unprecedented level of primary care for

the people of rural Haiti; and 2) to provide a unique educational experience for medical students,

faculty, and local community health workers.


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With a mission-led goal, we then created a slew of programs that implemented our purpose. A

major component of this new effort was to consolidate and expand the Emory medical trip

efforts serving Haiti. In the past year, we have added a specialty surgical trip and are in the

process of adding a second primary care trip in the spring. Realizing short-term medical trips

were only a small part of our role, however, we have also refocused on programmatic elementswith more pervasive effects. Specifically, we have tripled the number of academic research

projects being conducted and have begun raising capital funds to build a permanent primary care

center in Casse, Haiti.

Although the utility and ethics of short-term medical trips have been debated regularly in the

academic medical community, the programmatic approach undertaken by Medishare represents a

unique means of reconciling the practical limitations of U.S. healthcare workers while also

providing the best care possible to a nearly forgotten corner of the developing world.


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Kelly McQueen

Kelly McQueen is an anesthesiologist and public health consultant inPhoenix, Arizona. Dr. McQueen practices anesthesia in a large privatepractice group and she has expertise in obstetrical (OB), pediatric andneuroanesthesia. Dr. McQueen is an Adjunct Assistant Clinical Professor atthe Mayo Clinic Scottsdale, and a Fellow at the Harvard HumanitarianInitiative. She has special interests in the provision of surgical care followingdisasters and in humanitarian crises, and in the global burden of surgical


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disease. She was recently accepted for a Fulbright Senior SpecialistFellowship to examine the impact of surgery on the burden of disease in anunderserved area.Dr. McQueen received a Bachelor of Arts degree in Biology from ColoradoCollege, her MD from the University of Vermont College of Medicine, and a

Masters of Public Health from the Harvard School of Public Health. Shecompleted a residency in anesthesiology at the University of Arizona and theMayo Clinic, and completed a fellowship in obstetrical anesthesia at the MayoClinic.

Dr. McQueen has published articles in peer reviewed journals, has authoredand co-authored numerous chapters on a variety of anesthetic topics, andhas presented her research at national and international meetingsthroughout her career. She has also published two childrens books, anelementary school curriculum for HIV/AIDS education, and an instructionalvideo on HIV/AIDS for young children. While at the University of Vermont

she was elected to the Alpha Omega Alpha Honor Medical Society, and herbook, Whats a Virus Anyway? The Kids Book About AIDS, won the VermontBook Publishers Association Special Merit Award and the Benjamin FranklinChildrens Book Award.

Dr. McQueen was a Fellow for the American Association for the Advancementof Science (AAAS) and the Nuclear Threat Initiative (NTI) in Washington, DCduring 2002-2003. She performed her fellowship at the Office of NavalResearch (ONR), where she worked on policy issues related to DNA vaccinetechnology, telemedicine and other international health and human securityissues. During her fellowship year she also worked with the Mexican

Ministries of Health and Defense on US Mexico border health issues,including bioterrorism and other threats to public health, and on disasterresponse collaboration between the military and civilian sectors.

Kelly has had a career long commitment to disaster response andhumanitarian aid. She volunteered for the American for Society ofAnesthesiologys Overseas Teaching program in Tanzania; Operation Smile inChina, Jordan, Brazil, Peru and Mexico; and for Doctors without Borders in SriLanka. She participated in a US People to People Ambassador ProgramPerinatal Delegation in Russia, Lithuania and Latvia. During her year at theHarvard School of Public Health she participated in the Humanitarian Studies

Initiative, an education collaborative between Harvard, MIT and Tuftsdesigned to improve and expand the skills of humanitarian aid and disasterrelief workers. In 2005, Colorado College honored Dr. McQueen with theBenezet Lifetime Achievement Award for her humanitarian work.


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Krishan K. Bansal

Editorial Available online at (www.sciencedirect.com; Surgical Neurology 72 (2009) 8788)

Profiles in volunteerismFrom India to Peru as a neurosurgeon volunteer

As an associate professor of neurosurgery, Dr Krishan K. Bansal pursues a very busy academic

and professional career, but not so busy as to keep him from fulfillingwhat he believes to

be a responsibility. This responsibility he feels so deeply about is finding ways to give

back to those less fortunate, and he does so by helping to bring neurosurgical care to people in

developing countries who would otherwise not receive it. After completing his medical

education and neurosurgery residency, Dr Bansal received further training in microneurosurgery

as a Keinichiro Sugita Scholar with the Department of Neurosurgery at the University ofNagoya. Then, in 2004, he spent time at the UniversittsSpital in Zurich, Switzerland. In 2005,

he was a clinical fellow with the Brain Tumor Research Center at the Hospital for Sick Children

in Toronto, Canada. These postgraduate training experiences positioned him well for assuming

his current position as Associate Professor of Neurosurgery at the Himalayan Institute of

Medical Sciences in Dehradun, India. The thought of working as a volunteer one day was

something inherited from his grandparents. As the years progressed, he dreamed of someday

fulfilling this childhood passion of doing volunteer work in Peru, which his grandpa used to call

pattalwhich, translated into English, means people living under the earth. It was many

years later when this dream of becoming a neurosurgeon volunteer finally came to fruition. Ithappened one day while surfing the Internet. He found the Web site for the Foundation for

International Education in Neurosurgery. He immediately wrote to Dr Merwyn Bagan, president

of the Foundation for International Education in Neurosurgery, who responded to Dr Bansal's

letter from Nepalwhere he himself was doing work as a neurosurgeon volunteer. Receiving

words of both encouragement and direction, Dr Bansal was soon on his way to northwest Peru

where he worked as a volunteer/visiting professor in the cities of Chiclayo, Piura, and Trujillo.

His primary vision was to teach neurosurgeons in Peru techniques of epilepsy surgery that would

provide the only curative step in dealing with the lifelong, crippling disease. In spite of his

enthusiasm for planning and carrying out this volunteer effort to bring epilepsy surgery to peoplein Lima, Peru, Dr Bansal was surprised to find that his friends laughed at him upon hearing of his

plans. Why do you want to go to a country far away and work for nothing when you can make

big bucks doing neurosurgery here at home? they asked. Pondering questions like this one, Dr

Bansal decided one of his reasons for wanting to do work as a neurosurgeon volunteer was

simply to make a difference in the lives of those less fortunate. The other reason was that

because of his religious faith, he felt a spiritual calling to respond to the needs of those


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destined to live their lives with a crippling disease that he had been trained to deal with as a

neurosurgeon. Upon landing in Peru, he was driven to the hospital where he was to work with

the local neurosurgeon, Dr Ral de la Cruz Azaa, and found his first patient was already on the

operating table with the administration of anesthesia underway. Feelings of jetlag and the fatigue

of having just flown halfway around the world were quickly replaced by the excitement andsense of fulfillment that came with teaching new neurosurgical techniques and skills to his host

neurosurgeon who was so eager to learn. During his month-long experience as a volunteer in

Peru in April 2007, Dr Bansal worked in 4 different hospitals where he found that most of the

neurosurgical cases he was asked to do were for spinal problems. He also operated on a number

of head trauma cases, but other cranial cases were comparatively few in number, perhaps due to

the lack of diagnostic equipment and surgical instruments. None of Peru's major hospitals

appeared to have magnetic resonance imaging scanners, although several private facilities did.

Dr Bansal found that some of the national hospitals had computed tomographic scanners. He

found that some of the hospitals had basic neurosurgical instruments, and in some instances,neurosurgeons provided

Available online at www.sciencedirect.com

Surgical Neurology 72 (2009) 8788

www.surgicalneurology-online.com

The views and opinions expressed in this editorial are those of the

author, and the views expressed herein are not necessarily those of the

Publisher.

0090-3019/$ see front matter 2009 Elsevier Inc. All rights reserved.doi:10.1016/j.surneu.2008.04.017


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The End??

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?

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Its Your Turn

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