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The Emory International


Medical Volunteerism
Collaborative Books Series
Medical Volunteerism Books

1st Edition
(Promotion for the April 2010 Conference)

Book Organized by Marijan Pejic


Copyright © 2010 Emory University School of Medicine
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List of Included Medical Professionals:


Ashwin Viswanathan
William E. Silver
Jim Withers
Ann Kennedy
Rick Spurlock
Laura Davenport
Edwin Smith
Steven M. Roser
Bruce C. Steffes
David Goo
John Petros
Ira Leeds
Kelly McQueen
Krishan K. Bansal

This collaborative book has been designed for the promotion of Emory’s International Medical
Volunteerism 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 you’re interested in
participating, please contact Zoe Haugo at 404-417-9780 or at zoe_haugo@bellsouth.net.

This will be a free conference hosted by the Emory University School of Medicine. Participants
will be able to share their individual experiences and lessons learned, create an exhibit promoting
their 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, surgical
interventions, public health educations, and healthcare provider training. The currently
confirmed 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 medical
volunteerism book series right after the conference, and we hope to make the conference a
tradition.

The purpose of this collaborative book is twofold. It is meant to give you, the reader, a glimpse
of what you can expect from the conference. The second purpose is to tell a story. As the cliché
states, a pictures is worth a thousand words. If this cliché is right, then you are about to read one
of the longest 40-something page books in existence. Each one of the included medical
professionals has an experience that has changed his or her life. These stories are unedited and
come directly from those involved. They depict passion, peace, generosity… you can find the
rest of the descriptive nouns by yourself. This book is a tale of human compassion—a story of
the beauty of [medical] volunteerism. If the telling of at least one of these stories encourages you
to volunteer in any way, shape, or form…whether medically or not… then this project has been a
success.
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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 patient’s 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
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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 in
4-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 facial
injuries 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 Veteran’s Administration Medical
Center for the last 14 years. I have served on the Kenya Project governing board for the last 8
years. The Kenya Project’s mission is to minister to the children of Kenya by providing
sponsorship 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, we
determined 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 children’s 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 in
Narkuru 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 July
of 2001 when he traveled to Antigua, Guatemala and spent a month learning Spanish and doing
volunteer work at a hospital. While in medical school, he began traveling to Haiti with the
University of Miami’s non-profit organization, Project Medishare, helping to deliver healthcare
to the underserved of rural central Haiti. While working with Project Medishare he also worked
with the non-profit organization Partners in Health helping to organize the University of
Miami'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 residency
at Emory University for Emergency Medicine training. At Emory, he started the student
organization Emory Medishare with a group of residents and medical students which has been
running 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 project which will be producing
and distributing sodium hypochlorite solution to local villagers and partnering with the
Millenium Villages Project. Dr. Spurlock, also, is the founder and President of Emergency
Physicians International or EPI. EPI seeks to improve the delivery of Emergency Medicine in
developing countries by building Emergency Departments and enhancing the clinical skills of
local Providers.

Rick can be reached at rspur1@hotmail.com or by cell at 404.395.7810.

Rick Spurlock, M.D.


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Laura Davenport
House of Grace

My husband and I have had the great honor of being called twice to do mission work at the
House of Grace in Chang Rai, Thailand. House of Grace is a home for girls that have been
rescued from being sold into the brothels in Bangkok for prostitution. They range in age from 5
years 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 by
Mark Rutland through Global Servants.

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

The girls usually come from the village having lived with their heads shaved all their lives. That
is 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 villages
once per year, typically returning with a head full of lice. Those that don’t come back with them,
are exposed to those that now have picked them up from the village. We had the fun task of
examining 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. We
go back every chance we get, hoping to positively impact the health of these girls so they may
grow into strong, vital women.

For more information about House of Grace, visit our website at www.mybethesda.org (click on
House of Grace) or call 404-298-6078.
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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 one’s 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 through
established 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 Children’s 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 sessions
with 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 Children’s Cross Connections International will sponsor the fifth Pediatric
Urology focused mission to El Salvador. The steps toward a dedicated children’s urology
mission 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 for
managing some of the most severe cases was not available El Salvador. Two patients with
bladder exstrophy eventually traveled to Children’s 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 Atlanta
and 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 to
the Hospital Velez Paiz, the older of the two Ministry of Health, MINSA, children’s and
maternity hospitals in Nicaragua. One half of the team went to the screening area and the other
half began to unpack and sort the equipment and supplies that were brought with the team and
that had been previously shipped to the hospital via Rotoship, a humanitarian effort by the JFK
Rotary Club of New York.

The surgical and medical evaluation of the patients was done by the team’s surgeons and
anesthesiologists with their local counterparts. An estimated 400 people were waiting for the
team 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 families
traveled 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 taken
care of by future missions.
Surgery for selected patients was carried out from Monday through Friday. Anesthesia was
administered by the team’s four anesthesiologists with support from the Dr. Nicaragua, the Chief
of Anesthesia at the Hospital. Operations were performed mainly by the team’s surgeons with
assistance from the local surgical team headed by Dr. Martha Velladares, Chief of Plastic and
Reconstructive 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 team’s arrival. Over 60
children were pre-screened; surgeries were not scheduled the week before the team’s arrival and
patients discharged from the hospital to open up the beds for the team’s visit. Nursing care was
also a cooperative effort by both team’s nurses and local ones. Many nurses helped to take care
of the patients. The daily bed census ranged from 20-30. All patients were admitted the night
before surgery to give the team an opportunity to assure they were not sick and to assure
compliance 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 the
team during the week. The hospital had four functional operating rooms and anesthesia
machines. 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 the
rooms given to the team was fitted with two OR tables which permitted three operations to be
running simultaneously. The anesthesia team repaired one of the anesthesia machines that was
not 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 in
considerable effort to assist with the team’s in country logistics. This included arranging for
food, lodging and transportation. The most time consuming effort for the Managua Rotary
volunteers revolved around providing housing and food for the children and families that
traveled to Managua for screening and surgery. Rotary volunteers made the lunches delivered to
the 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 the
Nicaraguan Ministry of Health, MINSA, in advance of the visit. All received temporary licenses
to practice for the time of the mission. Hospital Velez Paiz was chosen for the mission during a
site 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 after
the 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 starting
at 8AM and the last patient discharged from the PACU at 8PM. Good rapport as well as mutual
respect developed between the visitors and their Nicaraguan hosts. 56 children received 67
procedures. As of three weeks following the team’s departure, there were no complications
reported. Dr. Velledares and her staff either personally performed the followup or arranged for it
to 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 cleft
patient.

All of the supplies for the mission were donated. Benefactors included, Baxter Allegiance
through World Vision, Medical Assistance Program, MAP, Ethicon, KLS Martin, Stryker
Leibinger, Biomet Lorenz, the Anesthesia Department at Columbia University Medical Center in
New York and Emory University Hospital in Atlanta, Georgia. The unused supplies were all
donated to the Hospital at the end of the week to be used by them to provide care for other
patients.

Fund raising for the mission is a continuous effort. We received many small and a number of
more substantial donations primarily from individuals. It is very gratifying to know that despite
an economy that is not good, people still have the good will to donate to help those less
fortunate.
Carl Bailey, a financial advisor from Connecticut, who is already involved in supporting an
orphanage and school in Nicaragua and helped with the initial contact with the Rotary in
Managua, participated in the team’s 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 next
mission and will arrange to have children from the East Coast of Nicaragua, a vastly underserved
area 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 New
York, New Jersey, Connecticut, California, Illinois, Massachusetts, Oklahoma, Georgia, and
New Mexico. All of the team surgeons are members of the American Association of Oral and
Maxillofacial Surgeons. They Include, Drs. Vincent Carrao, Lawrence Herman, Martin
Kaminker, Vincent Perciaccante, Steven Roser and Martin Steed.

There are many reasons why busy people with a full plate of responsibilities look forward to
participating 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 met
many friends--some will become lifelong friends, the others may only be a part of my life briefly
yet 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 “ –on
the days that get a little overwhelming I stop for a moment and think of something that happened
during the mission. The good feeling I get gives me the motivation to get through the next
challenge, “ and ..” l have been blessed with the opportunity to do something I love to do
everyday. The mission is a chance for me to give back.”

The positive response of patients and local medical providers to the mission underlies the need
for 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 Velez
Paiz and their Cleft Clinic require encouragement and support to build the capacity to manage
clefts in Nicaragua. Out of this a local team could provide regular outreach service to remote
parts of the country.

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

We returned to our friends and to Hospital Velez Paiz in April 2009. Our experiences allowed us
to schedule and perform surgery for 67 children. A pediatric dentist and his assistant
accompanied us and they were able to see and treat well over 100 children. We have commenced
with discussions with the Managua Rotary Club, Dr. Martha Velladares and the Hospital
administration 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
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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 (Samaritan’s 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 East
Africa. 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 in
churches, 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 to
teach 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,
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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 the College 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 for
International Medicine) and induction to the Medical Missions Hall of Fame, located at the
University of Toledo, Ohio.
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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 their
health care needs.

Organization Partnering with:


Gehlen Catholic Mission
Private self funded.
Cost: Approximately $1700 dollars for travel, buying the medications we give away, and room
and board for the time we are there.
Emory involvement: Part of non clinical activities
Website: http://www.gehlenmissionhonduras.org/jan_2009.shtml
Website 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 isolated
peoples throughout Honduras. At the current time we believe only 1300 Tolupan still live in
Montana de la Flor. Seivert said that because of their isolation it is hard to get medical care and
treatment to them.” This past year we brought a protein supplement Plumpy Nut (peanut butter
paste plus) to them and cured multiple cases of malnutrition.

Severe Kwashiorkor Muoc Malnutrition Bracelet Francesca’s mother died that day of malnutrition
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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) in
a regional hospital in Santa Rosa de Copan. This endeavor is expanding to train all the general
medical officers graduating each year in Honduras. This will be a sustainable teaching effort, a
model I plan to replicate around the world. The goal is to get the doctors of that area to become
PALS instructors and Training Center Faculty for PALS and have their own course that they can
manage 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 room
and board for the time we are there.
Emory involvement: Part of non clinical activities
Website: 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 and
surrounding countries.
29

• Exports five 48-foot containers of medical equipment and supplies per year valued at
approximately $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 and
train 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 USAID
established a pediatric emergency department in Tbilisi, Georgia. We have continued this
initiative 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 University
Salary and Travel re-imbursement
Cost to me: $0
Website: http://georgia.usaid.gov/index.php?m=28&newsid=364
From website:

USAID Program Trains New Georgian Emergency Physicians


USAID's Georgia Emergency Medical Services project has
launched a new mini-residency program in emergency medicine.
The program is implemented by Emory University (Atlanta),
together with Tbilisi State Medical University, Kipshidze Central
University Hospital (Tbilisi) and Partners for International
Development. The aim of the program is to train the first
generation of emergency medicine specialists. These specialists
will not only practice emergency medicine, but eventually serve as trainers themselves. Eleven
physicians enrolled in the first eight-month program. The training represents a major shift from
the current practice of emergency medicine, where specialists are not allowed to stray into other
specialties. 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 of
patients requiring expeditious medical, surgical, or psychiatric care.
30

Bogota, Columbia, November, 2008

Last November went as a guest lecturer and consultant to the pediatric emergency department at
Fundacion Nacional de Santa Fe. Discussed medical education with the Asociacion de Los
Andes 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, have
been to Puerto Rico twice do date 2006 and 2007, and will be returning this week to present
lectures on pediatric emergency medicine.

Objective: To teach and improve pediatric emergency care in Puerto Rico


Two former Emory fellows, Dr. Ricardo Jimenez and Dr. Carmen Le Bron are the contacts for
this conference.
Funding: Travel and lodging paid for by the Pediatric Society of Puerto Rico
31

John Petros

John A. Petros, MD is a board certified urologic surgeon and tenured full time member of the
Emory University School of Medicine faculty. Dr. Petros also holds an appointment at the
Atlanta 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 National
Institutes of Health (NIH) and the Veterans Administration (MERIT award) and is recognized
for his expertise in cancer genetics, especially mitochondrial genetics in prostate cancer.

Dr. Petros is
married to Teresa
M. Petros, MD his
wife of 27 years.
They reside in
Cumming, GA with
their 5 daughters,
ages 7 to 18. They
are active members
of Mary Our Queen
Catholic Church in
Norcross, GA and
members of the lay
apostolic movement
Regnum Christi
associated with the
order of Catholic
Priests the
Legionaries of
Christ.

Dr. Petros attended Loyola University Stritch School of Medicine in Suburban Chicago from
1982-1986 and this is where his medical volunteer activity began. He spent a month on the
island 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 wherein
providing free medical care and missionary work is an effective mechanism to demonstrate Gods
love for all people regardless of age, race, country or economic ability. He believes that all his
abilities 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), Chunhuhub
Mexico (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 made
house calls. In 2009 his volunteerism led him again to Mexico where he and 65 other volunteers
from Atlanta made house calls, Catholic missionary work and renovations and landscaping for a
local Catholic Chapel in Malinalco, south of Mexico City.
32

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 University’s 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 organization’s 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.
33

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 elements
with 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.
34

Kelly McQueen

Kelly McQueen is an anesthesiologist and public health consultant in


Phoenix, Arizona. Dr. McQueen practices anesthesia in a large private
practice group and she has expertise in obstetrical (OB), pediatric and
neuroanesthesia. Dr. McQueen is an Adjunct Assistant Clinical Professor at
the Mayo Clinic Scottsdale, and a Fellow at the Harvard Humanitarian
Initiative. She has special interests in the provision of surgical care following
disasters and in humanitarian crises, and in the global burden of surgical
35

disease. She was recently accepted for a Fulbright Senior Specialist


Fellowship to examine the impact of surgery on the burden of disease in an
underserved area.
Dr. McQueen received a Bachelor of Arts degree in Biology from Colorado
College, her MD from the University of Vermont College of Medicine, and a
Masters of Public Health from the Harvard School of Public Health. She
completed a residency in anesthesiology at the University of Arizona and the
Mayo Clinic, and completed a fellowship in obstetrical anesthesia at the Mayo
Clinic.

Dr. McQueen has published articles in peer reviewed journals, has authored
and co-authored numerous chapters on a variety of anesthetic topics, and
has presented her research at national and international meetings
throughout her career. She has also published two children’s books, an
elementary school curriculum for HIV/AIDS education, and an instructional
video on HIV/AIDS for young children. While at the University of Vermont
she was elected to the Alpha Omega Alpha Honor Medical Society, and her
book, What’s a Virus Anyway? The Kid’s Book About AIDS, won the Vermont
Book Publishers Association Special Merit Award and the Benjamin Franklin
Children’s Book Award.

Dr. McQueen was a Fellow for the American Association for the Advancement
of Science (AAAS) and the Nuclear Threat Initiative (NTI) in Washington, DC
during 2002-2003. She performed her fellowship at the Office of Naval
Research (ONR), where she worked on policy issues related to DNA vaccine
technology, telemedicine and other international health and human security
issues. 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 disaster
response collaboration between the military and civilian sectors.

Kelly has had a career long commitment to disaster response and


humanitarian aid. She volunteered for the American for Society of
Anesthesiology’s Overseas Teaching program in Tanzania; Operation Smile in
China, Jordan, Brazil, Peru and Mexico; and for Doctors without Borders in Sri
Lanka. She participated in a US People to People Ambassador Program
Perinatal Delegation in Russia, Lithuania and Latvia. During her year at the
Harvard School of Public Health she participated in the Humanitarian Studies
Initiative, an education collaborative between Harvard, MIT and Tufts
designed to improve and expand the skills of humanitarian aid and disaster
relief workers. In 2005, Colorado College honored Dr. McQueen with the
Benezet Lifetime Achievement Award for her humanitarian work.
36
37

Krishan K. Bansal

Editorial Available online at (www.sciencedirect.com; Surgical Neurology 72 (2009) 87–88)

Profiles in volunteerism
From 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 of
Nagoya. Then, in 2004, he spent time at the UniversitätsSpital 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
“pattal”—which, 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. It
happened 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 Nepal—where 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 people
in 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
38

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 Raúl de la Cruz Azaña, 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 and
sense 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) 87–88
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
39

The End??

No

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