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Surgical Neurology 72 (2009) 87 – 88 www.surgicalneurology-online.com

Editorial

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 fulfilling what 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
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

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 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

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Editorial / Surgical Neurology 72 (2009) 87–88

their own instruments, keeping them at their homes between cases. Microneurosurgical instruments were generally not available. While working in Peru, it was Dr Bansal's impression that the number of neurosurgeons available for providing neurosurgical care was marginally low. Furthermore, Dr Bansal concluded that, with assistance in terms of obtaining greatly needed neurosurgical diagnostic and operating room equipment (perhaps through donations from surgical supply companies), the number of neurosurgical operations could be greatly increased. Only one of the national hospitals in which Dr Bansal worked had a neurosurgery training program, and this was for training only 1 resident each year. Although most of the neurosurgeons indicated they had Internet access at home, this was generally not available to them in the hospitals. They also expressed their need for access to more journals. The most important needs expressed by neurosurgeons in the various hospitals visited by Dr Bansal in Peru were for provision of good-quality surgical instruments and for either assistance with development of neurosurgery training programs, or opportunities for younger neurosurgeons to travel to other countries for additional training. Both of these very important needs can be addressed, in part, at least, through neurosurgeon volunteerism efforts. As a result of “visiting professor” visits by experienced neurosurgeons from countries in which neurosurgery is highly developed, the level of neurosurgical training in lessdeveloped countries can be greatly enhanced, and as a result of short-term neurosurgeon volunteer visits similar to that of

Dr Bansal, donations of diagnostic and surgical equipment invariably become available. When asked whether he would recommend to others that they go to a developing country as a neurosurgeon volunteer, Dr Bansal responded, “Yes, I strongly recommend this type of service to any physician. Personally, I am planning to return to Lima, Peru, in June of this year, this time prepared to achieve my main aim of teaching epilepsy surgery to the neurosurgeons there.” Dr Krishan K. Bansal will likely tell you he worked especially hard in his own practice during the weeks before going to Peru to arrange the necessary time away. He will also likely tell you the work upon his return to his practice was demanding, indeed, but the one all-important thing Dr Bansal will definitely tell you is that his neurosurgeon volunteer time spent in Peru was “the experience of a lifetime!” This is attested to by the fact that as this editorial is being written, Dr Bansal is making plans and preparations for his next stint of volunteer service as a visiting professor in Lima, Peru, and this time, he will be returning with donated neurosurgical equipment, instruments, and supplies that, along with his teaching expertise, he will use in raising neurosurgical care in Peru to a higher level of excellence. Mel Cheatham, MD, FACS Department of Neurosurgery UCLA David Geffen School of Medicine Los Angeles, CA 90095, USA E-mail address: nurosgn@aol.com