Volunteering on Medical Missons Surgical Resident Helps Provide Financial Stability in Sierra Leone
Dr. Benjamin Chandler, a surgery resident at UMDNJ in Newark, NJ, couldn’t turn down the opportunity to join a medical mission to Sierra Leone. The organization, International Surgical Health Initiative (ISHI), runs humanitarian surgical missions to countries that don’t readily have access to surgical care.
Thirteen people joined Dr. Chandler on this mission. The surgical team consisted of three surgeons, an anesthesiologist, a certified registered nurse, a surgical scrub nurse, a recovery nurse, and a nurse practitioner. Equally important was the team’s community liaison, Muhammed, who helped integrate the team into the community.
What struck Dr. Chandler was how prevalent hernias, hydroseals and other basic surgical issues were. Most of the hernias he saw developed from heavy lifting resulting in a weakening of the abdominal wall. Consequently, many experience a weakness by the groin. “As this weakening gets bigger and bigger, over years their intestines can fall into it and become trapped. The area can grow to be quite large, making it difficult to walk and impossible to work,” explained Dr. Chandler.
The conditions that Dr. Chandler treated were not only life-threatening, they also threatened the economic stability of entire families, towns and cities. “When patients in Sierra Leone can’t work, they can’t feed their families. And if a family can’t work or eat, they cannot go to school or farm the land. As a result, the land goes into disuse.”
Dr. Chandler acknowledged that deciding to travel abroad on a medical mission is a daunting prospect for many residents. “Residents have valid concerns about practicing abroad—such as being away from family. To them I would say, if you can’t leave your family members, bring them with you. There’s a need for people beyond the medical team to join international missions as supporting staff. They are equally integral to the success of a mission.”
“In Sierra Leone physicians felt more free to follow their clinical judgment and avoid practicing defensive medicine because the climate was less litigious,” Dr. Chandler noted.
Dr. Chandler intends to continue supporting international missions beyond his residency. “My ‘a-ha’ moment came on the third or fourth day we were there,” said Dr. Chandler. “I realized this was exactly why I went to medical school. We were doing visibly good work. The experience reawakened and reaffirmed the humanitarian I wanted to become.”
For more information on the International Surgical Health Initiative, visit www.ishiglobal.org.
Dr. Svjetlana Lozo is a New York Regional Vice President for CIR and an ob-gyn resident at Maimonides Medical Center in Brooklyn. When she’s not treating patients there, she is often volunteering her services abroad performing reconstructive pelvic surgery at fistula clinics. This work has taken her to Tanzania, Jamaica and Eritrea on medical missions, and she spent time in Mexico in a Medical Spanish program.
What are the long-term effects of obstetric fistula that you are trying to combat?
Fistula is a connection between two closed cavities. In these cases, urine and feces leak through the vagina. Besides the physical limitations, there are huge social implications – in some of the communities where I have worked there are no indoor bathrooms and constantly leaking urine is not socially acceptable. There’s a huge stigma attached to it.
How did you get involved in global women’s health?
Through my advisor, Dr. Ambereen Sleemi. She’s a urogynecologist and a fistula expert. I joined her on all of my trips, except for Mexico. When I went to some of these countries, like Eritrea, I found that fistula is an epidemic.
Often it happens because women have been in labor for so many days. Some women are very tiny, so their bodies cannot handle a long labor. We saw a lot of 15 to 20-year-old women. In other circumstances they would have had a Cesarean, but that’s not available in these places.
What’s the biggest difference between practicing in the U.S. and practicing abroad?
In the third world, you’re always stripping it down to the bare basics. Every country has its own restrictions and challenges. In some cases, there’s no ATM in the entire country, for example. So you have to be prepared to do things differently.
I spent about five months preparing for my first mission. As a young physician who was trained in settings where resources are readily available, every moment of this preparation was needed. One moment in particular was an eye-opener for me in understanding how we must adapt in order to save limb and life.At the Rastafarian camp in Scott’s Pass, Clarendon, we encountered a young boy who had developed an abscess on the sole of his foot. He was in tremendous pain, with significant inflammation and swelling extending up the leg. As we prepared to incise and drain his foot abscess, he cried in pain. The distraction techniques that I learned during my training were not enough to calm him. Community elders and other clinicians also tried to soothe him. With limited supplies, my attending cleverly obtained Novocain from the dental team, and we administered Advil, Keflex and Clindamycin. He sat up and shouted to stop, but not intervening could have lead to sepsis or the loss of his leg. I had to place all my weight on him to stabilize him until the abscess was drained. I wondered about the long-term impact of this trauma, but I was reassured by his resilience. He was back playing with his friends at the end of the day.
OID also provided a great opportunity for me to network with other professionals and create new friendships. I also reestablished communication with my pediatrician who inspired me twenty years ago to follow this path.
I fell in love with OID’s mission, “helping others to help themselves,” because it mirrors the goals I set for myself at the beginning of residency. Through the OID, I have found another path to give back to the community and to widen my humanitarian spirit abroad.
For more information on Organization for International Development, visit www.oidinc.org.