This is a surgical mission trip with ReSurge International to Addis Ababa, Ethiopia. The goal of ReSurge is to build, scale, and sustain reconstructive surgical capacity to provide life-changing care to those with the greatest need. This mission will involve myself (a reconstructive microsurgeon on faculty at University of Washington), my colleague, our OR nurse, and one of our surgical trainees. We will be joined by a Canadian anesthesiologist as well. Together, we will be providing teaching in the format of lectures, hands-on activities, as well as operative teaching on patients the local surgeons have identified as benefitting from our expertise. This teaching will allow the local surgeons to then gain the ability to offer these life-saving reconstructive surgeries to their patients once this mission is over. It will also allow them to train future generations of surgeons in their training programs on these techniques.
I have volunteered for ReSurge as a female surgeon mentee to International female surgeons in their 1st year of practice. I have previously done one mission to Africa with Operation Smile as a resident trainee (cleft lip/palate), and this ReSurge trip would be my first trip as a surgeon teaching my specialty (reconstructive microsurgery)
The people of Ethiopia, and potentially neighboring countries who may send their complex patients to Addis Ababa for care. The Department of Plastic, Reconstructive, and Hand Surgery at ALERT Hospital holds the distinction of being one of the oldest departments at this hospital (over forty years of dedicated service). Originally established to provide free medical treatment for leprosy patients, it has evolved into a national referral center for Plastic Reconstructive and Hand surgery. In collaboration with Addis Ababa University College of Health Science, the department is affiliated for postgraduate programs in Plastic and Reconstructive Surgery at both specialty and subspecialty levels. It is a major training center, and thus our teaching will impact the ability of trainees to learn specialized techniques and then take these to their future practices throughout Africa. It is also a comprehensive specialized hospital that serves not only the population of Ethiopia, but also eastern Africa.
As noted above, this mission will involve a) the teaching and training of local surgeons in advanced reconstructive microsurgery, b) will enable local surgeons to then provide these reconstructive services once the mission is complete, c) will allow local surgeons to train their resident trainees in these techniques, d) will allow the population of Ethiopia and beyond to have access to reconstructive surgeries not previously available to them -- this could mean the difference between limb salvage and amputation, or offer the capacity to do big cancer surgeries that need reconstruction, etc.
On April 25th a team representing ReSurge International embarked on a trip from Canada/US to Addis Ababa, Ethiopia. We were comprised of 2 reconstructive plastic surgeons (myself, and colleague Dr Suzanne Inchauste), 2 plastic surgery trainees, a plastic surgery OR nurse, and an anesthesiologist. The mission was in keeping with that of ReSurge - to "build access to life-changing surgeries in low-income countries through training local surgeons and providing free reconstructive surgical care". Specifically, we were asked to provide teaching (both didactic and in the operating room) about breast reconstruction following cancer. Prior to this trip, breast reconstruction in Ethiopia had rarely, if ever, been done. Women do not have regular access to mammography/screening, and often present later in their disease. This means many will undergo mastectomies, lymph node dissections, chemotherapy and radiation therapy (if access permits) as a part of their treatment. Reconstructive options are limited given lack of materials (implants, for example), and lack of access to surgical techniques including free flaps (ie, using ones own tissue for reconstruction). We were able to teach and provide one woman (the first in Ethiopia) with reconstruction using her abdominal tissue - a "DIEP flap" reconstruction. In this operation, we provided teaching to the local surgeons, the resident trainees, as well as the nursing staff about how to do this operation, with the hope that they may provide this surgery to others as interest/awareness grows among the Ethiopian breast cancer population. And the woman who underwent reconstruction was so appreciative and excited to feel whole again. This trip was only the beginning, and follow-up missions will help foster the growth of this initiative as more women become interested in reconstruction! Our week in Addis proved successful, with several other surgeries taught/completed, friendships forged, and knowledge shared. We learned as much from our Ethiopian colleagues as they learned from us. And we got to explore the beautiful countryside, experience the culture, and make lifelong friends. It truly was a wonderful experience, and I look forward to the next trip!
