For this project, I will be working with the Head and Neck Outreach (HNO) Team during a ten-day surgical education camp in Kampala Uganda. HNO has been working with the Uganda Cancer Institute in Kampala, Uganda for over 17 years. Their goal is to augment care for patients with complex head and neck cancer. The African continent has a critical need for head and neck surgeons able to perform complex surgical resection and reconstruction for this population. During our surgical education camps, aspiring otolaryngologists have the opportunity for hands-on learning, lectures, and networking.
In preparation for our visits, the on-site clinical lead identifies patients who are ideal candidates for free flap reconstruction and/or other complex ENT procedures. Virtual surgical planning (VSP), introduced on the 2023 trip, facilitated development of patient-specific reconstructive guides that improved efficiency and efficacy in the operating room, and served as a tremendous educational resource for the fellow-level surgeons on site. This year, we hope to implement VSP on more cases, including non-sterile models that could be used outside of the operating room for teaching sessions.
Prior to the trip, my focus will be coordinating plans and supplies with HNO members. I will correspond with on-site team members about operative plans, including acquiring imaging needed for VSP. We will share imaging with Striker to generate plates for patient-directed surgical planning. I will also assist with supply acquisition, such as suction tubing, staplers, sterile drapes, gloves, and microsurgical instruments (couplers, etc). During the trip, my main priority is maximizing the learning opportunities for the local surgeons. While I will be available to assist in the operating room or in clinic, my personal commitment is to work alongside local residents and to share my experience taking care of free-flap patients during their immediate post-operative course.
Our primary beneficiaries for this surgical mission are the aspiring young surgeons who share our passion for managing the complexities of head and neck cancer (HNC). However, the true value to these trips is the cascade of peer education and patient care that builds with each encounter. HNC is currently the sixth most common cancer worldwide (NIH). Its incidence has grown exponentially in the past generation with both environmentally mediated cancers and virally mediated cases. Patients with HNC face high morbidity and mortality even without adequate care. However, adequate multidisciplinary care can preserve a patient's ability to speak, eat, and remain a productive member of society.
The Head and Neck Outreach team has committed to sharing knowledge and skills pertaining to head and neck surgery so that the most vulnerable populations have equitable access to HNC care. Though this trip is a short-term global health trip, our broader aim is to make a sustainable impact for under-resourced communities all across the African continent. Already, the long-standing relationship between the Uganda Cancer Institute and HNO has inspired surgeons across Uganda, Kenya, and other sub-Saharan countries to join our fight against head and neck cancer. Our goal now is to empower those individuals and inspire others to care for this vulnerable population.
Patient care is the root of everything we do in healthcare, including this mission. Preceding the trip, our partners identify patients with advanced head and neck cancer and/or endocrine pathology. During the trip, we will spend each day performing surgeries and supporting the clinical care provided by the Uganda Cancer Institute. There are two operating rooms dedicated to our mission for the week. There we will perform 1-3 cases per day including cancer resections with complex reconstructions. From an educational standpoint, we prioritize having the local team’s surgeons in the operating room. Thus, redundant members of the HNO team will be available to assist in scrubbing cases, post-operative care, clinical care, and other educational endeavors. With the vast experience of the HNO, we be able to safely provide more advanced surgical care that may not be readily available to patients in this setting. Participants from the local area include surgeons from UCI and select members from the community or other neighboring institutions. Our mission is to equip these individuals with the skills and diagnostic tools to effectively manage patients with head and neck cancer. Many of the trainees are committed the most remote communities. Thus, the skills taught during this trip will improve diagnostics, surgical care, and overall management of patients in the regions most underserved areas.
The Head and Neck Outreach (HNO) Team has partnered with the Uganda Cancer Institute (UCI) in Kampala for over 11 years. While the primary focus has been supporting the growth and education of UCI’s Otolaryngology Department, HNO has also conducted outreach missions to community hospitals across Uganda, helping reach rural patients who might otherwise lack access to specialized care. Previous outreach sites have included Gulu, Mbale, and now Kiwoko.
Kiwoko Hospital is a not-for-profit community hospital located about two hours outside Kampala. It primarily serves uninsured patients, focusing on general medical care, malaria treatment, and emergency surgical services. Recognizing the extensive needs of the community, Kiwoko has been actively seeking opportunities to expand the scope of care it provides.
This summer, HNO, UCI, and Kiwoko Hospital collaborated to deliver life-changing surgical care to thirteen carefully selected rural patients with advanced head and neck pathology. Among the cases were patients with large benign mandibular tumors affecting their nutrition, fungating scalp lesions causing social isolation, and malignant neoplasms threatening their long-term ability to care for their families.
Beyond patient care, the trip proved transformative for the medical teams involved. Returning HNO staff were challenged to adapt to a new clinical setting. For Kiwoko, this marked their first-ever surgical camp—they were humble learners, generous hosts, and fully engaged partners throughout. UCI surgeons gained valuable hands-on experience with free flap reconstruction and local tissue advancement techniques. Additionally, they retained all remaining supplies (e.g., microsutures, Bovie machine) to continue patient care until the team’s next visit.
On a personal level, this experience pushed me beyond my comfort zone, requiring me to step into new roles in the operating room and grow as a clinician. The trip was deeply rewarding—both professionally and personally. Though the trip was too short to fully immerse myself in Uganda’s rich culture, every day I sought to pick up one thing from the local team. Listening to the lyrical language, slowing my pace, and absorbing how they interact with each other and the world broadened my perspective and influenced how I approach my work back home. The resourcefulness, collaboration, and patient-centered care resonated with why I pursued medicine so many years ago. Finally, amid the hard work, there were moments of genuine joy and connection that made the experience even more memorable.
