James Friedman, MD
James Friedman, MD
Orthopaedic Surgery · Philadelphia, PA

Penn-Madagascar orthopedic surgical trip

April 27th
Antananarivo, Madagascar

Project Description

Penn Orthopedics and the University of Antananarivo Orthopedics (Madagascar) has built a relationship to build research infrastructure and for educational exchange between residents of both institutions. This is a surgical trip focused on performing trauma surgery, lecture exchange, creation of a more robust surgical database, and delivery of donated implants for patients who cannot otherwise afford them.

Population Served

Residents and Attendings from both institutions will gain perspective in surgical techniques implemented at both institutions. Patients will benefit from donated implants. The creation of a more stringent surgical database will allow residents of both institutions to better study surgical outcomes and will also allow the University of Antananarivo to be eligible to further implant donations (specifically SIGN nail). Madagascar represents one of the poorest countries in the world with an overwhelming amount of musculoskeletal pathology. With a now stable political system, the University of Antananarivo has great potential to increase its surgical capacity and ability to train future surgeons to meet this growing need.

Expected Impact

Donated implants will directly impact patients who would otherwise be unable to afford surgery. Lecture exchanges will impact the understanding of Orthopedics in different environments for residents from both institutions. Database strengthening will increase research productivity for the University of Antananarivo and potentially allow for further implant donation. This trip is part of an ongoing relationship with the University of Antananarivo, and this trip will help us to assess what implant types and lectures will be used in future trips.

Trip Photos & Recap

With the help of the Dox Foundation grant, Penn Orthopaedics recently spent two weeks with the Joseph Ravoahangy Andrianavalona Hospital (HJRA) orthopedics program in Antananarivo, Madagascar. Upon arrival we were inundated with patients, with pathologies including oncologic, congenital, acute and chronic fractures. In addition to a full clinic, the wards held dozens of people in traction, many who had been there for months with non-healing fractures. In our two weeks we assessed 60 patients and performed 22 surgeries. Each surgery included at least one surgeon from our team and one HJRA surgeon. All surgeries were provided free of charge. With the introduction of the SIGN nail, many patients were able to walk who had been otherwise condemned to weeks of traction. Our team was also able to perform multiple simple syndactyly releases returning function to those patients. Unfortunately the sheer number of patients as well as the complexity of pathology limited our ability to treat all patients. Long discussions were held with our HJRA colleagues to decide who would receive treatment during our visit. Happily, we were able to donate many supplies to the HJRA hospital with which the HJRA surgeons can continue to provide care to patients in need. We consider our trip a success and are grateful to our donors including the Dox Foundation. We look forward to continuing our relationship with HJRA with future visits.