June 17, 2018 | ° F

Medical students hone surgical skills during mission in Haiti

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Fourth-year medical students Christine Mau and Chris Ojeda represent the International Surgical Health Initiative during the Health Across Borders science fair at the Liberty Science Center in Jersey City, N.J. COURTESY OF ZIAD SIFRI

Fourth-year medical students, Christine Mau and Chris Ojeda, along with surgical resident and researcher Amy Gore, traveled to Haiti this year to raise awareness for global health and promote surgical care.

With aid from Rutgers New Jersey Medical School associate professor of surgery and guiding mentor Ziad Sifri, and several other accomplished surgeons, the three students were able to perform 47 surgeries over the course of five days.

“We chose cases that were relatively simple, but would have a big impact on the patient and their quality of life,” Gore said. “Because we were in a third world county without all the resources we would have in the United States, we were a bit limited in what we could do.”

Having no proper surgical unit set up and lacking critical hospital resources, the team was required to set up their own unit with instruments packed from home.

“Many patients had chronic hernias or hydroceles, while others had lumps and bumps that bled out,” Gore said. “One woman had a condition that required bi-weekly blood transfusions, which in Haiti, was not the easiest thing to come by.”

The students were given the opportunity to participate in the mission when they created International Surgical Health Initiative, a NJMS club that was a smaller-scale version of the non-profit organization originally co-founded by Sifri.

“The students came to me a few years ago and wanted to start an ISHI club where we could have educational lectures and raise awareness about global surgery, 'a neglected part of global health,'” Sifri said.

When the World Health Organization meets to discuss global health, they do not mention surgical care as part of their objective because it seems too expensive and only helps one individual at a time, but there are currently two billion people around the world that need these treatments, he said.

As the popularity of the club grew, Sifri eventually turned it into a non-credit elective so students could receive credit for participating in presentations, weekly lectures and global health projects, such as raising money or sending needed supplies.

Mau, who aspires to become a neurosurgeon, told The Daily Targum in a previous article that her biggest challenge was treating a neck laceration on an accident victim while having limited resources and instruments.

Ojeda also struggled with limited resources, as general anesthesia was not available four out of five days while in Cap-Haitien.

Since Ojeda plans to become an emergency response physician in the future, he worked with the anesthesia team to maintain spinal block and pharmacologic sedation on patients while in Haiti.

“As part of my daily tasks, I would round the ISHI ward with other surgeons and we would help patients with wound care,” Ojeda said.

He recalled a memorable moment from the mission, when a patient who had a large hydrocele removed, previously limiting his ability to work, told surgeons, “Number one is God, but number two is you guys.”

Gore, who aided in the logistical aspect of the mission with planning and packing, echoed this sentiment.

The patients were exceptionally grateful that these problems that had been troubling them for so long had finally been addressed, she said.

“You also become appreciative [of] the patients themselves, who put up with so much manual labor, even with hernias,” Gore said. “They provide for their family without welfare or societal support like we have here, and it’s pretty difficult for them.”

Having previously gone to Kenya on a medical mission through a different organization, Gore has also lectured at ISHI to explain how to conduct testing and select candidates for operations in third world countries.

Gore believes this kind of experience is invaluable to students, whether they choose to pursue surgery or not, due to the sheer amount of cultural and educational benefits.

“From the minute you get off the plane, you’re seeing things that you would never otherwise see in America,” she said.

All students agreed that the most important skills learned were of teamwork and shared respect.

“Hospitals operate on a hierarchy and medical students are pretty low on the totem pole,” Ojeda said. “On a medical mission, everyone is on one team working together and the ego and friction don’t seem as important.”

Sifri explained that many times with medical missions, other surgeons feel that medical students are not as prepared or knowledgeable to actively contribute to the operation, but he disagrees.

“I think for me what was most gratifying was seeing the students' work integrate so well into a team, as opposed to watching or waiting to be told what to do. Christine and Chris took on so many responsibilities and gained confidence by doing so,” Sifri said.

He also stressed the skills of critical thinking and problem solving that all students developed during the mission, having exposure to a more complicated, fast-paced environment.

“You never know how students are going to react until you get there, because it’s more intense than regular rotations,” Sifri said. “The patients are more complicated, the diseases are more advanced and you’re working outside an environment you’re comfortable with, so it was gratifying to see them confident and productive.”

The team expressed hopes that future students, especially first-years in the ISHI club would go on medical missions and apply their knowledge at an international level.

“I grew up in Lebanon, which was ravaged by civil war, and watched in admiration of the heroic work of the Red Cross who pulled injured people out of the rubble, risking their lives to save others,” Sifri said. “Since then, it was my dream to help people who have the highest need, and I hope this club will inspire students to do the same.”

Shazia Mansuri is a first-year student in the School of Arts and Sciences majoring in computer science. Follow her on Twitter at @shazia3x for more stories.

Shazia Mansuri

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