By Linda P. Zhang, MD
Over the last ten years, there has been increasing attention paid to the need for global surgery and training of surgeons in developing countries. There have been a variety of service-oriented programs, ranging from short-term surgical trips, to long-term capacity-building collaborations between U.S. based hospitals and local hospitals.
As someone who has been interested in global health, I have participated in many of these types of global health volunteerism. In college and medical school, equipped with my idealism and my eagerness to make a difference, I joined in health service trips to Ghana, Honduras, India, Dominican Republic, and Haiti. Each of these trips gave me insight in the health disparity among nations, and fueled my desire to further pursue global health/surgery. However, as the novelty of a new country and new faces wore thin, I began to feel that I was not contributing as much as I was personally gaining from these experiences. Despite assisting in repairing 80 hernia in one week, I was not making a lasting impact for the local population. My focus began to switch toward capacity-building projects and training of local surgeons.
In joining SAGES, I was astounded by the number of sustainable international projects that are supported and funded by SAGES. These projects aim to enable local surgeons to improve their skills and bring advanced technology to their patients. Many have argued that it is too challenging to bring high-tech equipment, like laparoscopy, to an underdeveloped country. Dr. Raymond Price, with support from SAGES, defied that misconception. His training courses in Mongolia allowed local surgeons to not only be self-sustainable in performing laparoscopy, but these courses also became a model for duplications and expansion across Mongolia.
Local Mongolian surgeons have now performed over 4,000 basic laparoscopic cases. His project has fundamentally changed how surgery is practiced in Mongolia. The Haiti Telementoring Lecture Series, also a SAGES sponsored project, has connected expert U.S. surgeons with Haiti surgical residents. It helps to fill the gap in surgical education left behind by the earthquake 7 years ago. In addition, SAGES’s Go Global has launched the Academic Exchange program in 2014, allowing Chinese surgeons the opportunity to do an observership in an institution in the U.S.
These are just a few highlights of what SAGES has achieved in global surgery. As for myself, under the guidance and support of my department chair at Mount Sinai, Dr. Michael Marin, I began by redesigning our general surgery resident rotation to the Dominican Republic. Each year, every PGY-3 rotate to the DR for one month in a large public hospital in Santiago, DR. This life-changing experience gives young surgeons the opportunity to gain valuable skills assisting in the diagnosis and treatment of patients in a resource limited environment. In return, our residents are building capacity by bringing down FLS training boxes and designing a curriculum for local residents to improve their laparoscopic skills. In addition, our residents are involving local surgical residents in year-long research projects. Dominican residents also rotate at Mount Sinai to see how surgery is practiced in the US. Our next project in Global Surgery will focus on creating an ambulatory surgery center in rural Uganda, and training local surgeons onsite while providing them with telementoring capability.
SAGES has been influential in broadening my perspective in what is possible in the arena of global surgery. It is a premier national organization in its commitment to global surgery and reducing health disparities in developing countries. I am very thankful to be part of this organization, and I look forward to seeing the sustainable impact it has in underserved countries in the near future.
Biography: Dr. Linda P. Zhang is an Assistant Professor of Surgery at Mount Sinai Hospital in New York. She is also the Director of Global Surgery for the Department of Surgery. Her scope of practice includes bariatrics, hernia, and robotics. Dr. Zhang is committed to reducing health disparities and has worked at various medical institutions abroad. She spent one year in South Sudan initiating a community health program that has now treated over 50,000 children with communicable diseases. In addition, she has been involved in surgical mission trips in the Dominican Republic, Haiti, Honduras, Ghana, and China.
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