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Medical Missions: Now and Then

Having been an editor of Penn Medicine publications for, um, several years, I’ve been privileged to learn about some of the many medical missions abroad that the institution’s physicians, nurses, and alumni have taken part in. Occasionally, our magazines have covered such initiatives.  In the most recent issue of Penn Medicine, for example, “On a Mission” takes a look at some of the doctors who make time in their schedules and lives to embark on such expeditions. 

Often, the conditions they work in are very different from those at their home base in Philadelphia, and they often face challenges. For example, on a recent visit to Vietnam, James Kirkpatrick, MD, assistant professor of cardiovascular medicine, remembers seeing three or four patients to a single bed on the cardiology floor of a Vietnamese hospital. Also in the Spring 2014 issue, Derek Donegan, MD, an assistant professor of orthopaedic surgery, recalls being on a mission to Nicaragua where the hospital lacked the pins, rods, screws, and plates customarily used to anchor fractured bones while they heal. Joli Chou, DMD, MD 2004, spent two weeks aboard the Africa Mercy, said to be the world’s largest floating hospital. During her stay, the ship was docked at Conakry, Guinea. Chou, an assistant professor of oral and maxillofacial surgery, performed three, four, or five cases each weekday, depending on their complexity. The ship’s limited resources prevented her from doing all she wanted for the patients, but, she says, “it’s such a positive environment to work in.”

Nicaragua

Derek Donegan, MD, performed orthopaedic surgery in Nicaragua.

The Spring 2010 issue of Penn Medicine included an article on “Penn Medicine One,” the nine-member surgical team that spent two weeks in Haiti after that year’s devastating earthquake. Reporting from the scene, Samir Mehta, MD, assistant professor of orthopaedic surgery, wrote: “I am stunned at the turnover time. Post-operative recovery is at the bedside for all of a few minutes to at most an hour. Between cases, our wait time is less than 15 minutes –- enough time to write orders and plan for the next case.” Despite the conditions and the limitations of what they could accomplish in their time in Haiti, Mehta noted that “Part of me has been totally changed by the experience.” As it turned out, Mehta has been on subsequent medical missions in Nicaragua as well.

A bit farther back, one of our former publications, Penn Health Magazine, ran an article on the work of two senior faculty members who are still very much part of Penn Medicine –- and the Children’s Hospital of Philadelphia. In 1998, when the article ran, Scott P. Bartlett, MD, professor of surgery who chairs the department of Plastic Surgery at CHOP, and Peter Quinn, DMD, MD, professor of oral and maxillofacial surgery, had already been visiting Poland for several years.  Their mission was to help deal with rampant congenital abnormalities among Polish children. While in the country on one- or two-week visits, they performed hands-on clinical training and patient care. By the time the article appeared, Bartlett had already traveled to Poland almost 20 times.  According to Quinn, “The children have deformities that we’ve never seen and don’t have a name for. We see more cases in a week than we see in six months at Penn.”

As the Perelman School of Medicine moves steadily toward its 250th birthday next year, it’s also instructive to take a look at some examples of engaging globally from many decades ago. Carol Perloff, a local writer and researcher, has been unearthing many such instances. For example, James Bradford, an 1823 alumnus of the school, is said to have been the first American physician to have practiced in China. Another alumnus, Josiah C. McCracken (MD 1901) served as president of the University Medical College in Canton (1907-1913) and subsequently as dean and professor of surgery of the Pennsylvania Medical School of St. John’s University in Shanghai (1914-1942).  The goal of the latter school was to provide mission hospitals with well-trained physicians as well as to train Chinese physicians and investigate local diseases.

Another early missionary of health was Victor Rambo (MD 1921), who apparently bore no similarity to Sylvester Stallone’s well-known character. Dr. Rambo’s education was paid for by Penn’s Christian Association, which also continued to support his work to eliminate blindness in India. Under Rambo’s leadership, Christian Hospital Mungeli became known for its work in saving and restoring sight. In recognition of his work, Rambo received the Honorary Fellow of the Royal College of Surgeons, Edinburgh.

George D. Ludwig (MD 1946), then an associate professor of medicine whose expertise was in metabolic, endocrine and molecular diseases, led a team from Penn to Algeria in 1962.  The mission was part of an emergency program to restore medical services to the war-torn country. When Algeria gained its independence after a fierce war with France, it also lost all the French physicians and medical personnel who had lived there. Ludwig’s mission earned praise from President John F. Kennedy.

Perhaps the best-known of Penn Medicine’s current medical missions involves a different nation in Africa, Botswana. Established in 2001 by the Government of Botswana and Penn’s medical school, today the Botswana-UPenn Partnership involves many of Penn’s schools, both faculty and staff. Its initial focus was combating the HIV/AIDS epidemic in the country, but today the focus includes cervical cancer, heart disease, education of local health-care workers, and telemedicine. For more information, visit its web site.

 

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