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Taking Surgery to the Tropics

Taking Surgery to the Tropics

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OVER THE PAST DECADE, pediatric emergency medicine physician Karen Schneider had already treated thousands of children in remote areas of the world through her tropical medicine elective. She and her teams of pediatric residents and nurses would set up clinics in remote places in developing countries like Peru and Guyana for weeks at a time, treating medical conditions ranging from dehydration to malnourishment.

But any surgical cases that came her way she’d have to refer to urban hospital centers with a surgical service—some hundreds of miles away and difficult to access for poor families. Also, many families could not afford the fees for even the simplest operations, like hernia repair.

“I had 95 patients on the waiting list for hernia operations in Peru but they didn’t have the money,” says Schneider. “Surgeons wanted $500 per child.”

Five years ago Schneider decided she needed to take a new tack to treat these patients. She recruited a general pediatric surgeon and anesthetist to perform operations at the nearest local hospital. If there was no local hospital, she’d set up a surgical clinic, using a portable pressure-cooker sterilization unit she purchased in the states. The pediatric residents who accompanied her on her tropical medicine elective would screen patients for surgical as well as medical needs, take online courses in sedation and assist in the makeshift ORs.

“Anyone who has been on a trip with me knows the difference between hernia and hydrocele and which patients need a surgical consult,” says Schneider. “This is exactly what they would do as pediatricians.”

The impact of the surgical missions? To date, Schneider and her teams have completed a dozen surgical missions in Haiti, Kenya, Nigeria and Peru, among other developing countries, providing or facilitating surgical services for some 800 pediatric patients.

This article first appeared in the spring 2015 edition of Hopkins Children'smagazine.

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