About every 18 months, Kevin Hansen, MD ’98, travels with his wife and kids to a hospital near Tegucigalpa, Honduras.
While Hansen cares for people in need, his children spend time with kids who live in an orphanage on the same property as the hospital.
“You go there because you want to give back and you want to serve an underprivileged area, and you leave feeling so energized,” says Hansen, an orthopaedic surgeon from Granite Bay, California, who is among an untold number of Wake Forest-trained medical professionals who help others around the world.
“You don’t really leave feeling sorry for people,” he says. “You leave feeling like they’ve been uplifted, you’ve been uplifted and it’s been an enriching experience overall.”
It’s an experience that many alumni, faculty, students and staff of the School of Medicine have in common.
‘Never a Perfect Time’
Hansen has visited the Honduran hospital four times, most recently in October 2019, on trips coordinated through the nonprofit group One World Surgery.
“The motivation comes from a personal desire and to teach my kids that we’ve been blessed in many ways, and I feel some obligation and motivation to give back where I can,” he explains.
“There’s a practical aspect too. You’re doing surgery that you could do in your sleep back home, but down there, with different equipment, you’ve got to be imaginative and engineer things through in your mind. You have to think through every step. It’s educationally and intellectually stimulating and lets you look at things from a different point of view.”
Hansen says such service opportunities are easy to postpone to a more convenient time in life—after paying off student loans, developing your career or starting a family.
“There is never going to be a perfect time,” he says. “It always comes with some sacrifice. In the five different medical mission trips I’ve done, I've seen people come with every kind of attitude and reservation and have doubts and anxieties about it. Every single person by the time they leave has been thrilled with the experience. I don’t think that’s unique to the location. When you spend time like that completely outside of yourself, it’s a very positive, enriching thing.”
As rewarding as the work can be, sometimes it’s not easy to find the right opportunities.
“There’s a little bit of a hurdle to get started,” says Stan Tennant, MD ’78, a retired cardiologist in Greensboro, North Carolina. “I needed a few friends to help me see what it was like and get me started. That was encouraging.”
In January, he joined a group of physicians, including alumnus Doug Boyette, MD ’75, on a medical mission trip to the Dominican Republic. The group has been going for more than 20 years, and it was Tennant’s third trip with the group. He also has helped perform heart surgeries in Nicaragua and worked in clinics in Guatemala and Haiti.
“We need a little charity in our heart and a curiosity about life to do these things,” Tennant says. “I fault myself for not venturing out and finding these opportunities earlier in life. It’s never too late to get started though.”
He sees potential for connecting medical students and faculty who are interested in medical missions with alumni who are involved in such work. The school’s HOST Program, which helps alumni from across the country host fourth-year students as they travel for residency interviews, could serve as a model.
“It just takes a little bit of coordination,” Tennant says. “It would be a great opportunity for alumni to be involved with students. It connects alumni with a teaching situation. It gives students a chance to test their clinical skills in a different setting. I think it has wonderful potential.
“It’s always good to team up with someone who’s gone before. It takes a lot of infrastructure and a little bit of homework to get it set up, but getting plugged into an ongoing effort is the easiest way to get started.”
Work Within the School
Although a number of departments and faculty within the School of Medicine are involved in international work, there is no one entity that organizes all of it. Much of it is embedded throughout the school.
“You name a clinical department, and I’ll name a country and a faculty member who is associated with it,” says Avinash Shetty, MD, associate dean for global health and professor of pediatrics. He leads the Office of Global Health, which serves as the connecting hub for global health activities within the school.
Shetty lists numerous outreach efforts involving various departments and faculty leaders, some that work through partnerships with nonprofit groups and others with corporate support. One example: Ophthalmology.
The department’s residents take part in the WakeECHO International Ophthalmology Program, which includes a partnership with an eye clinic/operating room in Honduras. Twice a year, a team of faculty surgeons joins senior residents and fellows for a week at the Lion’s Club Eye Hospital Fraternidad in San Pedro Sula.
The department’s “surgical brigade” took the program’s eighth trip in June 2019 and included faculty members Matt Giegengack, MD, Timothy J. Martin, MD, House Staff ’90, and Paul Dickinson, MD; senior residents Levi Kauffman, MD, and Kathy Tsamis, MD ’15; and Bethany Bouldin, MD Class of 2022.
Residents and fellows learn manual surgery techniques and give sight to patients who have been blinded from cataracts. This program has also provided opportunities in India and Ethiopia and is expanding to include glaucoma, retina and other services.
Shetty points out that other successful partnerships with nonprofit groups (for example, Kybele Inc. led by Medge Owen, MD, in anesthesia), corporations (HanesBrands with Dale Browne, MD, House Staff ’87, in ear, nose and throat) and academic centers (Tanzania, led by Bret Nicks, MD, in emergency medicine) offer opportunities for faculty, staff and trainees to engage in strengthening global health systems in Ghana, the Dominican Republic and other countries.
A Training Partnership
Thanks to the efforts of Lynn Anthony, MD, House Staff ’01, senior associate dean for faculty affairs and professor of radiology and pediatrics, residents have a training rotation opportunity in Kenya.
Anthony first learned about Kenya’s Kijabe Hospital six years ago when her sister and her sister’s husband—both pediatricians—moved there. There is no radiologist at Kijabe, so Anthony’s sister soon began seeking her advice about images, scans and equipment.
“I thought we could partner with this site and make it a win-win,” says Anthony. “We could go there, provide our expertise in medical image interpretation, work with techs to train them and build a team, while also thinking about how radiology could be a part of the strategic plan for the hospital there.
“Of course, I’m an educator, so I wanted to bring learners with me.”
She found a number of radiology residents at the medical school who were interested.
“We are not about dabbling in global health,” she says. “This is about building something sustainable. We wanted to choose one place and be there over time, building the relationship and the expertise across their site as a partnership, not telling them how to do it. Eventually, we want to work ourselves out of a job there.”
She takes groups to Kijabe once or twice a year, usually for a month. The trip has expanded to include techs in radiology, CT and ultrasound, and residents from surgery and internal medicine. Recent trips also have included a master’s student in biomedical engineering and a Wake Forest Baptist Health in-house counsel who helped counterparts at Kijabe write legal policies.
While there, Anthony also delivers lectures to radiology residents at a nearby university.
“There is not a pediatric radiologist in all of Kenya,” she says. “When you go in to lecture at their preeminent radiology residency program, it’s useful to them because they don’t have that expertise there.
“Every time we go there, we interact with a lot of their learners in different specialties who will be going out from Kijabe to other parts of Kenya and other parts of Africa. It’s a chance to multiply our impact.”
For faculty, students, residents and fellows who are interested, the school offers a Global Health Certificate program, and the Office of Global Health provides scholarships to promote innovative research and educational initiatives abroad at affiliated sites.
The office also leads Wake Works, the medical school’s service arm, which facilitates a range of outreach projects locally and abroad with faculty and medical professionals within Wake Forest Baptist Health.
Since 2011, HanesBrands has worked with volunteers from Wake Forest Baptist to provide medical care to thousands in need in Latin America. The partnership has included regular trips to Honduras to provide medical consultations since 2014. The latest trip, last October, included a Wake Works team that visited two cities to provide health screenings, primary care, emergency medicine, family medicine and pediatric care for approximately 1,000 children ages four to 15.
Shetty says student and faculty interest in global health opportunities remains high. The Global Health office is the first point of contact for students who want an international experience, and there is a formal approval process for those who want to receive academic credit. Any fellow, resident or medical student who receives funding for such trips must complete a predeparture process through the office. Students have engaged in research projects at global health sites under the supervision of faculty mentors. Residents often work through their departments, which coordinate travel with the Global Health office.
“If you take 100 MD students, about 25 of them will do a rotation at a global health site during their course of study,” he says. “If you take 100 students coming in, I would say 15 to 20 have already had some experience in missions or some similar global health activity, even if it’s not structured as a course.”
Nurse Anesthesia: International Focus
The percentage of students in the school’s Nurse Anesthesia Program who pursue international experiences is even higher, about 90% according to Michael Rieker, DNP, CRNA, FAAN, the program’s director.
The program has been involved with organizations and groups in North and South America, Africa and Asia. In 2012, it became the first program in America to be accredited by the International Federation of Nurse Anesthetists.
Recent graduates Anna Middleton, CRNA ’19, and Meaghan Locke, CRNA ’19, traveled to Zambia in summer 2019 to serve with Samaritan’s Purse. Working with full-time missionary doctors at Mukinge Hospital, they completed more than 75 surgical cases, taught CPR and neonatal resuscitation to local nurses and nursing students, helped teach Local Anesthetic Systemic Toxicity to operating room staff and did wellness checks at a local men’s prison.
“I tell folks that global education is not about what goes overseas, it’s about what comes back,” Rieker says. “Students regularly tell us that this is a life-changing event. It’s not just about doing some interesting procedures and seeing medical illnesses that we manage a lot better here in the United States. More importantly, we’re educating leaders. We want them to have a global view of the contribution they can make in the world.”
Into the World
When two new PA programs were getting started in the United Kingdom, faculty and students from the School of Medicine’s PA Program were there to help.
Gail Curtis, MPAS, PA-C ’81, associate professor and chair of PA Studies, has conducted joint lectures at the Royal College of Surgeons in Dublin, Ireland, and the University of Plymouth, England, and worked as a consultant as those programs got up and running. Wake Forest PA students also have served as “big brothers and sisters” to students at those schools.
That is in addition to PA students who have done mission work in Haiti and joined with students from other programs at the school to help with other international efforts.
As those students, alumni and faculty go out into the world, they carry the Wake Forest School of Medicine banner with them.
“There’s no question that I’m representing every stage of my training including medical school,” Hansen says, “and it’s something I’m very proud of.”
Are you involved in medical missions work or do you volunteer abroad? Let us know at email@example.com.