Every year, physicians from the University of Arizona College of Medicine and University of Arizona Medical Center take working vacations for medical missions abroad. This summer, several obstetricians and gynecologists headed to Africa and Central America to assist in surgeries, cervical cancer screenings and training of medical personnel in remote locales.
Preventing Cancer, Saving Lives
In June, Pam Lotke, MD, assistant professor at the UA Department of Obstetrics and Gynecology, spent two weeks in Nicaragua with Prevention International: No Cervical Cancer (PINCC). It was her fourth trip to the country. "I'm going to León and, for the first time, to Laguna de Perla on the unincorporated Atlantic Coast. Now there's a road there. It used to be accessible only by water. That will be new," she said before she left.
Dr. Lotke works with local doctors, nurses and medical assistants to teach them how to do simple visual inspection with acetic acid screenings for cervical cancer and loop electrosurgical excision procedures to remove precancerous growths. Last summer, she spent a week in Nicaragua and another in Peru. "When I was in Nicaragua, we maybe saw only 75 to 100 women. Then, I went to Peru and, with fewer volunteers, we saw almost 400 patients. At some point, you just have to shut the door and say you won’t see any more people today."
Dr. Lotke participated in similar work in Honduras in 2008 and 2010 with a nongovernmental organization called Salud Juntos. Her motivation comes from the fact that cervical cancer – often easily diagnosed and treated – is the No. 1 cause of death from cancer in the developing world. That's higher than breast and ovarian cancer.
Redeeming the Pariahs
Bill Meyer, MD, is a UA clinical associate professor whose missions focus on fistula surgery to repair holes that develop between the bladder and rectum or vagina due to complications in labor, resulting in incontinence and other problems.
"These women are treated as outcasts ... they're ostracized," said Dr. Meyer. A few weeks after surgery, it's as if "the patient gets their life back. They are so grateful."
Dr. Meyer was in Uganda for two weeks in March and had been planning another trip to Africa in June but pushed it back to the fall. He also has participated in missions to Ecuador, Eritrea, Ethiopia, Ghana, Kenya, Nigeria and Zambia. A 2003 New York Times article inspired him to go to Africa to learn fistula repair surgery. The article was about Dr. Catherine Hamlin, an Australian OB-GYN who moved to Ethiopia in 1959 to perform these surgeries. Through the International Society of Obstetric Fistula Surgeons, Dr. Meyer has worked with Dr. Hamlin as well as Dr. Tom Rassen, an original Royal Flying Doctors Service physician who joined him in Uganda, and Dr. Kees Waaldijk, who has performed 27,000 fistula surgeries since 1984, largely in Nigeria.
"I'm probably at around 300 fistula repairs to date, which is nothing compared to Dr. Waaldijk," he said. "He's a giant in this procedure."
Click here to read about some of Dr. Meyer’s earlier missions.
A Privilege to Give Back
Another OB-GYN, Lynn Coppola, MD, MPH, a maternal fetal medicine specialist, took a two-year leave of absence in July to move to Nalerigu, Ghana, where she is a surgeon at Baptist Medical Centre. Dr. Coppola has done missions in Ghana previously and will be joined in December for two weeks by Ilana Addis, MD, MPH, who completed a 10-day stint in February in Nairobi and Bungoma, Kenya, helping train medical staff on and performing cervical cancer screenings with PINCC. Both are UA assistant professors of obstetrics and gynecology.
Dr. Addis also accompanied Lotke to Nicaragua last summer and has done medical missions to El Salvador and Honduras. Her first mission was as a consultant to a non-governmental organization on contraception and sexually transmitted infections in Turkmenistan in 2004.
"One of the things I like about the organizations I've worked with is it's not really medical tourism, but what we're doing is teaching local practitioners to do these methods themselves so that they are able to continue screening when we're gone," Dr. Addis said.
Local folks she works with, both medical staff and patients alike, are poor and often travel hours to days to and from the clinic or hospital to learn new procedures or seek treatment.
"I feel so privileged to be able to give back to these people," Dr. Addis said.
Other versions of this article appeared recently on the University of Arizona Health Network website and UAHN’s Network News newsletter, Lo Que Pasa – a weekly e-newsletter for university faculty, staff and students – and UA@Work. UAHN includes the University of Arizona Medical Center - University Campus, UAMC - South Campus, dozens of clinics, several health plans and the University of Arizona Physicians – the practice plan of the faculty physicians of the UA College of Medicine - Tucson.