St. Luke’s University Health Network in Bethlehem, Pennsylvania, has developed the
St. Luke’s International Surgical Studies (SLISS) program to help meet the health care needs of populations in developing nations through sustained improvements in care as well as training the next generation of medical professionals to meet the needs of the international community. This program was designed specifically to partner with hospitals in host nations and provide supplies, equipment, training and visiting medical professionals.
To accomplish this, we partnered with Mbingo Baptist Hospital (MBH) in Cameroon, Africa, and will assist them in serving their patients. Much needed supplies are shipped and hand carried to MBH. In addition, the SLISS program developed an elective where fourth year general surgery residents, accompanied by an attending from the Division of Trauma and Acute Care Surgery, will have the opportunity to spend one month at MBH. They will be working with MBH residents who are trained through a program administered by the Pan African Academy of Christian Surgeons (PAACS). Residents from St. Luke’s work side by side with their African counterparts in an ongoing exchange of training and experiences which are mutually beneficial.
October 2014 was the first rotation at MBH and an excellent start for the SLISS program. Due to this overwhelmingly positive experience, and the strong desire of MBH to have the program continue, St. Luke’s has sustained support through multiple trips in 2015 and 2016. The total cost of each trip is $3000.00 per person and funded solely through donations.
Richard P. Sharpe, MD FACS
Director, St. Luke’s International Surgical Studies
Q&A with Dr. Sharpe
Since Spring 2014, the St. Luke’s International Surgical Studies Program (SLISS), has partnered with the Mbingo Baptist Hospital in Cameroon, Africa to improve access and quality of health care for nearby villagers while also providing St. Luke’s surgical residents with a rewarding and eye-opening international medical experience. The partnership was the brainchild of Dr. Richard P. Sharpe, who leads the SLISS program and has escorted five groups to the third-world country for one-month stays. Recently, Dr. Richard Sharpe answered questions about the initiative.
Q: How did the relationship begin?
A: I had served in the U.S. Navy and knew that when I got out of the military I wanted to start an international care program. When I was on active duty, I served with a pediatric surgeon who had worked at Mbingo Baptist Hospital; he told me about his experiences there. To be a suitable clinical experience, the third-world partner hospital had to be safe from armed conflict and infectious diseases, and be very busy surgically. Mbingo met the criteria.
Q: How much surgery is performed at Mbingo?
A: It is actually much busier than St. Luke’s Bethlehem campus. They do more than 6,000 major surgeries and 4,000 minor surgeries every year. At any given time, it is not unusual to have 500 people visit in their surgery clinic every week. It is one of only three tertiary hospitals in the entire nation of Cameroon. (Note: Cameroon has a population of more than 23 million people, almost double Pennsylvania, which has a population of about 13 million.)
Q: Can you describe the hospital?
A: The hospital resembles a United States hospital of 40 or 50 years ago. It has large open wards – separate ones for men, women and children. They have windows that close, but they leave them open year-round because while temperatures hover in the 80s, there is no air conditioning. The hospital lacks modern technology and ancillary services such as a radiologist and CAT scanner, surgical specialists, and respiratory therapy. MBH has only rudimentary laboratory capability.
Fees also resemble days past with a simple hernia operation costing about $7. There are no insurance plans, or government entitlement programs, like Medicare or Medicaid. So, even with the low prices, it can be difficult for the villagers to pay their bills because they have such extreme poverty. The hospital actually hires them and they work off their bills. It sounds strange to us, but they are more than happy to have the opportunity to do so because there is such high unemployment. They’re happy to have the work.
Q: How many trips have representatives of St. Luke’s made to Cameroon and who has gone?
A: Besides me, a total of seven residents and four attending physicians have made the trip. I was the first to travel to Mbingo Baptist Hospital in March of 2014. The following October I returned accompanied by general surgery resident, Dr. Kathryn Balinger. In April 2015, general surgery resident Dr. Christopher Balinger completed a rotation accompanied by Dr. Scott Keeney. In September 2015, I made my third trip along with Dr. Ikemefuna Akusoba, general surgery resident.
Our largest group visited Cameroon last February. Besides myself, attending in February were: Dr. Maggie Lin, general surgery resident; Dr. Charles Sides and Dr. Shenali Abeysekera, obstretrics-gynecology residents accompanied by attending Dr. Gail Burgery and Dr. Chinenye Nwachuku attending physician. In April I accompanied Dr. Melissa Mao, general surgery resident.
We go and serve them and find out what they need. We take supplies and equipment and often ship materials to them between trips. For example, we gave them suction machines, ventilators, and monitoring equipment.
Q: How does the experience benefit the residents?
A: They get to see and treat diseases that you do not find in the U.S. Also, because access to care is so limited and primary care and community hospitals are so substandard common conditions often go undiagnosed and untreated. As a result, residents get to see diseases, such as breast or colon cancer, in late stages. Take peptic ulcer disease, for example. In the United States patients receive treatment and manage their condition, but in Cameroon, it’s very common to have perforated ulcers.
Q: What are other challenges?
A: Services that support a surgeon in decision making, such as imaging and laboratory testing, are very limited. Our residents get to experience what it’s like to practice with limited information. This makes the residents dig deep into their medical learning.
Q: How does the experience change the students?
A: They get to see their value as a surgeon. They have a great impact on the lives of their patients – even bigger than back home. They have the opportunity to treat patients and return them back to their families.
Also, while in Cameroon, the St. Luke’s physicians work side by side with their African counterparts in an ongoing exchange of training and experiences. Only fourth year residents travel to Cameroon and because they are already experienced in many advanced procedures, they help teach first year African residents. Permanent staff and St. Luke’s visitors learn much from each other.
Q: What are your living conditions like?
A: The hospital has guest quarters, where we live. It is sort of like a hostel or dorm. We have our own bedroom and bathroom. The quarters have a kitchen where our meals are cooked fresh. The food is delicious. We live much better than the surrounding villagers.
Q: What are the living conditions for local people?
A: Most people, including many of the employees of the hospital, live in tiny, open-air homes without running water, plumbing, electricity or gas. They cook their food over open fires and walk to get firewood and water.
Q: What is it climate like?
A: It is a very beautiful country. MBH is located in a mountainous area, about 4700 feet above sea level. For nine months of the year, it rains every day but even so it has low humidity. The temperature hovers in the 80s.
Q: What is transportation like?
A: The roads are very bad. The hospital is 205 miles from the airport but it takes about eight hours to get there. The potholes are horrendous and the side roads are dirt. There are no posted speed limits. The main roads are very busy and bumpy. Herdsmen bring their animals on the road so you have to maneuver around them.
Motorcycles far outnumber cars. If you are rich you have a motorcycle. If you are very rich you own a car. They have taxis but many people can’t afford them. Everyone else walks or hitches a ride to get around. It’s not uncommon for a patient who is very ill to take two days getting to the hospital through a combination of walking and hitchhiking.
Q: Do they ride animals, like horses, donkeys or oxen?
A: No, they are too poor to own animals large enough to ride.
Q: Recently, St. Luke’s donated an ambulance to MBH. Can you explain the significance?
A: Mbingo Baptist Hospital has never owned an ambulance so this will truly be life saving. It will be used primarily to transport very sick patients to another hospital for CAT scans because MBH doesn’t have it’s own CAT scanner. It will also be used to provide care to critically ill patients in the community.
Q: How is your program funded?
A: So far, we have been fortunate to find donors to cover the students’ cost of the trip. Attending physicians pay their own expenses. We are very appreciative to those individuals who have helped to support the program.
Anyone interested in contributing to SLISS should contact Patrick Bower, St. Luke’s University Health Network Vice President of Development, at 484-526-4135. Anyone interested in learning more about the program should contact Dr. Sharpe at 484-526-2200.