Surgeons honored for volunteerism and humanitarianism

The American College of Surgeons (ACS) Board of Governors (B/G) Surgical Volunteerism and Humanitarian Awards Workgroup has announced the recipients of the 2019 ACS/Pfizer Surgical Humanitarian Awards and Surgical Volunteerism Awards. As in previous years, the workgroup received exceptional nominations, reflecting the remarkable commitment of ACS Fellows to providing care to underserved populations.

The contributions of the award recipients are summarized in this article and will be formally recognized at Clinical Congress 2019 in San Francisco, CA, during the annual B/G reception and dinner October 29. Clinical Congress attendees are invited to hear the honorees speak at a Panel Session, Humanitarian Surgical Outreach at Home and Abroad: Reports of the 2019 Volunteerism and Humanitarian Award Winners, 9:45−11:15 am October 28 at the Moscone Center South, 154.

Surgical Humanitarian Awards

The ACS/Pfizer Surgical Humanitarian Award recognizes Fellows who have dedicated much of their careers to ensuring that underserved populations have access to surgical care and have done so without expecting commensurate compensation. This year, the award will be presented to two surgeons.

Donald E. Meier, MD, FACS, a pediatric and general surgeon from Dallas, TX, will receive a Surgical Humanitarian Award for his decades of surgical, training, and education service around the world, primarily in West Africa.

After completing his surgical residency at the University of Texas (UT) Southwestern Medical School, Dallas, and serving for two years in the U.S. Army, in 1982 Dr. Meier and his family joined Dr. Meier’s friend John Tarpley, MD, FACS, FWACS, at the Baptist Medical Centre, Ogbomosho, Nigeria. Alongside Dr. Tarpley, he worked as a true general surgeon, performing urology, otorhinolaryngology, neurological, pediatric, plastic, and orthopaedic surgical procedures. He worked as a practicing surgeon and physician in this low-resource setting until 1999, periodically returning to the U.S. to rejoin faculty at UT Southwestern, but his most lasting accomplishments came through educating generations of African residents and faculty to help establish a self-sustaining training program, particularly in Nigeria.

During his 17 years in Nigeria, Dr. Meier was one of the educators in the general surgery tract of the general medical practice residency program, teaching residents and medical students to provide quality surgery with limited resources. Dr. Meier was a key surgeon working with the Nigerian College of General Medical Practice, a group created to address the needs of Nigerians in rural areas where access to care is limited, to improve surgical capacity and care in those settings. Dr. Meier chose to focus on this area of great need in the 1990s, decades before providing aid in rural, low-income settings would become a focus in global surgery. Physicians who Dr. Meier trained provide fundamental surgical care, including Caesarean sections, emergency obstetrics, incarcerated hernia procedures, and so on, at a district level in various states across Nigeria. Many of the physicians he trained are now health care leaders in the country.

Throughout his career, Dr. Meier continued to broaden his skill set for the sake of surgical patients. At age 50, after many years of active practice, he saw the acute need for pediatric surgeons in Africa and returned to the U.S. and became the first pediatric surgery fellow at Children’s Medical Center, Dallas. After completing his board certification in pediatric surgery, he returned to Nigeria to care for children and to teach local physicians safe pediatric surgical techniques.

After training in pediatric surgery, Dr. Meier completed many short-term mission trips to resource-poor areas such as Kosovo, Albania, Afghanistan, and Haiti, as well as other African nations, including Cameroon and Ethiopia. In 2003, Dr. Meier moved to El Paso, TX, which at the time had no pediatric surgeons, to establish pediatric surgical services. For several years after his arrival in El Paso, he was the only pediatric surgeon in a metropolitan area that served more than 1 million people. Dr. Meier has since participated in establishing a local medical school and children’s hospital.

Devendra S. Saksena, MBBS, FACS, a cardiothoracic surgeon in Mumbai, India, will receive a Surgical Humanitarian Award for his nearly 50 years of service in establishing cardiothoracic surgery services in India and throughout remote areas of Africa.

After completing his cardiac surgery training in the U.S. in 1971, Dr. Saksena returned to his native India and helped to launch cardiac surgery services in several underserved areas in the country. After being given a small consulting room and one operating room slot at Bombay Hospital, Mumbai, at the recommendation of then Prime Minister Indira Gandhi, Dr. Saksena started the program that would become the Bombay Hospital Cardiac Surgery Center, the city’s first major cardiac center. It became a recognized center of excellence, and after Dr. Saksena started the Bombay Medical Aid Foundation in 1979, the hospital provided surgery to medically indigent patients at no charge.

Dr. Saksena then began providing surgical services and training and building capacity in other locations in India. He and his surgical team visited Sawai Man Singh (SMS) Medical College in Jaipur for three years to teach the surgeons at the Heart Center, who primarily were trained in cardiothoracic surgery. He also brought the SMS Heart Center’s surgeons, perfusionists, anesthetists, and nurses to Bombay for training several times. As many as 900 operations are performed annually at the SMS Heart Center, and it is a major training center in the region. Dr. Saksena also was on staff in the cardiac surgery at Super Specialty Hospital, Nagpur, Maharashtra, and started the Nirmal Village Charitable Hospital to assist the tribal population of the village, which is approximately 50 miles from Mumbai.

Some of Dr. Saksena’s most impactful work has taken place in Mauritius, a remote African island nation of approximately 1.3 million people, hundreds of miles from the coast of Madagascar, leaving patients there without access to a developed medical center. Dr. Saksena was invited by the local government to help patients who lacked facilities and treatment for advanced heart disease. Because the cost of transporting patients was prohibitive, in 1986 Dr. Saksena began performing cardiac operations in a camp setting, which housed a small general surgery theater and no intensive care unit (ICU) or diagnostic facilities or tools except for electrocardiogram, chest X rays, and a stethoscope. Nonetheless, he performed more than 200 operations with a less than 2 percent mortality rate.

The services in Mauritius eventually developed to include dedicated diagnostic facilities, preoperative evaluation, and an ICU. A full suite of common cardiac procedures became routine, in part as a result of Dr. Saksena’s direct intervention and the training he provided to local physicians. He continues to visit Mauritius to provide surgical services at least twice a year for a two-week period. The people of the island valued Dr. Saksena’s services to such a degree that, in absence of a government plan, they began to construct a heart center. Eventually the government funded the effort and completed the Sir Seewoosagur Ramgoolam National Hospital, marking the first known instance where the foundation for a heart center was literally laid by local volunteers.

Surgical Volunteerism Awards

The ACS/Pfizer Surgical Volunteerism Awards recognize ACS Fellows and members who are committed to giving back to society through significant contributions to surgical care as volunteers. This year, three awards will be granted to the following individuals.

Steven Bolton, MD, FACS, a general surgeon in Pontiac, MI, will receive the Domestic Surgical Volunteerism Award for his efforts over nearly three decades to initiate and operate a medical clinic for underserved residents in Pontiac, MI.

Although Pontiac is the county seat of relatively affluent Oakland County, the city, with a population of approximately 60,000, is home to many low-income people. After General Motors closed manufacturing plants in the city and the primary source of work disappeared, it became increasingly necessary for the city’s residents to have access to medical care that could attend to their needs without adding more financial burden. Dr. Bolton joined forces with St. Joseph Mercy Oakland Hospital to open Mercy Place Clinic.

Mercy Place is a comprehensive patient care clinic that resembles a large, well-staffed, well-equipped physician’s office, and also serves as an urgent care center. Dr. Bolton started the clinic with two examining rooms in Pontiac’s St. Vincent DePaul Catholic Church Annex, which was staffed by only a nurse and a volunteer physician. After 10 years of helping poor patients and with increasing demand, Mercy Place moved to a modern 6,000 square foot medical center with a parallel increase in permanent staff. Mercy Place provides adult health care services, including surgical evaluation, case management, pharmacy, women’s health, health screenings, pregnancy testing, wellness exams and physicals, disease prevention, ophthalmology and eyeglasses, and chronic disease management.

Since Mercy Place opened, Dr. Bolton has operated at and had oversight of the facility. Originally, he managed both the facility and staff, especially the volunteer staffing physicians who were usually recruited from the medical staff at St. Joseph. Today, specialty surgeons including orthopaedic surgeons, urologists, and neurosurgeons are enlisted from St. Joseph for major operations. Dr. Bolton has solicited donations and grants to maintain and improve the clinic, as well as helped to obtain necessary contributions, such as furniture, medical equipment and supplies, and medications.

In addition to cofounding Mercy Place, Dr. Bolton has participated in other charitable related endeavors, including obtaining, packaging, and delivering leftover food from the physicians’ dining room at St. Joseph to a local shelter, the Grace Center of Hope.

Richard W. Furman, MD, FACS, a cardiothoracic surgeon from Boone, NC, will receive the International Surgical Volunteerism Award for his long career of providing medical care to underserved patients around the world and for cofounding World Medical Mission (WMM).

After beginning his medical missionary work with a trip to India in 1977 to teach pacemaker insertion to local medical workers, that same year Dr. Furman and his brother, Lowell B. Furman, MD, FACS, a 2003 recipient of the ACS Surgical Volunteerism Award, worked with Samaritan’s Purse International Relief to create WMM and fill a global medical need for short-term, volunteer assignments in low-income settings. In its second year, WMM sent seven physicians to areas of need; in its third, it sent 18; more than 40 years later, WMM sends approximately 600 volunteer medical professionals annually to underserved areas and recently sent its 10,000th volunteer. WMM volunteers now serve in 45 overseas hospitals, with more facilities in the process of receiving or requesting support. Dr. Furman has operated in many of these hospitals, on conditions ranging from common breast and colon cancer to more unique cases, including a thoracotomy to remove an arrowhead embedded in connective tissue between the aorta and superior vena cava.

One of WMM’s greatest successes has been in providing more permanent placement of physicians in these foreign hospitals. As many hospitals in low-income countries closed or were turned into nurse-run clinics, it became evident that these locations needed more U.S. physicians. To that end, WMM began the Post-Residency Program, which provided a two-year, on-site fellowship in global medicine. The purpose of the fellowship, which includes a stipend and travel and living expenses, is to place physicians in locations for long-term commitments. Since 2004, more than 185 physicians have participated in the fellowship program, and more than 80 percent of them have stayed in those locations beyond their initial commitment.

Throughout his time with the WMM, Dr. Furman has been active in visiting areas that require surgical or medical attention as the result of a natural disaster or war. During the Battle of Mogadishu, Somalia (also known as Blackhawk Down), he set up emergency care for wounds. He and other surgeons traveled to Kigali, Rwanda, a month after the Rwandan genocide because an entire hospital had been routed. He provided surgical care after the 2010 Haitian earthquake, 2015 Nepal earthquake, and 2016 Ecuador earthquake, and he operated in an emergency field hospital outside of Mosul, Iraq, in 2017, treating both enemy combatants and Iraqi citizens.

Dr. Furman has been a long-time advocate for sending U.S. medical aid to countries that need it most. He regularly traveled to Africa with former U.S. Sen. Bill Frist, MD, FACS (R-TN), to hospitals in low-income countries to assess their needs, which eventually led President George W. Bush to implement a program to provide more than $15 billion in aid to 15 countries. Beyond this indirect influence, Dr. Furman has helped to secure medical resources for WMM’s physicians and hospitals; in the last decade, the organization has sent more than 585 20-foot containers of equipment and supplies, valued in excess of $46 million, to these locations.

Alison Smith, MD, a general surgery resident at Tulane University, New Orleans, LA, will receive the Resident Volunteerism Award for the dedication she has shown in her early career to provide medical service to the people of Haiti.

Dr. Smith has an extensive history as both a domestic and international volunteer, starting as a teenager and continuing in her time as a medical student and resident, including serving as a community volunteer in Minas de Oro, Honduras, in 2005; a medical student volunteer at Ozanam Inn Homeless Shelter, New Orleans, from 2007 to 2014; and a trauma/cardiopulmonary resuscitation volunteer in Kathmandu, Nepal, in 2014.

Among her most impactful volunteerism efforts have been in Haiti, where she first traveled in 2008 to assist in a medical clinic. Dr. Smith’s efforts grew precipitously in 2010 after the massive earthquake that killed more than 100,000 people and devastated Haiti’s already fragile infrastructure. She was one of the first medical volunteers to arrive at the General Hospital in Port au Prince, just 96 hours after the earthquake. There, she worked for two weeks helping to triage patients in the field and assist patients from remote areas find surgical care.

In the deadly cholera outbreak that followed the earthquake in November 2010, Dr. Smith was involved in developing and implementing a program in Jacsonville, Haiti, to help prevent the disease’s spread. More than 9,000 people across the country died, but Jacsonville, which is located in the Haiti’s Central Plateau and is the poorest region of the poorest country in the Western Hemisphere, had only one death.

Following these efforts, Dr. Smith and several other medical student volunteers from Tulane founded Sante Total, a not-for-profit organization with the goal of building a clinic in Jacsonville that will serve as a permanent access point to health care for the local population. With support from the Rotary Club in Ellicott City, MD, and private donors, the clinic is scheduled for completion in 2020. In the meantime, volunteers have constructed latrines to improve public sanitation; instituted a program to provide meals to elderly residents; and conducted public health programs aimed at improving hygiene, empowering women, and teaching about disease transmission. Sante Total also has worked to provide medical education scholarships to Jacsonville’s young adults, with the goal of having these individuals eventually run the clinic. The first scholarship recipient has been working on her nursing education and will begin working in the community soon.