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HealthCare Volunteer Surgeon Returns from First Medical Mission to Sumbawanga, Tanzania.

Rukwa, Tanzania USA (6/22/2007) - - Dr. Samuel Feinstein, a general surgeon from Arizona, has just returned from a three week medical expedition in Sumbawanga, Tanzania where he worked with local staff at the existing government hospital to teach and perform modern surgical practices. Bringing his expertise to a facility that uses surgical equipment and supplies corresponding to what he describes as the 1920s and to a society that still uses traditional healers, Feinstein was thrust into a much altered environment from what he is accustomed.

Feinstein traveled difficult, and at times, non-existent roads to reach the hospital in Sumbawanga. Drugs in this area of Tanzania are in very limited supply, and only three or four of the oldest, generic antibiotics are available. There is no oxygen, pulmonary assistance technology, ward suction or any of the tools that are readily available in the United States. Even basic supplies for dressing wounds are extremely difficult, if not impossible, to obtain.

Serving an area of 250,000 people, the hospital in Sumbawanga maintains only 250 beds and employs three surgeons. Feinstein developed a close bond with Chief Physician Jasper Duwasindi who he describes as “marvelous.” Feinstein and his two Malaysian medical students, Stephanie Ng and May Ching, worked closely with Duwasindi. At the same time, the trio held a great deal of independence because the chief frequently had administrative tasks to deal with.

A reciprocal teaching and learning relationship developed between the American and Tanzanian surgeons. Feinstein was able to teach Duwasindi modern surgical techniques and decision-making processes while Duwasindi taught him essential skills for treating diseases like malaria and typhoid that he had never dealt with before. Feinstein documents dealing with several cases of intestinal perforation secondary to typhoid, pediatric hernias (some of which were threatening to become incarcerated), open removal of bladder stones, hysterectomies for tumors, and cesarean sections. He must assume that the tumors removed were benign, but cannot be certain as there is no pathology available.

While in Sumbawanga, Feinstein and the local staff dealt with three life-threatening burn patients. He notes, “My biggest frustration was that there were no drugs or equipment to treat them properly.” A somewhat primitive technique of small, free hand grafts was used, and the burns themselves were covered with honey which according to Feinstein, worked surprisingly well. Although the patients were all alive upon his departure, he believes that only one of the three has a substantial chance for survival.

A young girl of sixteen was the single fatality during the trip. After receiving an operation for an intra-abdominal abscess the girl’s condition deteriorated in her fifth day of recovery. Feinstein speculates that her death was due to a pulmonary embolism. In a modern circumstance, this condition would have been treated routinely using DVT prophylaxis. Unfortunately, such treatment was unavailable at the hospital.

Feinstein finds a positive element amidst such a frustrating deficit of modern equipment and medicine. Lacking such modern diagnostic methods as x-rays and labs, the doctor had a chance to educate his young medical students in what he calls, “the lost art of physical diagnosis.” Ng and Ching had the chance to actually place both hands and stethoscope on their patients to make diagnoses. Beyond this, Feinstein notes that the students had opportunities to perform and witness conditions and procedures that they will not view or execute at home. He observed a growing sense of compassion and obligation to assist that he does not frequently witness in modern medical students.

Feinstein certainly made a difference in the lives of the many patients that he treated while in Sumbawanga. Beyond this, the modern techniques he taught the local surgeons of Sumbawanga will be used to help countless future patients. Feinstein believes that he has made contacts in Tanzania that will last a lifetime. Sharing a hotel that is frequented by cabinet ministers, regional governors, local officials, and businessmen, he came extremely close to many prominent individuals of Tanzanian society. He was asked by the governor of the Rukwa region, where Sumbawanga is located, to prepare a report on the health care system as he witnessed it. Feinstein, “[intends] to submit it in a complimentary, non-critical way suggesting a few inexpensive changes that can vastly improve the flow of supplies.” He continues, “My aim is to threaten no one, maintain friendships and try to make improvements.” Feinstein plans to schedule another trip through HealthCare Volunteer in 2008 and would like to remain in Tanzania for at least two months on his next mission abroad. He also has plans to create a calendar out of photographs he took while there and will donate proceeds to the hospital in Sumbawanga.

For more information on how you can volunteer abroad, visit www.healthcarevolunteer.org.

HealthCare Volunteer, a 501 (c) (3) non-profit organization, was started in January 1, 2006 by an American dental and medical student, who realized the need for a free non-profit portal that connects all volunteers interested in health care to volunteering opportunities. Due to resource constraints, several national health care organizations rightfully chose not to undertake such a drastic project, and so the opportunity to unite health care volunteers globally remained. It was clear that an independent, 3rd party, non-partisan, non-governmental organization (NGO) unaffiliated with any country or entity needed to be formed to promote health care volunteering in a rapidly globalizing world.

By Neilesh Patel


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