December 1999 Bulletin

Grant gives orthopaedists new perspective

OREF award to Orthopaedics Overseas has many benefits

C. Kelly Bynum, MD, visits with 18-month old patient and mother in hospital in Cusco, Peru. An OREF Educational Grant awarded to Orthopaedics Overseas enabled Dr. Bynum and three other physicians to travel to South America and Africa.

When Holly K. Brown, MD, began medical school, she recalls always having a strong desire to practice medicine overseas.

And that desire became a reality twice in her life, most recently when she traveled to Umtata, South Africa in May 1999, as the first recipient of funding from the OREF Educational Grant awarded to Orthopaedics Overseas.

"I wanted to incorporate practicing medicine overseas in my medical training," says Dr. Brown, who practices at the University of California, San Francisco. "It's important for not only training purposes, but also to keep myself fresh in what often is a negative environment of American health care."

Her other medical travels led her to San Miguel, El Salvador in September 1996 with the California nonprofit Operation Rainbow team. "Both experiences-though culturally different, have given me insight into why participating in medicine overseas is not only an important personal experience, but also has so much to offer from a training and educational perspective, as well," Dr. Brown says. "On a personal level, we can expand our own understanding of the world by having the opportunity to experience it first hand. On a professional level, understanding people from diverse cultural backgrounds helps us provide better care for and communicate with an increasingly multicultural base in the United States.

"There's a lack of medical access for the three million people in the Umtata surrounding area. These people have a definite need for medical care. It's not like it's an option; they need medical care so they can go back to work and survive."

Mostly, Dr. Brown says she provided a broad range of medical care for all ages. "A lot of people were suffering from trauma related to motor vehicle or farm accidents," she says. "The predominant infection was tuberculosis. I also did about six to eight thoracotomies with anterior spinal decompression and fusion-that was for tuberculosis of the spine causing paralysis and deformity."

Although Dr. Brown says the facilities at Umtata General Hospital and Bedford Orthopaedic Hospital were modernized, outdated equipment was a problem. "There's a lot of old, dull instruments such as drills, osteotomes and saws," she notes. "A lot of things were done manually instead of with power-which I got used to. But the facilities were in need of additional orthopaedic implants and we couldn't really do total joint replacements." Access to medical books and literature was also very limited.

Heading up the orthopaedic department at the Bedford Hospital is Charles C. P. McConnachie, MD, originally from Hendersonville, N.C. who moved to Umtata many years ago. "He's been involved in training several orthopaedic residents and has a desire to establish a formal residency program," says Dr. Brown.

"The fellowship was an incredible opportunity and reminded me of why I wanted to become a doctor in the first place," says Dr. Brown. "A physician can have such a major impact on these people's lives. It's clear these people need help."

The other recipients of the OREF Education Grants were residents C. Kelly Bynum, MD, who went to both Lima and Cusco, Peru; Jeffrey Sawyer, MD, Blantyre, Malawi; and James T. Guille, MD, who may travel to Peru next year.

"Treating the Peruvians who struggle to make ends meet, much less receive medical care, was very rewarding for me," recalls Dr. Bynum, "I really enjoyed interacting with patients in a different language and cultural environment. Doing so has given me a new perspective and new approach to patient health care in the U.S., broadening my perspectives which will help in my interactions with them."

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