Going the Distance: Area Physicians Travel to Serve
Sep 10, 2013 09:28AM ● Published by MED Editor
Dr. Paul Amundson on a recent trip to Nicaraguan.
Every year, teams of American doctors, dentists and other healthcare professionals clear their schedules and pack their bags for some of the world’s poorest and most remote places. Their mission: to improve the lives and futures of underserved and vulnerable people around the globe by providing medical, dental, and surgical care, medicines, equipment, instruction and support. While their ranks are not large, their service-driven hearts invariably are. For this month’s Cover Story, we spoke with three area physicians who have embraced the joys and considerable challenges of medical mission work.
Craig Hedges, MD, Ear Nose & Throat
It is not always easy to craft an article focused on physicians who travel extensively. ENT Craig Hedges, MD, is a case in point. When we first reached his office to request an interview, he was in the midst of his fourth trip to Honduras, where he was teaching otolaryngology techniques at a medical school.
Honduras, which Dr. Hedges first visited in 2011, was a relatively late addition to his list of medical mission locations. Although he has served in Russia, Africa, Mexico and Cuba since 1994, teaching and training and bringing equipment, his first love is Vietnam, where he has served on 18 separate mission trips in 19 years.
“The people of Vietnam were so open and welcoming and clearly glad we were there,” recalls Dr. Hedges of his first trip to the country. “The response was just so drastically different from what we had seen in Moscow earlier the same year (1994), that I asked one of the doctors what he thought the difference was. He said, ‘Moscow has been humbled and is bitter, but we are happy because we are free. In Vietnam, we are poor, but we are happy.’”
While he did some patient examinations and performed some procedures on that first trip, Dr. Hedges especially enjoyed sharing his knowledge and experience with his gracious Vietnamese colleagues.
“The doctors there were so grateful and eager to learn that I thought, ‘Man, this is great!’,” says Dr. Hedges. “I am not a high-powered academician, but, as it happened, the things that we do and see on a day-to-day basis in Sioux Falls – cancers and nasal polyps and perforated ear drums and chronic infections – were the exact things they wanted to learn.”
When he returned a second time to Vietnam 18 months later, Hedges and his team brought 25 boxes of donated ENT equipment, including otoscopes, cameras, and microsurgical equipment – tools of the trade that were rare or unheard of in Vietnam.
“When I first went, they were taking safety razors and breaking them into two pieces and holding the broken piece with a hemostat in order to make an incision,” says Hedges. “They were reusing rubber gloves. They were performing procedures with pliers and other things they could get in a hardware store.”
Most of Hedges’ trips have been orchestrated by Resource Exchange International, a humanitarian organization aimed at developing human resources through training and education in multiple areas, including medicine. Dr. Hedges now sits on the REI board of directors.
The work has rewarded Dr. hedges with lasting relationships. He and his family have hosted several of his Vietnamese colleagues in their Sioux Falls home. Now, when he returns for his annual two- to four-week mission trips in places like Hanoi, Hoi, Saigon, and Ho Chi Men City, he is greeted by friends instead of strangers. Beginning next year, he hopes to make two annual trips to Vietnam and may make his first trek to Nepal.
“I have to admit that it is a little addictive,” says Dr. Hedges, the 2006 recipient of the American Academy of Otolaryngology’s Humanitarian Award. “It has made me much more grateful for what we have and compassionate for the suffering and needs of people around the world. God has made me a doctor and I find great satisfaction and pleasure in being able to impart what I have learned to improve other people’s lives.”
Paul Amundson, MD, Family Medicine
Dr. Paul Amundson’s adventure with medical missions began 12 years ago with simple curiosity about Nicaragua, a country served by the regional Evangelical Lutheran Church in America through a partnership with the Lutheran Church in Nicaragua.
“I knew some people who went and came back with interesting stories,” recalls Amundson, an active member of his Sioux Falls Lutheran church. “I thought it sounded like an opportunity to get involved in some short term medical work in an area that was readily accessible geographically and that really had a need.”
After that first trip, providing primary care services to clinics and rural villages in the second poorest country in the Western Hemisphere (Haiti is first), Amundson never looked back. Working through the South Dakota Synod of the ELCA, he has travelled 10 of the last 12 years on teams that also included nurses, PAs, NPs, students, and non-medical support personnel. Amundson’s ophthalmologist wife and his teenaged son have even served with him on a few of the annual trips, which typically take place in February and March – the dry season – when rural roads are still passable .
“We drive through dried out creek beds to get to villages of 10 to 15 families where we set up a clinic in whatever structure is available,” says Amundson. “These are mountainous areas with very limited access to healthcare. Even if the nearest clinic is 25 miles away, if your means of transportation is a donkey, it’s a long way. For some, we are the first physicians they have ever seen.”
As in many developing countries, parasites are a common problem in Nicaraguan villages. Issues related to malnutrition are next on the list. The increasing availability of cheap packaged foods and soft drinks are wreaking havoc on the health of a Hispanic population already prone to diabetes and obesity.
“They know their wells are contaminated, so they drink pop,” says Amundson. “They are hungry, so they eat potato chips. We have really been seeing more diabetes, high blood pressure, and obesity – things you wouldn’t normally see in developing countries. So we are doing more public education, as well.” Asthma and allergies exacerbated by Nicaragua’s dusty, smoke-filled air are another problem.
“We are so blessed in this country with clean air and clean water,” says Dr. Amundson, who often stays in villagers’ homes when on the road in Nicaragua. “You become very emotionally close to the people you are trying to help when you see firsthand how much they suffer just to survive.”
As if the work itself was not challenging enough, the Nicaraguan government has further complicated the cause of medical mission work in the country by limiting the medications that can be brought in and requiring more detailed credentialing and activity information from volunteers. Still, Amundson says he will continue to provide what he admits may be “Band-Aid medicine” in Nicaragua, in the hope that it will have an impact he may never even know.
“Have we made a big improvement in the health of the Nicaraguan people?”, he asks, philosophically. “Probably not. But hopefully we have built cross-cultural relationships that will last for generations. The biggest impact may not even be in a person we have treated, but as people there see that there are people who care about them, maybe it will instill some hope. And perhaps we will instill the passion in someone else, who will go on to do something even greater.”
Greg Schultz, MD, Vascular Surgery
Vascular surgeon Greg Schultz, MD, was connected to his first medical mission experience through his friend Greg Kuiper, MD, a former Luverne, MN family doctor who serves as Director of Ministry Development in the Sioux Falls-based Luke Society.
“I told Greg, ‘If there is ever an opportunity where you need a surgeon to provide volunteerism in a Spanish-speaking country, let me know,” says Schultz, who says he speaks “marginal Spanish”. Two years ago, he got his chance in Gracias, Honduras, one of more than 50 sites around the world where the Luke Society provides support to indigenous mission-minded physicians.
“It was an incredible week,” recalls Dr. Schultz. Although the Luke Society typically sends doctors to support, rather than practice, Dr. Schultz’ skill was needed in clinic where no surgeons were available. “On our first day, we probably saw 50 to 60 cases and they all came in with obvious medical problems… gallbladders, hernias, cancer. These people travel for 6 to 10 hours on bumps roads, have major operations, and get up and leave the next day. And they are so gracious and so happy about it.”
An experience on that first Honduran trip ensured Dr. Schultz’s connection to the country long-term. On the last day, the team encountered a six-year-old girl with a perforated anus and a draining colostomy. Working with Sanford USD Medical Center, Schultz was instrumental in bringing the child, Sulmy, to Sioux Falls last June for more extensive treatment. After multiple operations, the child is now “socially confident” and is looking forward to eventually being reunited with her family in Honduras.
“One of the tragedies in these developing countries is that healthcare is not a priority,” says Dr. Schultz, who will travel to Honduras with the Luke Society for the third time this year. “Medical treatment is really only for those who are critically ill. If you want to have a growing tumor or a painful hernia treated, it’s very hard to get help. And there are so few surgeons available that cases are often very advanced by the time they are seen.”
Like so many other Americans who volunteer in developing countries, Schultz was shocked and humbled by the poverty around him. “These are people who sleep in huts with dirt floors. Heat is provided by a fire inside the house. There is no running water and the water that is available is almost always contaminated with parasites. The roads are dirt and are bumpy. Eight people might live in a single room house.”
Schultz and his surgical brigade of 14 to 15 people brought with them 60 to 80 thousand dollars of surgical equipment and other donated supplies. He has even collected clean, used Ace bandages to be used on future trips. Although he admits that it is challenging to take ten days away from his busy Sioux Falls practice, Dr. Schultz calls mission work “the joy of my life”, a chance to return to the reason most physicians got into medicine in the first place.
“This is what medicine should really be about – taking care of people,” says Dr. Schultz. “Everything is not about money. It’s about helping people. That is the core of what we do. I think that, if you talk to anyone who does this kind of work, they will tell you that they get so much out of the feeling that they are really helping mankind. It is very fulfilling and satisfying.”
you a physician with an interest in short-term medical mission work? There are many ways and places to serve. Click here for a list of global sending organizations: Connecting with Global Service Opportunities - 09/10/2013