Surgeons honored for volunteerism and humanitarianism

Slide 1

Dr. Cropsey (seated) with his wife, Shirley, at KKMCH in 2002. Shirley became a nurse anesthesiologist after her and Dr. Cropsey’s four children, who were raised in Togo, went to college.

Slide 2

The Hospital of Hope team in 2015, shortly before the hospital opened. Pictured are the nurses, nurse aids, technicians, administrative aids, and maintenance personnel, as well as the missionary medical team. Dr. Cropsey is on the right side of the photo.

Slide 3

Dr. Robicsek (left) at the bedside of a young patient who underwent open-heart surgery at UNICAR.

Slide 4

Dr. Robicsek in front of a mobile catheterization unit in Managua, Nicaragua. The unit is one of eight donated to Central America by the International Medical Outreach Program.

Slide 5

Dr. Wren (center, seated) with a group of participants at the annual International Humanitarian Aid Skills Course at Stanford.

Slide 6

Dr. Wren in Harare, at the University of Zimbabwe College of Health Sciences, with the DREAM— Dedicated to Reach, Empower And Mentor women—student group. Dr. Wren teaches these students basic surgical skills, such as suturing.

Slide 7

Dr. Stockinger (second from right) in Haiti in early 2010 during earthquake relief operations, performing a site survey of one of the functioning hospitals outside of the Port-au-Prince epicenter to determine their needs and capabilities.

Slide 8

Dr. Stockinger operating on a victim of an improvised explosive device victim in a field hospital in southern Afghanistan in 2009.

Slide 9

Dr. Lin (second from left) with stakeholders in health care and surgery in Kigali, Rwanda, after a meeting to draft the country’s first national surgical plan.

Slide 10

Dr. Lin (far right) teaching residents and medical students in Kigali, Rwanda, how to tie square knots.

The Board of Governors (B/G) Surgical Volunteerism and Humanitarian Awards Workgroup has announced the recipients of the 2017 American College of Surgeons (ACS)/Pfizer Surgical Humanitarian Award 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 the Clinical Congress 2017 in San Diego, CA, during the annual B/G reception and dinner October 24. Clinical Congress attendees are invited to hear the honorees speak at a Panel Session, Humanitarian Surgical Outreach at Home and Abroad: Reports of the 2017 Volunteerism and Humanitarian Award Recipients, October 23, 9:45–11:15 am, San Diego Convention Center, room 1AB.

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.

Robert E. Cropsey, MD, FACS, a general surgeon from Ypsilanti, MI, will receive a Surgical Humanitarian Award for his work in establishing two hospitals and serving the needs of medically underserved patients in the West African country of Togo for the last three decades.

Dr. Cropsey intended from the beginning of his medical career to become a surgeon so that he could live in Africa and offer his services to those in need. After completing his general surgery training at St. Joseph Mercy, Ann Arbor, MI, he went to Togo with his wife and four children to provide care to the medically underserved people of the country. Upon his arrival he collaborated with locals and other medical professionals and missionaries to open the Karolyn Kempton Memorial Christian Hospital (KKMCH) in 1985, working with the Association of Baptists for World Evangelism. Dr. Cropsey has served as the hospital director, chief of staff, and chief of surgery since KKMCH opened.

KKMCH, known as Hôpital Baptiste Biblique to the Togolese, is several hours from Togo’s capital, Lomé, and situated deep in the jungle near the border of Ghana. As the only major medical center in a remote location, the 50-bed facility admits more than 3,000 patients annually, serving neighboring Ghana and Benin, as well. In addition to an adult intensive care unit (ICU), pediatric ICU, ultrasound rooms, and isolation rooms, the hospital has two operating rooms (ORs) that are capable of supporting most major operations. More than 1,250 operations are performed at KKMCH each year, including hernia, high-risk obstetric, soft-tissue infection, traumatic injury, and pediatric procedures.

KKMCH also trains medical students and surgical residents, and Dr. Cropsey and the hospital administration are working with the Pan-African Academy of Christian Surgeons (PAACS) to begin a five-year residency program to train local surgeons. The hospital recently started a $10 million expansion project that will double the number of beds and increase the capacity of all health care services.

In 2005, Dr. Cropsey and KKMCH were invited to open a hospital in Mango, a remote community in northern Togo lacking modern health care. Over the next 10 years, Dr. Cropsey traveled between Togo and the U.S. to plan, coordinate, fundraise for, lay out, and build the first real medical center in the area—the Hospital of Hope. When the Hospital of Hope opened in 2015, thousands of patients who were previously unable to receive care came to the hospital, and it has since remained busy. Other services available through the medical center include community health education, mobile clinics, and community development services.

Francis Robicsek, MD, PhD, FACS, a retired cardiothoracic surgeon from Charlotte, NC, will receive a Surgical Humanitarian Award for his more than 50 years of work to provide medical care, particularly cardiothoracic services, and establish a medical infrastructure in Central America.

Dr. Robicsek began his humanitarian work in the early 1960s in Honduras, treating surgical tuberculosis patients. He then expanded his surgical services to other countries, providing direct surgical care to patients in Belize, Guatemala, Nicaragua, as well as in Eastern Europe. His contributions to cardiothoracic surgery in Central America are particularly noteworthy. Dr. Robicsek performed the first open-heart operations in Honduras and Guatemala and initiated and assisted the first open-heart surgery by a native surgeon in Belize, where he maintains an active open-heart surgery program.

Even more influential than his direct surgical skill has been the sustainable medical aid that Dr. Robicsek has brought to the region through training, supplies, and infrastructure. He was a cofounder in 1959 of Heineman Medical Outreach, Inc., a one-time research organization in Charlotte, NC. As president of the organization for nearly 50 years, Dr. Robicsek has guided its evolution to becoming a local and humanitarian aid program in partnership with the Carolinas HealthCare System.

He has been instrumental in providing surgical and health services to a historically underserved region. In the 1970s, he arranged to have patients from Guatemala flown into Charlotte for operations, and he accepted Guatemalan surgeons for training fellowships. His ties with the Guatemalan government and health care system eventually led to the founding of Unidad de Cirugía Cardiovascular de Guatemala—or UNICAR—the Guatemalan Heart Institute, where more than 700 heart operations are performed annually. These and other operations in Central America are, in part, made possible by the more than $1.5 million in new and refurbished hospital supplies that Dr. Robicsek arranges to have delivered to the region each year. UNICAR now serves patients from neighboring countries, as well.

A major component of Dr. Robicsek’s humanitarian activity centers on training Central American surgeons in Charlotte so they can return home with the skills necessary to care for their native populations. For many years, he has maintained a guest house at the Carolinas Medical Center for Central American and Caribbean surgeons and nurses to train at no cost. Dr. Robicsek’s efforts also have led to the establishment of burn units, mammography, echocardiogram networks, catheter labs, and more across Central America. Since 2010, when Heineman and the Carolinas HealthCare System established the International Medical Outreach Program, these humanitarian efforts have continued to grow in scale and effect.

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.

Sherry M. Wren, MD, FACS, FCS(ECSA), a general surgeon in Palo Alto, CA, and professor of surgery and director of global surgery, Center for Innovation and Global Health, Stanford University School of Medicine, CA, will receive the International Surgical Volunteerism Award for her work with Médecins Sans Frontières (MSF, also known as Doctors Without Borders) in several African countries, as well as her work in the U.S. aimed at preparing surgeons to provide international humanitarian aid.

Dr. Wren began volunteering with MSF to provide humanitarian aid and surgical care to several African countries engaged in armed conflicts, including Côte d’Ivoire, Chad, and the Democratic Republic of Congo. In addition to surgery related to the trauma of war, her volunteer work with MSF included the spectrum of surgery, particularly general, obstetric, and orthopaedic surgery.

Beyond her clinical work, Dr. Wren has spearheaded research and training initiatives in the region that have had a significant effect on patient care.

Her first long-term project was at the University Teaching Hospital, Harare, Zimbabwe, where she created a bidirectional surgical residency exchange program with the University of Zimbabwe that was recognized by the American Board of Surgery and met Residency Review Committee requirements. She has directly trained more than 40 Zimbabwean surgeons in trauma, ultrasonography, low-resource laparoscopy, and other procedures. She started a medical student interest group in surgery for women in Zimbabwe, as all surgeons in the country are men.

Dr. Wren also partnered with the Mbingo Baptist Hospital in Bamenda, Cameroon, to conduct location relevant research with local staff. Dr. Wren’s experiences in Africa led to her election to the College of Surgeons of East, Central, and South Africa (COSECSA), an African surgery professional organization. She participates in the COSECSA’s certification and examination processes as well as examinations for advanced surgical designations (masters of clinical surgery and fellowship of clinical surgery). Dr. Wren also worked extensively with surgeons in Ebola-ravaged African countries during the 2014 outbreak of the virus.

Dr. Wren’s training and educational experiences led her to design the International Humanitarian Aid Skills Course at Stanford, a course dedicated to preparing surgeons for a role in providing humanitarian aid. The course involves didactics, case studies, simulation, and video-based teaching for the critical areas of tropical medicine, low-resource anesthesia, burns and wounds, orthopaedic trauma, and emergency obstetrics, among other topics. Dr. Wren teaches the course, which has been presented approximately 10 times to more than 400 physicians from around the world.

CAPT Zsolt T. Stockinger, MD, FACS, a U.S. Navy general surgeon, Fort Sam Houston, TX, will receive the Military Surgical Volunteerism Award for providing surgical care and training and developing surgical capacity while on voluntary deployment to austere environments.

In 2010, Dr. Stockinger volunteered for the U.S. military mission to Haiti to provide medical care after the earthquake that ravaged the country, but he also stepped in to fill some of the planning and organizational gaps in emergency response. The USNS Comfort served at the center of the military’s aid efforts, acting as the referral center for medical centers in Haiti. Seeing that the volume of incoming patients was too high to accept all, Dr. Stockinger developed acceptance criteria, strategies to guide patient flow, and a discharge plan. To enable the transfer and continuity of postoperative care for seriously injured patients aboard the Comfort, Dr. Stockinger surveyed all of the functional civilian hospitals in Haiti. He was the only U.S. military general/trauma surgeon present for the Comfort’s entire seven-week mission.

Dr. Stockinger also has served on voluntary deployments to embattled regions of Afghanistan. He was in Kandahar in 2011–2012, when the local Afghan army hospital was understaffed, with all trauma patients going to the regional North Atlantic Treaty Organization (NATO) hospital. Dr. Stockinger was able to communicate with the Afghan Army corps commander to increase medical personnel and capability at the local hospital, which led to it becoming the Level I trauma center for both Afghan Army and civilian injuries in the region. This amplified medical capability became increasingly important as U.S. military presence in the country decreased.

He then volunteered as the North Atlantic Treaty Organization (NATO) Regional Command surgeon in Helmand province in 2013. This was the only region of the country without an Afghan Army hospital or any surgical capability. NATO funding for a planned hospital had been diverted, and no resources were available to build one. Without trauma treatment capability, Afghan Army forces were expected to experience severe losses as U.S. and coalition forces withdrew. Dr. Stockinger worked with coalition contacts, the Afghan surgeon general, and the Minister of Health, and within six weeks Afghan surgeon teams from Kabul were deployed to Helmand to operate in a tented facility. By the end of his tour, ground had been broken for a permanent facility and funding and equipment procured for the first-ever Afghan Army surgical facility in Southern Afghanistan.

In addition to his work in Haiti and the Middle East, Dr. Stockinger has provided direct surgical intervention, infrastructure development, and surgical training in Pakistan, Ukraine, Mauritius, Ghana, and Southeast Asia.

Yihan Lin, MD, a fourth-year general surgery resident at the University of Colorado Hospital, Denver, will receive the Surgical Resident Volunteerism Award for her efforts to provide, establish, and improve medical and surgical care to underserved populations around the world.

Dr. Lin has been active in surgical volunteerism since she was a medical student. She was the student director for the Stout Street Clinic for the homeless in Denver in 2009–2010, running weekly health clinics. From there, Dr. Lin started to work in an international capacity. In 2009, she offered workshops to educate women in Quito, Ecuador, about birth control. That same year, she spent a month in Uganda providing care to patients in ORs, wards, and clinics; performing needs assessments for equipment; and compiling a dictionary of common conversational and medical phrases of the local dialect, Rukiga. She was in Leogane, Haiti, in 2013 assisting local surgeons and assessing patients in pre- and postoperative clinics and in the emergency ward.

In 2015, Dr. Lin was accepted as a Paul Farmer Global Surgery Research Fellow in the Harvard Medical School Program in Global Surgery and Social Change, Boston, MA. Since she began the fellowship, she has been involved in developing surgical capacity, infrastructure, and research capability in Zambia and Rwanda.

In Zambia, Dr. Lin has been one of the research fellows leading the effort to create a national surgical plan to increase surgical access, capacity, and equity for the population. To that end, she engaged with key stakeholders in the Zambian Ministry of Health and surgical care providers to understand their priorities, led several research assistants in performing a comprehensive review of all data on Zambia’s surgical systems, and then facilitated weekly committee meeting workshops in the Ministry of Health to draft the plan. She also has been working with local stakeholders to create solutions in service delivery, the workforce, information management, and financing. The plan recently was signed into law, and Dr. Lin, her colleagues, and the Zambian government are now designing an implementation strategy.

Dr. Lin also has been working with the Rwandan Ministry of Health to create a national surgical plan in that country. In addition, she has been working to build local research capacity in Rwanda using the Operational Research Training program. In the course of one year, she was a research mentor and worked with seven providers in the Rwandan health care system, including surgeons, anesthesiologists, statisticians, and financing personnel, to design and implement research projects. Topics covered in the course included developing a research protocol, data collection and analysis, and manuscript preparation.

Beyond her work in Africa, Dr. Lin has recently been working with the World Health Organization on a variety of projects, including developing a manual on strengthening surgical systems, and leading a research project at Harvard to create a surgical hospital assessment tool for low- and middle-income countries.

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