The American College of Surgeons (ACS) Board of Governors (B/G) Surgical Volunteerism and Humanitarian Awards Workgroup has announced the recipients of the 2018 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 the Clinical Congress 2018 in Boston, MA, during the annual B/G reception and dinner October 23. Clinical Congress attendees are invited to hear the honorees speak at a Panel Session, Humanitarian Surgical Outreach at Home and Abroad: Reports of the 2018 Volunteerism and Humanitarian Award Recipients, at 9:45−11:15 am October 22 at the Boston Convention & Exhibition Center, room 257AB.
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.
Nandakumar C. Menon, MB, BS, FACS, a general surgeon from Gudalur, Tamil Nadu, India, will receive a Surgical Humanitarian Award for the decades he spent providing sustainable, equitable medical services and training to the indigenous Adivasi people of southern India through the Association for Health Welfare in the Nilgiris (ASHWINI).
Dr. Menon, director of Gudalur Adivasi Hospital (GAH), left a successful practice in Winchester, NY, in 1990 to go to the remote Gudalur valley in Tamil Nadu’s Nilgiris district with the goal of establishing a health care system for the Adivasis, a historically reclusive population due to years of persecution and subjugation under colonial rule. Their reluctance to interact with outside groups left them cut off from modern medicine, and many died from gastroenteritis, pneumonia, childbirth-related complications, and other treatable conditions.
In response, Dr. Menon co-founded ASHWINI, a charitable organization with a unique vision—to create medical institutions that the Adivasi people would own and manage.
Early on, when the facility was a rented building with a few mattresses on the floor, an examination room under a staircase, and an austere 8′ x 6′ operating room (OR) with a homemade operating table, Dr. Menon primarily operated on emergent trauma injuries from farming accidents or animal attacks. He also performed nonsurgical treatments on pregnant women with eclampsia and patients with tuberculosis. He even returned to the U.S. briefly to learn how to administer anesthesia.
These and future treatments were made possible through Dr. Menon’s most enduring accomplishment—training and preparing the Adivasis to participate in their own collective health care through ASHWINI. Motivated young people were trained to staff the hospital as nurses, lab technicians, and community health workers. Major decisions were taken in consultation with the community at large, which was capable of giving valuable feedback because many of its members were a part of the health care team. Guided by Dr. Menon, the Gudalur Adivasi Hospital has transformed from its humble beginnings into a 50-bed secondary care hospital. Opened in 2014, the facility houses a maternity ward; outpatient clinics; diagnostic facilities, including a general and microbiology lab and an imaging department; blood bank; endoscopy suite; and a full surgical complex. In 2017, the ASHWINI Adivasi School of Nursing opened to provide further training to the community, and 20 young women have enrolled. Throughout all these changes, the hospital and associated primary health care outposts remain managed by the Adivasis. To date, more than 100 members of the community have completed training, and many continue to work with ASHWINI.
Dr. Menon has been a consistent advocate for the system and has received donations from Indian and international funding agencies to support its programs; implemented a sickle cell disease care plan that the Indian government uses nationwide; and created the ASHWINI Disability Center to provide aid to disabled individuals, among other accomplishments.
Roland R. Stephens, MD, FACS, a general surgeon from Berrien Springs, MI, will receive a Surgical Humanitarian Award for his 50 combined years of surgical care to underserved populations around the world, primarily at the Karanda Mission Hospital in Zimbabwe.
Working with The Evangelical Alliance Mission, in 1962 Dr. Stephens traveled with his family to what would become the Karanda Mission Hospital in Southern Rhodesia (now Zimbabwe) to provide surgical care to the medically underserved population near Mount Darwin, a remote town approximately 120 miles away from Harare, the nation’s capital. He was the only physician at Karanda Mission Hospital for five years. In addition to providing all surgical care, he also treated tuberculosis, malaria, acquired immunodeficiency syndrome, and a host of other medical problems. Dr. Stephens would regularly travel into the wild, undeveloped Zambezi Valley by plane or motorbike to visit clinics and triage patients to bring them back to the hospital.
His surgical and medical accomplishments are especially notable considering the environment. From 1964 until Dr. Stephens left in 1978, the area was involved in political strife that eventually deteriorated to a multi-faction civil war over the governance of the country, placing Karanda in an active combat zone. Firefights occurred near the hospital regularly, with stray bullets piercing homes and water tanks. Dr. Stephens treated casualties from all sides, often performing specialized plastic reconstructive surgery on patients disfigured through torture during the war years.
Beyond direct surgical and medical treatment, Dr. Stephens was instrumental in starting the Karanda School of Nursing in 1964 alongside a nurse from the hospital. Through the school, Dr. Stephens assisted in training medical assistants, general nurses, and midwives who worked in the hospital and the community. Additionally, he initiated the hydrocephalus treatment program, which today treats more than 100 hydrocephalic children annually and oversaw the construction and opening of the hospital’s tuberculosis ward, outpatient waiting shelter, and airstrip.
Dr. Stephens was forced to leave Karanda in 1978 because of the increasing danger of the war. While he practiced in Michigan from 1978–1995, he frequently traveled overseas on volunteer missions to underserved locations including Kenya, Rwanda, and Bangladesh. After retiring from active practice in the U.S. in 1995, he returned to Karanda to continue volunteering alongside his son, Daniel Stephens, MD, FACS, who had become, and remains, a leader at Karanda. The senior Dr. Stephens chose to work for the next 18 years, through his retirement and without remuneration, at Karanda to help fill the hospital’s needs.
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.
Barbara A. Barlow, MD, FACS, a pediatric surgeon from New York, NY, will receive the Domestic Surgical Volunteerism Award for her dedication to preventing injuries to the children of Harlem and across the U.S.
Dr. Barlow, professor emeritus of surgery in epidemiology, Columbia University, New York, NY, has dedicated her career to improving the health of children. She was the first woman to train in pediatric surgery at Babies Hospital, Columbia University Medical Center (now Morgan Stanley Children’s Hospital) and spent her career working at Harlem Hospital Center and Columbia University, first as chief of pediatric surgery and then as director of surgery, until retiring from active practice in 2009.
Most of Dr. Barlow’s academic and research career and her activism have been focused on childhood injury prevention. In her training, she saw that the rate of children hospitalized for preventable injuries in Harlem was twice the national average, with the deadliest injuries being falls from unsecured windows. After documenting these injuries, she worked with city administrators to develop prevention strategies. By 1979, Dr. Barlow was instrumental in having New York City issue an ordinance requiring landlords to install window guards. She also worked with the New York City Department of Health to develop an educational campaign, Children Can’t Fly, which warned parents of the danger of children falling from open windows in high-rise buildings. By 1981, the number of injuries to children falling from windows had decreased in Harlem by 96 percent.
Dr. Barlow also observed that many children were being injured by faulty and dangerous equipment on Harlem’s school playgrounds. The community lacked after-school activities, which contributed to childhood safety concerns. To address these preventable injuries, she obtained funds to repair Harlem’s playgrounds and enlisted community organizations. In 1988, the Robert Wood Johnson Foundation gave her a three-year grant of $125,000 a year to perform a photo survey of the playgrounds, document their dangers, and present a report to city commissioners. With support from the city’s Parks Department, she enlisted an architect to design whimsical, low-cost playground structures and artists and volunteers to paint murals. Since 1991, more than 40 new playgrounds have been built in Harlem, and a coalition of funding sources and Harlem community organizations now offer after-school activities ranging from sports to creative art classes.
In addition to her clinical and public health activities, Dr. Barlow founded the Injury Free Coalition for Kids in 1988. A national program that was funded in part by the Robert Wood Johnson Foundation, this organization comprises hospital-based, community-oriented programs focused on research, education, and advocacy. The coalition has more than 30 sites nationally and serves as a clearinghouse for childhood injury prevention resources.
Dr. Barlow’s accomplishments have been recognized by awards from the American Hospital Association, the American Academy of Pediatrics, the National Safety Council, and the Centers for Disease Control Foundation, among others.
Michael R. Curci, MD, FACS, a pediatric surgeon from Cumberland, ME, will receive an International Surgical Volunteerism Award for his decades of operative, training, and education service in Haiti and, more recently, Rwanda.
Dr. Curci began his volunteerism career in earnest in 1969 when, as a resident, he traveled to the Hôpital Albert Schweitzer (HAS) Haiti, Deschapelles, to provide pediatric surgical care to underserved children. On the annual two-week volunteer trips to HAS that he has taken for more than 40 years, Dr. Curci has helped to develop general surgical services at the hospital, brought many surgeons and residents from the U.S. to encourage international volunteerism, and helped to train local surgeons and medical staff to improve health care in Haiti from within.
In the last decade, Dr. Curci has been assisting with surgery, training, and education in Africa, particularly at the University Teaching Hospital of Kigali (CHUK), Rwanda, on annual, three-month visits. He has been working to build surgical capacity in the under-resourced, low-income, land-locked Central and Eastern African country. Operating under the Clinton Health Access Initiative−Human Resources for Health, Rwanda, Dr. Curci is in his sixth year as an attending pediatric surgeon at CHUK and is training Rwandans for academic and surgical leadership roles.
This training has taken the form of mentorship and guidance for promising surgeons. When Dr. Curci arrived at CHUK in 2013, Edmond Ntaganda, MD, then a resident, was assigned to work with Dr. Curci to focus on pediatric surgery, which is severely lacking in the country. Dr. Curci suggested that Dr. Ntaganda participate in a three-year pediatric surgery fellowship at BethanyKids, Kijabe, Kenya; while he was away, Dr. Curci took on another CHUK graduate general surgeon, Alain Jules Ndibanje, MD, MMed, in order to create the continuity of training future pediatric surgeons. With Dr. Ntaganda’s return to Kigali in 2017, Rwanda now has a gifted pediatric surgeon and anticipates training more soon thanks to Dr. Curci’s work.
Dr. Curci also is active in all aspects of pediatric and general surgery training at Kigali. He attends and co-directs the surgical case conference, Monday through Friday, during which all admissions and operations from the previous day are reviewed with faculty, residents, and medical students; operates four to five days a week, mentoring Dr. Ntaganda in the care of neonates with trachea-esophageal fistulae, anorectal malformations, and Hirschsprung’s disease, among other conditions; and takes night call and clinic hours. Throughout all these activities, he serves as backup to Dr. Ntaganda.
Since Dr. Curci’s arrival to CHUK in 2013, the hospital has added a nascent pediatric ward in the pediatric portion of the hospital, a dedicated OR, and will soon house a nearly state-of-the-art children’s OR, which will be used collaboratively by pediatric surgery, neurosurgery, orthopaedics, and otorhinolaryngology for the surgical care of neonates, infants, and children. Together with his contributions to the workforce, education, and training of pediatric surgeons, CHUK is well positioned to continue improving surgical care into the future.
Bruce C. Steffes, MD, FACS, a general surgeon from Linden, NC, will receive an International Surgical Volunteerism Award for his more than 20 years of providing surgical and administrative skill to underserved areas of the world.
Dr. Steffes, assistant professor of surgery, Campbell University School of Osteopathic Medicine, Lillington, NC, changed the focus of his life in 1997, retiring from his practice in Fayetteville, NC, to dedicate the rest of his career to international volunteerism. From 1998 to 2005, Dr. Steffes has worked in many countries throughout Africa, Asia, and Central and South America in multiple mission hospitals, assisted the work of Samaritan’s Purse in Afghanistan in 2002, and provided surgical services on Mercy Ships on several occasions.
Some of Dr. Steffes’ most impactful work has been in Africa, working with the Pan-African Academy of Christian Surgeons (PAACS) since 2003. PAACS is a nondenominational, multinational volunteer service organization that serves Africa’s poor and under-resourced areas, building health care capacity and maintaining the faith-based health facilities that have historically provided the majority of surgery in these locations.
In addition to operating on patients with conditions such as traumatic injury, advanced cancer, and burns, Dr. Steffes was chief executive officer/executive director of PAACS from 2006 to 2014 and medical director from 2014 to 2016. Under his leadership, the organization grew from two sites in two countries to 12 sites in nine countries; from nine trainees per year to 76; from three graduates to 63 (55 general surgeons, seven pediatric surgeons, and one head and neck surgeon); from eight volunteer short-term faculty to more than 200 per year; from one specialty program to four; and from two approved missionary faculty to 59. Notably, all PAACS graduates have stayed in Africa to practice and expand the surgical workforce in the continent. Many are interested in providing surgical training themselves, which represents the only sustainable solution to the workforce crisis throughout Africa.
Dr. Steffes also serves as an external examiner for the College of Surgeons of East, Central and Southern Africa and the West African College of Surgery, which are close partners with PAACS and actively influence the design of surgical community training in Africa.
The work of PAACS and many missionary hospitals in Africa would not be possible without strong infrastructural and volunteer support, which Dr. Steffes has helped to provide. While in his leadership positions, Dr. Steffes led fundraising efforts to support PAACS’ programs and its residents, increasing the operating budget from $37,000 to $1.77 million by 2016, enabling PAACS to provide training and salaries to residents who would normally need to pay for their own residency. Dr. Steffes coordinated the purchase or donation of medical equipment from around the world. He also travels throughout the U.S., recruiting young surgeons interested in mission work, mentoring and guiding many of them regardless of his other time commitments.