Surgeons and residents honored for volunteerism

The American College of Surgeons (ACS) Board of Governors (B/G) Surgical Volunteerism and Humanitarian Awards Workgroup has announced the recipients of the 2021 ACS/Pfizer Surgical Volunteerism Awards. As in previous years, the workgroup received exceptional nominations, reflecting the remarkable commitment of ACS Fellows and members to providing care to underserved populations.

The contributions of the award recipients are summarized in this article and will be formally recognized at the virtual 2021 B/G Award Program, which will be available for viewing in October. Attendees of the virtual Clinical Congress 2021 are invited to hear and view the honorees speak at a Panel Session, Humanitarian Surgical Outreach at Home and Abroad: Reports of the 2021 Volunteerism and Humanitarian Award Winners, 11:00–11:55 am Central time Monday, October 25. The session will be available for on-demand viewing afterward.

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, five awards will be presented.

International Surgical Volunteerism Awards

Seng-Feng Jeng, MD, FACS, a plastic and reconstructive surgeon in Kaohsiung City, Taiwan, will receive an International Surgical Volunteerism Award for his nearly 20 years of volunteerism in Vietnam, where he performs free reconstructive surgery and teaches local surgeons and health care teams in an underequipped health system.

Dr. Jeng, professor of surgery, department of plastic surgery, E-Da Hospital, Kaohsiung City, participated in his first reconstructive microsurgery charitable mission with Operation Smile Vietnam in 2002, after which he was inspired to continue a charitable mission program to help build Vietnam’s severely underfunded health system. Since his first mission, Dr. Jeng and his team of surgeons, anesthesiologists, senior nurses, and administrative staff from Taiwan have returned to Vietnam—most often Hanoi and Ho Chi Minh City (HCMC)—every year for seven to 10 days to provide free surgical services. The operations that Dr. Jeng and his team have provided have varied, including reconstruction of cleft lip/palate and facial deformities, which are common in Vietnam; the release of burn scar and subsequent reconstruction with free anterolateral thigh flap; reconstruction of breast cancer lesion with free transverse rectus abdominis flap; and free fibular flap to restore bone tumor of the mandible, among other procedures. In the last trip before the coronavirus 2019 (COVID-19) pandemic began in Asia in September 2019, the team provided 166 patients with medical consultations, 90 operations, and 102 surgical procedures at the Quang Ngai Hospital for Children and Women.

However, a short annual trip could not address the surgical needs of Vietnam’s low-income citizens. Recognizing the high demand for their services, Dr. Jeng and his team increased the frequency of their missions and focused on training local surgeons to perform basic microsurgery cases while assisting with more complex cases. They share clinical expertise and have taken a train-the-trainer approach to advance the level of local surgical expertise so that more operations can be performed in these underserved areas.

Beyond the borders of Vietnam, Dr. Jeng’s missions have gained support from the Ministry of Foreign Affairs of Taiwan, which has influenced the Taiwanese government to allow foreign fellows to participate in hands-on, experiential, practical training in Taiwan. Dr. Jeng and his team have been able to secure funds to allow surgeons from Vietnam and other countries, including the Philippines, Nigeria, Romania, and Colombia, to visit Taiwan as fellows to learn, train, and return to their home countries with new skills. In addition to surgical mentorship, Dr. Jeng has mentored the affiliated hospital teams to establish and replicate a standard working clinical protocol that includes screening potential patient candidates, preoperative medical evaluation, assessment of fitness for general anesthesia, and postoperative follow-up consultations.

Dr. Jeng has worked diligently to secure funds, supplies, and training opportunities for Vietnamese surgeons and health care teams, as well as to advocate for an improved health system. He worked with the leadership team at his home institution, E-Da Hospital, to gain committed funding to continue charitable missions as a formalized program. E-Da Hospital has sponsored more than five different missions with a monetary commitment of more than $150,000 (U.S.).

Additionally, Dr. Jeng has arranged for equipment donations, including the first modern microsurgical equipment in southern Vietnam, basic laboratory supplies, and more. Dr. Jeng also served as an international advisor to the Vietnamese Surgical Standards Workshop to establish and advocate for the implementation of national surgical standards. This advocacy work is meant to lead Vietnam to a higher standard of safety and patient quality care as its health care system continues to develop.

Brent A. Senior, MD, FACS, an otolaryngologist in Chapel Hill, NC, will receive an International Surgical Volunteerism Award for his decades of work in providing otolaryngologic surgery services and education in Southeast Asia, particularly Vietnam.

Since 1998, Dr. Senior, the Nathaniel and Sheila Harris Distinguished Professor and chief, division of rhinology, allergy, and endoscopic skull base surgery, University of North Carolina (UNC) School of Medicine at Chapel Hill, has been leading two-week surgical missions to Vietnam to help build medical and surgical infrastructure in a nation that was devastated in the Vietnam War and has struggled since.

Working in both Saigon and HCMC, Dr. Senior has performed hundreds of operations in his time as a volunteer, spanning the breadth of otolaryngology-head and neck surgery. The operations performed include basic otology and head and neck cancer surgery, facial plastic procedures, and general otolaryngology. Dr. Senior and his teams introduced modern endoscopic sinus surgery procedures to the country, and the operations have included advanced techniques such as cochlear implantation for deaf patients and endoscopic skull base procedures for tumors. Dr. Senior also performed the first endoscopic trans nasal pituitary operation in Vietnam, which is now performed more routinely in major academic medical centers. He and his teams have operated on more than 1,000 patients since 1998, and Dr. Senior has performed more than 250 of these operations himself.

Perhaps even more importantly, Dr. Senior focuses on educating and training local otolaryngologists to perform these procedures. All surgical procedures that Dr. Senior or his team perform in Vietnam are completed with either a local surgeon or a resident to ensure a broader educational experience for Vietnamese surgeons. In addition, Dr. Senior leads didactic training courses regularly as part of his annual trips. And the educational aspect of his work extends beyond Vietnam’s borders. Dr. Senior has personally financed 18 Vietnamese surgeons to come to the U.S. for three-month mini-fellowships at UNC and across the country. Through these fellowships, Vietnamese surgeons learn modern medical and surgical concepts, skills, and techniques, which they take back to Vietnam to proliferate through the health care system. As a direct result of these efforts, Vietnamese otolaryngologists have instituted quality improvement processes at the two major teaching centers. They now have regular grand rounds and morbidity and mortality conferences, which did not previously exist. Because COVID-19 has waylaid international travel, Dr. Senior has initiated a monthly one-hour Zoom mentoring program for residents and junior physicians in otolaryngology in training at the National ENT (Ear, Nose, and Throat) Hospital in Hanoi.

Dr. Senior also has worked to ensure a chain of medical equipment donations. He has solicited funds through the North Carolina Medical Foundation, arranging for donations totaling more than $2 million in equipment from Karl Storz, Olympus, and Brainlab. He arranged the donation of the first computer-assisted image guidance system to the ENT Hospital in HCMC. In addition to equipment, he has personally donated books, journals, and educational materials. As a result of becoming recognized for his long commitment in Vietnam, he has been able to advocate on behalf of the National ENT Hospital in Hanoi and the ENT Hospital in HCMC with the Minister of Health for Vietnam, as well as local leaders in Hanoi and HCMC.

Domestic Surgical Volunteerism Award

Rochelle Dicker, MD, FACS, a trauma and critical care surgeon in Los Angeles, CA, will receive the Domestic Surgical Volunteerism Award for her efforts to develop firearm injury prevention education, support for victims of firearm violence, and advocacy for firearm injury reduction-based legislation, particularly through the San Francisco Wraparound Project.

In 2001, Dr. Dicker started her fellowship in trauma at the University of California, San Francisco, and a fellowship in violence prevention with the California Wellness Foundation, during which she recognized a need for firearm injury prevention and support for victims of firearm violence as she provided clinical care to victims.

Beyond the surgical care she provides to victims of firearm violence, Dr. Dicker, professor of surgery and anesthesia, vice-chair for critical care, chief of surgical critical care, associate trauma director, University of California Los Angeles David Geffen School of Medicine, developed the Wraparound model, which transformed into the San Francisco Wraparound Project. The project works to reduce injury and criminal recidivism among the most vulnerable citizens of San Francisco and is based on three critical components: a public health approach for injury prevention based on evidence that addressing root causes of violence such as poverty and systemic racism to prevent future injury and incarceration, health communication and services that are culturally appropriate, and recognition that a major event like trauma provides a teachable moment.

In partnership with community-based organizations, the Wraparound Project provides services to create social capital in individuals and communities affected by violence. Some of the services provided include crisis response services along with the city’s Crisis Response Network and crisis home visits, vocational training programs via art workshops and Friends of the Urban Forest, and employment opportunities throughout the region, among others.

Dr. Dicker expanded her work from the Wraparound Project to bring the model of firearm injury prevention and support for victims to 70 hospitals around the country. As other institutions implemented the Wraparound Model, Dr. Dicker and colleagues identified an additional gap in which to further expand resources and support firearm prevention. These hospitals joined together to create the Health Alliance for Violence Intervention (HAVI). HAVI fosters hospital and community collaborations to advance equitable, trauma-informed care and violence intervention and prevention programs. Recently, HAVI expanded to Europe.

A major component of Dr. Dicker’s model is education, teaching, training, and mentoring for individuals involved with firearm injury prevention. The Wraparound Project and HAVI offer a multitude of programs to ensure the success of firearm injury prevention and support for victims, educating the academic community, health practitioners, the communities surrounding San Francisco, and children in schools on topics related to violence prevention. It provides instruction to trauma centers to develop other hospital-based violence prevention programs.

Dr. Dicker also recognized the need to reframe firearm violence as a public health issue, as well as to address the social determinants of violence. Through the Wraparound Project and HAVI, Dr. Dicker has been a key participant in advocacy efforts to secure funding for the programs and to create legislative support in the U.S. Department of Health and Human Services for the implementation and continuation of firearm injury prevention programs nationwide. She also leads the ACS Committee on Trauma Improving Social Determinants to Attenuate Violence (ISAVE) group, which is establishing a curriculum for trauma-informed care to be implemented in trauma centers, creating a guide for integrating social care into health care, and developing a roadmap for trauma centers to invest in disinvested communities heavily affected by the social determinants of health.

Resident Volunteerism Award

Rami Kantar, MD, MPH, a general surgery resident in Baltimore, MD, will receive the Resident Volunteerism Award for his work to provide logistical support, surgical and clinical services, and capacity building with the Global Smile Foundation, which offers comprehensive cleft care in underserved countries around the world.

Since 2013, Dr. Kantar, University of Maryland Medical System–R. Adams Cowley Shock Trauma Center, Baltimore, has been volunteering with the foundation, which focuses on areas of need, underserved patient populations, and geographical areas significantly affected by geopolitical instabilities and conflict. Dr. Kantar helps to organize and provide logistical support to all missions, and he has provided surgical care to address cleft lip and palate repair in approximately 10 missions to Beirut, Lebanon; San Salvador, El Salvador; and Peru. These areas have been experiencing high rates of poverty and political unrest, and the COVID-19 pandemic has compounded the already existing backlog of untreated patients with cleft lip and palate.

On his missions, Dr. Kantar and his teams have provided both primary and secondary cleft lip repair and cleft palate repair. Other surgical services provided include scar revisions, complex facial tissue rearrangements, and surgery for velopharyngeal insufficiency and speech deficits. These missions include surgical, dental, speech, and language pathology, as well as psychosocial services, and Dr. Kantar has worked as a liaison to link patients to each in his organizational role.

Dr. Kantar with a Global Smile Foundation patient at cleft surgery mission in Beirut in 2015

Dr. Kantar (far right, kneeling) with the cleft surgery team, patients and their families, and local support staff in Beirut in 2015

Concurrently with direct surgical and patient care services, the Global Smile Foundation develops and implements capacity-building cleft care initiatives to empower and assist local physicians and communities in reaching cleft care expertise, with the aim to transition surgical missions into autonomous local cleft care centers. The foundation to date has established local cleft care centers at two sites in Beirut and Guayaquil, Ecuador. Dr. Kantar has worked to implement educational initiatives in the form of simulation-based comprehensive cleft care workshops in areas of need, through which he and his colleagues provide hands-on training to students and practicing surgeons.

Dr. Kantar has closely worked with and led multiple initiatives from Global Smile Foundation focused on teaching and mentoring health care workers, with the goal of empowering them to become agents of change in their communities. He has organized simulation-based educational comprehensive cleft care workshops, the first of which was held in Beirut in 2018 and was attended by approximately 100 individuals, while the second workshop took place in Lima, Peru, in 2019 and was attended by more than 200 individuals. Through these workshops, Dr. Kantar and colleagues have provided hands-on, simulation-based teaching to cleft surgeons. Moreover, as part of the research committee of the Global Smile Foundation, Dr. Kantar is directly responsible for mentoring and supporting postdoctoral research fellows.

To help support the activities of the Global Smile Foundation, since 2013 Dr. Kantar has participated in multiple fundraisers and advocacy efforts aimed at making more resources available for patients with cleft lip and palate, as well as improving their access to care. The foundation donates supplies to local sites where they operate, including suture material, surgical instruments, anesthetic agents, anesthesia machines, dental supplies for preoperative naso-alveolar molding, and supplies for speech and language therapy including naso-endoscopic instruments, in addition to patient clothing and other necessities. Dr. Kantar and the foundation also have worked closely with local government and health authorities in Ecuador, Lebanon, and Peru to raise awareness of cleft lip and palate services, secure transportation for patients experiencing poverty, and more.

Academic Global Surgeon Award

Chandrakanth Are, MBBS, FACS, FRCS, will receive the inaugural Academic Global Surgeon Award for his efforts in creating and sustaining various global curricula and programs in surgical oncology to help alleviate health care disparities in low- and middle-income countries (LMICs), with a particular focus on India.

Dr. Are, the JL & CJ Varner Professor of Surgical Oncology & Global Health, and vice-chair of education, department of surgery, University of Nebraska Medical Center (UNMC), Omaha, has been closely involved in the surgical global outreach efforts of the Society of Surgical Oncology (SSO) and served as the chair of the SSO International Committee. During his tenure as chair, he led the joint efforts between the SSO and the European Society of Surgical Oncology to develop a Global Curriculum in Surgical Oncology, which highlights the global variation in cancer care education and makes the case for a streamlined global surgical oncology curriculum of uniform standards. This resource-stratified curriculum can be used as a foundational platform for training surgical oncologists, which is critical in LMICs. The modular nature of this curriculum helps each country select elements that are suitable for their local and regional needs and, perhaps most importantly, that are affordable given their available resources. Several countries have reached out to explore pathways to regionally implement the curriculum, with one expressing interest in implementing it across their entire nation.

Dr. Are (seated, third from left) at the inaugural Global Forum of Cancer Surgeons, Seattle, WA, in 2017

Dr. Are (second from right) in a meeting to establish a relationship between MNJ Cancer Hospital, Hyderabad, Telangana, India, and UNMC in 2009

In addition, Dr. Are developed a global curriculum in research literacy for surgical oncologists, the main purpose of which is to build the research infrastructure and capacity in countries where research can be difficult to conduct because of limited resources, lack of training, and so on. For example, Dr. Are initiated the Global Cancer Surgery Research Collaborative between the UNMC and a tertiary care cancer center in India. As the founding director of the collaborative, Dr. Are and his team stimulate trainees and junior faculty to pursue and include research in their daily practice.

Dr. Are also is the founding director of the Global Forum of Cancer Surgeons (GFCS), which was formed under the auspices of the SSO in 2017 and comprises 15 oncology societies from around the world. The membership of the GFCS represents approximately 75 to 80 percent of the global cancer burden by incidence and mortality and is aimed at improving surgical care for cancer patients through multidisciplinary clinical care, education, research, outreach, advocacy, and leadership.

Within his home institution of UNMC, Dr. Are initiated an exchange program to train Indian surgeons in the U.S. As founding director of the program, he helped develop a memorandum of understanding between UNMC and the State of Andhra Pradesh, now divided into Andhra and Telangana, in 2009. Since then, Dr. Are has facilitated visits of nearly Indian 900 candidates to UNMC, including medical students, residents/fellows, and faculty. Before the COVID-19 pandemic, in a given month between two and six candidates were on the campus, and some students’ entire visits are supported through grants. Dr. Are also initiated and developed a novel International Surgery Fellowship for the general surgery residency program at UNMC.

In India, he performed an assessment of educational gaps and needs for oncology professionals and obtained grants for assessing educational gaps and needs for oncology professionals, which included surveys done at the annual meetings of the Indian Association of Surgical Oncology in India.

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