Surgery and Healing in the Developing World - Dartmouth-Hitchcock

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408 Surgery and Healing in the Developing World
Telemedicine
Lately we are using the support of Telemedicine. We have conducted preoperative
and postoperative interviews with patients with two computers communicated
through standard telephone lines or Internet. We have also transmitted pictures of
lesions or diagnostic images (X-ray pictures or sonograms) and we have conducted
telementoring sessions during laparoscopic operations performed in the Ecuadorian
Amazonic jungle and projected life in Yale University a New Haven CT.
We have also established telecommunication during surgery with the Department
of Surgery of the Virginia Commonwealth University.
Teaching
Besides serving rural and suburban communities, we have a teaching program
for medical and nursing students and surgical and anesthesiologist residents. We are
affiliated to the University of Cuenca-Ecuador and we constantly receive visiting
students from several universities of the United States, as well as students from Europe
and Latin America.
Besides teaching them the art and science of surgery and anesthesia we try to
awaken in them the principles of solidarity and compassion for our fellow men and
women.
Research
We are always conducting some research programs comparing the mobile system
with the standard hospital care, regarding to complications, costs and patient
acceptance. We also study alternative surgical and anesthesia procedures, looking
for excellence in our health delivery system.
Results
After six years of work with an excellent motivated and trained voluntary team
and the growing support of our communities, we have performed over 3.000 operations
in General, Urologic, Gynecological, Reconstructive and Ophthalmologic surgery
(Tables 1 to 7) at a much lower cost and with greater patient´s acceptance. We
take care of people that otherwise have few possibilities of access to surgical care and
we do in their own habitat, taking very little of their working time and their family´s.
Special bonds are created between the members of the team sharing this humane
adventure and between the team, local doctors and patients. Also the relationship
between the patient and his or her family is strengthened after closely sharing the
surgical experience and participating in the postoperative care.
We have had no mortality and the complications rate comparable with the most
advanced medical centers in the world. We have contributed to the education of
several promotions of students and residents and have received over one hundred
foreign students. Over a dozen articles have been published about our experience
and research programs in journals and books from Ecuador and the United States.
The Future
We believe that Mobile Surgery should be expanded. We have already contributed
to a similar program in Honduras and the Ministry of health from Ecuador has
under way a plan to expand the system.
If Surgery, with its need of sophisticated technological support can be brought
out of the hospital any other branch of medicine can. A mobile system of school
health and general medical care is starting in our Country.