Pathways Around the Globe: International Outreach

Quillen College of Medicine’s Surgery Department is refining a global surgery fellowship program that will open a pathway for better partnerships and increased capacity at host hospitals within low- and middle-income countries.

While the college has many times offered month-long service trips, a new SEAL Global Surgery Fellowship places a fellow onsite for a year or more. SEAL stands for Surgical, Education, Access to care and Leadership.

The program has already graduated one fellow, Dr. Nick Carter, who served at St. Boniface Hospital in Haiti. The second fellow, Dr. Catherine Lewis, concludes her term in July after a year and a half of service at Kitovu Hospital in Uganda.

Under the new model, the program builds capacity at the host hospital, rather than limiting what is accomplished to the finite time that Quillen surgeons are present to complete surgeries.

“The model is education based on long-term capacity building, access to care by supporting the local system, and leadership: empowering local leaders,” said Dr. Michelson Padovany, Global Health Advisor for the fellowship program. “It needs to be culturally acceptable, so we work hand-in-hand with local partners and under the guidance of the local team.”

Dr. Padovany and Dr. Luther Ward, Quillen’s Global Surgery Director, have each personally experienced the suffering that results from a lack of access to care. While serving as a Peace Corps volunteer, Ward saw several students die after a car accident. As a result, he went to medical school and developed his passion for global health.

In Haiti, delayed care caused Padovany’s mother to lose her leg and spend more than three months in the hospital after a traffic accident.

“I was 6 or 7, and I said to myself that I needed to work in the medical field,” Padovany said. “As a surgeon today, I realize that we could have saved her leg if we had a better care system.”

When Padovany was a surgeon at St. Boniface, he and Ward successfully brought capacitybuilding improvements to the hospital. Through their initiative, they grew a residency program and cross-trained surgeons. This improved patient access to care and resulted in better outcomes.

Now, they are working together at Quillen to build capacity in low- and middle-income countries through the fellowship.

“By the fellows staying long term in places, they get a deeper understanding of the issues, which then allows them to come up with deeper solutions that tend to work in long-term capacity building,” Ward said. “That’s the biggest benefit that I’ve seen – the synergy that you see between the fellows and the host hospitals, and what that synergy brings about. It often brings about things that you don’t expect, but it is almost always good and deep and thought provoking.”

Monze Mission Hospital in Zambia will be a key focus of the program in the future, according to Dr. Brad Feltis, Chair of Quillen’s Surgery Department.

The program opens opportunities not only for fellows, but for residents who choose to participate during their fourth-year elective month, and even for medical students, who will spend at least a month helping to gather research data to shed light on issues facing the host hospital.

The new model opens more opportunities for faculty. Because a fellow is present for at least a year, faculty can schedule a trip to help train Monze’s surgical staff about their areas of expertise at their own convenience. This allows more faculty to visit, and opens the door for allied health professionals to travel to Monze to train, or for the Monze medical professionals across multiple disciplines to come here to teach students and residents about their experiences.

Dr. Sufyan Ibrahim, Monze’s lead surgeon, will be the first to come to Quillen through the program. He will lecture for medical students and residents, teaching them how to work in low-resource environments that are applicable to rural America. “He’s going to be a tremendous asset to come here from Zambia and teach us all he knows, and we’ll be able to help train him with advanced procedures,” Feltis said. “Almost every university has a department of global surgery, but very few are actually doing the kind of things that we’re doing – supporting a full-time fellow, supporting multiple faculty, and building up different divisions.

“It just opens up so many avenues of thought and growth and education,” Feltis added. “Ultimately, the sky’s the limit. Perhaps one day we’ll have an ETSU Zambian campus.”

For more information, visit: etsu.edu/ com/surgery/global-surgery.php.