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PRODUCED BY AND FOR MEMBERS OF THE DEPARTMENT OF SURGERY October 2013 | Archived Issues

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Surgeons Cross Borders to Improve the Lives of Children

Above and inset: Photos from previous trips to China by Cedars-Sinai surgical teams

Cedars-Sinai pediatric surgeons have been embarking on overseas trips to perform transformative operations on children who have no specialists in their homeland. At the same time, our surgeons mentor the local surgeons with limited operative experience to help raise their skill level and independence.

Philip Frykman, MD, associate director of Pediatric Surgery, is travelling to China in October 2013 for his third trip to do at least 17 complex anal malformation procedures on children who have been abandoned because they have been deemed "damaged" and "unfixable."

David Kulber, MD, director of the Plastic Surgery Center of Excellence, recently returned from Mozambique, where for a week he performed reconstructive procedures on children and training the only plastic surgeon in the hospital, who had limited operating experience. Robert Bernstein, MD, medical director of the Cedars-Sinai Orthopaedic Center and vice chair for Clinical Affairs, plays a role in the Mozambique project to help identify physicians who Cedars-Sinai surgeons can have an impact on so they can begin teaching and creating a modern medical system that is self-sustaining.

Andrew Freedman, MD, goes to Guatemala annually to perform urologic procedures on children. Children from Kenya and Ghana have even travelled to the United States to have Freedman perform procedures they otherwise could not get in their country.

Thus far, each time Frykman has returned from China, he has quickly received news one of the children he "fixed" is now in the process of being adopted. In 2011, 11 patients had surgery and four were adopted. In in 2012, 12 patients had surgery, and all are now adoption candidates with one pending. This year, he will be operating in two suites in the Luoyang Women's and Children's Hospital.

Frykman's trip this year is focused on a heavier case load and sustainability just like the project in Mozambique. Shiwei Zhai, MD, the surgeon he is training in China, has a skill set that is significantly improving, and operating room visits for observation from interested surgeons has grown. They will be coming from four large hospitals in Luoyang — building relationships with local surgeons is important in achieving the sustainability portion of the mission.

The goal is to give Zhai graduated independence and ability to scrub with local pediatric surgeons. Frykman will be the keynote speaker at a regional pediatric surgery conference.

Our surgeons are making an impact on the international surgical landscape and helping to provide sustainability for countries that cannot currently serve the needs of their populations. Despite limited government support in some of these countries and outdated instruments, our surgeons are identifying leaders in their homelands and have these local and motivated surgeons participate in self-sustaining models that may even include trips back to the U.S. for specialized training.

These "indigenous surgeons" are making rounds, participating in operations and handling patient-care issues because of the long-term commitment our surgeons are making to help children outside the U.S. get the surgical care they so desperately need.

Previously in Medical Staff Pulse:

A photo from the 2013 medical mission to Guatemala