Surgeons Honored for Volunteerism and Humanitarian Efforts

The ACS Board of Governors (B/G) Surgical Volunteerism and Humanitarian Awards Workgroup has announced the recipients of the 2022 ACS/Pfizer Surgical Volunteerism and Humanitarian Awards. The workgroup received exceptional nominations, reflecting the remarkable commitment of ACS Fellows to provide care to underserved populations.

The contributions of the five award recipients are briefly summarized in this article and will be formally recognized at Clinical Congress 2022 in San Diego, CA, during the annual B/G reception and dinner Tuesday, October 18. Clinical Congress attendees are invited to hear the honorees speak at a Panel Session, Humanitarian Surgical Outreach at Home and Abroad: Reports of the 2022 Surgical Volunteerism and Humanitarian Award Winners, Monday, October 17.

Academic Global Surgeon Award

This award honors those surgeons committed to giving back to society by making significant contributions to surgical care through organized educational activities. This award is intended for ACS Fellows in active academic global surgical practice who are committed to applying research, training, and evidence-based advocacy to make significant contributions to surgical education and care in regions of inequities, or retired Fellows who have been involved in academic global surgery during their active practice and into retirement.

This year, the Academic Global Surgeon Award will be presented to James Allen Brown, MD, FACS, a general surgeon in Johns Island, SC, for his nearly 2 decades of work providing surgical education and training to physicians in Cameroon.

During his time as a US Navy surgeon and as a private practitioner, Dr. Brown joined several medical mission trips to Latin America, Asia, and Africa. In 2003, he traveled to Northern Cameroon for 2½ weeks, where he witnessed an overwhelming lack of surgical services and determined that surgical training could assist in addressing these gaps. In 2008, Dr. Brown and his wife moved to Cameroon full time, partnering with the Pan-African Academy of Christian Surgeons (PAACS), a not-for-profit dedicated to high-quality surgical training in Africa.

Dr. Brown’s contributions to academic surgery in Cameroon, through his work at Mbingo Baptist Hospital, have been comprehensive and transformative. Among his achievements, he initiated a Residency Review Committee (RRC) composed of all the PAACS training program directors, the chief hospital administrator, senior nursing supervisor, the head chaplain, and the chief residents from each program.

The RCC served as oversight for planning and policy decisions for the training programs. He opened a seven-bed intensive care unit (ICU) and a four-bed postanaesthesia care unit, where 12 ICU nurses completed their training and began working. In addition, Dr. Brown invited two US perioperative nursing educators to teach a 6-month perioperative nursing course. Before this point, none of the operating room (OR) nurses or surgical technicians had any formal training. Instructors used an OR nurses textbook from the US to teach 3 months of classroom didactics and 3 months of hands-on operating room procedures for 20 nurses and techs. This course revolutionized the OR, and safety, efficiency, and professionalism improved.

Fifty African surgical residents across the continent have received training from Mbingo in Dr. Brown’s tenure, and 20 fully trained surgical graduates from the Mbingo program now work in nine African countries.

In terms of infrastructure and practice, Dr. Brown supervised the construction of a new surgery clinic at Mbingo, which transformed the clinic from a single room with a curtain between two stretchers to seven private exam rooms with a sink, desk, and laptop in each room. He also oversaw an OR expansion, renovating six rooms and adding four more, as well as adding specialized equipment for laparoscopy, ophthalmology, orthopaedics, and pediatric surgery.

This renovation included dramatically expanding storage for OR supplies. Dr. Brown implemented a peritoneal dialysis program for acute renal injury, raising the survival of those patients from zero to 70%, and the program is now taught throughout the region.

Throughout his time in Cameroon, Dr. Brown has advocated for improving surgical resident education. He has partnered with numerous international university programs to establish partnerships to receive residents and faculty for global surgery rotations and research; worked to get hospital accreditation from regional surgical societies such as the College of Surgeons for East, Central, and Southern Africa; and established collaborative relationships with national surgeons, hospitals, and medical schools to share resources, enhance consultations, and provide training.

Even in the face of the ongoing Cameroonian civil war, which has brought active conflict to his immediate area and threats of violence against himself, his wife, and his staff and students, Dr. Brown’s work to train residents and treat patients has continued. Though training has often been interrupted and the surgery volume has dropped, thousands of patients who would not have had access to care have received the care they needed.

International Surgical Volunteerism Award

The International ACS/Pfizer Surgical Volunteerism Award is given in recognition of those surgeons who are committed to giving back to society by making significant contributions to surgical care through organized volunteer activities abroad.

This year, the award will be given to Eid B. Mustafa, MD, FACS, for his more than 30 years of volunteer surgical and medical services to the people of the Palestinian West Bank, in addition to other underserved areas of the Middle East.

Dr. Mustafa was born in the West Bank, received his medical education in Egypt, and then moved to the US to perform his residency and fellowship training in plastic and reconstructive surgery. After his training, he relocated to the medically underserved city of Wichita Falls, TX, where he was the only practicing plastic and reconstructive surgeon for many years. His international volunteerism began in earnest in 1987, when he met Charles Horton, MD, the founder of Physicians for Peace, who worked with Dr. Mustafa to initiate medical missions to the West Bank the following year.

For many years, Dr. Mustafa traveled to the West Bank for between 10 and 21 days. His initial efforts focused on congenital defects, burn care, and reconstruction from injury. As his missionary work evolved, he recruited a multidisciplinary team aimed at the needs of each individual community, including specialists in urology, orthopaedics, peripheral vascular surgery, off-pump cardiothoracic surgery, cardiology, and physical therapy. With the advent of minimally invasive surgery during this period, he arranged for equipment and education to be provided in the West Bank to accommodate the growing interest.

His trips provided preoperative care, interoperative teaching, and postoperative care for the patients.

The teams developed by Dr. Mustafa have provided more than 2,000 procedures to date. Dr. Mustafa has been responsible for all logistics, including planning with the host country, setting up patient visits, acquiring visas, and making travel and lodging arrangements for his team and educational venues. He has conscientiously provided for the safety of his volunteers in areas with significant personal security concerns.

Dr. Mustafa’s efforts have now expanded beyond surgical services. Recognizing the burgeoning need for care of the increasing diabetic population in the West Bank, Dr. Mustafa founded centers in Al-Bireh, Nablus, and Hebron to deliver dietary information, preventative foot care, smoking cessation, neuropathy education, and medication management. These centers also offer education about the long-term sequalae of diabetes, including cardiovascular disease, kidney failure, and ophthalmologic complications. In addition, burn centers were established in Nablus and in Hebron due to the war-time thermal injuries seen in these areas. These centers were not only equipped to take care of the burn injuries but provided education and training to the surgical staff, nurses, and therapists.

In addition to educating US medical students on the need for and realities of international surgical volunteerism, medical education is included in each of Dr. Mustafa’s mission trips, which are open and free to all who wish to attend. These missionary conferences are coordinated with the Ministry of Health and often one of the local medical schools. Subjects are chosen based on the needs of the medical communities and include topics such as trauma care, patient safety in the operating room, and complication assessment. Dr. Mustafa also has been a diligent advocate and fundraiser for his medical services, gathering funds and resources from countries including the US, Germany, Kuwait, and beyond.

Dr. Mustafa has been an international ambassador for the ACS, taking pride in his fellowship and advancing the ideals of the College. He began teaching the principals of the Advanced Trauma Life Support^® curriculum on the West Bank years ago, at a time when political divisions prevented formal recognition and certification of the course.

Resident Surgical Volunteerism Award

The ACS/Pfizer Resident Surgical Volunteerism Award is given in recognition of those surgeons who have been involved in significant surgical volunteer activities during their postgraduate surgical training. This award honors surgeons committed to giving back to society by making significant contributions to surgical care through organized volunteer activities. This year, the award will be given to two surgeons: Alexis Bowder, MD, and Matthew Goldshore, MD, MPH, PhD.

The first Resident Surgical Volunteerism Award recipient is Alexis Bowder, MD, a general surgery resident in Milwaukee, WI, who receives this award for her 10 years of volunteer work in practice, education, and research, primarily in Haiti.

Dr. Bowder has been involved in global volunteer work since 2012, when she spent 6 weeks as an interpreter at a primary care clinic in Honduras between her first and second years of medical school. Between her third and fourth years of medical school, she worked for 1 year at Hôpital Universitaire de Mirebalais in Haiti, working as a research associate with Harvard Medical School’s Program in Global Surgery and Social Change. As a sub-intern, Dr. Bowder recorded vitals for surgical patients and removed dressings before rounds. In the OR, she filled roles ranging from circulating to first assisting surgeon. Patients seen in the surgical clinic or around the hospital were given her phone number and could contact her for perioperative issues. In addition to working with the Haitian team, she was the liaison for any visiting surgical teams from the US or internationally. She helped visitors reach the hospital, locate patients to evaluate, and schedule procedures.

As a resident, even with ongoing political strife primarily in the capital of Port-au-Prince, she continued regular trips to Haiti, where she shifted the focus of her clinical and education efforts to include St. Boniface Hospital in Fond-des-Blancs. While continuing to participate in daily rougnds and postoperative care of patients, Dr. Bowder dedicated more time to developing the surgical research skills of the Haitian medical students, residents, and faculty, and supported their clinical research.

Her work supporting surgical research at St. Boniface Hospital led to the development of a sustainable database of surgical cases and their postoperative outcomes, including the design of an electronic database to be implemented in the coming years. In collaboration with Haitian colleagues, she established a not-for-profit organization, the Haiti Surgical Research Consortium, which seeks to strengthen the Haitian surgical system by promoting Haitian-led surgical research training and capacity building to better inform efforts and provide universal access to timely and affordable surgical care. Dr. Bowder has been integral in collaborating with several Haitian organizations and Info-CHIR, Haiti’s only peer-reviewed journal of surgery and anesthesiology, to implement an annual surgical research curriculum to teach Haitian clinicians the skillsets to design, conduct, and disseminate their own clinical research.

Even early in her career, Dr. Bowder has been a strong advocate on the global stage for improving care in Haiti. In the last 2 years, she attended the United Nations General Assembly to advocate for surgical care and attended grassroots meetings on the importance of developing a National Surgical, Anesthesia, and Obstetric Plan (NSOAP) in the country. Additionally, she worked with the Global Surgery Foundation and the United Nations Institute for Training and Research to perform a situational analysis of obstetric and cervical cancer care in Rwanda and Zambia to inform future interventions for decreasing maternal mortality by improving access to cesarean sections and surgical care for cervical cancer.

In addition, Dr. Bowder personally has raised more than $5,000 to support Haitian faculty and trainees in their research efforts—assisting with publication and international presentation of their work and developing a Haitian research education platform.

The second Resident Surgical Volunteerism Award recipient is Matthew Goldshore, MD, MPH, PhD, a general surgery resident in Philadelphia, PA, for his work toward establishing the Center for Surgical Health (CSH), which serves as an access point into high-value surgical care for patients who typically rely on the emergency room for treatment.

Dr. Goldshore’s educational background in public health helped him develop the skills to become a key part of the development of CSH, which opened in 2021. CSH has developed a sustainable surgical access model for uninsured Philadelphians that relies on partnerships with community organizations, with several partners throughout the city aiding in expansion of clinical services.

Recognizing that changing the landscape of surgical care for vulnerable populations requires a multipronged approach that includes improving access to surgical consultation and operative intervention, interdisciplinary public health and clinical outcomes research, and beyond, Dr. Goldshore implemented a one-to-one, patient-centered system in which CSH collocates at health centers for assessment of surgical disease. Patients immediately are paired with an interdisciplinary Personal Patient Navigator (PPN) team composed of medical, nursing, legal, and social work trainees. The team walks the patient through their perioperative trajectory, registering them within the Penn Medicine system and submitting medical assistance applications to the state.

When their Emergency Medicaid or Medicaid application is approved, the patient receives care at University of Pennsylvania (UPenn) surgery from residents and faculty, who support them from preoperative diagnosis to postoperative primary care handoff. When an application is denied, it is sent to a partner at Community Legal Services, who support the appeal. Most referrals to CSH come from community organizations or from emergency department encounters.

Dr. Goldshore and his colleagues at CSH understand the need to address a patient’s social determinants of health. CSH provides a direct connection to the UPenn Social Needs Response Team, with the ability to offer a range of services to match specific patient needs. For example, patients without reliable transportation to in-person office visits or appointments are given parking passes or are scheduled for transportation services, and patients whose primary language is Spanish are connected with a translator and often assigned a PPN fluent in Spanish.

Dr. Goldshore meets with CSH staff weekly to discuss their approximately 80 patients from nine clinical divisions, including general surgery, women’s health, pediatrics, and so on. Each individual patient’s status and next steps of care are reviewed, which provides a teaching opportunity for medical students and lays the groundwork for patients to receive the best standard of care. The clinics actively support patients through the perioperative continuum.

Education and advocacy are critical elements of successfully running a practice like CSH, and Dr. Goldshore is intimately involved in supporting each of these areas. He is a leader in courses at CSH, UPenn Perelman School of Medicine, and the Measey Surgical Education program funded by a grant he submitted. As an advocate, Dr. Goldshore played an integral role in securing funding for CSH and for key staff though the University of Pennsylvania Health System and the Perelman department of surgery.

Surgical Humanitarian Award

The ACS/Pfizer Surgical Humanitarian Award recognizes Fellows who have dedicated a substantial portion of their career to ensuring the provision of surgical care to underserved populations without expectation of commensurate reimbursement.

This award is intended to honor an ACS Fellow who has dedicated a significant portion of his or her surgical career to full-time or near full-time humanitarian efforts rather than routine surgical practice. This effort may reflect a career dedicated to “missionary surgery,” the founding and ongoing operations of a charitable organization dedicated to providing surgical care to the underserved, or a retirement characterized by surgical volunteer outreach.

This year, the Surgical Humanitarian Award will be given to Ted Sugimoto, MD, FACS, for his more than 3 decades of work providing surgical care to disadvantaged patients in several African countries.

Dr. Sugimoto first became involved in volunteerism while he was a medical student traveling to the Dominican Republic. He and his wife, a registered nurse, chose to pursue full-time work overseas following his general surgical training. In 1989, he began his full-time career in surgical volunteerism in the Zaire, now the Democratic Republic of Congo (DRC), and has since split his time between DRC, Kenya, Senegal, and Somalia.

Much of Dr. Sugimoto’s surgical career was spent in the DRC and Somalia, both volatile areas, and sometimes conflicts put him and his family in personal peril. For example, in 2002, he was working in eastern DRC when tribal conflicts escalated to war, which led to the massacre of at least 3,000 people from both tribes involved in the conflict. Many patients, hospital workers, and others were killed. Much of the hospital, built in the 1950s, and the surrounding homes and structures were destroyed, including the home where the Sugimoto family first lived when they moved to the DRC. Throughout these dire situations, Dr. Sugimoto continued to deliver care for locals and those who suffered casualties from the conflict.

Despite the relative stability of Kenya and Senegal, Dr. Sugimoto worked with underserved populations in these areas, often providing care to patients who were unable to cover the costs for care at government hospitals.

Though trained as a general surgeon, Dr. Sugimoto often was required to provide care outside of the standard scope of practice for US-based general surgeons. He gained this additional knowledge over the years from specialists in other fields, but often relied on books and internet resources to provide the necessary care. As the only surgeon for a large area and without specialist referral options, he became an orthopaedist, urologist, gynecologist, and plastic surgeon. He learned reconstructive techniques, including cleft lip and palate repairs.

Aside from providing surgical care, he accumulated equipment and medication while stateside to supplement what the hospitals were able to find locally. He collected equipment from donors, purchased equipment from organizations, and arranged transport overseas, sacrificing personal space and funds to bring the equipment directly to the hospital. While working in Senegal, he was an integral part of transitioning the physical structure of the hospital to a working facility, particularly regarding surgical care needs.

Dr. Sugimoto also has been heavily involved in training the next generation of care providers, often local physicians who had limited exposure to surgery during medical school. He taught at both the nursing and medical schools, training DRC postgraduate general medicine students in surgery. He has served as an instructor and principal at a nursing school; an intern instructor in Kenya; and both an academic and hands-on surgery education leader in Somalia—where the program is now largely run by locals—demonstrating the long-term impact of his work.