Improving Global Orthopaedic Care Through Travel

Orthopaedic surgeon from Tanzania travels throughout United States to learn new treatment methods and techniques to share with colleagues

Fanuel Bellet, MD, a surgeon who recently completed his orthopaedic and trauma residency at Kilimanjaro Christian Medical University College (KCMC) in Moshi, Tanzania, discovered this firsthand. With funding provided through the HVO Wyss Scholarship—a fund supporting the professional development of emerging global health leaders from HVO project sites—Dr. Bellet attended the AAOS 2018 Annual Meeting in New Orleans and completed a five-week observership with HVO volunteers at various hospitals throughout the United States in the spring of this year.As orthopaedic surgeons and other health professionals who volunteer internationally with Health Volunteers Overseas (HVO) often report, practicing in a different country, in the context of a different health system, is an eye-opening experience that exposes providers to new treatment modalities and approaches to patient care.

“Our hope is that Dr. Bellet learned some orthopaedic care that he can apply back in Tanzania and that being a part of the resident lectures, journal clubs, and grand rounds here will help inspire lifelong learning,” said Charity Burke, MD, of the Norton Orthopedic Institute in Louisville, Ky. Dr. Burke, who has volunteered twice at KCMC through HVO, was the first to host Dr. Bellet at her home.

While visiting the Norton Orthopedic Institute, Dr. Bellet observed many surgeries for the first time, including procedures performed for both degenerative and traumatic indications in both adult and pediatric patients, such as arthroplasty, spine surgery, arthroscopy, intramedullary nailing, and hand surgery.

After Dr. Bellet visited Louisville, Glen Crawford, MD, HVO’s project director for the orthopaedics project in Tanzania, brought him to Newberry, Maine, where he was able to see a number of trauma patients.

“It was such a nice experience, observing trauma cases and how they are [cared for], because they are the major problem in my country,” Dr. Bellet noted in his post-trip report.

The approach to patient care outside the operating room in the United States also made a significant impression on Dr. Bellet. He reported that a key takeaway from his observership was the importance of visiting every patient before and after surgery to ensure their full understanding of the procedure and follow-up care. Dr. Bellet also listed several other lessons learned, including the value of preoperative planning and having all the instruments and implants needed in the room before skin incision, how critical team efficiency can be, and how preoperative surgical site cleaning helps reduce the risk of surgical site infection.

Most of all, Dr. Bellet noted the benefit of observing a variety of new procedures firsthand. “Most of the surgeries were my very first to observe, and this helped me to know how they are done, the precautions to take while operating, and teamwork spirit among the theater personnel,” he wrote.

During his time in the United States, Dr. Bellet also traveled to the Midwest. While in Madison, Ind., he learned from Travis Clegg, MD, how important teamwork is to being a successful orthopaedic surgeon. In Chicago, Dr. Bellet observed Andre Ivy, MD, MS, as he treated 60 outpatients over two days. Dr. Bellet also learned about administering steroid joint injections for a variety of conditions, including shoulder arthritis, rotator cuff tear, carpal tunnel syndrome, and arthritis of the wrist and other joints of the hand.


Fanuel Bellet, MD, discusses his work in Tanzania with a fellow AAOS 2018 Annual Meeting attendee.

Since returning to KCMC, Dr. Bellet has reciprocated the hospitality he experienced in the United States with HVO volunteers in his country. Paul Crowe, MD, a spine surgeon and one of the first volunteers to visit KCMC after Dr. Bellet returned from his observership, noted that Dr. Bellet was a wonderful host. Dr. Bellet took it upon himself to organize grand rounds for spine surgery, line up cases for Dr. Crowe, and arrange lecture time for Dr. Crowe to discuss spine surgery with students taking board exams. In addition, Dr. Bellet ensured Dr. Crowe had a working cell phone, as well as power and hot water in his lodgings. Dr. Bellet even helped Dr. Crowe’s wife, a social worker, find a volunteer placement during her husband’s assignment.

The knowledge Dr. Bellet gained during his stay in the United States, including both his attendance at the AAOS 2018 Annual Meeting and five-week observership, will extend beyond his own patients and even the walls of KCMC. By sharing his newfound familiarity with surgical procedures and exposure to new treatment concepts with his colleagues, Dr. Bellet can improve the quality of care for orthopaedic patients throughout his community.

Andrea Moody, MA, is the project support manager at HVO.

Opportunities available through Health Volunteers Overseas
Health Volunteers Overseas has many short-term volunteer opportunities available, including projects in Bhutan, Bolivia, China, Costa Rica, Ghana, Malawi, Myanmar, Nicaragua, the Philippines, St. Lucia, Tanzania, and Uganda. Assignments generally last two to four weeks, and volunteers are placed throughout the year. For more information, visit www.hvousa.org.

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