O_Dr. Wyatt and Dr. Krueger performing surgery.gif
Dr. Wyatt (left) and HVO volunteer Philip Krueger, MD, also an AAOS fellow, perform surgery on a patient at Bedford Hospital in South Africa.
Courtesy of Ronald Wyatt, MD

AAOS Now

Published 8/1/2011
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Jennie McKee

HVO celebrates silver anniversary

Volunteers provide care, training around the world

Treating the mangled hand of a patient who was bitten by a baboon isn’t something U.S. orthopaedists often do. It’s equally uncommon to make a “house call” to a monastery to see a Buddhist monk with a flail arm.

But those are just two of the many memorable experiences Ronald Wyatt, MD, has had—in South Africa and Viet Nam, respectively—as a volunteer with Health Volunteers Overseas (HVO). The nonprofit organization helps improve health care around the world by enabling medical professionals to provide care and train local healthcare providers.

HVO had its genesis in orthopaedics, based on the successful model of Orthopaedics Overseas (OO). Since the OO Board of Directors voted to support the establishment of the new organization on Aug. 1, 1986, HVO volunteers have completed 7,900 assignments and travelled to 51 countries around the world.

“The past 5 years have been a period of continued growth for HVO,” said Nancy Kelly, HVO executive director. “The number of incoming requests for training programs has grown significantly, which is likely a function of both our growing reputation and the global economic crisis.”

As HVO celebrates its 25th anniversary, orthopaedists and other physicians and medical professionals continue to volunteer their time and skills to raise the levels of care around the world.

Meeting challenges with ingenuity
HVO missions can last from 1 week to 6 or more weeks. The organization provides assistance with many of the travel arrangements, but volunteers are expected to pay their own way.

Resources available in different locations vary widely, said Dr. Wyatt, who has served in 8 different countries.

“My latest assignment was at a teaching hospital in Wenzhou, China,” he said. “I helped train attending surgeons in the latest sports medicine techniques and also lectured to orthopaedic residents, interns, and medical students on a variety of subjects.

“It was a fairly sophisticated hospital, so the training and teaching were at a pretty high level,” he said. “For example, one lecture was on capsular shift for recurrent shoulder instability. Another lesson was on arthroscopic meniscus repair.”

Even in locations where the equipment and facilities are very basic, teaching new and innovative techniques is possible.

“In Vietnam,” he said, “I taught local healthcare personnel how to perform small wire external fixation for periarticular fractures by using bicycle spokes for pins.”

Germaine R. Fritz, DO, who has volunteered in places such as Peru, Costa Rica, Nicaragua, and Ethiopia, has treated a wide range of injuries and conditions at many different kinds of facilities.

“Each location has different needs,” she said. “I have treated many fractures, congenital defects, infections, and nonunions, as well as tendon and nerve injuries. Many patients have long-neglected injuries.

“Sometimes it is challenging to work without a certain type of equipment or without equipment as sophisticated as what we are used to,” she added. “It forces you to be more creative and rely on ingenuity and faith.”

Dr. Fritz has found that residents, attending physicians, and other medical personnel she has taught have a good knowledge base and now have improved access to the internet to obtain information.

O_Dr. Wyatt and Dr. Krueger performing surgery.gif
Dr. Wyatt (left) and HVO volunteer Philip Krueger, MD, also an AAOS fellow, perform surgery on a patient at Bedford Hospital in South Africa.
Courtesy of Ronald Wyatt, MD
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Dr. Wyatt treated this patient’s severe hand injuries in South Africa. The patient sustained multiple broken bones and dislocations when a baboon he was trying to kill bit him.
Courtesy of Ronald Wyatt, MD

“Many of them, however, still lack experience and confidence in performing up-to-date procedures,” she said.

During trips to places such as Peru, Malawi, and Ghana, Peter G. Trafton, MD, has found that the biggest challenge is “helping locals develop treatment techniques that are affordable, effective, safe, and locally teachable.

“In settings with limited resources, HVO helps local surgeons develop into better caregivers and competent educators for their younger colleagues,” he said. “If we are able to help a local institution become a self-sufficient setting for patient care and for orthopaedic surgical training, we have fulfilled our goals.”

The rewards of volunteering
Dr. Fritz appreciates the opportunity to develop unique relationships that have allowed her to “grow professionally and emotionally” during her trips with HVO.

“Customs, circumstances, and rituals are different, but people laugh, love, learn, and care in the same ways throughout the world,” she said.

“What I have found most rewarding is connecting with and teaching people,” she continued. “I enjoy the enthusiasm they have for learning. They appreciate interacting with volunteers because they can’t get the same experience from a book or the internet.”

Dr. Wyatt agrees that volunteers gain more than they can ever give, remembering one of his patients—a young South African child in cervical traction for a spine injury who smiled broadly when given a small stuffed animal.

“It is refreshing,” he said, “to practice where surgeons want to learn, patients are very motivated to get better and always express their appreciation and thanks, and excessive regulations and lawsuits are not issues. It is pure medicine.”

Dr. Wyatt, who will volunteer in Cambodia this December, strongly encourages other orthopaedic surgeons to volunteer with HVO and other humanitarian organizations.

“Those who volunteer will rediscover the excitement and rewards of practicing medicine and will get back to the roots of why they became physicians and surgeons,” he said.

Jennie McKee is a staff writer for AAOS Now. She can be reached at mckee@aaos.org

More about HVO
HVO currently offers volunteer opportunities for orthopaedists in the following countries:

  • Bhutan
  • Cambodia
  • Cameroon
  • China
  • Costa Rica
  • Ghana
  • Malawi
  • Moldova
  • Mongolia
  • Nicaragua
  • Peru
  • St. Lucia
  • South Africa
  • Tanzania
  • Uganda

To learn more about donating or volunteering, visit HVO online at www.hvousa.org

While there, be sure to view the information about HVO’s 25th anniversary, including photos and stories dating back to 1986.

“We will have a volunteer photo contest, with categories such as humor, children, nature, local scenes, and volunteers in action,” said Nancy Kelly, HVO executive director.

HVO will also celebrate its 25th anniversary with a special section in its fall newsletter and a celebration in Washington, D.C., next April.

“Our Board has also approved the creation of the ‘HVO Silver Fund,’ which was created to assist HVO in meeting future challenges and opportunities,” added Ms. Kelly.