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July 20, 2014
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Vail-Summit surgeons lead medical mission trip to Rwanda

EAGLE COUNTY — When two local surgeons landed in Rwanda, they almost doubled that country’s number of orthopedists.

Rwanda, a country with 12 million people, only has three orthopedic surgeons. Dr. Richard Cunningham and Dr. Peter Janes, of Vail-Summit Orthopaedics, along with a surgical team were there for a medical missionary trip to teach Rwandan surgeons to do the kinds of surgeries most of us think are routine.

Janes spent days teaching them to treat clubfoot. Cunningham taught arthroscopic reconstruction.

They learned as much as they taught.

“It’s such a cliche to say that it makes you appreciate everything we have in this country and this valley, but it’s so true,” Cunningham said. “I had never done a medical mission. After 10 years, I was looking to do something like this, recharge my batteries and remind me why I got into this in the first place.”

Rwanda is recovering

Rwanda, you may recall, was gutted by a civil war that killed millions. The violence mostly subsided two decades ago, and the country began the long road back.

“It has advanced light years since that brutal genocide. They’ve done remarkable things in 20 years,” Cunningham said.

Still, most people don’t have electricity and running water, Cunningham said.

He and Janes spent their week working in a hospital supported by a Saudi prince that was built just before the genocide started.

Cunningham’s 16-year-old son came along. He worked in an orphanage for the week.

“It’ll change the perspective of anyone who was raised here,” Cunningham said.

Everything all the time

Rwandan doctors currently don’t do ACL arthroscopic reconstruction, but they are learning. However, they do everything else all the time.

“They have to deal with such a wide variety of things. Here, we are so specialized. One day they’re working on a knee, the next a spine, then a hand. They’re a jack of all trades and do it all very well,” Cunningham said.

Then there’s the equipment. Cunningham and Janes helped build the only set of working arthroscopic gear in the country while they were there.

“We weren’t sure we’d be able to do it, but with everyone working together, we were able to pull together bits of equipment and made it work,” Cunningham said.

Orthopedic companies Smith & Nephew and DePuy donated some equipment. The Vail-Summit team packed it in their bags and took it with them. If it goes through customs, it never shows up.

“It’s impossible to say what happens with it,” Cunningham said.

Even with the equipment they brought, they didn’t have a working set of arthroscopic gear.

Cunningham said there was a moment when he wasn’t sure they’d be able to do this. Then again, they’re surgeons; they fix people and things.

They cobbled together pieces and parts meant for other things entirely, like urology tubing, and created one set of working arthroscopic equipment.

“You realize how you take everything for granted. I have everything I need, and it’s all right there,” Cunningham said.

Improving constantly

Finally, it was time to see patients.

They worked one office day with the three surgeons and saw 50 patients. Then they set about teaching arthroscopic surgery the other three days, operating on 15 patients in three days.

On their clinic day, they saw a 20-year-old male who had spontaneously become paraplegic because of tuberculosis.

There was a guy from Rwanda’s armed forces who had badly injured his knee. He wouldn’t be able to be part of the armed forces unless they fixed him. They did.

It was slow. They’d operate for an hour, then wait an hour and a half for the equipment to finish sterilizing so they could operate again.

“They kept getting better each time they did it,” Cunningham said.

Curing clubfoot

Clubfoot is a birth defect that occurs once in about every 1,000 births, Janes said. The foot turns inward and points downward, and it often appears that the patient is walking on his or her ankle.

Babies in the United States with clubfoot are normally treated soon after birth, when the tendons and ligaments are still very flexible.

“Unfortunately, for many children in Rwanda, this method is not always available following birth, and treatment then requires more difficult surgical procedures,” Janes said. “The result is that some children with clubfoot are left untreated and have physical limitations for life.”

‘TRAINING OTHERS’

Janes led Centura Global Health Initiative training for 30 Rwandan physicians and physical therapists at the Sainte Marie Orthopaedic Children’s Hospital in Rilima, Rwanda.

The trainees were then sent back to their clinics and hospitals across Rwanda to become the trainers of others, Janes said. Vail-Summit is also setting up a fellowship program for junior doctors from Rwanda.

“Our hope is that those surgeons will be able to make an impact. They’re helping patients, but they’re also training others,” Cunningham said.

Staff Writer Randy Wyrick can be reached at 970-748-2935 and rwyrick@vaildaily.com.


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The VailDaily Updated Jul 20, 2014 09:31PM Published Jul 21, 2014 02:52PM Copyright 2014 The VailDaily. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.