overheard - what our readers have to say

Dr. Kerr responds to letter

I have read Dr. Gueye’s letter concerning Mike Danaher’s involvement in surgery during his visit to Kikuyu Orthopedic Rehabilitation Centre in Kenya (Catcher Trades Gloves for Scrubs) in the fall 2012 issue of Binghamton University Magazine. Because the mission of Wilson Rehabilitation Foundation is to help mission hospitals provide the best possible orthopedic care for their patients, I appreciate Dr. Gueye’s comments and want to respond to them.

Yes, Mike was allowed to scrub in surgery. It is true that here in the United States this is unlikely to happen until the student is in medical school. However, Mike never performed surgery. His role, as noted, was limited to retracting, suctioning, placing an occasional screw in the bone, and learning to suture skin. This was done under the direct supervision of the primary surgeon, either myself or the Kenyan orthopedic surgeons, who had no objections to Mike being in the operating room or to anything that he did while assisting.

This is very different than the role of an orthopedic resident. Mike did not make any decisions concerning the type of surgery or the approach to surgery. He did not do any of the critical parts of surgery, such as making an adequate reduction of a fracture or deciding where and at what angle a bone should be cut. He was never left by himself in the operating room with a patient.

Below is Dr. Michael Maru’s response to the letter. He is the Director of Clinical Services at Kikuyu Orthopedic Rehabilitation Centre:

“Having read the article and the responses, it appears to me that Mike’s report was misinterpreted. The fact that Mike was allowed to do a few things during surgery under direct supervision is no different from our own pre-med students who occasionally come for attachment here. Having worked as surgeon in western world, I fully agree that the students are more involved in surgery in Africa. The resources for learning and health provision are more limited in Africa, and this calls for more involvement at different levels for those in the health sector irrespective of their origin.

“For the period I have been in charge of KORC, I am not aware of some students being allowed to overstep their limits. We want to expose potential students of medicine to various aspects of this field within safe limits under supervision, and I believe this is what goes on at KORC.”

I hope that this allays Dr. Gueye’s concern that the Kenyan patients were demeaned, devalued as humans, experimented on, or that they received less than the excellent care delivered in the operating room at Kikuyu. We celebrate our partnership with the medical staff in Kikuyu, Kenya, and the opportunity we have to learn from one another.