Steven C. Hall, MD, Anesthesiologist
Discusses use to Sonosite ultrasound during a medical mission to Gitwe, Rwanda
Medical Missions for Children is one of the largest nonprofit groups in the United States that provides surgical care for children and adults in some of the poorest and most underserved areas of the world. This is the fourth time a team went to Gitwe, Rwanda, to provide two weeks of free care. The team consisted of surgeons, anesthesiologists, and nurses from around the U.S. Several of us had been there before. Rwanda is the most densely populated country in Africa and one of the poorest. Gitwe is a village in west central Rwanda that is isolated and without consistently reliable water and electricity resources. (This village is so small, you can’t even find it on Google Earth.) Our host for the trip was Reverend Gerard Urayeneza, a local minister and civic leader who has almost single-handedly built grammar and high schools, as well as a small hospital. There is very little medical care in this area, and surgery is not performed at the hospital when our team is not there.
The surgeries are, for the most part, repair of cleft lips and palates in children and adults, as well as subtotal resections of goiters. This second series of operations could not have been done this and last year without the generous assistance of Sonosite. Most of the people in Rwanda are subsistence farmers, barely growing enough on small plots of banana, sorghum, manioc, rice, and sugar cane to survive. There is very little cash in these communities. Because of their diet and their inability to purchase iodized salt, thyroid problems abound, leading to many adults developing huge goiters, growths of the thyroid gland that can be larger than a baseball. The goiters interfere with breathing and swallowing. Unfortunately, medical management can’t shrink these goiters, leaving surgery as the only option to allow these patients to resume a normal life.
The problem is that these patients often have large quantities of thyroid hormone circulating, producing a dangerous condition of hyperthyroidism or even thyroid storm, with extreme levels of high heart rate and blood pressure when surgery is attempted. The only safe way to prepare these patients and treat them during surgery is to administer beta-blockers, with depress the heart and heart rate. These can only be done safely if the cardiac function is directly observed. Up until now, that was not possible, and the surgeries were life-threatening. But for the last two years, due to the generosity of Sonosite, we have been able to prepare and treat these patients while monitoring cardiac function with your ultrasound. On behalf of the anesthesiologists, surgeons, and nurses who went to Gitwe, thank you. Thank you for helping to make the lives of the people there better.
Steven C. Hall, MD, is an Anesthesiologist based in Chicago, Illinois.
