A year had passed since a young man came to the clinic with severe joint disease in his hips that left him unable to stand up straight, his torso pitched forward about 45 degrees as he steadied himself on a crutch.
But thanks in part to a group of volunteer clinicians from the Brigham, he was now running laps up and down a hallway at a hospital in the Dominican Republic, where he had received bilateral hip-joint replacement surgery through Operation Walk Boston—an orthopedic medical mission founded by Thomas S. Thornhill, MD, former chair of the BWH Department of Orthopaedic Surgery.
The program partners with Hospital General de la Plaza de la Salud in Santo Domingo to perform hip- and knee-joint replacements for patients who can’t afford the procedures. It completed its ninth mission last month.
Seeing that young man run down the hall when he came back for a follow-up visit was an unforgettable moment—one that illustrates why BWH volunteers give their time to give back, said Judith Nagle, MSN, RN, CNOR, nurse-in-charge in the Orthopaedics Operating Room who has gone on every Operation Walk Boston mission since its launch in 2008.
“When people come back and show you what they can now do that they couldn’t do last year, it just overwhelms you,” said Nagle, who took on the role of scrub nurse in the Operating Room during the trip. “I only did my job; these patients did the hard work.”
The latest mission served 37 patients and resulted in 56 replaced joints over five days. To date, Operation Walk Boston has provided 380 people with joint replacements. Clinicians perform the procedures pro bono, and all supplies are donated.
Each year, the mission takes about 50 volunteers, including surgeons, anesthesiologists, nurses, physical therapists, pharmacists and Operating Room staff. That group also includes residents from Orthopaedic Surgery, the Department of Anesthesiology, Perioperative and Pain Medicine, and Pharmacy. Additionally, the team trains about 70 medical students in the Dominican Republic to help support local care providers.
Daniel Tobert, MD, a third-year resident in Orthopaedic Surgery, went on his first Operation Walk Boston mission this year. Although the days were long, often starting at 4:30 a.m., he says the experience was fulfilling both personally and professionally.
“Everyone on the trip is giving up their free time to do hard work—and, in some respects, harder work than we’d do in a normal week—but it’s an incredibly rewarding experience,” said Tobert, who will be the mission’s chief medical officer next year.
Sarah Kelly, PT, DPT, a senior physical therapist in the Department of Rehabilitation Services, also joined Operation Walk Boston for the first time and says she was humbled by not only how grateful the patients were, but also how hard they worked during recovery. Because the volunteers are there for such a short time, they have to get patients walking as soon as possible, sometimes within a few hours of surgery.
“It’s one of those trips that reminds you why you wanted to be a physical therapist in the first place,” Kelly said. “Patients who haven’t walked in years can finally get up and sit at the edge of the bed, stand on two feet or bend their knee a little more. To help somebody do that for the first time is unbelievable.”
Julia Rodriguez, RN, a staff nurse in the Post-Anesthesia Care Unit who has gone on several Operation Walk Boston missions, says she enjoys connecting with the patients and the Dominican clinicians and medical students. She also appreciates having the opportunity to speak her second language, Spanish.
“It appealed to me: going to a country that had fewer medical services than we have and being able to do mission work for patients who can’t afford this surgery on their own,” Rodriguez said.
Taking the Lessons Home
Volunteers say the mission also provided learning experiences they wouldn’t normally be exposed to and fostered a deep sense of teamwork. Nagle appreciated the opportunity to attend a grand rounds-style meeting where doctors discussed their plans for surgery that week.
“You get to hear their thought process, which adds a whole other dimension to my practice here at home,” Nagle said.
Learning is also a two-way street, she said. Over the years, BWH volunteers have trained hundreds of medical students in Santo Domingo and helped local practitioners improve their quality of care.
The limited resources during the mission can be challenging, but volunteers say they enjoyed having the chance to think critically and creatively to find solutions.
“It presents a situation we don’t normally have here, where you have an isolated opportunity to intervene surgically,” Tobert said. “This gives me experience in how to deal with more complex care decisions, which is something they don’t teach you in medical school.”