Partnering to Reduce the Burden of Disease

18 Jan Partnering to Reduce the Burden of Disease

Volunteer surgeon Dr Mark Shrime, believes he has learnt as much as he has taught during his many years at Mercy Ships.

Working with a global network of surgeons has been a constant learning curve for him and everyone he has worked with.

Dr Shrime learned one of his biggest lessons from Mercy Ships veteran surgeon Dr Gary Parker: surgery is not just about technique or skill. It’s about confidence.

“As soon as you start getting scared, you start to pull back, and you stop doing this particular case and you stop doing that particular case,” he said. “And as a result, the more difficult cases just go untreated,” Dr Shrime said.

When Dr Shrime visited Zambia to work with partner organisation CURE International in the autumn of 2021, he wanted to pass on this lesson and others.

He had an opportunity when a patient was brought into the operating theatre at the University Teaching Hospital in Lusaka, Zambia. It was a child with a cleft palate.

Dr Chris Kapeshi, the senior maxillofacial surgeon in the country, gestured for Mercy Ships volunteer ENT surgeon (specialising in treating diseases of the ear, nose, and throat) Dr Shrime, to lead the surgery.

Dr Kapeshi had performed many tumour removals, but cleft palates were relatively new for him. Dr Shrime was in Zambia sharing a very specific cleft palate repair technique.

“I said, ‘No, you’re operating here,’” Dr Shrime recalled with a laugh and encouragement.

Dr Kapeshi agreed to lead and began the procedure, working cautiously, with his mentor beside him.

“After 20 minutes, you could see it click in his head. Then, I’ll tell you, it was true knowledge transfer,” said Dr Shrime.

When the surgery was over, both doctors knew something important had happened.

“He [Dr Kapeshi] literally said, ‘I will start doing these cases now,’” Shrime said. “‘I’m going to start doing cleft palates now.’”

The moment was the highlight of Dr Shrime’s two weeks in Zambia. He spent time working alongside staff at both the University Teaching Hospital and a CURE International Hospital.

“I’m really excited to just be part of that partnership,” Dr Shrime said. “CURE needed a bunch of surgeons and anaesthesiologists. It was a neat, collaborative programme.”

He’s one of several Mercy Ships volunteers who have travelled to Africa during the COVID-19 pandemic, as Mercy Ships pivoted in response to the pandemic and found new ways to bring hope and healing. In 2021, Mercy Ships began partnering with CURE International to help support and staff their hospitals, bringing accessible surgery to patients across Africa.

In addition to working with Dr Kapeshi, Dr Shrime worked with two ENT residents: a doctor who had just finished his training and a trainee at CURE. He also delivered a lecture to the Surgical Society of Zambia.

Although he did impart some new techniques, he said it’s important to avoid a “colonial framing” of medical partnerships in Africa. His relationship with Dr Kapeshi is one example.

“Spectacular surgeon, he taught me some techniques that I really like and will incorporate into my practice,” Shrime said. “The man’s done, guaranteed, more surgery in his life than I’ve done in my life.”

The relationship, Dr Shrime said, is one between colleagues. Not mentor and mentee.

“We have a WhatsApp group now and we’re sharing cases with each other,” he said. “There isn’t this idea that I am a font of knowledge that I will bless you with.”

Within these collegial relationships, Dr Shrime believes it’s important to teach new techniques–even to fully trained surgeons.

“The burden of disease is so large, and the number of surgeons is so small,” he said.

There are two maxillofacial surgeons in Lusaka, Dr Shrime said. Dr Kapeshi is one of them.

“You have excellent surgeons who simply haven’t seen the particular technique,” Dr Shrime said. “So it’s not like you’re coming in and being like, ‘Let me teach you to be a surgeon.’ It’s, ‘Here’s a particular technique for a particular disease.’ And I think that’s really important, because otherwise, the burden of that particular disease isn’t necessarily getting treated.”

Thanks to partnerships like this Mercy Ships and CURE International can address the global surgery crisis and provide essential services to patients who need life-changing care – while also sharing vital knowledge to all involved.

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