Skip to contents
In This Issue:
As a teenager spending summers in Haiti, Alexi Matousek, MD, used to hike to the local hospital from the mountain village where his family ran a nonprofit literacy program. Matousek spent hours watching surgeons in a barebones suite extract tumors, close up wounds and treat other conditions common in poor countries. “I wanted to be a surgeon because of that experience,” he recalled.
Matousek soon realized he also wanted to help improve surgical care in the impoverished Caribbean country.
People in resource-poor countries bear a disproportionate burden of surgical disease, whether from advanced cancer, complicated childbirths, traffic accidents, infected wounds or burns. However, more than two billion people worldwide lack adequate access to surgical care, according to a 2010 study by Harvard School of Public Health (HSPH) investigators.
Now a clinical resident in surgery at BWH, Matousek is pursuing his dream. In July, he and colleague JaBaris Swain, MD, will inaugurate a new residency track in academic global surgery. The two-year Global Health Equity Residency in General Surgery is designed to train academic surgeons in the science and practice of surgical care delivery in austere settings. The residency, which augments the standard five-year surgical training requirements, is also designed to inspire research and policy leaders in the new field.
Matousek and Swain will pursue master’s degrees at HSPH, followed by a year of fieldwork (with Matousek in Haiti and Swain in Rwanda), before completing their surgical training in Boston. The track, housed in the BWH Center for Surgery and Public Health, is one of the few global surgery residencies in the U.S., said Associate Surgeon Robert Riviello, MD, MPH, who developed the program. “We’re seeking to build a cadre of people to engage as thought leaders in this field,” he said. “Our goal is to create a program that, over time, moves the needle of surgical care and delivery for destitute sick and injured populations.”
The residency builds on the international experiences of BWH surgical residents Gita Mody, MD, MPH, and Kendra Bowman, MD, PhD. It also expands on efforts at BWH and the wider Harvard community to promote health equity and relieve suffering near and far. For example, BWH faculty, students and colleagues have developed several low-cost surgical tools, among them a wound pump, a pulse oximeter and a safety checklist championed by Atul Gawande, MD, MPH.
“This is truly a ground-breaking effort, and one that promises to shape academic global surgery as a career track,” said Samuel Finlayson, MD, MPH, Kessler Director of the Center for Surgery and Public Health. “Our hope is to tap the Center for Surgery and Public Health’s expertise in rigorous health services research to address the significant challenges of surgical care delivery in resource poor settings. We thank many people for getting this program off the ground, especially Dr. (Michael) Zinner and Dr. (Betsy) Nabel. Their support has been invaluable.”
Zinner, BWH’s surgeon in-chief and the Mosely Professor of Surgery, noted that establishing this program has been a key milestone for the Center for Surgery and Public Health.
“This program is testament to our commitment to establishing and supporting necessary infrastructure, providing important resources, and fostering local relationships to ensure those in under-resourced settings have access to quality health care,” he said. “The Global Surgery Residency will transform the way our surgical trainees think about care and further enrich their development in ways that will benefit patients globally and locally.”
During his year in Africa, Swain plans to examine the costs and benefits of cardiac surgery interventions in the developing world. He’ll be amplifying his work with Team Heart, a volunteer group of BWH and MGH employees helping to build a cardiac surgery program in Rwanda, especially for patients with rheumatic heart disease—a sometimes fatal but preventable condition caused by uncontrolled infections.
Matousek plans to establish an electronic medical record for the teaching hospital Partners In Health is building in Mirebalais, Haiti. The goal is to smooth daily workflow for surgical providers and track outcomes for quality improvement purposes.
Swain and Matousek applaud BWH’s surgical leadership for supporting contributions to global health.
“I’m excited about working on these challenges for the rest of my career,” Matousek added. “That’s why I came to the Brigham.”
JaBaris Swain cares for a cardiac surgery patient in Rwanda.