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A Need For Increased Volunteerism

By Charles Ekstein, MD

I’ll always be grateful for the training and mentorship that I received during my fellowship year, a formative compendium on hand surgery from some of the most respected surgeons at the Hospital for Special Surgery. From complex wrist reconstructions to total elbow replacements and everything in between, it was one of the most interesting years of my life.  They are learnings that will shape my first practice—at a teaching hospital where I’ll be lucky to influence others’ educational experiences as well.

As I do that, there’s just one thing I’d like to change: increasing exposure to volunteer experiences in our field, whether internationally or in our own backyards. Four months into my fellowship, I had the opportunity to join the Touching Hands Project in San Pedro Sula, Honduras. Founded in 2013 by Dr. Scott Kozin, the Touching Hands Project completed its first mission in 2014; four years later, it has helped almost 300 volunteers perform over 1,200 surgeries in 13 countries around the world.

Traveling in our group were a host of incredible surgeons including Dr. Andrew Weiland, Dr. Bobby Chhabra, Dr. Duretti Fufa, Dr. Fraser Leversedge, and Dr. Mark Elzik—plus multiple hand fellows from around the country, anesthesiologists, a nurse, and a hand therapist. We joined a local staff of scrub techs, OR nurses, and trainees in Honduras, and had one week to see and treat as many people as possible in one of the poorest countries in the world.

Going to Honduras gave me a front row seat to so many aspects of hand surgery that I hadn’t previously appreciated.  For example, thinking about severe barriers of care in the developing world had always been an abstract exercise for me until I found myself there, fixing a radial club hand with a second case unfolding within eyeshot. Between my table and the next, there was often nothing more than a small fragment set that served a week’s worth of patients; my colleagues and I pulled from it with clean gloves because that’s all we had. These circumstances—combined with complex diseases and a relative lack of resources—create the greatest crash course in thinking outside the box.

If thinking on my feet was one of the most important skills I tried to emulate from my mentors during fellowship, nowhere was this more evident than in Honduras. In addition, meeting and working with other hand surgeons from around the country was a great way to get exposure to different techniques and different ways of thinking.

As hand surgeons, there is a massive need for our skills, not only in the developing world, but here at home as well.  In addition to its international mission trips, The Touching Hands Project includes days of domestic outreach here in the USA.  Any fellowship program should consider involving its trainees in programs like these, both to foster critical thinking skills and instill the importance of volunteering in young talent.

I was lucky enough to be in the right place at the right time to have this impactful experience—one I hope to pursue again in the future.  Encouragement from program administrators for other fellows to do the same would no doubt leave an indelible positive mark on our industry as a whole.

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