Nina's Reading Blog

Comments on books I am reading/listening to

Posts Tagged ‘Tony Bartelme’

A Surgeon in the Village: An American Doctor Teaches Brain Surgery in Africa

Posted by nliakos on February 17, 2019

by Tony Bartelme with Catharina Hoek-Ellegala (Beacon Press 2017)

Dilan Ellegala is a Sri Lankan-American neurosurgeon. In this engaging narrative, Tony Bartelme tells how Ellegala escaped the craziness of an academic superstar neurosurgeon career to spend six months in a small village hospital in Tanzania. What he finds there changes his life, his career focus, and his priorities. He realizes early on in his time at Haydom Lutheran Hospital that the constant stream of visiting foreign doctors and medical students has the unfortunate consequence of teaching the Tanzanian staff to doubt their own abilities, to depend upon outside help to do their jobs. Ellegala had an idea: he would teach one of the staff, a young man named Emmanuel Mayegga, how to do simple brain surgery. Mayegga was not a doctor, just an Assistant Medical Officer (AMO), so this might seem overly optimistic, but in fact, he did learn to do brain surgery from Ellegala, and he later taught a young Tanzanian doctor fresh out of medical school what he had learned. The young doctor, who eventually became the hospital’s director, taught a second young doctor. Ellegala had not only succeeded in replacing himself; he had launched a chain of teaching surgeons at the hospital, where surgery had never been done before except by visiting “medical missionaries”. He then became infused with the desire to start an NGO devoted to sending Western surgeons to teach African doctors to perform surgery, rather than sending them to do the surgeries that the African doctors were unable to do. Thus was born Madaktari Africa. Hundreds, then thousands of babies, children, and adults, who would have died without surgery, could now be saved.

This forced me to think about the down side of modern medicine. It works too well. People who would have died instead survive and go on to have children. Earth’s population explodes. People accustomed to having large families to ensure that enough children would survive to adulthood to carry on their genes (and farm their land and take care of their elderly parents) now find themselves struggling to support all those surviving kids. Food, water, and jobs are all in short supply. Of course, I speak from a position of huge privilege; who am I to say that I should live and Tanzanian children should not have the same chances that I had? I cannot say that, yet whenever I read or hear of how many deaths have been averted by this or that medical technology or wonder drug, I cannot help but think that what seems like a good thing can have unintended negative consequences. Sure, if modern medicine went away and antibiotics no longer worked (something that is already happening anyway as bacteria become resistant to the antibiotics that we have) and surgery were no longer an option, we would all live shorter lives. As it is, we are crowding out other species (both plants and animals) and are already starting to see the effects of over-population: wars and massive refugee crises.

What is the answer? Is there an answer?


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