By Martin CahnChronicle Independent(Camden, S.C.)assistant editor
Camden orthopaedic surgeon Joe Jackson took a trip in March to Australia and the south Pacific island nation of Fiji. This was no ordinary vacation. Yes, he and his wife, Peggy, got to hook up with son, Joseph, who is helping write intellectual property policy in Canberra, Australia, for a non-profit group working on the genetic engineering of plants.
Yes, he got to go snorkeling along the Great Barrier Reef and visit Ayers Rock. But he also helped train and work with physicians at Fiji's Colonial War Memorial Hospital. There, he spent a week teaching physical therapists, medical students, and the medical staff different techniques to treat a number of bone and other related injuries and deformities.
It's all a part of his work with Orthopaedics Overseas, a division of Health Volunteer Overseas, a private, non-profit organization founded in Washington, D.C., in 1986 dedicated to improving global health through education and training.
Jackson was also there on behalf of the Surgical Implant Generation Network (SIGN), another non-profit group dedicated to creating equality of fracture care throughout the world. "SIGN was founded by Dr. Lou Zirkle, who served as an orthopaedic surgeon during Vietnam," said Jackson. "He became aware of problems in the developing world. By 2020, he believes, trauma will be the No. 1 health problem in the developing world."
What SIGN does, said Jackson, is help supply kits made up of low-cost metal rods that can be implanted in a patient's tibia, the weight-bearing bone of the lower leg, or femur, the thigh bone. "It's all funded by private money; SIGN even has its own factory and has conducted 20,000 implants in 18 hospitals in Vietnam and in 30 other countries," Jackson said.
He said that in the U.S., physicians are required to use sophisticated X-ray equipment to help guide the implantation of such rods. Developing nations like Fiji, however, don't usually have access to such devices, said Jackson.
The kits, which he said
are set up in duffle bags, cost about $15,000 each but are given to the receiving hospital free of charge through private donations. "They're made up of one set of tools and 100 nails. We only have two rules: the host country can't be charged for the kits, and everything has to be entered into a database accessible on the Internet," he said.
Jackson said he hopes that database will lead to global collaborations and coming up with new ideas.
The stainless steel tools are non-powered. Physicians do everything by hand, using special L or T-shaped handles and other devices to implant the rods. They are easy to sterilize and use, said Jackson. It may sound painful and crude, but it does what it's supposed to, he said: get people back on their feet.
Jackson said Colonial Memorial is "pretty rustic" and that, once the staff there found out he specialized in hand surgery, asked him to help out in that area, too. "They gave us a place to stay about a block away in the capital of Suva, and we met some doctors from Bangladesh who were helping, too," said Jackson. "Everyone was very cordial, smart and eager to learn."
He said Fiji is a place where, due to the lack of modern medicine, there is a lot of neglected trauma. "Students have to intern on remote islands, with no phones. They might have a two-way radio. Some medical students don't even have access to cadavers to practice on," he said. So, Jackson agreed to help out with some hand patients, including one boy who needed to get back the use of one of his hands for a very important reason: both deaf and mute, he has to sign to communicate.
"He had a fracture in his forearm. He was supposed to have changed out a splint for a cast but never did. Every time he lifted his hand, two of his fingers would pull down, so he couldn't sign properly," said Jackson.
The boy's hand and arm were numb in certain places, leading to the conclusion that the fracture was doing some kind of nerve and muscle damage, Jackson said.
Surgery consisted of freeing up the constriction around the nerve and freeing up the tendon. "I showed the students how to do it by drawing on an operating room cloth," said Jackson. "The next morning, the patient had normal feeling. He was beaming; everyone was thrilled."
In another case, a man's flexor tendons, the tendons connecting through the wrist to the small hand bones, had been damaged. Jackson, who had worked on flexor tendon injuries at Walter Reed Army Medical Center in D.C., assisted with that surgery, too.
Normally, a special rubber band would be attached to the man's finger to help fix the laceration, but Colonial Memorial didn't have one. "So we had to improvise and use part of a rubber glove," said Jackson. He said that case is indicative of Fiji's greatest need: getting young men, the breadwinners in most Fiji households, back to work, whether that be in a field or office.
"You can give a man a fish and feed him for a day, or teach him how to fish and feed him for a lifetime," Jackson quoted the old saying. "If the breadwinner's in the hospital, then the whole family goes down the tubes. We can't help everybody or fix everything, but if we concentrate on getting the young breadwinners back to work, then I think we've made the most impact."
It wasn't all work in Fiji, especially after son Joseph flew the four hours from Australia to meet them. "Fiji is made up of hundreds of islands, and we went jet skiing around a few of them, including ones they said Tom Hanks used to film 'Castaway,'" he said.
From there, it was on to Cairns on Australia's northeast shore and the Great Barrier Reef. Visiting Ayres Rock, located in the center of the continent, was a mystical experience, said Jackson, who took an astronomy class while there. "We got to see the Southern Cross, Saturn's rings and Mars," he said.
They also visited Melbourne and Canberra, where Joseph will work for several more months. "We went to a military museum there," said Jackson. "The Australians were a big part of the Great War and World War II, and they've never forgotten it. But the best part was that Peggy was with me."
A good thing, too, since, back on Fiji, Jackson came down with conjunctivitis. Luckily, the doctors there were able to treat him. "I went there to share my knowledge and left them a CD for self-learning. They have so many things they have to take care of: teens and children with burns, neglected club feet.
I regret that I wasn't able to spend more time there to do this," Jackson said. With both Health Volunteer Overseas and Orthopaedics Overseas celebrating their 20th anniversaries, and SIGN going strong as well, there's always a chance Jackson will get to go back.
In the meantime, he's glad Zirkle came up with the kits, and that he got the chance to work with SIGN. "Orthopedists are basically tinkerers. We like to fix things," said Jackson, "and help doctors that are in their home countries. I'd like to think we're bringing modern medicine to the world."