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The Heart of BIDMC

BIDMC Interpreters Lead Medical Mission to Africa

Team up with physicians to bring urologic care to Cape Verde

by Kelly Lawman
Beth Israel Deaconess Medical Center Staff

Since emigrating from Guinea-Bissau on the west coast of Africa to the United States in 1997, Bubacar Balde, medical interpreter at Beth Israel Deaconess Medical Center, has dreamed of a ways to give back to his country.

"I always wanted to find a way to help our people back home," said Balde.

Two years ago Balde approached fellow medical interpreter, Ernestina Damoura-Moreira and shared a brewing idea to organize a medical mission to bring much needed health care services from BIDMC to Africa. Damoura-Moreira immediately signed on, but there was a catch, Balde's country - Guinea-Bissau - was politically unstable and it seemed impossible to bring the mission there.

Damoura-Moreira suggested that her own home country of Cape Verde, just off the west coast of Africa might be more feasible. Balde agreed.

"Africa for Bubacar means the whole Africa. It didn't matter to him where the mission went," said Damoura- Moreira. The two invited co-worker Luis DaCosta, also from Cape Verde to join them.

"I came into it, got up to speed and from there we never stopped," recalls DaCosta.

Cape Verde, by contrast, is politically stable and the medical system has steadily improved over the past several years, but there is still great need in the country. DaCosta and Damoura-Moreira shared memories of witnessing men who lived with discomfort for years and others who actually died from infection or other urologic complications. They discovered that the entire population of Cape Verde - nearly a half million people - was served by just one urologist.

This fact, combined with knowledge of the volume of Cape Verdean patients seen at BIDMC each week for urologic concerns, brought the focus of the mission to urology and to the attention of Michael Kearney, MD, director of BIDMC's community urology clinic.

"Doing missionary urology has always been something I wanted to incorporate into my practice," said Kearney, "but, I always thought that it would have to be later in my life. Running the community clinic and interacting with the interpreters helped me realize that maybe this could be manifest earlier."

With Kearney on board, the planning phase began. The team started collecting donated medical supplies, coordinating with the Cape Verdean consulate, looking for a host hospital, and arranging for an additional interpreter, Carla Iozza, and two urology residents, David McDermott, MD and Ravi Kacker, MD to join the team. The mission was at last scheduled for late November 2010.

Damoura-Moreira wasn't able to make the trip, but she did escort her colleagues to the airport. "I was so nervous. I wanted to help check the bags and make sure they actually got on the plane," recalls Damoura-Moreira. "And I wanted to let them know how proud I was that we were actually doing it."

When the team arrived at Hospital Regional de Santiago Norte in Santa Catarina, patients were lined up to see them, and over the course of the next 72 hours, the interpreters, Kearney, the residents and Joao Tavares, MD, an internist from Miriam Hospital in Providence, Rhode Island, saw some 90 patients and completed five surgeries. The surgeries included "the first trans-urethral resection, which is a telescopic resection of a prostate that allowed someone who hadn't urinated in 10 years to be able to urinate on his own," said Kearney.

Several Cape Verdean physicians were also on hand to observe and learn from the BIDMC team. "More than anything else, it was a teaching environment," said DaCosta.

"The goal was to try to improve urological care while we were there," added Kearney. "We wanted to start the process of training Cape Verdean doctors to be able to do these procedures on their own."

Tired, but satisfied with their success, the team returned to Boston three days later already planning for next year. They hope to continue the work in urology and to expand to other areas of medicine in and outside of Cape Verde. "We plan to create an organization that will help us go on a yearly basis and teach people what to do." said Balde. "I really 100 percent believe this project has more than legs, this has wings to fly too."

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted March 2011