Jeff Carney and Edwin Smith Make 7th Surgical Trip to El Salvador

Dr. Carney (left) and Dr. Smith (center) at Bloom Hospital.

Dr. Carney (left) and Dr. Smith (center) at Bloom Hospital.

February 2016

Emory Urology surgeon Jeff Carney, MD, doesn't refer to the annual surgical trips he takes to Benjamin Bloom Children's Hospital, San Salvador, with Georgia Urology and Children's Healthcare of Atlanta (CHOA) surgeon Edwin Smith, MD, as a mission. Instead, he prefers calling them a "campaign."

"We assemble the team, book the flights, and get the medical supplies together," he says. "We pay all the expenses ourselves. Our focus is to continue transferring our knowledge to the El Salvadoran pediatric surgeons we work with, who have already progressed to the point that they can do certain pediatric urologic procedures without us. Now they just save the really complex cases for our visits, do them with us, and keep learning."

Drs. Carney and Smith have been going to Bloom Hospital — the only public children's hospital in El Salvador — for seven years, with their most recent visit being February 6-13. Their long-standing team includes Brenda Middlebrooks, RN, of CHOA; Gerda Swenson, RN, of Georgia Urology; Louis Perez, MD, a pediatric urologist based in Charlotte, NC; and Dr. Perez's daughter, Anna Nicole Perez, RN, of the Newborn Critical Care Center at UNC Children's, Chapel Hill. Once at Bloom's, the team is joined by El Salvadoran pediatric surgeons Eduardo Rodriguez, MD, and Uriel Perez, MD. During the 2016 trip the group performed 35 surgeries, with complex hypospadias repair being the most common procedure.

This was Dr. Smith's 15th trip to El Salvador. "It all started when the non-profit Children's Cross Connection International contacted Dr. John Whelchel, a transplant surgeon at Piedmont Hospital, and asked if he could assemble a team to go down to Bloom's to do pediatric kidney transplants," says Dr. Smith. "I was part of that team. After a few years, Dr. Whelchel's group didn’t need to go anymore because Bloom's surgeons were able to do the transplants themselves, though the hospital still didn't have any pediatric urologists on staff, so I kept going back."

Dr. Smith originally recruited Dr. Carney because of his expertise with urethral reconstruction, a highly specialized and uncommon expertise, especially in El Salvador. Being the director of the Emory pediatric urology fellowship for the past 19 years, Dr. Smith was also able to arrange for the trips to be a regular feature of the fellows' training experience.

"The trips have certainly benefitted from the fellows' participation," he says, "and they in turn have had a great opportunity to learn the value of international service." The current fellow was unable to do the 2016 trip.

Despite problematic conditions within El Salvador's public health sector, such as a faulty infrastructure and the limited access to services experienced by its poorer citizens, Drs. Carney and Smith find the working conditions at Bloom's reasonably reliable and comfortable. This year was somewhat complicated, however, by the appearance of the Zika virus in the country, which has one of the highest rates of the infection in Latin America.

"We had to take special precautions to control patient exposure to mosquitos," says Dr. Carney. "Basically, we took a lot of repellant with us and carried on like we always do."

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