International Medical Missions and Clinical Rotations

Gabriel J. Martinez-Diaz
Stanford University School of Medicine
Operation Rainbow - Ecuador 2007
Cuenca, Ecuador

During the last week of October of 2007, I had the pleasure of joining the Operation Rainbow Ecuador 2007 team, led by Dr. Richard Gosselin. A team of thirty four doctors, nurses, physician assistants, technicians, interpreters, and trip organizers flew into Guayaquil, to then move together to our final destination of Cuenca, Ecuador. The trip was organized, so that in our first day in Cueca, we got accustomed to the high altitude setting, and also prepared for the first day in clinic. we were fortunate that the team of local doctors did an outstanding job pre-screening patients for our mission. On Sunday, October 20, we saw over 70 patients with orthopaedic complaints. Most of the cases were children, but there were a few adult cases that generated interests in the physicians, and were added as surgical candidates.

My main role in this trip was to serve as a medical interpreter, as well as helping with any patient issues that aroused after surgeries and during the each day. I had the opportunity to "scrub-in" a few cases, as well as observed others - both with pediatric orthopedic surgeons and general orthopedic surgeons. To me, it was surprising to see the large number of congenital hip disorders, as well as a case of osteogenic imperfecta - for which I never thought in my life I would see it. We had a very special patient - Luis - whom Dr. Gosselin operated on a prior trip with Operation Rainbow - for a novel case of Bilateral Hip Fusion secondary to Slipped Capital Femoral Epiphysis (SCFE). He had done one of the hips approximately eleven months prior to our trip, and had planned an total hip replacement for the second hip for this trip. The surgery went well, and we were able to follow up on Luis for five days post-operatively.

I will particularly remember the faces of the patients, as well as their family members, once the surgeries were completed. All of them were truly appreciative of the help that they received from our team. The people in Ecuador were very hospitable and accomodating of all of our needs, for which I am very thankful for. Overall, this experience was a great one, and I can't wait to have another opportunity like this in the near by future.

Dr. Richard Gosselin, MD, MSc, team medical director and mentor, and Gabriel J. Martinez-Diaz

This is a picture of one of Guayaqui's cathedrals.

(from Left to Right) Gabriel J. Martinez-Diaz, Dr. Larry Stevenson, and Dr. Richard Gosselin

(from Left to Right) Dr. Richard Gosselin, Gabriel Martinez-Diaz, and Dr. Larry Stevenson

Eugene Yim, SMS III
Stanford University School of Medicine
Trip with Orthopedics Overseas
Yanji, China
Jan 2007

With the help of Dr. Coughlin, I was connected to a orthopedist, Dr. Paul Lee, who travels frequently to Yanji, China to teach and train local physicians at Fuzhi Hospital.  The hospital was founded by South Korean missionaries as a partnership with the local Chinese population; since then, the hospital has become a hotbed for international collaboration that focuses on rural capacity development in the health sector.  Under the auspices of Orthopedics Overseas, Dr. Lee has worked over the last few years to develop a training program for native Chinese orthopedists.  Since no formal training programs have been installed in China, these missions have been critical for the orthopedists trained at the hospital.  These local orthopedists have benefited greatly from exposure to the numerous physicians that have traveled with Orthopedics Overseas to that hospital.  For a couple weeks during my winter break, I was able to shadow Dr. Coughlin as he made one of these visits to the hospital.

During my time in Yanji, I was also able to explore my personal interest in humanitarian aid efforts focusing on North Koreans.  The Fuzhi Hospital is well connected to the numerous foreign agencies stationed in Yanji and was able to set up a number of meetings with those agencies.  Through funding from the Center for Family and Community Medicine at Stanford Medical School, I met with these NGOs and developed an informal asset map of the humanitarian aid organizations in the area.  These NGOs are stationed strategically in Yanji, only a couple hours from the China-North Korea border.  While visiting the NGOs, I was asked to develop a TB guideline document for the loose connection of community clinics that serve vulnerable populations in the area.  Through consultation with TB experts at WHO in China, China CDC, and Partners in Health, I compiled a policy document for the clinics.  The experience with these NGOs and also with Dr. Lee with Orthopedics Overseas has expanded my view of what orthopedists can accomplish in foreign countries and has grown my desire to work in that setting in the future.

Here are the originals pictures of my trip with captions:


The OR suite at Fuzhi Hospital.  Local Chinese-Korean physicians watch as Dr. Lee performs a procedure on a patient.  Advanced cases are postponed when possible until Dr. Lee can come to teach techniques that have not been learned by the local surgeons.

Dr. Lee (right) is seen operating on a patient at Fuzhi Hospital.  The chief orthopedic physician at the hospital is seen watching from the left side.


Dr. Lee (right) seen operating on a patient at Fuzhi.  The chief orthopedic surgeon at Fuzhi can be seen in the middle assisting Dr. Lee. 


Afternoon clinic at Fuzhi Hospital.  A child from a local orphanage is being seen by Dr. Lee for a hip disorder.  Many of these orphans are of Korean descent and have little access to specialized medical care.  The chief orthopedist at Fuzhi can be seen on the left assisting Dr. Lee.


Eugene Yim (right) seen with the coordinator of social services at Fuzhi Hospital, Sujin Lee (left).  The social services office at Fuzhi is responsible for managing patients receiving welfare insurance and is also well connected with the local NGOs that serve vulnerable populations in the area.  Eugene was connected to these NGOs through this office at Fuzhi.


Another picture of a procedure at Fuzhi Hospital.