A Mission With No Completion Date

Dr. Medhat Allam, center, with members of his team and children in Uganda.

Dr. Medhat Allam has a difficult time picking just one humanitarian medical mission as the most memorable, explaining that every single one of the 54 undertaken by his Southampton Village not-for-profit over the past 22 years inevitably creates unique — and equally moving — memories.

For example, volunteers with Operation International’s New York team — one of eight across the nation now overseen by the organization, all featuring a mix of surgeons, anesthesiologists, nurses and other staff — were still setting up three portable operating rooms in Rakai, Uganda, in April when they had to stop and perform an emergency caesarean section.

The woman, Dr. Allam explained recently, had already started to give birth — one of her baby’s hands was protruding — and doctors could not locate her baby’s heartbeat. After performing the surgery, volunteers immediately initiated CPR and were able to save the baby’s life as well.

Working 16-hour days for the next week, team members would go on to perform 72 major surgeries, including the removal of oversized cysts and tumors, to the correction of congenital anomalies, such as clubfoot and cleft palate, while tending to more than 350 adults and children living in a rural section of the landlocked East African country.

Then on a separate mission to the Philippines last year, surgeons successfully separated the fused legs of a 6-year-old boy after he suffered severe burns on his lower extremities. The complex surgery took several hours to complete, and the boy — who shared with doctors his dream of one day being able to ride a bicycle — then completed several months of physical therapy so he could learn how to walk again.

Upon learning that he had finished his recovery, Operation International bought the boy a bicycle and arranged for its delivery to him.

“When I saw the video of him riding the bike, I had tears in my eyes,” said Dr. Allam, a general and bariatric surgeon at Stony Brook Southampton Hospital who, in 1996, co-founded Operation International with two colleagues: Dr. Robert Mineo, a nurse anesthetist at Stony Brook Southampton Hospital, and Dr. Ravi Kothuru, chief of thoracic surgery at Kingsbrook Jewish Medical Center and Brookdale University Hospital Medical Center, both in Brooklyn.

“This is another memorable moment in one day in one mission,” Dr. Allam continued, referring to last year’s journey to the Philippines.

And those moments are just from two recent missions, completed less than two years apart.

To date, the three longtime friends and associates have helped schedule trips, raise funds, coordinate the shipments of medical supplies and enlist fellow volunteers en route to completing nearly five dozen medical missions, each lasting between 10 days and two weeks, and each benefiting scores of newborns, children and adults in impoverished and underserved communities around the world. The three doctors, as well as the more than 200 medical professionals now under their charge, have completed more than 3,000 surgeries, as well as provided care to thousands of others while visiting roughly two-dozen countries, including Guatemala, Haiti, Ghana, Ecuador and Nepal.

While they are continuing that mission with the help of a constantly growing army of volunteers — plans are now in the works to create ninth medical team based out of Hong Kong and whose members would be the first residing outside of the United States — Dr.  Allam, Dr. Mineo and Dr. Kothuru have also slightly modified their priorities over the past two decades. In addition to providing emergency care, they also make sure their teams offer hands-on medical training and educational classes to local health care workers so the healing can continue after volunteers have packed up their gear and returned to the United States.

But their mission does not end there either.

The more established squads, including Team New York and Team Ear Nose and Throat, the latter of which is based in Brooklyn, are continuing to develop the connections they have during their visits. In Team ENT’s case, members have made a commitment to those they previously assisted in Guatemala and are now working on training local surgeons, upgrading equipment at the local hospital and establishing new programs. Meanwhile, members of Operation Kids, a New Jersey-based team that has completed nine missions in seven countries since its establishment, recently signed a five-year commitment in Ghana, promising to continue to work to improve both the infrastructure of the local hospital and the training received by doctors there.

In their other free time, volunteers distribute much-needed supplies, such as food and mosquito netting in some of the more exotic locales. Others visit local orphanages so they can deliver food, clothing and other necessities.

“The amount of work that goes into a successful mission is tremendous,” said Dr. Kothuru, noting that volunteers sometimes carry between 80 and 90 bags of medical equipment and supplies onto the airplanes themselves. “And no matter how well we prepare we are always getting hit by some unexpected roadblock so that we have to improvise.”

Dr. Medhat Allam and Nurse Anesthetist Bob Mineo, photographed in Dr. Allam’s Southampton office on Wednesday, 5/30/18. Michael Heller photo

Three Men, One Mission

In addition to working together at different points during their respective careers, Dr. Allam, Dr. Mineo and Dr. Kothuru share common ground in another critical area: a desire to provide free medical care to those who lack access to it.

The need hits close to home for Dr. Allam who grew up in El-Mahalla, a small town in Egypt’s Nile delta, and who, at a young age, watched his 14-year-old cousin, Ayman, die from a treatable infection after suffering second-degree burns.

“I just couldn’t believe that children can die like that, and it wasn’t that nobody cared, it just was the lack of resources and education,” said Dr. Allam, who has lived in Southampton since 1996. “He was talking and viable for several days before infection and sepsis took his life. Looking back I know all he needed was antibiotics and IV fluid, none of which was available.”

Dr. Medhat Allam with a young patient.

Dr. Allam’s natural empathy can also be attributed to his late mother, Mahrousa, who worked as a nurse at a hospital run by the Misr Spinning and Weaving Company, a publicly owned textile company in Egypt. She started as an operating room nurse before being placed in charge of the hospital’s outpatient and clinic area, where she was entrusted to lance abscesses and distribute medications.

The doctor credits his mother for instilling in him what is largely lacking in the field of medicine these days: compassion. He explained that she often treated patients at their house, typically in the evenings after work, and never once complained about what some would consider an intrusion. “She never said no to anyone and never charged anyone a single penny,” Dr. Allam said. “She thought it was part of the reason she existed.”

Though he says there were other factors that also inspired him to become a doctor, such as the respect shown to healers in his native Egypt, Dr. Allam said his dream of one day founding a not-for-profit started to take form as he was still learning the ropes of the field. After graduating from medical school, and shortly after moving to the East End, Dr. Allam said he reached out to Dr. Kothuru, with whom he first shared his dream, to see if he’d be willing to come along for the ride. The two men met while both were residents at Brookdale University Hospital Medical Center in the early 1990s; Dr. Allam was chief resident and Dr. Kothuru was his junior resident at the time.

Dr. Kothuru, who has joined Dr. Allam on every single one of their missions aside for the 2016 trip to Tanzania, said he thinks their not-for-profit is successful because it offers flexibility to volunteers. Unlike most similar organizations, the doctors founding Operation International were fresh out of medical school and just starting their own private practices, meaning they did not enjoy the same luxuries as their older and more-established counterparts.

“Our team, when it was started, was unique because we were almost like neophytes,” said Dr. Kothuru, who hails from India and now lives in New York City. “We wanted to have a say in how we could go, when we could go and for how long we could go.”

He explained that, in many instances, volunteers also had spouses and young children at home, and whom they were expected to leave for up to two weeks at a time. Therefore, the flexibility given to the individual teams—they get to pick when, where and how long their missions will last—also made for a successful formula, according to Dr. Kothuru. “The family commitment to this cause is so important,” he said, “so we’re all really blessed to have that also.”

As for motivation, Dr. Kothuru said he grew up in India where he and others are always taught that, when capable, they should give back to their community. At the same time, he admits that he was a tad surprised when his former colleague called him in 1996 and invited him and Dr. Mineo on the maiden mission to Haiti.

“Both of us never ever dreamed that it would happen the following year,” said Dr. Kothuru, who had lunch almost every day with Dr. Allam when they worked at Brookdale.  “The three of us went to Haiti … and we did about 35 or 36 cases in this one room.”

“We struck a friendship, and often enough I talked about that dream, and he started to dream with me,” Dr. Allam said of Dr. Kothuru.

Shortly after moving to Southampton, Dr. Allam met Dr. Mineo, who was already working at what was then known as Southampton Hospital as a nurse anesthetist, and shared his dream with him as well. Dr. Mineo was one of the first people to sign up for Operation International’s inaugural mission in 1997.

“He is the best,” Dr. Allam said or Dr. Mineo. “I think of him as the keel of the boat—not visible but invaluable.”

Doctors from Operation International’s New York team.

More Work To Do

Even though he only recently returned from a mission to Uganda, Dr. Allam caught a flight back there on May 31, along with members of Team Maryland as they set off on their maiden medical mission. Members of that team, who include general practice doctors as well as those who specialize in head, neck and plastic surgery, will continue the work of their predecessors who have adopted the region and are continuing efforts to ensure that the nearly 500,000 people living there continue to have access to medical care.

“The goal is to teach them how to run a medical mission under difficult conditions and get them started in the right direction,” Dr. Allam said over Memorial Day weekend while finalizing his travel plans.

Though he and his associates have families and demanding jobs, Dr. Allam insists it isn’t too hard to plan missions that require traveling thousands of miles and the delivery of hundreds of pounds of medical supplies. He notes that much of the planning can be done before work and in the evening hours, and it helps that Operation International is never short on volunteers.

He explained that those who step up are often eager to do so again as they cannot help but establish relationships with those they are training in their stead, not to mention the feelings that they return home with after a mission is completed.

“Other important factors are more inner and difficult to describe,” Dr. Allam said, explaining his motivation. “You see, the patients I treat here in the USA can get their treatment done by many other surgeons in my absence, but those in poor countries—they really need me, and I think I need them as much.

“They give the feeling of gratification, the feeling that I am actually doing what I was meant to do, to share knowledge, to extend a hand, to bring healing,” he continued.

That’s not to say that they also don’t learn from their mistakes or, more precisely, the unanticipated obstacles of their earlier missions. “Every mission teaches you something new, no matter how experienced we are as a team now,” Dr. Kothuru said.

As for how long he intends to keep at it, Dr. Allam offers a simple retort: “Until death do us part.”

An Immediate Need for New Ambulance

The nearly 500,000 people living in the Rakai section of Uganda, a landlocked East African nation, rely on a single hospital for their emergency medical care.

That facility, Rakai General Hospital, employs only four physicians, according to Dr. Medhat Allam, a general and bariatric surgeon at Stony Brook Southampton Hospital.

And those doctors must rely on a single outdated ambulance whenever they must transport patients during emergencies.

It is a situation that Dr. Allam, co-founder of Operation International, a Southampton Village-based not-for-profit dedicated to providing emergency medical care to impoverished nations, describes as grim.

“The existing ambulance is decades old vehicle with no stretcher, no interior lights, and no patient’s vitals monitor,” Dr. Allam wrote on the a newly launched crowd-funding page that looks to raise $100,000 in donations—money that would go directly toward the purchase of a new ambulance.

“Currently, patients in crisis often don’t reach medical help in time; some don’t make it to the hospital at all,” he continued. “At a cost of under $100,000 we can together save thousands of lives by donating an ambulance.”

Dr. Allam, who returned to Uganda on May 31 even though he and members of Operation International’s Team New York just completed a medical mission there in April, said the hospital in Rakai is under-funded and, as a result, also understaffed. In addition to performing 72 major surgeries, and providing care to another 350 individuals during their two-week mission, team volunteers also delivered more than $600,000 in assorted medical supplies.

To learn more about the initiative, or to make a donation, visit crowdrise.com/o/en/campaign/ambulance-needed-for-hospital-in-uganda.