JENNIFER BOULDEN

Dr. Lowry Barnes visits with an Operation Walk patient after a successful surgery.

When orthopedic surgeon Lowry Barnes and his nurse of 14 years, Marty Bushmaier, returned to Lima, Peru a few months ago, several locals were so excited to see them, they danced in the hospital's hallways.

That's because they were showing off their newly functional hips, replaced the previous year by Barnes, Bushmaier and a team of other healthcare providers through Operation Walk, an orthopedic-specific medical mission founded twelve years ago in Los Angeles, Calif.

"It's fairly unusual to return to the same place on subsequent medical missions," Barnes said, "but being able to see the patients we had operated on last year, walking and moving naturally, all smiles, was that much more gratifying. The women all wanted to dance for us, show us they could now."

Medical missions are as old as medicine itself, but are becoming increasingly popular for physicians and healthcare providers of all fields as technology and global connectivity make planning for and organizing trips more efficient. Countless organizations in the state, nation, and around the globe routinely embark on medical missions of every variety. The one thing they all seem to have in common, though, is the renewed enthusiasm they generate for the practice of medicine.

"One of the other members on my trip remarked, 'This is the most selfish, selfless thing you can do,'" Barnes said. "That sounds contradictory, but it's true. While you are giving of your time and expertise, truly the doctors and the medical team who go get more from it than the patients do. The feedback is incredible."

Stephen Hudson, MD, a surgeon at OrthoArkansas, who recently returned from a trip to Honduras with an Arkansas medical mission called Operation New Life, said the same thing.

"It's very gratifying and fulfilling," he said. "For one thing, it makes me appreciate what I have. We all complain about our own equipment from time to time, but I don't think I'll be complaining about that for a while after operating in the conditions down there."

Hudson was prepared for some disparity in the facilities and equipment compared to American healthcare—this was, after all, a medical mission trip—but he still was taken aback by just how different some aspects of the system were there.

What was so surprising, he said, was the system that has evolved there, was out of necessity.

"If someone has broken their leg and they need a plate and screws, well, the hospital simply does not have plates and screws," he explained. "They'll have to give the person a prescription for the implants, and then if the family has the money, they can go buy the implants on the open market. If they get them and bring them in, then they can have their surgery. Otherwise, they're confined to being in traction or a splint or a cast.

"It's pretty odd to see people showing up with their implant in a bag, ready to have their surgery."

Part of the mission of Operation New Life, he said, is supplying the hospital with equipment they did not have. Sometimes that means donating large equipment like an X-ray machine or operating room beds, but bringing smaller things like implant devices is just as needed.

"We brought a bunch of implants for them, so that patients who could not afford to go buy them on the market could still have the surgery."

He said that in contrast to some broader-focused medical missions, Operation New Life also has a major emphasis on teaching the local health care teams.

"These physicians have good training, but they don't have the equipment and they don't have the specialization that we have in the U.S.," Hudson said. "The surgeons there are very excited about learning to do more things. They want to learn and be able to do more, they just have limited resources."

To that end, Hudson and his orthopedic colleagues brought along television and recording equipment and conducted a learning clinic as they did hip and knee replacements. He said about 30 physicians from throughout Honduras gathered at a local hotel to watch a live telecast of the operations and ask questions of the surgical team during the surgeries. A translator liaised between the two groups, facilitating learning.

Bushmaier said that neither she nor Dr. Barnes were Spanish speakers, but that did not interfere with their ability to operate in a foreign country. "I could have done more teaching to the Peruvian nurses if I had been able to speak Spanish," she said, "But you'd be surprised how well you can communicate in the OR. In the OR, everyone sort of speaks a common language; it's very clear."

Barnes agreed. "I don't speak Spanish, but a hug is pretty universal, and that's what you get from the patients after surgery, and everybody knows what that means."

Bushmaier said one of the most inspiring parts of the trip was seeing just how well everything could come together. "We had all these people from different places all working together to pull off these marathon surgeries, one after another," she said. "You see that, see 50 people work together and set something up that complicated and make it work, it's amazing. You could see the excitement in the room, you really could."

Barnes said the Operation Walk team completed 49 joint replacement surgeries in three days.

The exhaustion is overwhelming, Bushmaier said, but added that so is the high.

"When I get home, I'm always so tired and I say, 'I'm not going to do that again,' but then a year goes by and you start remembering what a unique experience it was and how rewarding it was," she said. "Yes, I would go again."

She said the most difficult thing was seeing how many patients they had to turn away, either because they were not candidates for surgery for one reason or another—often, because they needed additional medical care before they would be healthy enough for surgery—or because they simply could not get to them all in the time allotted.

Hudson said that because of the emphasis Operation New Life puts on teaching (the group returns to the same site several times a year with different specialties), he knows that the expertise shared with the local physicians and medical team will help more patients during the year than a single mission trip could ever reach. Having a continual commitment to a single hospital or community means that they don't have to give up on patients they did not have time or the equipment to treat during the trip.

"For instance, this time we saw several people that we were not able to operate on this time, but we got their X-rays and can make plans for a future trip, bring the equipment needed to do their surgery next time," he said. "I certainly hope I have an opportunity to return."

Barnes said his medical mission trips are by far the most rewarding thing he's ever done in medicine.

"If you haven't done it, it's a great reminder for doctors as to why they actually went into medicine. I've been in practice 17 years, and sometimes although you still like taking care of patients, you get caught up in the paperwork, filing the insurance forms and everything else that goes into practicing medicine. The main reason you do it gets lost in the daily ordeal of being a doctor instead of getting to actually doctor," he said.

Medical missions, though, are much more immediate.

"On these medical missions, it's all about a patient who has a problem and a medical team who has a solution to that problem, and the sharing of that solution, simple doctoring," Barnes said.

He said there is nothing as gratifying as directly helping someone who needs help as badly as the patients he saw did.

"This year I had a woman in her 50s who had not been able to walk for years, could not even sit down and go to the bathroom because her hips had fused on their own, essentially solid," Barnes remembered. "In a single setting, we operated on both her hips, put two new total hips in and on the third day she walked 200 feet and sat in a chair for the first time in years. Her joy was overwhelming to everyone around her. And all the patients are like that, they are just so appreciative for everything that's being done for them, and it's a beautiful thing to be a part of."