IVUmed Resident Scholar Andrew Eschenroeder Describes His Workshop in India

Thanks to the generous support of the Southeastern Section of the American Urological Association, Dr. Andrew Eschenroeder had an outstanding experience in Mahuva, Gujarat, India, where he volunteered his time at the annual Mahuva Camp at the Sabdhavna Trust Hospital in February 2019.

Dr. Eschenroeder shares his experience:

“In February 2019, I traveled to the Sadbhavna Trust Hospital in Mahuva, Gujarat, India to participate in the annual Mahuva Camp, a weeklong urologic surgery workshop. I accompanied Dr. Gopal Badlani and Dr. Joel Hancock from the United States and worked alongside four other Urologists from elsewhere in India who volunteered their time and expertise to the camp. Dr. Pravin Baldaniya is the Surgical Director of the hospital, a charity organization that serves a predominantly indigent and rural population. Along with a staff of two gynecologic surgeons and one general surgeon, Dr. Baldaniya and his team routinely perform 30-40 cases each day in a single operating theater containing 4 tables.

“Operatively, our days were busy with a wide variety of cases. There was a significant number of pelvic organ prolapse cases, as the camp was focused on training local surgeons in these techniques, while simultaneously covering the gamut of general urology cases. I personally performed 26 cases in 4.5 days and assisted on several others. At least half were endoscopic cases including ureteroscopy, monopolar TURP, TURBT, percutaneous cystolitholapaxy, and one table dedicated to PCNLs, which ran for the duration of each day. The remainder of the operative experience consisted of open pyeloplasties, pediatric ureteral reimplants, simple orchiectomies for metastatic prostate cancer, and laparoscopic renal cases.

“The experience was demanding—once familiar cases were cast in a new light with the paucity of equipment available, and several techniques were entirely novel. I was pushed to the limits of my abilities several times and felt grateful for the improvement I achieved under the guidance of the other visiting urologists. For cases that I had more experience performing, I was granted much more autonomy in this setting. The scrub nurses were excellent. Even though we couldn’t converse over the language barrier, we were able to operate efficiently with an unspoken understanding of the work at hand. My most memorable moment from the OR was during a ureteral re-implant, when the 9-year-old girl (who had spinal anesthesia) introduced herself and said ‘thank you” while I was finishing her operation.

“Outside of the OR, Dr. Baldaniya shared his community with us. We were able to meet the families of patients and other members of the small villages in the region. All were incredibly welcoming; we were invited into strangers’ homes for tea, meals, and we even attended our fair share of individual and group weddings—83 in total. Gujarat knows how to throw a party.

“The surgical and social experiences were equally affecting. The role of the surgeon in the community—his sense of duty to those he cared for and the gratitude they felt for his care—was manifest in all settings. He took consultations during social events as a matter of course. With his abilities, he could certainly have more for himself, and practice in any setting he desires. And yet, the obligation to serve his community both rewarded and motivated him more than any remuneration or fancier hospital could. This idea— the primacy of the patient and the duty, as a surgeon, to serve a community— was reflected in everyone serving at the camp. The staff, visiting surgeons, local surgeons, those who could converse with patients and those who couldn’t, were all guided by this motive that was rarely articulated. It struck me as the obvious reason why we go into medicine, and yet novel; maybe because the day-to-day of US medical practice obscures these ideas. I’ll keep this experience with me as I navigate my own career and seek out similar service opportunities in the future. I have experienced no better way to feel a true sense of purpose as a surgeon.”