Making lasting change in Liberia
By Dr. Delaney Orcutt
Our U.S. urologic surgical team, composed of myself, Dr. Joseph Smith, Dr. Niels Johnsen, and
Dr. Mark Farha, arrived in Monrovia on a Saturday before continuing on to John F. Doe
Memorial Hospital in Tapeta, Liberia. We reached the hospital on Sunday, February 22nd.
The hospital’s campus included clinical facilities and dedicated guest housing where we
stayed throughout the week. On arrival, we met with the hospital’s leadership and with
Liberia’s only practicing urologists Dr. Cassell, Dr. Kortimai, and Dr. Konneh, who joined us in
the operating rooms each day. Because all potential surgical patients had been preadmitted, our team rounded on them that evening, reviewing their paper charts at bedside
and planning the operative schedule for the week. Many of the patients with urethral
strictures had suprapubic tubes in place.
We operated Monday through Friday, using two operating rooms led by Dr. Smith and Dr.
Johnsen. The Liberian urologists rotated between rooms for each case, and Mark and I
assisted throughout the week. Several general surgeons and surgery residents also
participated. Across the week, we performed approximately eight open simple
prostatectomies, eleven to twelve urethroplasties, a first-stage proximal hypospadias
repair for a teenager, and a scrotoplasty. We did many different techniques of
urethroplasty including buccal graft augmentation. Patients were admitted to the hospital
postoperatively, and Mark and I would check on the patients throughout the week, and all
were doing great post-operatively. Our mission centered on teaching surgical techniques
that the local providers could continue using long after our departure.
A meaningful component of the experience was the communal time spent with the general
surgeons and urologists during meals. Breakfast was served at the hospital prior to the start
of the operating day, and lunch and dinner were shared at the guest house. These shared
meals facilitated ongoing dialogue, strengthened team cohesion, and contributed
significantly to the collaborative environment that developed over the week. Overall, our
week Tapeta was deeply meaningful. Working alongside Liberia’s urologists and surgical
staff reinforced the importance of partnership, education, and sustainable skill
development. I believe the relationships built and the knowledge shared will continue to
support patient care in Liberia well beyond our time there.