It all began with “a simple conversation” between Peggy Frisella, RN, a research nurse, and Brent Matthews, MD, then chief of minimally invasive surgery, at Washington University School of Medicine. One morning, Matthews asked Frisella where she was going on vacation. Guatemala, she replied – to serve as a nurse. This sparked an idea: Matthews had been on medical missions in Haiti. Could they partner in organizing surgical missions to developing countries in Central America?
With seed money from The Foundation for Barnes-Jewish Hospital, Matthews and Frisella travelled to a hospital (surgery clinic) near Santiago, Dominican Republic, in 2009 to perform open hernia repairs. Hernias are a significant medical problem in developing countries because they are physically disabling, and the poor cannot afford the operations. Matthews left the medical school in 2013 but has continued the missions with Frisella. The two formed the non-profit group SOfA (Surgical Outreach for the Americas) along with Saint Louis University/Mercy Hospital surgeon Joe Hurley, MD, and Wes Vega, a translator who works in the medical device field.

Having performed their 1,000th surgery in 2015, the group went on hiatus in the Dominican Republic after the trip last year – there were not enough people left needing hernia repairs to justify another mission. But SOfA had already been going to a second country, El Salvador, annually since 2016. They completed a first trip to Honduras in February 2019.

They continue to perform primarily hernia surgery in El Salvador and Honduras. “The majority of our patients have always been farm workers – day laborers,” says Frisella. “The ability to work and provide for their family is crucial. They live with chronic pain, and when it gets too bad, they can’t work.”

In these countries, the wealthy can pay $10,000 for an operation and the super wealthy can travel to the United States for treatment. Poor people are given a list of medical supplies to buy or collect and are told they may possibly get surgery if they bring the supplies back to the hospital.

SOfA tries to help in other ways, when possible. They train local hospital doctors and staff. In El Salvador, they are training an OB/GYN physician how to perform diagnostic laparoscopy so he does not have to open up patients to determine the cause of pain. A pediatric emergency room physician at St. Louis Children’s Hospital, Clayton Cummings, MD, has accompanied them on many trips and makes it possible to operate on children, who are more difficult to anaesthetize and monitor. In Honduras, where they were assisted by the International Medical Aid Foundation, they are looking to see if there are needs they can fill.

The motivation of SOfA team members to provide the impoverished medical care and their dedication to doing so are self-evident.

“We are so lucky here in the United States, and these people, who have little access to medical care, have so much hope,” says Matthews, now chairman of the Department of Surgery at Atrium Health based in Charlotte, North Carolina.

Frisella puts in the many hours needed to keep the SOfA outreach in motion – fundraising, getting donations of supplies, organizing, and serving as the person to fill in any gaps once the surgeries start.

When will she have enough? “It’s fun. When I retire, this will be all I do,” she says.

                                           Greg Barnett is a Freelance Writer in St. Louis, Missouri

Greg Barnett is a St. Louis freelance writer

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