Two Silver City physicians had to go back to basics
to help patients on a medical mission to Nigeria.
by Dawn Newman-Aerts
When Dr. Roland Snure first found himself in a dim and dingy operating room in southeastern Nigeria late last year, he immediately wished he were back in the United States. As an American surgeon with a practice in Silver City at Surgical Associates, Snure admits he has come to expect the high standard of a sterile environment, sophisticated diagnostics and — at a bare minimum — general anesthetic for surgery. "What we actually administered, and what was available," he recalls, "is known mostly as a pain killer for horses."
Dr. Victor A. Nwachuku (left) and Dr. Roland Snure traveled from Silver City to Nwachuku’s home town in Nigeria on a medical mission.
Snure, who is chief of surgery at Gila Regional Medical Center, is one of thousands of doctors, nurses and dentists who journey each year to desperate parts of the world. He works according to the Hippocratic Oath, to "treat the sick to the best of one's ability," and nowhere is that care more critical than for the people of Mbaise, in Nigeria.
For over two weeks in late December and early January, Snure, along with friend and colleague, Dr. Victor A. Nwachuku, journeyed to Nigeria, a world as tainted and raw as its chaotic, colonial history. Here you'll find people like Folorunsho Alakaija, a Nigerian oil tycoon, one of the 10 richest women in the world — an icon among 150 million others who can only imagine the luxury of clean water, electricity and access to affordable medicine.
"What I saw were people living on less than a dollar a day," says Snure, who grew up in Apache, Ariz., and attended Animas High School. "Of course, I've seen real poverty up close, too, in Mexico and in the remote stretches of the Southwest." But nothing could prepare him for the reality of Nigeria.
His first trip to Africa took him to Zimbabwe in 2012. "Growing up, I'd seen photos of the country's natural beauty and heard stories of the history," Snure says. That visit was a high-end American tour with air conditioning, indoor plumbing and upscale restaurants, where so-called "primitive camp-outs" turned into luxurious outings. "I think this is what many Americans see when they visit." But Snure wanted to experience something more.
It was Nwachuku, an OB/GYN at Cassie Health Center for Women and GRMC's chief of staff, who proposed plans for a second trip to Africa.
Snure says, "I remember he said to me, ‘Roland, do you want to see the real Africa? Do you want to be part of a medical mission?" In the end, it was an offer Snure could not easily ignore. "Victor explained the many needs there — the primitive settings we would mostly work with, the noise of generators, and the inferior medical equipment we would use. But I didn't have a clue about the situation we would find ourselves in."
What Snure found in Nwachuku's home village was sweltering heat, flashlight-lit care, and a country plagued by corruption, poverty and the desperate need for medical care. "I have to say (as word got out) there would be long lines of people waiting at the doors each morning," says Snure. There were few phones, "but somehow, they heard that two American doctors were coming here. So people arrived, on foot, many in great pain, to get any treatment available."
Victor Nwachuku knows Mbaise, a region in Nigeria still dominated by subsistence farming, well. It is a place where his father, Emmanuel Ukachukwu Nwachuku, left a legacy of humanitarian work.
"My father was a very giving person and a leader in this town," says Nwachuku. "When his own father died, he raised six siblings and put them all through high school. Over the years, he helped establish the first medical system of care here. So there is a foundation now for care — there are medical supplies and equipment shipped here each month. The buildings have been upgraded…. So it's a beginning."
In Nigeria, expectant mother mortality rates run high and fatal infections are common. "You see, there really are no set rules in place, no privacy laws, or records kept," says Nwachuku of the neighborhood clinic. "This area (of Nigeria) has no ambulance system for emergencies, very little modern equipment or diagnostics. So there is a lot yet to be done, to organize resources — and to put structures in place for better care."
Nwachuku credits the GRMC, private individuals and the First Baptist Church in Silver City with providing ongoing financial support for the medical mission at Ogbor Nguru Holy Rosary Hospital. "Each month, we have people here who donate funds for equipment and medical supplies," says Nwachuku of the outreach clinic that provides for an average of 18 deliveries per month in Mbaise. "So the assumption is, if we can just get the medical shipments and supplies through, it's working, but there is no guarantee with delivery."
Unfortunately, there is a lucrative black market in Nigeria, kidnapping happens, and people barter for food and services while corruption and bribery is common to small and large villages alike. Snure says that travel with armed body guards is not out of the ordinary for people who can afford it. At Nwachuku's family compound, both doctors relied on armed security when moving throughout the city and for protection day to day. And this time, their pre-shipment of medical equipment and supplies was impounded at the airport by government bureaucracy.
"In short, we needed help in securing our shipment through the Lagos airport, and then to have it released to an assistant there," says Snure. "I guess it's an all-too-common issue in Nigeria — they held up most of our new equipment, and we were never able to access all of our supplies."
In the end, the two physicians "made do" with what they had.
Snure points out that many of the surgeries were minor in nature, such as pediatric hernia, with a variety of basic procedures. Still others, however, were life-and-death operations. "There was one man who came to us with a perforated ulcer — and we had to operate immediately," says Snure.
“There would be long lines of people waiting at the doors each morning,” says Dr. Snure. There were few phones, “but somehow, they heard that two American doctors were coming here.”
Another woman arrived begging for treatment for a disfiguring face tumor — "Can you help me?" she would cry. Unfortunately, Snure says, there were no MRI, ultra-sound scans or biopsies to preview. "I just didn't think we could do this without more sophisticated equipment."
But Nwachuku knew what disfigurement means for women in Mbaise — in short, no marriage, no future, no life. Snure recalls, "He calmly said to me, ‘Roland, we've got to do this, and maybe we can change her life.'"
Even seeing to operate could be a challenge. Snure says, "Like most of the people who live in Nigeria, we had generators to operate power and lights, but if those stopped working, if the lights went out, then we had to use flashlights — and that was our only option."
Many surgeries were performed without general anesthesia, Snure adds. "So we dealt with malfunctioning or out-of-date instruments, in a mostly non-sterile environment…. When I saw the real conditions of this facility, I had to think about backing out for a time. We had no diagnostic/ultrasound scanning equipment and few medications. And I thought to myself, ‘How can I actually function in this as a doctor?'"
Nwachuku admits he knew what they would face in this part of Africa, and the challenges of getting good equipment and supplies to the clinic. "There really is no safety net here for most people — few rules, no order, and no one there to object to the dismal conditions."
During their mission, Snure estimates that they diagnosed, treated and released more than 35 patients with the chance for a better future.
Some patients were beyond the scope of their ability to perform a surgery given the conditions, however. Several had to be turned away for lack of resources or equipment.
Nonetheless, Snure says, "It's hard to believe, given the conditions, but these people could not thank us enough. They'd fall to the floor in gratitude. It didn't matter how much pain they had experienced; we had changed their life."
"In the future, I would like to see many more people get involved with this mission," says Nwachuku of his hope for clinical improvements, more structure, and a working medical triage system. "My father taught me a great deal about hard work. He would always say, ‘If you become successful, remember to find a way to give back, to pull people up.' It was his legacy for Mbaise."
Says Snure of the trip, "More than anything, it really changed my perception of this world — of my role as a doctor. I know we helped some people. We fixed some hernias and made life better for others. But there's a bigger impact here, to know just how bad it is in countries like this, and how good it is in the US."
Dawn Newman-Aerts is a former Minnesota newspaper journalist who lives in Rodeo.
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