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THE MESSAGE ILIANA SWEIS (M90, GM97) PLAYED BACK ON HER ANSWERING MACHINE IN EARLY 1996 ABSOLUTELY FLOORED HER. THE JORDANIAN EMBASSY IN WASHINGTON, D.C., HAD CALLED SWEIS, A PHYSICIAN SPECIALIZING IN PLASTIC AND RECONSTRUCTIVE SURGERY: SWEIS' WRITTEN REQUEST TO PROVIDE FREE SURGICAL CARE FOR UNDERPRIVILEGED JORDANIAN CHILDREN HAD REACHED ITS DESTINATION. AND THE RECIPIENT OF HER LETTER, KING HUSSEIN, WOULD LIKE TO MEET TO DISCUSS HER PROPOSAL. "I WAS TRULY SHOCKED," RECALLS THE JORDAN NATIVE, WHO LEFT THE MIDDLE EAST AT AGE 6. "WHEN PLANNING THIS VOLUNTEER EFFORT, I HAD REALIZED THAT I WOULD EITHER NEED THE KING'S PERMISSION OR AT LEAST THE GOVERNMENT'S SUPPORT TO CARRY IT OUT. SO I WROTE HIM A LETTER DESCRIBING WHAT I WANTED TO DO AND SIMPLY ADDRESSED IT TO HIS MAJESTY KING HUSSEIN I. I NEVER EXPECTED AN ANSWER, LET ALONE A MEETING. IT WAS WONDERFUL." In March 1996 Sweis met the late king at the Mayo Clinic in Rochester, Minn., where he was having a medical checkup, and gained his full approval for the mission. She returned to Chicago, assembled a medical team and collected some $150,000 in donated medical supplies. Fourteen months later, Sweis and her team of health care volunteers flew — courtesy of His Majesty — to Jordan's capital, Amman. For two weeks the team operated on 55 patients with ailments ranging from cleft lip and palate defects to burn and landmine injuries. To thank Sweis, King Hussein bestowed upon her a gold medal, Jordan's Award of Highest Distinction. Every day, medical personnel around the globe struggle to provide essential health care services. War, poverty, civil discord, epidemics and natural disasters prevent individuals as well as entire populations from achieving basic physical, mental or social well-being. Heeding calls for assistance, Northwestern alumni in health care professions have been volunteering their knowledge, skills and time for years on overseas medical missions that have taken them to India, Ukraine, Nigeria, Nicaragua and points in between. In return, they have received rewards beyond measure, experiences of a lifetime and a deep sense of accomplishment. "You feel joy when you help someone without any thought of what is in it for you," explains Robert Cooley (D56, GD70), who returned to the United States this spring from an 18-month volunteer tour of duty at a university medical center in Jakarta, Indonesia. "What you receive in return...a smile or the look in the eyes of someone you have assisted...seems, somehow, more pure." A pediatric dentist and professor emeritus in the Dental School, Cooley arrived in Jakarta with his wife, Rozann, in October 1998 during a time of political upheaval and daily street demonstrations. Thirteen student protestors were shot one day not more than a mile from the Cooleys' apartment. Putting the social unrest in the background as much as possible, Cooley worked with dental faculty members and graduate students at the University of Indonesia. His mission was to help advance their knowledge in the treatment and prevention of disease by establishing oral health programs. "While it's hard to measure lasting success with all of our efforts, at the university we did make significant progress in changing the teaching methods from rote learning to problem solving," says Cooley. "It was gratifying to see some faculty members begin to present their courses using a problem-solving approach. We also started them down the track of preventing disease rather than just correcting it." For plastic surgeon Nicholas Retson (WCAS71, M75), the tears streaming down the face of an 8-year-old girl from Cuilapa, Guatemala, were alarming. The previous day, he had surgically corrected the child's harelip — a birth disorder that can adversely affect a person's ability to speak, hear, swallow or eat. "I asked her where she hurt," recalls Retson, medical director for the Illinois–Northwest Indiana chapter of Healing the Children and a volunteer who has gone to Central America annually since the late 1980s. "She said she wasn't crying in pain but in happiness. Now that her harelip was fixed, she could finally go to school with all the other kids." The type of aid that health care volunteers offer often extends beyond the medical realm, especially in times of war. Infectious diseases expert Claire Panosian Dunavan (M76, GM80) served, as she terms it, as a "witness to history" during a relief effort for refugees who had fled Kosovo to neighboring Albania last year. "The refugees wanted to tell us their stories. They didn't know if the rest of the world knew what was happening to them," says Dunavan, director of travel and tropical medicine at the University of California, Los Angeles. "I learned very quickly that these people needed us to be witnesses. Sometimes doctors are in the best position to do just that." And so, on July 27, 1999, 30 health care workers from UCLA and Santa Monica–UCLA Medical Center released a human rights violation report at a public presentation at the Museum of Tolerance in Los Angeles. Based on interviews with Kosovar refugees — some 3,400 were treated during a two-week medical airlift in May and June of that year — the report described their conditions after they arrived in the refugee encampments. Many exhibited physical and psychological problems related to the rape, torture and mass murder committed by Serbian military and paramilitary forces. For anesthesiologist Aurora Teixeira (GM67), a nearly 20-year civil war in northern Sri Lanka has drawn her to that South Asian island three times since August 1997. Working with Doctors Without Borders, a Nobel Prize–winning nonprofit relief organization, Teixeira has scrubbed in on countless routine and emergency surgeries on civilians in the country's battle zones, where skilled human resources are scarce. Her group's proximity to the fighting determines how many war-related injured it receives, explains the Eau Claire, Wis., physician, who returned in April from another medical mission to Bangkok, Thailand. "My work in Sri Lanka has made me reflect on the real meaning of peace," she adds. "I don't want to talk about the war; I only hope it will end soon." In 1969, as a U.S. Army captain, John W. Smith (GM76) spent 12 months in the jungles of Vietnam treating wounded American soldiers. Last November, some 30 years later, the plastic surgeon found himself back in the country performing surgery on children with birth defects. "I had always thought about volunteering, but I never found the time," says Smith, who, ironically, did his volunteer work in a Vietnamese military hospital. "When I heard the mission was to Hanoi, I had to go." Although being at a military installation was a little unsettling at first for him, the appreciation of the Vietnamese people helped Smith with his emotional journey to a place that had once been so hostile. "They were very happy to have us there," says the Evanston-based doctor. "That was a revelation for me." Accustomed to U.S. health care standards, many Northwestern alumni volunteers face professionally eye-opening experiences working in other parts of the world and quickly adapt their skills to suit the situation. Far from his former private dental practice in Reno, Nev., Van Ness Hansen (D54) was in Bangalore, India, from 1995 to 1997, where he sometimes used flashlights to examine patients' mouths. "We set up temporary dental 'camps' in the rural slums and treated indigents and street children," explains the retired dentist. "Frequently in old concrete buildings with few lights and windows, we would place our patients close to an open doorway so we could see what we were doing." The sweltering temperatures in the little town of Ille Jusu in West Africa's Nigeria didn't prevent Wayne Wertz (M53) from performing hernia operations and other surgical procedures as a volunteer in 1995. However, the lack of air conditioning in the operating room was only one problem. Wertz's team had brought surgical gowns, but someone at the Nigerian clinic resterilized them in one bunch, causing the gowns to stick together. "They had no breathability," Wertz recalls. "It was the first time I've ever had to wear a sweat band in the OR. After less than an hour we were just soaked." He, too, had a bit of a lighting problem. Power shortages meant the operating team could either turn on the surgical monitor or a little lamp purchased beforehand at a stateside Kmart for the evening hours in the operating room — but not both. "Otherwise, the transformer would burn out," Wertz explains. Such shortages in supplies, equipment and skilled support staff can force volunteer health care workers to opt for alternative treatment plans or to face difficult decisions they would not ordinarily have to make at home. When pediatric urologist Earl Cheng (WCAS86, M88, GM94) traveled to Antigua, Guatemala, three years ago to operate on children with kidney, bladder and genital problems, he and his medical team refrained from highly sophisticated surgeries. "The surgery is the easy part in the United States," says Cheng, who practices in Oklahoma City. "It's the follow-up care that can be problematic. We had a great fear of being too aggressive and not being assured of adequate follow-up after we left." Pediatrician Rosalyn Singleton (M82, GM85) was deeply affected when she saw firsthand the lack of basics during her volunteer stint in West Africa's Ivory Coast in May 1999. She worked with missionary physician Tim Herrick (M83) and Joan Burlingham Herrick (Physical Therapy 82) in a hospital in the provincial city of Ferkéssédougou. "Blood transfusions are given to malaria patients. At one point, the hospital only had two pints of blood left," says Singleton, whose husband, Jim (D83), volunteered his dental services during their three-week stay (the couple also brought their two sons, ages 10 and 13). "Hospital staff members said to me, 'You have to make the choice. Who really needs the blood today? Who will die without it?' These were dilemmas I rarely face at home." Going beyond volunteering, the Herricks have spent the last eight years helping others at their Ivory Coast facility. Both of them are developing a village-based community health program in about a dozen villages surrounding Ferkéssédougou, while Tim Herrick, who is medical director of the hospital, is training local physicians. In fact, volunteers frequently share their expertise not only by seeing patients but also by educating local health care professionals. "You do accomplish something when you treat patients, but there are so many people with problems that you make a small dent," says Charles Snorf (M58, GM63) of Carmel, Calif. "The biggest benefit I can bring as a volunteer is to teach local physicians techniques that will improve how they care for their patients." An orthopedic surgeon, Snorf started volunteering in 1993 and has gone to Bhutan, Vietnam, St. Lucia, Cuba and Nepal. Using interpreters for simultaneous translations, Kirk Noraian (McC85, D88, G91, KGSM98) felt like an "ambassador for periodontics" when he taught a continuing education course twice in Moscow in 1996 and once in Yerevan, Armenia, in 1997. Using lectures, models and live demonstrations, he taught strategies for preventing gum disease and the basics of periodontal therapy to dental professionals who were largely unfamiliar with his area of expertise. "These were very enlightening experiences for me as a periodontist," says Noraian, who lives in Bloomington, Ill. "At that time, periodontics didn't exist as a specialty in Russia or Armenia. There was a general lack of understanding about prevention, and if patients were not in pain they didn't seek treatment. While it is difficult to measure how much of a difference I made, I think I opened practitioners' eyes to what options and therapies are available." For more than 20 years, Roger Kallal (D61) has volunteered once or twice a year at a cleft lip/palate center in Bauru, Brazil. Kallal gains so much from teaching Brazilian specialists about oral surgery that every year he also sends one of his senior dental residents to the center for a month of training and service. "You can't teach without learning," says Kallal, who is a Dental School faculty member. "You learn whether you are giving or taking." Stealing time away from busy medical and dental practices and personal obligations to volunteer requires a commitment, yet Northwestern alumni around the country continue to find ways to do it. "Volunteering can be a financial burden," says William Balanoff (D83), whose first volunteered to share his knowledge with local dentists in Ekaterinburg, Russia, in 1992. "Yet the bottom line is that when you have pure intentions your personal reward is often worth a thousand times more than what you put into the effort." Since the early 1990s Balanoff has volunteered multiple times in Russia and been involved in the Dental School's Outreach Ambassador program, in which dental school alumni volunteer their professional services from teaching to patient care. Running his own informal exchange, he periodically hosts visiting Russian dentists at his private practice in Fort Lauderdale, Fla. Often, the origin of the impulse to volunteer abroad starts at home. Health care volunteers frequently begin by offering their services in the United States, at, say, an inner city clinic or a rural community outpost or as public health proponents. A leader in regional and national activities of the American Cancer Society since the early 1980s, surgical oncologist Stephen Sener (WCAS72, M77, GM82), a professor in Northwestern's Department of Surgery, has long promoted cancer prevention and control strategies to influence U.S. public health and policy. When an opportunity arose to volunteer at a 2,000-bed hospital in Moscow in May 1999, he saw it as a chance to extend his life's work and passion in a country where cancer still carries far more of a social stigma than in the West. "By the time patients receive treatment they have advanced cancers," explains Sener. "Russians see cancer as an automatic death sentence." Not wanting to engage in a "one-time deal," Sener initially turned down the request. He then thought about the global issue of cancer control and decided that maybe he and his fellow volunteers — including David J. Winchester (M86, GM92), also a Northwestern professor of surgery — could help make a difference and "alter the stigma" that cancer holds for the Russian people. Two trips to Moscow later, Sener and his colleagues have developed an ongoing relationship with their Russian counterparts and hope to collaborate on future projects ranging from cancer research to public awareness. Reflecting on the reasons for his volunteer work — both near and far — Sener borrows a quote from famed anthropologist Margaret Mead: "Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has." Cheryl SooHoo (J86) is an Evanston-based freelance writer who specializes in medical topics.
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