The Positive Feedback Loop

Dr. Gilman and a patient in Cartagena, Colombia.

My first medical mission trip in 1998 was one of those absolutely life altering experiences.

I had been interested in this work for some time and was approached by a friend who needed an additional surgeon for a trip to Cartagena, Colombia. Working during that first trip, I really felt as if it gave me the opportunity to practice what we do as surgeons and physicians in the purest possible way. There are no other considerations but to offer our expertise to the people we see.

I’ve continued to visit this same hospital each year for 15 years, now leading an annual mission for pediatric reconstructive plastic surgery.  I am convinced that any volunteer participating in a medical mission would describe themselves as getting more out of the experience than they put into it.  I grow as a surgeon and as an individual on each mission I participate in.  It’s a very positive feedback loop.

Why Cartagena and how we help

During 15 medical missions, our teams have operated on more than 750 children. These children come from the poorest segment of their country and have limited access to health care. In many cases they would have led lives of seclusion and shame without the surgery we are able to provide. It’s not that there are no qualified surgeons in Colombia, but they are not supported by their health care structure to reach patients in rural areas with few economic resources.

Each year, the medical mission group returns to the same hospital in Cartagena, Colombia.

In addition to the surgical procedures we perform, we offer education to local plastic surgeons, general surgeons, resident surgeons and medical students. We also are able to help bring money and supplies into the hospital in several ways. The government offers the hospital a small amount of money for each child who is cared for, even if that care is delivered by our mission team.  Also, we have donated supplies and equipment directly to the hospital thus improving the conditions there over the years.

Volunteerism alone is not sufficient to bring about a successful mission.  For us, it is important to ensure all participants have proper qualifications and that we return back to the same hospital each year. This allows us to follow up with our patients and grow a working relationship with domestic providers. Continuity of care and respectful relationship building are cornerstones to successful medical mission trips and we’ve been fortunate to have a partner in the Hospital Infantil Napoleon Franco Pareja (Casa des Nino) in Cartagena, Colombia.

How mission trips make us better providers

The experiences I’ve had during medical mission work affect many parts of my life. Though I have always had a great deal of respect for all my patients, both during normal work and volunteer work, my perspective has broadened.  I’m more aware of things that we otherwise take for granted. We are privileged to work in an environment conducive to the practice of good medicine.  Operating with fewer resources in Colombia has made me a more flexible and capable surgeon. It’s a good lesson for all of us who should be able to offer great care under a variety of different conditions.

One of the patients and mothers the medical mission team was able to care for in Cartagena, Colombia.

One thing that has been really important to me—and as a consequence, has changed my career—is that over the years I have taken a chief resident from the University of Michigan and Harvard plastic surgery sections on these medical missions. Over the years, I’ve taken combined 29 residents from the University of Michigan and Harvard on these missions. Many of these residents are now practicing and serving as leaders at hospitals around the country, including Dr. David Brown who is an associated professor here at U-M and Dr. Jay Austen who is now the chief of Plastic Surgery at the Massachusetts General Hospital.  That long-term relationship with the residents, faculty and staff has helped guide my path in unforeseen ways. After many years away and a long career in the Boston area, I have now returned a full time member of the plastic surgery faculty at the University of Michigan where I finished my residency in 1982. On my most recent mission, February 5-15, 2014, we were traveled to Cartagena, Colombia as a team of 19 professionals, including plastic surgery chief resident, Dr. Erika Sears and  pediatric anesthesiologist Dr. Joe Martinez.

Supporting medical mission trips for years to come

It is my goal for each of the residents who come to Cartagena to find the experience so rewarding that they integrate mission work into their own careers. A very important piece here is that we support residents and other mission workers in an organized fashion. Leaders in plastic surgery have been exploring ways to integrate mission work into training, to standardize guidelines and qualifications, and to connect interested professionals with established mission organizations.

The medical team in Cartagena. Dr. Gilman is far back left, in U-M scrub cap.

In addition to pursuing this standardization of mission-based education experiences, I’ve been able to establish The Robert H. Gilman Fund for International Travel through the University of Michigan President’s initiative and with the help of grateful donors. The fund provides financial assistance to plastic surgery residents who would like to experience international medical mission work.