Einstein surgeon Pak Shan Leung, MD, recently returned from a volunteer mission with Doctors Without Borders in South Sudan. He worked in the only hospital in an isolated village, lived in a one-room mud hut with no indoor plumbing, endured smothering heat that often soared above 110 degrees and was on call around the clock for five weeks. He treated everything from infections to broken bones to traumatic wounds in the tumultuous East African nation beset by civil war.
The hardest part for him was—leaving.
“I was happy to come home because I missed my friends and colleagues,” said Dr. Leung (pictured here in the left of the photo), “but it was difficult to leave the hospital and country knowing there’s so much work that has to be done.”
Dr. Leung, 36, associate chair of the Division of Trauma and Surgical Critical Care at Einstein Healthcare Network, chose to go to the Agok region in South Sudan for his first overseas mission precisely because the need was so great.
For years, South Sudan has been ruptured by civil war, and millions of people have been displaced. Doctors Without Borders, an independent international medical humanitarian organization which sends volunteers to crisis-plagued areas around the globe, runs the only hospital in Agok.
“The whole country is so undeveloped,” Dr. Leung said. "There’s no infrastructure, no cities, no medical infrastructure, no education. That was one of the main reasons I wanted to go there, not just to provide care but to provide education for people there and also to set up some kind of infrastructure.”
Dr. Leung helped establish a communication and transfer system with an outpatient clinic at the battlefield front 40 miles away, so that critically ill patients could be transported to his hospital for inpatient care. He trained the staff to do triage (classifying patient illnesses and injuries from the least to most urgent) because “they had no formal education in how to assess a patient in a systematic or organized manner.”
“I was happy to come home because I missed my friends and colleagues, but it was difficult to leave the hospital and country knowing there’s so much work that has to be done.”
Some of what Dr. Leung witnessed in South Sudan was familiar. As a trauma surgeon, he’s dealt with broken bones; there were many in Agok as a result of vehicular accidents on roads made of mud. As a physician in an urban setting, he’s dealt with gunshot wounds. In South Sudan, they often resulted from raids in which one tribe stole hundreds of cattle from another tribe.
Some of what he witnessed was unfamiliar: patients who had perforated intestines from typhoid fever and, most poignantly, children with injuries sustained from landmines.
The one case that stands out for Dr. Leung epitomizes the inadequacies of the health care facilities and the heroism of staff and volunteers. It involved an 11-year-old boy who had such a severe brain injury from a landmine that it was uncertain he’d survive surgery. But it was his only chance.
“We all decided to proceed, knowing the path was going to be difficult,” Dr. Leung said.
The boy didn’t awaken from the anesthesia, though. In a modern American hospital, he’d be transferred to the intensive care unit and put on a ventilator to breathe for him until things resolved one way or another. There was no ICU, no ventilator or other life-sustaining devices. So for 15 hours straight, Dr. Leung and two others took turns, “bagging” the boy—manually squeezing air into his lungs with a hand-held resuscitation device. Finally, the boy awoke. He was recovering when Dr. Leung left to come home.
In between Dr. Leung’s arrival in South Sudan on March 20 and his departure on April 27, he handled about 350 cases. The first thing he did when he arrived in Geneva, Switzerland, on his way home was to buy two bottles of Diet Coke. “It was the only thing I missed,” he said in an amused voice. “People who know me would not be surprised at that.”