Volunteer Work - Shoulder Arthroscopy in Cuba

Building Bridges with Shoulder Arthroscopy Watch the Video>>

William B. Stetson, MD

I traveled to Cuba in September 2004 and was so moved by what I found that I wanted to share my experience with my medical community. I went to Cuba for a medical humanitarian trip that started with the SICOT/SIROT Annual International Conference and ended with two arthroscopic shoulder surgery courses. In the midst of all of these projects we had the privilege of discovering a beautiful country and wonderful people.

This project started 9 months ago when I first visited Havana with Dr. John Feagin, who had recently retired from Duke University. John had previously traveled to Cuba and had laid the groundwork for our visit. During that visit, we met with Dr. Rodrigo Alvarez Cambras, the President of the Cuban Orthopedic Society, his son, Dr. Rodrigo Lorenzo and Dr. Tony Castro de Valle. We discussed the medical needs of the people of Cuba, as well as the shortage of needed medical equipment, including arthroscopy equipment. We were so touched and inspired by the people of Cuba that we committed ourselves to helping them obtain the much needed medical equipment. By teaching shoulder arthroscopy, we saw an opportunity to start building relationships between our two countries.

For the following nine months we contacted equipment vendors, doctors and hospitals asking for donations. It turns out that many of them had a collection of new and used medical and arthroscopy equipment that they were able to donate. In total we collected 75 boxes of arthroscopic surgical equipment and accessories, amazing! Without the generosity of these companies, this project would have never been possible. Many thanks to Arthrex, Smith and Nephew/Dyonics, Arthrocare, Linvatec, DJ Orthopedics and Sawbones for their generous support.

We arrived in Havana on Friday night, September 24 and spent a little time on Saturday walking through Old Havana, which is a striking city filled with history and lovely buildings. Driving through Havana is like driving through the United States during the 1950s. The cars are all classics from the USA and Russia and many of the buildings have elaborate, beautiful architecture. While everything is clean, it does not appear as if any buildings have been built, or painted, since 1950.

On Sunday morning at 2am the shipment of donated equipment arrived at the Havana airport. Dr. Rodrigo Lorenzo, of Frank País Hospital, drove to the airport at midnight and spent 3 hours convincing airport officials to give him the shipment of boxes. No easy task, but somehow he convinced them and transported the boxes to his hospital early Sunday morning. We spent our free time over the next 5 days organizing the equipment and making sure everything was in working order. Many thanks to Fundacion Amistad and Havana Tours who were instrumental in helping us ship the equipment.

On Friday, October 1st, we did a one day symposium for the Cuban orthopedic surgeons on shoulder arthroscopy, which went very well. We had five North American doctors (Dr. Scott Powell, Dr. Gene Muse, Dr. Don Johnson, Dr. Brian Day and me) who gave lectures and then did demonstrations on Alex shoulder models.

I would like to take this opportunity to thank Scott, Gene, Brian and Don for taking a leap of faith and coming to Havana to help in this project. I am not sure they exactly knew what they were getting themselves into when they agreed to come, but I think they would all agree it was a chance of a lifetime.

On Saturday, October 2nd we performed a live shoulder arthroscopy at Frank País Hospital in Havana. The surgery room was setup with a live video feed to the auditorium with about 100 surgeons watching. Even though we had brought multiple boxes of arthroscopic equipment, there were still things which we did not anticipate needing.

For example, they had no sterile tubing for inflow to the camera and were planning on using IV tubing to gravity with one liter glass saline bottles. Luckily, we had brought some extra tubing so we were able to perform the surgery though visualization was a challenge. After this surgery, I probably hold the record for the longest arthroscopic subacromial decompression on record but all went reasonably well. The audiovisual equipment was all makeshift and jury rigged but thanks to my wife, Erica, the live video feed to the auditorium worked and all the doctors were able to see what we were doing. Many thanks again to Scott, Gene, Don and Brian for all of their time and effort during the course and live surgery, this course was a success because of them!

One of the primary Cuban doctors that I am working with is Dr. Tony Castro de Valle. Tony is a 35 year old orthopedic surgeon and the son of Fidel Castro. I have agreed to teach him shoulder arthroscopy with the understanding he will go on and teach these skills to his Cuban colleagues. We had the pleasure of spending the two weeks of our trip with Tony and his wife, Yolanda. She is an Olympic diver and both of them had just returned from the Olympic Games in Athens. In addition, Dr. Rodrigo Lorenzo and his wife, Alina, were our primary hosts for the two weeks we were there, offering their time to provide our transportation around Havana and through the beautiful countryside of Cuba, as well as providing extensive language interpretation support. By the end of the trip, we had developed a special bond and I now feel that I have two more brothers in Cuba (as if the four I have isn’t enough!).

On our last night in Havana, Tony was kind enough to arrange a meeting with his father, President Castro. He was very interested in our work. We met President Castro and talked with him for over four hours (until 5 o’clock in the morning) about healthcare, education, the environment, the recent hurricanes and the devastation they levied on other countries in the Caribbean. Politics was never discussed and he was very gracious and accommodating during our visit. We came away with a better understanding of Cuba and its people.

Our master plan was to develop relations with Tony and Rodrigo through shoulder arthroscopy and build bridges between our two countries. We never had any idea we would have this sort of opportunity to meet such a world figure.

The people of Cuba have all the basic necessities of life; food, clothing, medical care and housing. There were no homeless people, gangs, graffiti or malnourished people and crime appears to be low. Once you move away from the basic necessities of life we found even the smallest of luxuries, like toilet paper, to be scarce. Most people live with multiple generations of family within a small house since it is virtually impossible to buy a home.

While the countryside is lush and the beaches are beautiful, it is the people of Cuba that are the most amazing jewel of this large island. Given the strained relationship between the USA and Cuba, it would not be unreasonable for the people of Cuba to be angry or unwelcoming towards us. However, from the moment we walked off the plane we encountered nothing but smiles, friendship and open arms. The people were generous, kind, friendly and curious about us and our country.

It seemed that wherever we went the heritage of music could be found. Whenever a group of musicians started playing, the Cubans would blossom and sing and dance with joy in their hearts and a love for life. It was beautiful and inspiring. Every moment was a reminder that we are all the same, we are just people and we all want the same things from life; healthy friends and family, peace, friendship, love, joy and laughter with the hope that we can give our children a better world. Race, gender, nationality and skin color mean nothing.

We are committed to bringing more orthopedic surgeons to Cuba this September for an international orthopedic conference to introduce doctors from North America to our Cuban colleagues. The meeting is scheduled for September 23-30, 2005 in Havana and Cayo Guillermo, Cuba.

We have over 35 doctors from the United States, Canada, Mexico, and Europe who will be traveling with us. This will be in conjunction with the Cuban Orthopedic National Annual Congress and SICOT. Again, our vision is to use our common love of orthopedics to build bridges to our colleagues in Cuba.

If you are interested in attending or helping out with the collection of more medical equipment, please contact us via email at orthopedicsincuba@hotmail.com.

For those of you who speak/read Spanish, we have attached URL links to two articles that were written up in the national Cuban newspaper about the Shoulder Course work that we did in Havana and Ciego de Avila:

http://www.jrebelde.cu/2004/octubre-diciembre/oct-3/ruptura.html

http://www.jrebelde.cu/2004/octubre-diciembre/oct-7/realizan.html

I need to take this opportunity to thank my wife, Erica, who was instrumental in this project. She collected, organized, packed and help ship every single piece of medical equipment. No small task. She did all this while also organizing our wedding which took place on September 4. I convinced her that going to Cuba was going to be our ‘second honeymoon.’ Well, it was much more effort than either one of us bargained for but the rewards have been tremendous and we feel that new bridges have been built.

Finally, I need to thank Dr. John Feagin who has been our guiding light and inspiration for this project. Although John was not able to accompany us on this trip, he is the one who originally paved the way for us and introduced us to the wonderful Cuban people. Without him, we would have never been able to accomplish what we did. Many thanks, John, for being such a wonderful mentor and friend.

Watch the Cuba 2005 Video>>