NYMC Faculty Undertake Medical Missions to Improve Global Health

CLOSING THE SURGICAL DIVIDE

Every year, Christa N. Grant, M.D., associate professor of surgery and pediatrics, travels with a small group of pediatric surgeons, anesthesiologists, surgical residents, and nurses, to Yantalo, a rural Peruvian town in the upper Amazon jungle. There, they spend a week surgically correcting pediatric hernias and other types of non-urgent anomalies of the soft tissues, abdomen, or genitourinary system. “Ingual hernias are common in children, and repair is mandatory because the intestines can get trapped in the hernia, leading to severe complications, such as intestine blockage or perforation,” Dr. Grant explains.

The clinic where Dr. Grant and her colleagues work is not part of a full-time functional hospital but rather like a surgi-center that opens for specific medical mission teams, she says. “Yantalo is extremely rural, about 600 miles from Lima,” she says, describing the trek there, which entails flying into the capital, taking a second flight to the city of Tarapoto, and then a two-and-a-half-hour bus ride. “We arrive at the clinic on a Sunday afternoon, where patients have been waiting all day for us,” she says.

To inform the local population of their arrival, the Yantalo team distributes flyers in advance, featuring pictures and descriptions of commonly treated conditions, such as hernias, to encourage parents and caregivers to bring their children to the clinic if they have such a condition. “Families come by moto-taxi (a small, covered two-wheeled carriage attached to a motorcycle) or motorcycle with a child riding between two adults,” she says. “After a same-day operation, I will see them bumping home along mud roads on these motorcycles on their parent's lap," says Dr. Grant, noting some children require overnight or multi-day monitoring after more complex operations, such as anoplasty or intestinal procedures.

Dr. Grant’s passion for medical mission work took root in her childhood home of Saint Ann Parish, Jamaica, where she lacked access to regular care for a chronic ear problem. “There was one specialist who I got to see only intermittently because she came to our town just once a month,” she says. This experience inspired her interest in the divide between patients who do and don’t have ready access to health care.

Her interest grew during her medical studies at the State University of New York Downstate College of Medicine, which offered a six-week elective in global surgery at a Christian mission hospital in Kikuyu, Kenya. “I was striving to see if, in my own way, I could help to balance the scales a little bit,” she says. 

She and a core group of surgeons and anesthesiologists from her pediatric surgery fellowship days at the University of Michigan, volunteer in Yantalo, where they evaluate 20 to 70 patients in one afternoon, triaging and deciding which patients require surgery. “We operate Monday through Wednesday and stay in town on Thursday to assess any remaining overnight patients and to answer questions—typically via WhatsApp—from those who have been discharged,” she says.

The clinic’s small capacity—an operating room with two tables, two functional anesthesia machines, and a recovery area—limits the surgical procedures that Dr. Grant and her colleagues can do. “We do elective surgeries only and can’t do anything too major or acute because there is no blood bank, and the lab may not be open to check hemoglobin,” she says.

She and her team perform orchiopexies (the surgical repair of undescended testicles), circumcisions, as well as inguinal and umbilical hernia repairs. Occasionally, they perform complicated intestinal surgeries on infants who are born with no anus, a condition that she says is prevalent in Yantalo. Correcting it requires performing a colostomy within the first few days of life, which local adult general surgeons typically do, and then months later, creating an anus (anorectoplasty), performed by specialist visiting surgeons, including Dr. Grant and her team. The clinic has a regular rotation of three to four pediatric surgery teams from the U.S. every three to four months. “We all work together. One team does the anorectoplasty and another team closes the colostomy,” she says. "The role of the local adult surgeons who intervene when needed cannot be understated. “Without prompt colostomy after birth, a child would die."

Dr. Grant also volunteers locally through the Global and Local Surgeons of New York, the organization she and her colleagues co-founded to deliver surgical care to underserved populations in New York State and beyond. “Besides going abroad once or twice a year, we want to make an impact locally, to educate people and let them know we’re here to provide care locally, regardless of legal or financial status.”

HISTORIC ENDOVASCULAR FIRST

One day in May 2025, endovascular and cerebrovascular neurosurgeon Justin Santarelli, M.D., walked into the largest hospital in Zambia, the University Teaching Hospital in Lusaka. Dr. Santarelli’s visit was random, the kind he typically makes when traveling abroad, to learn how neurosurgeons outside the United States deliver care. “I wanted to find a hospital in Africa that provides some amount of stroke coverage where I could observe or teach,” says Dr. Santarelli, assistant professor of neurosurgery.

Over three days, Dr. Santarelli participated in the neurosurgery department’s grand rounds and gave lectures on cerebrovascular pathology and the management of acute stroke and aneurysms. He evaluated 20 to 30 patients a day, who lined the hospital halls holding CT scans and MRIs, seeking his assessment of their untreated pathologies. He also performed the first acute stroke endovascular intervention in Zambia’s history. “There’s tremendous satisfaction in providing complex medical and surgical care that literally changes people’s lives in front of your eyes,” he says. 

In the United States, endovascular surgery has been part of the neurosurgery toolkit since the early 1990s. This minimally invasive technique employs the thinnest catheters, wires, stents, and coils to withdraw blood clots from arteries to reduce the risk of stroke and improve chances of viability for stroke patients. Meanwhile, large swaths of Africa lack access to this type of surgery because of its costly technology and lack of training. “There are areas that are entirely unserved by new technology partly because of the massive expense involved for minimal treatment of these conditions,” Dr. Santarelli says.

Lusaka’s teaching hospital has a neurosurgical training program and treats conditions such as acute head trauma and pediatric hydrocephalus. Yet, it lacks the infrastructure and experience to treat cerebrovascular disease with endovascular surgery. “There is a tremendous need in sub-Saharan Africa for stroke treatment and an incredible appetite among young neurosurgery trainees to be able to offer this state-of-the-art technology to the patient population, but because of the outlay of funds required, there are significant limitations,” Dr. Santarelli says. For instance, just replacing the hospital’s 25-to-30-year-old angiogram machine, even with a used one, would cost seven figures, he says. The hospital also needs catheters and stents that endovascular stroke treatment requires, ranging from $5,000 to $10,000 per patient. “We’re talking astronomical numbers,” he says.

Using the hospital’s aged angiogram machine, Dr. Santarelli taught neurosurgeons how to do cerebral catheterization procedures. He also emphasized the importance of creating a special ward in the hospital for managing stroke and donated three suitcases worth of catheterization equipment. “A successful outcome of my voyage was teaching the local population about the management of cerebrovascular disease and inspiring interest in bringing this technology to the patient population,” he says.

Most importantly, he instructed hospital staff about the importance of recognizing stroke as a major disease, noting that Africa’s 54 countries have dramatically higher incidences than the developed world. “Patients in Africa tend to have stroke at younger ages than patients elsewhere in the world because they develop risk factors, like diabetes, hypertension, or hyperlipidemia, at younger ages,” he says. The third or fourth leading cause of morbidity and mortality in the United States and Africa, stroke affects Africans during their fifth or sixth decade of life compared to Americans’ seventh or eighth decade, he says.

Ultimately, teaching hospital staff and patients how to detect the earliest signs and symptoms of stroke and administer timely treatment, such as aspirin or a thrombolytic, may have been Dr. Santarelli’s most critical contribution, he says. “A lot of measures that must be taken to advance stroke care don’t have to involve a multimillion-dollar investment in stroke technology,” he says.  

THE GIFT OF SIGHT

By treating economically and medically underserved patients in the Dominican Republic, Kelly Hutcheson, M.D., M.B.A., helps them live better lives. “We have the gift of sight, and we share it with people who have very little,” says the professor and chair of the Department of Ophthalmology about performing sight-saving surgeries on patients with cataracts or other ophthalmological anomalies.

Every year, she and cataract surgeon Sankara Mahesh, M.D., assistant professor of ophthalmology, travel with a team of 20 clinicians—ophthalmological surgeons and surgical residents—to the Hospital Ricardo Limardo in Puerto Plata, where they spend a week treating as many as 150 patients of all ages. They work on behalf of Casa de Luz (“Lighthouse”) Medical and Eye Surgery Mission, the nonprofit that Dr. Hutcheson founded in 2006, to support her ophthalmological missions. “Because we’re a nonprofit, we can take donations and partner with other NGOs, who provide us with supplies and equipment,” she says. One such NGO, and Casa de Luz’s partner on the ground, is Surgical Eye Expeditions International, which provides instrumentation and supplies, like the lens implants needed for cataract surgery.

Dr. Hutcheson and her team work at the same hospital each time they go. “They let us take over some of their space and lend us staff to help with pre-screenings and post-operative care,” she says. “For the time we’re there, we have our own eye clinic and we bring mostly everything else we need, including an operating microscope, all ophthalmological equipment and surgical supplies,” she says. 

Most of Dr. Hutcheson’s cases include eye muscle surgery on patients with strabismus, a common childhood condition involving misalignment of the eyes. Dr. Mahesh, associate director of Casa de Luz, performs all the cataract surgeries. Cataracts typically develop in older age, when proteins and fibers in the lens begin to break down, turning vision hazy or cloudy. “Cataracts are very treatable except for patients who don’t have access to care. Even with insurance, there’s a significant out of pocket fee,” Dr. Hutcheson says. Left untreated, cataracts can cause blindness, leaving patients unable to work, and care for themselves and their families.

For those with means, however, treatment is simple. Dr. Mahesh makes a micro-surgical incision to remove the damaged lens in one piece and then replaces it with an intraocular lens implant. “He does a lot of these surgeries, while also teaching the residents. It’s a great training opportunity for them,” Dr. Hutcheson says. “One reason we bring residents and students on these mission trips is so they can perpetuate what we do, which is part of NYMC’s legacy,” she says.

In addition to cataracts, Dr. Hutcheson and her colleagues treat strabismus or “crossed eyes” in children as well as adults. “Some adults in Puerto Plata have had crossed eyes for their entire life and didn’t know they can be corrected,” she says.

They also treat pterygium, a growth that occurs over the front part of the eye, frequently resulting from heavy exposure to dust and wind. “A lot of people in the Dominican Republic get around on motorbikes or mopeds and don’t wear goggles, which puts them at high risk for pterygium, which can cause discomfort, tearing, or irritation,” she says. Treatment entails removing the growth and inserting a skin graft to cover any remaining defect, she says. “Usually after we do surgery, patients will come back the next day. They can see and we can see the improvement,” she says.

What is clearest at the end of every mission is that giving goes two ways. “We’re all doing this because we want to give back,” Dr. Hutcheson says. “It is so rewarding to do something that helps other people.”

FACES OF GLOBAL SERVICE

Manoj T. Abraham, M.D., FACS, a facial plastic surgeon and clinical professor of otolaryngology, has spent more than two decades leading medical mission trips with Healing the Children Northeast, Inc., across the globe. He also serves as a senior advisor and former chair of the American Academy of Facial Plastic and Reconstructive Surgery’s (AAFPRS) FACE TO FACE humanitarian program and is the organization’s eastern regional director.

“I’m very fortunate to have survived the ethnic conflict in my home country of Sri Lanka and come to the United States as a child,” explains Dr. Abraham. “I consider myself incredibly lucky to be where I am and that’s my motivation to give back —especially by using my skills to help people around the world who lack access to medical care.”

Dr. Abraham leads two to three medical mission teams each year, where he works closely with local medical staff and brings a team of 20 to 25 medical professionals. These teams typically include surgeons, pediatricians, nurses, anesthesiologists, and speech-language pathologists, as well as NYMC residents and his facial plastic surgery fellows from Mount Sinai Hospital, where he serves as co-director of the facial plastic surgery fellowship.

Through his global work, Dr. Abraham and his team have developed long-lasting relationships with the hospitals they serve, returning regularly to treat patients and train local surgeons. In July 2025, he returned to Bugando Medical Centre in Mwanza, Tanzania, where they have been developing their own plastic surgery residency program, with guidance and support from Dr. Abraham, to increase the number of patients they can treat locally. During his stay, he works with Francis Tegete, M.D., the hospital’s senior plastic and reconstructive surgeon and one of the only plastic surgeons serving the entire eastern region of Tanzania and neighboring countries.

During the trip, the physicians performed 30 to 35 reconstructive surgeries on infants and children with congenital facial deformities, as well as head, neck, and facial plastic surgeries. They also treated cancer-related conditions, traumatic injuries, and hyena bites.

“It’s tremendously gratifying to help children in this way,” he says. “I’m always moved, especially when I do rounds the next day and I get a chance to talk to the parents, and everybody's in tears. We take photographs and they come back the following year for us to do the second stage of the procedures if needed. It’s always great to see how well they're doing and going back to having normal lives.”

Two months prior, Dr. Abraham was joined by Augustine Moscatello, M.D., M.S., professor emeritus and former chair of the Department of Otolaryngology, for their fourth mission trip to a regional hospital in Lviv, Ukraine. Organized by AAFPRS in collaboration with Healing the Children Northeast, Inc., Razom for Ukraine, and Ingenious, the team treated dozens of Ukrainian soldiers and civilians—some as young as five years old—with severe facial injuries. They also trained local surgeons in advanced reconstructive techniques, including microvascular reconstruction and 3-D patient-specific implants. Despite air raid sirens sounding at times during surgery, the team was not affected by active attacks during their stay. Over four years, they have addressed complex eye, nasal, jaw, and facial injuries, including a 14-hour jaw reconstruction surgery.

Dr. Abraham and his team are creating new opportunities to expand their reach and multiply their impact. “We are continuing our work in Ukraine by bringing Ukrainian surgeons to train with us here in the United States, in Oklahoma and in New York at NYMC and Mount Sinai Hospital and have set up educational webinars to provide them much needed education on surgical techniques,” says Dr. Abraham.

Looking ahead to future missions in Tanzania and Ukraine, Dr. Abraham remains committed to expanding global surgical care and seeks participants eager to contribute to upcoming medical mission trips.

STAYING CONNECTED

For 14 days, Carrie Muh, M.D., professor of neurosurgery, traded the halls of NYMC and operating rooms of Westchester Medical Center for Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu, Kenya, treating patients who shared stories she will never forget. In September 2025, Dr. Muh joined the group Giving Back to Kenya and Kisumu Neuroscience Initiative on a mission trip serving dozens of people of all ages with neurological conditions—from spinal disorders to brain injuries.

“The hospital was very crowded,” recalls Dr. Muh. Kisumu is the third largest city in Kenya, with one neurosurgeon for a catchment area of more than one million people. Many people arrived at the hospital to be treated by Dr. Muh and other physicians on the mission trip after weeks of seeing advertisements of the “neurosurgery camp” visitation. Weeks before the trip, hospital physicians triaged and admitted the patients who would undergo surgery by Dr. Muh and her colleagues.

Dr. Muh’s former co-resident, Bethwel Raore, M.D., a Kenyan American, travels to Kenya annually with other physicians to train residents and assist the local neurosurgeon to improve long term care of the region. When Dr. Muh heard that he was planning to go back, she asked if she could go along and brought one of her chief residents, Nitesh Damodara, M.D., instructor of neurosurgery.

“When we arrived, there were dozens of patients in one huge ward — just bed after bed after bed after bed, and three big rows of people just waiting for us,” she recalls, noting dozens of patients walking miles to be seen. “We would go down the rows and look at the CD that each patient brought with them of their imaging to see if we could offer them surgery.”

Serving on a mission trip in 2024 to Ukraine and having spent time in hospitals and research labs in Shanghai, China, and rotations in Taichung, Taiwan, Dr. Muh was eager to provide an additional helping hand to the under-resourced area.

In Kisumu, she and her team treated 54 cases that ranged from pediatric and adult brain tumors to abscesses in the brain to babies born with myelomeningoceles, a birth defect where the spine and spinal canal remain open after birth, in addition to tending to patients who visited the clinic. Surgeries spanned two hours to as long as seven hours with some workdays reaching 15 hours.

In Kenya, Dr. Muh operated on a teenage boy with cerebellar abscesses who was in the hospital for months on antibiotics to stop the infection from getting worse. The placement of the abscesses on his brain caused him to be unable to bring a cup to his mouth without shaking and walk without someone holding him upright. After draining the three abscesses, he was walking and drinking water without any problem.

“My experiences abroad have made me see things differently,” says Dr. Muh. “In the U.S. we use disposable tools and wait to take on a case until we have all the high-tech equipment. In Kenya and Ukraine, there are times you have to improvise —using sterilized, reusable tools or older techniques like handheld drills and Gigli saws. It's beneficial because it makes you think of creative ways to treat patients besides the slightly more spoiled way that we are used to in the States.”

Before leaving, the mission team also taught general surgery residents a variety of neurosurgical techniques, helping ensure that more procedures could continue even after the trip ended. Months after the trip, Dr. Muh remains in touch with the general surgeons and residents, checking on the progress of their patients and providing guidance for future cases until she returns again.