"A lot of young men sustain injuries in the mines and don't have an option for care," says Dr. Kaul. "I wanted to develop some resources to help the people out there. It has taken awhile to gather the resources, but we were finally able to make our first trip to the Congo for the Spine Africa Project in August of 2011 and operate for the first time."
Dr. Kaul discusses his experiences in the Congo and his hopes for the future of the Spine Africa Project.
1. Project goals. Through his efforts with the Spine Africa Project, Dr. Kaul hopes not only to provide care for people of the Congo, but also promote a sustainable base of care within the country by educating healthcare providers. For the moment, he is working with the local medical professionals to perform open spine procedures because he lacks the resources to perform the minimally invasive surgeries that have made his practice successful in the United States. The open procedures are also better for promoting the educational aspect of his mission. However, he would eventually like to build the funds to bring the minimally invasive equipment to the Congo for his patients.
2. Access to spine care. In the United States, when people sustain back injuries or develop back conditions, there are safety nets in place to make sure they have access to care, even if they don't have private insurance. When workers sustain injuries on the job, the company provides them with compensation for being unable to work. However, this is not the case in the Congo.
"If the breadwinner for the family sustains an injury, there isn't a support system for them or their families," says Dr. Kaul. "These people become a drain on their family and village, and often their untreated injuries result in paralysis. Help for them is often nonexistent."
During his first trip to the Congo, Dr. Kaul met a 25-year-old man who had worked in the mines until an accident left him unable to work and crippled with back pain. He visited the local healthcare facilities and the physicians didn't know what to do for him, so he was sent back home. Since he couldn't work, his family became destitute.
Even when patients are able to receive spine surgery, there are additional aspects of healthcare that are prohibitive. The patients are expected to purchase their own pain medication and anesthetics, and if they aren't able to afford them, they must suffer through the pain.
3. Common spine pathology. Many of the people with spinal injuries in the Congo are suffering from degenerative spinal injuries from repetitive hard labor and continuous internal conflict. Even though the civil war in Rwanda ended more than a decade ago, the strife spilled over into the Congo and hasn't settled down. There have been several instances of traumatic spine injuries due to this conflict. Additionally, mining accidents were the cause of several traumatic spinal injuries for men while women bore the brunt of the degenerative conditions from manual labor jobs they took on to support their families.
"As the country continues to struggle with a deteriorating infrastructure, a lot of the manual labor has fallen on the backs of women," says Dr. Kaul. "One of the things we saw was women carrying 200 pound packs of material several miles into the marketplaces so they could sell it."
Additional prevalent spinal conditions include tuberculosis of the spine and a collapse of the thoracolumbar spine.
4. Healthcare facilities. There is a lack of healthcare facilities in the Congo, and those that do exist are often dilapidated due to lack of funding. Infection control guidelines aren't followed and in some places are non-existing. "The infection control techniques that we use in the United States are at best minimal over there," says Dr. Kaul. "There was a lack of running water and intermittent electricity. There were times when we were in the middle of operating on a case and the power would go down."
As part of his efforts with the Spine Africa Project, Dr. Kaul is raising money to begin bringing equipment, such as a backup generator and sterilization equipment, to the hospital. He will also provide educational programs for Congolese physicians on sterile technique to improve their facilities in the future.
5. Socioeconomic impact of care. The socioeconomic impact of providing spine care to people in the Congo is great because once people are able to overcome their spine injuries, they can return to work and become productive members of society. "For a relatively small input of time, resources and effort, the output is relatively huge," says Dr. Kaul. "Physicians can donate money to the foundation or collect surplus materials that they don't use anymore for our efforts. We are also looking for people who are willing to volunteer their time for a week every year to provide care for people in the Congo."
Dr. Kaul treated several patients during his first trip to the Congo and already has 10-15 major operative cases scheduled for his next trip this coming December. He expects to see 50-70 patients in the clinic and operate on patients every day. Each surgeon accompanying him could expect the same.
The Spine Africa Project is holding its first fundraiser in New York on Nov. 12, with the hopes of raising enough funds to cover its December trip. The organization has also created a short video documentary of the trip to promote awareness for their cause. Surgeons interested in learning more about the project can visit the website at www.spineafricaproject.org/
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Humanitarian Spine Care: 5 Things to Know About Spine Africa ProjectWritten by Laura Miller | October 14, 2011
Richard Kaul, MD, founder of New Jersey Spine & Rehabilitation in Pompton Lakes, NJ, first visited the Congo about three years ago in a humanitarian capacity. While there, he visited hospitals and clinics and found there were no provisions for spine care even though a huge portion of the population suffers from spinal injuries, deformities and sustain debilitating traumatic experiences during their work in the mines. Upon returning to the United States, Dr. Kaul set the gears in motion to found his charitable organization, the Spine Africa Project, to bring more advanced spine care to the Congo.
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