Operation Walk Boston: 10th Annual Trip

The Operation Walk Boston team performs free joint replacement surgeries for patients in the Dominican Republic.

Interview with Chief Operating Officer Roya Ghazinouri, PT, DPT, MS

Emma C. Lape (ECL)

Roya Ghazinouri (RG)

ECL: What are the goals of the trip? How have they changed (if at all), looking back as you complete the 10^th annual trip?

RG: The goals have always been threefold: to provide safe surgical care and follow-up to ensure good outcomes; to educate local providers; and finally to conduct and disseminate research about global surgical care. While the goals stay the same, the balance of what we do has evolved as we’ve built our partnership with the hospital in the DR [Hospital General de la Plaza de la Salud, Santo Domingo]. In the first 2 or 3 years, we focused on making sure we had the facilities and workflows in place for safe surgeries—so much training and coordination goes into building a team that communicates and where everyone knows what they have to do. Next, we began to focus on refining our clinical guidelines to meet the needs of our patients, and also on education and training of local care providers.

ECL: Reflecting on this year’s trip, what were the highlights? Were there any surprises?

RG: This year was smooth sailing, a fabulous trip. In part, this was because we had a robust screening process for patient selection and surgical evaluation. This process typically starts 6 to 8 months before our mission. We worked closely with our surgical and anesthesiology teams in the US and in the Dominican Republic. We are fortunate to also have a collaboration with medical students at Universidad Iberoamericana (UNIBE), who act as our mission coordinators in the DR. They work closely with us and the hospital and care providers in the DR to ensure that all aspects of the mission are managed.

The surprise, for me, was that everyone knew exactly what they needed to do! We’ve developed such an efficient, functional team. There is tremendous passion and teamwork.

I’d have to pick a few highlights: First, we had a 10^th Anniversary celebration, in which patients from the past 10 years came back and gave testimonials. It was great to hear how the surgeries had changed their lives, and to see continuity across 10 years and keep in touch with patients long after the usual 2-year follow-up.

This year we also began a collaboration with the Boston Scholar Athletes program, which is a program started in the Boston Public High Schools to promote academic achievement through sports. This year we had 2 students join us, and it was fantastic to see their motivation to learn about all aspects of the trip.

Finally, I always hesitate to put a patient in the spotlight, but one patient this year touched all of us, so I’ll share her story. She’s a woman in her 20s with severe bilateral hip disease, which had forced her to drop out of medical school. Last year, we didn’t have the specialized equipment needed for her surgery, so this year we were prepared. After operating on one of her hips, we halted the second operation because of safety concerns. She did beautifully with physical therapy, and she was optimistic and cheerful at the end of the mission. We hope to make sure she receives her second hip surgery next year. It was truly a life-changing operation.

ECL: The continuity of coming back year after year is really powerful, being able to adapt and prepare for what a patient needs in subsequent years.

One final question for you: What are the takeaways? What would you like orthopedic surgeons and researchers to know about surgical mission and research trips like OpWalk?

RG: I’d want them to know that these surgeries are really needed. Second, it takes a highly trained and coordinated team to do these surgeries in a mission format. But the key to success is to ensure that local surgeons are trained and able to perform these surgeries independently in their own countries.

I’d also like people to be aware of the unusual opportunity we have here to combine a surgical trip with a robust research program. There are very few trips like this, as far as I know, that also perform this volume of systematic and longitudinal research. Our research team is led  is led by Dr. Katz, and the boots on the ground are often Harvard Medical School students and other local and US students interested in research. We’re fortunate to be in a position to combine care delivery with academic medicine—a rarity in short-term missions. It’s been a pleasure to be part of this mission for the past decade.