This past summer, I worked on three projects with the Harvard Global Orthopaedic Collaborative, including 1) technical priorities for orthopaedic trauma care development in Malawi, 2) socioeconomic consequences of femoral shaft fractures in Malawi, and 3) the utility of a low-cost negative pressure wound therapy device in cameroon.

The first project required analysis of preexisting data to create a curated list of challenges to orthopaedic trauma care delivery in Malawi. These challenges were then sent to our colleagues in Malawi and underwent a Delphi methodology to produce an expert opinion consensus statement from all 12 orthopaedic surgeons in Malawi. The second project involved the analysis of previously collected data to comment on the socioeconomic consequences of femoral shaft fracture, including changes in the standard of living and financial well-being of patients and their families. The third study, which was recently developed and currently in the final stages of being initiated, involves the delivery of low-cost wound therapy devices to northern Cameroon and subsequent study of their efficacy.

For these projects, I utilized knowledge and skill sets that I acquired from both my MD and MBA degrees. The medical knowledge acquired during my first three years of medical school related to orthopaedic trauma care was particularly helpful with my projects. Additionally, I benefitted greatly from my understanding of cost-benefit analyses and operations, which I acquired during my MBA. Ultimately, I realized that while a medical education is crucial in determining what is clinically optimal, this treatment modality was oftentimes not even feasible in low-resource settings. It was my business education that really gave me the tools and mindset to effectively address some of the more essential infrastructural and systematic challenges associated with orthopaedic trauma care delivery.

First and foremost, there were some inherent challenges with being remote. In an ideal situation, I would have loved to be on the ground in Malawi to really move along the projects. However, this was, of course, not possible due to the current situation. Given the connectivity limitations in Malawi, this made it difficult to communicate effectively with our colleagues in Malawi and made the project far more slow-moving than we had initially hoped. Additionally, there were some political challenges associated with our project. Given the pandemic, many foreigners left Malawi, and this caused many Malawians to be distrustful of the intent of foreigners in health care delivery and capacity building. Also, due to controversy around the recent Malawian presidential election, our projects were delayed for a few weeks until the subsequent social unrest subsided.

My experiences this summer and the connections that I made in the field of global orthopaedics will be paramount to my success in the future. Through this work, I learned a great deal about devising capacity building projects, conducting qualitative and quantitative outcomes studies, and studying the efficacy of innovative devices all in low-resource settings. As I progress in my own career as an orthopaedic surgeon, I will undoubtedly utilize skills that I attained through this experience to direct my own work in global orthopaedics.