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Unexpected Challenges Caused by COVID-19: Humanitarian Work Abroad

Feb. 28, 2021

Within the last decade, humanitarian health work has increasingly become more and more embedded in medical curriculums across the country.


Many physician residents and fellowship students have opportunities with their training institutions and organizations overseas to serve vulnerable populations, both domestic and international, that don’t have access to necessary healthcare services.

“Beyond providing services to underserved populations, it builds positive relationships between the host and visiting programs that allow for shared learning, research and friendship,” explains Chad A. Zender, MD, UC Health associate chief medical officer and head and neck cancer surgeon, and professor of otolaryngology at the University of Cincinnati College of Medicine. “Humanitarian health programs expose individuals to new cultures nationally and internationally, solidifying that all humans have fundamental needs in health, friendship and family.”

At the time when Dr. Zender was completing his fellowship education, there were only a few training programs in the country that offered these types of opportunities. It was then he saw a need, and ultimately, in 2014, co-founded the Head and Neck Outreach (HNO) with Katrina Harrill, RN, clinical nurse manager on the oncology navigation team. Together, they partnered with Jeff Otiti, MD, fellow head and neck specialist from the Uganda Cancer Institute.

HNO is a nonprofit medical outreach organization focused on developing sustainable head and neck care education, research and surgical programs. HNO provides attending physicians, residents, medical students and nurses from all over the U.S. the opportunity to partner with the Uganda Cancer Institute, located in Kampala, Uganda.

“In the past six years, our partnership has allowed us to perform over 200 operations, see over 500 patients and complete 10 trips to date,” said Dr. Zender.

The scope of their work ranges from standard endoscopies to evaluate a patient’s airway, to long operations needed to remove and reconstruct disfiguring jaw tumors.

“Returning to the same location and helping build infrastructure that includes both personnel and equipment is a fundamental philosophy of our outreach program. This approach has helped Dr. Otiti and his team to continue to offer services to head and neck patients year-round in an increased capacity at the Uganda Cancer Institute,” Dr. Zender stated.

The UC College of Medicine is working toward formalizing humanitarian health programs within various curriculums to allow more residents to participate on these types trips, including ones led by Christopher Lewis, MD, UC’s vice provost for academic programs, associate professor in the Department of Family and Community Medicine at the UC College of Medicine and a UC Health primary care/family medicine physician.

Dr. Lewis founded the Village Life Outreach Project in 2004, bringing healthcare and health education to underserved populations in Honduras, El Salvador and Tanzania.

Support from a Distance

Unfortunately, COVID-19 travel restrictions forced these efforts to pivot and transition to virtual collaboration.

“We had to cancel our spring trip in March 2020 due to the beginning of the COVID-19 pandemic here in the U.S.,” explained Dr. Zender. “It was a tough decision due to the negative impact on the host country and the visiting clinicians.”

Although they had to cancel their annual mission trip, Dr. Zender and his team continue to collaborate with their Ugandan partners.

“We continue to connect with Dr. Otiti in order to understand their needs as the pandemic has drawn on,” said Dr. Zender. “Our goal here in the U.S. is to help identify their needed resources that can be secured and shipped early this year.”

Despite these challenges and thanks to their solid partnership, Dr. Otiti is able to continue to care for patients at the Uganda Cancer Institute.

“Currently, we are working toward a trip in early summer and supporting a project led by Vanderbilt University involving ultrasound use in low middle-income countries,” said Dr. Zender.

With the rollout of the COVID-19 vaccine, hope is no longer just on the horizon — it’s here.

Physicians like Dr. Zender and Dr. Lewis are eager to plan their next trips abroad in order to be able to continue building partnerships and providing patients across the world with the benefits, resources and differences that academic medical centers, like UC Health, have to offer.