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Following up on successful visit in 2006

U.S. doctors will return to Mauritius

By Pamela de St. Antoine

Washington Correspondent

A medical team from the United States, including a Mauritian who is a registered nurse, will return to Mauritius in November to perform delicate surgeries on adults and children who suffer from various deformities, wounds, burns and tumors.

Dr. Mark Granick, head of plastic surgery at the New Jersey Medical School, will again lead the mission to the Victoria Hospital in Quatre Bornes. Last year they performed 20 surgeries and conferred with many other patients.

The team will work with Dr. R.P. Gunessee, who is the sole plastic surgeon in Mauritius. Gunessee has lined up about 15 surgeries to be done during their 10-day stay in early November. The doctors will also check the progress of patients on whom they operated last year.

Dr. Granick sees his role as a partnership with Gunessee, whom he called a highly competent surgeon who works tirelessly under challenging circumstances. As the only plastic surgeon on the island, Gunessee has a very demanding workload, performing about 1,000 surgeries a year, and not often with the most adequate and modern equipment.

Gunessee was trained in Belgium, but because of the geographic isolation of Mauritius, is not able to attend many medical conferences and subscribe to costly medical journals that can keep him up-to-date on the latest plastic surgery techniques. "This field changes rapidly, and you must keep current," Granick said, adding that he was able to show Gunessee the latest techniques in reconstruction, including breast and ear.

Demand remains strong in Mauritius for procedures that are complicated and costly. Not all patients that need a high level of care can afford to travel to Europe or South Africa, so their conditions often go untreated until they worsen or become life threatening.

Last year, Granick's team saw patients needing breast reconstruction, surgery for cleft palates, repair of facial fractures, and treatment of wounds from burns and inadequately healed operations. Granick said there were many wounds - mostly to the foot - caused by under-treated or untreated diabetes, which is a common ailment in Mauritius.

He also treated children who were born without the external part of an ear, a condition called microtia.

In an interview with Weekend from his office in New Jersey, Dr. Granick recalled that when he arrived at Victoria Hospital for the first time last year, there were 50 patients lined up waiting. Doctors couldn't handle every case, however, as some were too complicated and required multiple visits over long periods of time, while others required treatment with more sophisticated equipment than what was available.

"The equipment was a bit crude but the surgeon was able to manage well despite of it," Granick said. "And there were a lot of people helping who were full of enthusiasm. It was a pleasure working with everyone."

But Granick said the hospital lacked disposable items used during surgeries that are taken for granted in U.S. hospitals and that the sterilization machine and procedures used for sterilization were antiquated.

As a result, Granick plans to bring to Mauritius a new sterilization machine, which he will pay for from money raised at fundraisers. He is contacting several American medical companies to secure donations of material to treat wounds and for plates and screws needed to repair facial and hand fractures. "Companies have been very open to such donations, it's just a matter of getting to the right people."

Granick said that he would also like to give talks to Mauritian doctors and medical staff regarding pre- and post-operative patient care, and will bring a set of protocols that describe proper handling of medical instruments.

Accompanying Granick will be another plastic surgeon, Shyam Noruthun, a Mauritian-born nurse who works with Granick, and Carol Singer-Granick, Dr. Granick's wife, who is associate professor of pediatrics at the medical school. Singer-Granick, a pediatric endocrinologist, plans to meet with pediatricians and medical doctors to discuss managing diabetes in children.

Bringing medical experts to Mauritius was the idea of Noruthun, a native of Triolet, who works with Dr. Granick at the New Jersey Medical School in Newark, N.J. He once worked as a registered nurse at SSR National Hospital, Pamplemousses.

Noruthun had watched other doctors from the school travel on humanitarian missions to places like India and Bangladesh. He wondered why such a trip couldn't be organized to Mauritius, where many medical conditions go untreated or are inadequately treated, especially among the island's poorest residents. While doctors have come to Mauritius in the past from Europe, India and South Africa, this is believed to be the first time an U.S. medical team has worked on the island.

Noruthun asked Dr. Granick if he would be interested in taking a trip to Mauritius, and when he agreed, Noruthun began making inquiries to the government of Mauritius about organizing such a mission.

He was told to confer with Dr. Gunessee, who eventually convinced the Hon. Satya Faugoo, Minister of Health, to support the mission. Faugoo arranged for the government to pay the transportation and lodging expenses of the American medical team. Cooperation from the government was excellent during the first visit (the minister came to the hospital and made a presentation and checked on the patients), but Noruthun was frustrated and disappointed that it took more than two years for the government bureaucracy to approve the project. Fortunately, Noruthun was persistent and didn't give up.

"My goal has been to help people in Mauritius, and to give something back to the country by organizing this," Noruthun said. "Dr. Granick is fabulous to work with and he has a great heart to help people. He is providing all this medical care for free."

Both Granick and Noruthun said they would like to continue to come to Mauritius on a yearly basis, because their work is so appreciated.

"This was really an altruistic effort, and I feel that we were able to make a difference," Granick said. "Most of the patients will have long lasting improvements in their lives" as a result of the surgeries.

a m e r i c a n   s c e n e

WEEK-END --- dimanche 2 septembre 2007