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Geoffrey Walker teaches ‘real’ orthopaedics on trips to Ethiopia, Laos
He trains local doctors using only available materials and facilities so they can perform the procedures themselves after he’s gone.
About four times a year, Geoffrey Walker, FRCS, puts his more than 50 years of orthopaedic experience to work teaching the fundamentals of orthopaedic surgery in Laos and in Ethiopia.
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Courtesy of Geoffrey Walker |
But each time Walker travels from his home in London to these two countries, it is an adventure because he is never quite sure what he will be expected to teach the local physicians when he arrives. Fortunately, he thrives upon that kind of uncertainty and those ever-changing scenarios, which range from late-presenting trauma cases and tumors to congenital deformities and late results of polio.
That also means he needs to be truly prepared for just about anything. And, it appears he is.
In an interview with Orthopaedics Today, Walker said that given these circumstances he feels qualified to provide the kind of on-the-spot orthopaedic training needed in developing countries. Decades of taking such trips through World Orthopaedic Concern (WOC) have equipped Walker, age 78, to effectively lecture on about nearly every orthopaedic topic he encounters.
“It’s all very oriented to the patients who present, the X-rays that are shown, always teaching fundamentals and emphasizing the need to know anatomy,” he said.
Personal teaching
Over time, Walker has also mastered those hands-on teaching methods that best help the Ethiopian and Laotian doctors to use the techniques and treatments that they are taught. “This teaching has to be very clinically oriented … interactive. It’s all very personal teaching both in the wards and in the morning staff meetings and in the outpatients,” he said.
Before he retired in 1988, Walker practiced pediatric and adult orthopaedics and traumatology surgery at Queen Mary’s Hospital for Children in Carshalton, London, and Epson District Hospital, part of the St. Georges training circuit.
In Laos and Ethiopia, where he now instructs “future department heads,” Walker takes a teaching-the-teacher approach, preparing those he trains in such a way that they can later train others.
“I don’t operate, but I used to operate. So now it’s really just teaching the staff, postgraduate and undergraduate students as best I can. And they really do need a good deal of help.”
International trainees
These trips have also become valuable training opportunities for orthopaedists from the United Kingdom and other countries. Walker takes residents and others with him on his trips, and he always welcomes trainees. “I’ve had American trainees in Ethiopia and English and French trainees in Laos,” he said, noting he also encourages senior people to go.
Walker has other responsibilities on these trips, too. When other English-speaking surgeons are onsite in Laos, he may do some translating, particularly when they don’t know French, the language most spoken there, after the Lao language. Last December when he was in Vientiane, Laos’ capital, he expected a team of Australian hand surgeons that did not speak French to be there at the same time. Walker anticipated spending time helping them do their work by translating what they said into French and then having someone else translate that into the Lao language.
Satisfying work
Starting in the 1960s, his love for this type of work inspired him to volunteer in many areas of world, including Nigeria and Bangladesh. That same interest now fuels his regular return to Ethiopia and Laos year after year. About 18 years ago, he first visited Addis Ababa, Ethiopia, as a professor working there for two years for the British Council. Except for three years when someone else went there in his place, Walker has consistently returned to the Black Lion Hospital in Addis once or twice a year, staying for about six weeks each time.
Ten years ago he started similar biannual visits to Mittaphab Hospital in Vientiane.
“My main message is it’s fascinating work and it’s good fun,” Walker said.
In addition, he is convinced he has helped improve the quality of the health care in the two areas he visits by encouraging orthopaedic surgeons there to unlearn some of the inappropriate surgical methods previously taught to them.
“They’ve been taught fairly sophisticated surgical operations, which perhaps aren’t too suitable for the country and for the provincial hospitals. People come to the ‘center,’ but [they] only learn how to operate on fractures, rather than how to treat them conservatively,” he noted.
Signs of progress
“In poorer and less developed areas, a very great deal can be done if one follows the basic principles of our specialty and learns to use and to teach with the materials and facilities locally available,” Walker wrote in an article at the Web site for the U.K. branch of WOC.
In recent years, he’s seen progress at both countries he visits. In Addis, for example, more private hospitals have opened to provide care for people who can afford it, thus reducing the need for patients to go abroad for treatment. “They can get most of the reasonable treatments locally, which saves the country hard currency,” Walker said.
What about the future? “I get asked how long I’m going to go on doing this. While I am asked, while I seem to be appreciated, while I remain fit, and, above all, while I enjoy it, I shall continue.”
Walker realizes the day should come when his impact in these places has passed its peak. But, at that point he would not discontinue his work with WOC: “I’d just consider going somewhere else.”