Available online at www.sciencedirect.com
Gary Heit, MD, PhD, and Americare Neurosurgery International
Pursuing a medical education followed by additional long
Arias Villena. They operated on 25 patients. Cases ranged
years in specialty training requires vision, commitment, hard
from reconstruction of complex spinal deformities to repair of
work, perseverance, and an unwavering desire to achieve
pediatric skull fractures and treatment of adult brain tumors.
excellence. These requirements and goals become habits that
Because of the excellence and expertise of the well-trained
serve us well as we grow our careers.
and well-organized neurosurgical team, they were able to
The specialty of neurological surgery and of allied
complete their work without experiencing any complications.
specialties has grown to levels of excellence often taken
Doctor Heit and his neurosurgical and orthopedic team
for granted today, and this has occurred primarily during the
returned home physically tired but exhilarated and with
lifetimes of many of us who are today's senior neurosur-
stories to tell. They also had a vision for more volunteer work
geons. To the question, “Where does the specialty of
in the future. Doctor Heit and his colleague, Ms Gerstner,
neurosurgery go from here?” we must respond, “To even
developed a medical care model for a humanitarian
organization they named Americare Neurosurgery Interna-
We must also address the question, “What can be done to
bring modern neurosurgery to people in developing
The stated goal of AMCANI is to promote locally
countries where so little neurosurgical care is available
sustainable, modern neurosurgical care in developing
countries, maintaining respect for the local population and
Gary Heit, PhD, MD, works to bring modern neurosur-
with integration of the work into the local culture. It is the
gery to people who do not have access to it. His first medical
endeavor of AMCANI to increase the level of medical care
mission was inspired by his sister who lives in Peru and who
in host countries by providing professional training and the
told him of the tremendous health care needs there. Sharing
development of appropriate support resources such as
his vision with colleagues, he found that they, too, were
physical therapy, rehabilitation skills, and nursing care in
interested in joining him on these missions.
the context of supply capital equipment that the host country
Then, Dr Heit learned that neurosurgical instruments and
other items of essential equipment commonly available here
In launching AMCANI, Dr Heit describes his premise:
are absent there. Children in Peru die because shunts are not
“We as Americans are fortunate yet wasteful. Modern
available to treat hydrocephalus. He approached medical
neurosurgery requires expensive capital equipment that
equipment and supply representatives, asking for donations.
frequently cannot be afforded in developing countries. At
Many have demonstrated heartening generosity, donating
the same time, hospitals in the United States are retiring
equipment that is still viable for medical practice. For
On May 18, 2002, Dr Heit set off for Cuzco, Peru, as a
example, the operative microscope has been a defining
neurosurgeon volunteer. Accompanying him were 13
element of modern neurosurgery, and even though these
surgical colleagues, nurses, and surgical technicians. They
instruments have the potential to last for many years
brought shunt hardware, spinal fusion instruments and
requiring only such low cost maintenance as light bulb
hardware, external ventricular drains, and antibiotics includ-
changes, they are often replaced by newer models. However,
ing Kezol and Keflex, steroids, and of course, greatly
delivery of a retired operative microscope to a competent
appreciated donations of cash to cover transportation costs.
neurosurgeon in a developing country can revolutionize his
Arriving in Cuzco was an operating team composed of 2
neurosurgeons, 1 orthopedic surgeon, several registered
“It is the aim of AMCANI to recycle durable equipment
nurses, and other perioperative personnel. The team spent
that has minimal overhead and to deliver with that equipment
10 days in Peru working in association with Dr Diomedes
training in the neurosurgical techniques it enables and the
0090-3019/$ – see front matter 2008 Elsevier Inc. All rights reserved.
Editorial / Surgical Neurology 69 (2008) 544–545
postoperative care required for more complex procedures. By
person who has had a vision for service to others becomes
having neurosurgical teams accompany this equipment, and
the spark that ignites the fire in others.
offering teaching expertise, this model will benefit thousands
Through Profiles in Volunteerism editorials in Surgical
of patients throughout the developing world. The plan will
Neurology, it is our goal to raise awareness of the tremendous
also help in minimizing waste in our own US medical system.
needs in the world today and to encourage others to help
“In sum, the purpose of AMCANI is to deliver
bring modern neurosurgery to people in developing
neurosurgical training and durable medical supplies to
countries. We also remind our readers of their unique
local neurosurgeons in developing countries.”
abilities to identify medical equipment and supplies that
The Americare Neurosurgery International has received
might be donated by hospitals and by surgical supply
501(c)3 status from the Internal Revenue Service. This
companies for use in countries where the needs are so great.
enables volunteer physicians and nurses to deduct on their
As Dr Heit and his colleagues have shown us, much can
tax returns their travel and subsistence expenses.
be done to bring improved neurosurgical care to developing
Since the Peru mission, Dr Heit and AMCANI volunteers
countries. The American College of Surgeons (ACS) has
have also done volunteer neurosurgical work at the
launched Operation Giving Back Program through which
Department of Neurosurgery at the Hue Medical College
neurosurgeons who wish to volunteer can find their place to
in Vietnam, and they are preparing to work in hospitals in
serve. The ACS offers a list of organizations like AMCANI
other countries. For these, AMCANI seeks neurosurgical
through which neurosurgeons can volunteer.
teaching volunteers who are board eligible or board certifiedNeurosurgeons, and also surgical nurses, neurointensivists,
neurologists, and other qualified team members.
The volunteer work Dr Heit has done through AMCANI
demonstrates the effect that can be accomplished by one
person. The enthusiasm shown in the telling of stories by one
Your help is needed, in bringing Neurosurgery to the world.
Can you help the journal of Surgical Neurology in the following ways?
1. If you have done volunteer work as a Neurosurgeon, or know of someone who has done this kind of work, please send a
summary page giving your name, or that of the other volunteers you are able to identify to [email protected]
andalso contact information and a brief description of the work you (or they) have done. Through an editorial page in SurgicalNeurology, we want to identify as many neurosurgeon volunteers as we can.
2. Should you have an interest in volunteering for a short-term assignment in a developing country, either as a Clinical
Neurosurgeon or as a Visiting Professor of Neurosurgery, please let us know.
You may contact Surgical Neurology, to see what you can do to bring Neurosurgery to people less fortunate than you
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