Operation Greater Good

Posted by Jill Clendening on Tuesday, January 3, 2023 in Fall 2022, Features, Homepage Highlights .

Rondi Kauffmann, MD, MPH, HS’13, associate professor of Surgery in the Division of Surgical Oncology and Endocrine Surgery, can pinpoint when her spark to address disparities in global health caught fire. She was a wide-eyed 12-year-old staring up at a 10-story mountain of garbage in Manila, Philippines.

“It was the summer of 1990, and my family was living for three months just outside of Manila,” she said. “Thousands of people lived on this mountain of trash. They had makeshift homes and made money by looking through the garbage to find things to sell.

“There were a lot of children running around, and the person driving us explained how just one in five, or two in five, children would live to the age of 5. They died of pneumonia, malaria and other communicable diseases, and that just seemed incomprehensible to me. In my naïve, sixth-grade mind, I decided I would do something about that.”

Kauffmann did international service work during high school, college and medical school. While she initially intended to specialize in infectious diseases, she ultimately chose surgery. As she applied to residency programs, she was advised to consider Vanderbilt University Medical Center where John Tarpley, MD, then program director for the General Surgery residency, was renowned for efforts he led in global surgery.

Kauffmann came to Nashville and learned from Tarpley and other mentors about how to partner with others to provide surgery and training in often resource-poor environments. After completing a fellowship elsewhere, she returned to VUMC and began coordinating one of Tarpley’s projects, a general surgery residency rotation at a hospital in Kijabe, Kenya.

Now, Kauffmann has been selected to be the inaugural vice chair for Global Surgery in the Section of Surgical Sciences. In this role, she will support the section’s global surgery efforts; improve communication and build teams for initiatives both within the section and with other groups at VUMC and Vanderbilt University; represent the section in Medical Center and University-wide global health efforts; and provide funding for travel and education.

“Rondi is a superb clinician and has already demonstrated herself a proven leader at the state level as an advocate for patients and surgical programs,” said Seth Karp, MD, H. William Scott Jr. Professor of Surgery and chair of the Section of Surgical Sciences. “A goal of the Section is to contribute to knowledge and teaching to improve the care of surgical programs throughout the world. Collaborations with other countries provide mutual benefit for the participants to

understand different care models, ways to care for patients, and specific cultural issues that improve care for all.”

Kauffmann also serves as director of the Vanderbilt Global Health Equity and Access Leadership in Surgery program, co-director of the Kijabe-Vanderbilt Research Methodologies for Healthcare Providers Course, co-director of the Vanderbilt Collaborative for Global Health Equity and directs collaborative surgery efforts with AIC Kijabe Hospital. She is also committed to addressing domestic health inequities as evidenced by her work to coordinate surgeries for uninsured patients at Shade Tree Clinic and Siloam Clinic in Nashville.

“There is a Bible verse that says ‘to whom much is given, much is expected,’” Kauffmann said. “Vanderbilt has been an international force in global health for a long time. The Vanderbilt Institute for Global Health is such a great example of that, as the institute brings together physicians from different specialties and nonphysicians involved in global health to work in a centralized way. The Section of Surgical Sciences has had global health involvement for more than a decade, and our impact will be exponentially increased as we work in partnership with VIGH and other departments at VUMC.”

Kauffmann is known among her colleagues for analyzing seemingly intractable impasses and then chipping away until a solution is reached. For example, when VUMC residents and faculty go to Kenya, they are allowed an active role in patient care; when foreign medical professionals visit the U.S. they are not.

Kauffmann began researching the issue and learned there was no way for medical practitioners coming to Tennessee from abroad to participate in patient care because there was no way for them to obtain even a temporary medical license. She then played an instrumental role in the recent passage of state legislation which creates a 90-day, limited license. With this license, medical practitioners from abroad will be able to participate in patient care in Tennessee, under the supervision of a Tennessee-licensed physician.

“It was signed by the governor in May, and now the Board of Medical Examiners will write the rules that will allow the licensure category to be applied,” Kauffmann said. “This is a game changer because this has been a big challenge for some of these international collaborations.”

Kauffmann also played a key role in the creation of an Open Manual of Surgery in Resource Limited Settings, an open-access, online resource detailing surgical techniques to aid surgeons in resource-limited settings. Richard Davis, MD, a VUMC voluntary faculty member and program director for the general surgery residency at AIC Kijabe Hospital, pointed out this need, as most online surgical resources are written for high-resource settings, charge an access fee, and poor connectivity can limit use of high-fidelity content.

Section of Surgical Sciences system administrator Paul Lang and communications consultant Deborah Doyle worked with Christopher Bozorgmehr, a VU undergraduate student and VIGH intern, to build the open manual website.

“The table of contents has about 135 planned chapters, and we have more than 30 of them populated,” Kauffmann said. “They’re all PDFs, and there are no imbedded videos, so they’re designed to be low fidelity.”

Michael Dewan, MD, MSCI, assistant professor of Neurological Surgery, and Nhue Do, MD, assistant professor of Cardiac Surgery in the Division of Pediatric Cardiac Surgery at Monroe Carell Jr. Children’s Hospital at Vanderbilt, join Kauffmann to serve as associate vice chairs for Global Surgery.

Do has been deeply involved in global surgery in Southeast Asia, and his expertise in cardiac surgery will be an asset as Vanderbilt builds a partnership in cardiothoracic surgery with Tenwek Hospital in Kenya.

Dewan is surgical director of the Pediatric Neuro-Oncology Program and Pediatric Neuro-Vascular Program and academic director of the Global Neurosurgery Program. He is a core faculty member of VIGH, co-founded the NeuroKids nonprofit to train neurosurgeons in resource-constrained settings and is actively involved in the Global Neurosurgery Global Burden of Disease Initiative to study the burden of pediatric neurosurgical disease.

Tarpley, and his wife, Maggie, his lifelong partner in global health and humanitarian efforts, are serving as senior consultants for the Global Surgery team.

An immediate goal of Global Surgery in the Section of Surgical Sciences is to secure funding to endow a fellowship to support ongoing efforts, said Karp.