Thursday, September 25, 2014

Challenges & Lessons Learned - Mike Dominello, MD


Dr. Dominello at Zomba Central Hospital in Malawi

This year, I had the opportunity to travel to two African nations, Malawi and Tanzania. While in Zomba, Malawi this past November, Dignitas International, and staff working at the Zomba Central Hospital kindly welcomed me to their facilities where I was invited to lecture on cervical cancer and participate in their clinic. With annual global incidence of cervical cancer over 500,000 and greater than 80% of these cases reported in developing nations, cervical cancer is a major cause of cancer-related morbidity and mortality in Sub-Saharan Africa. Lecturing at both Dignitas International's main office and Zomba Cental Hospital, I had a chance to interact with the clinical and office staff including physicians, nurses, medical officers, and researchers. Finally, I had the opportunity to work in the Zomba Central Hospital Kaposi Sarcoma Clinic which offered a unique snapshot of the type of oncology care available in Malawi.

Halfway up Mt. Kilimanjaro! #yesthereisafilter

In the Spring, I returned to Africa to present research at the Greater Horn Oncology Symposium (GHOS) held in Moshi, Tanzania. The conference was sponsored by Radiating Hope, a nonprofit organization that works to provide resources to improve oncology care and access to oncology care in developing nations. A Kilimanjaro climb and Safari were organized by Radiating Hope to raise money for a new cancer center in Moshi. The symposium had a strong radiology and radiation oncology focus and included sessions by notable leaders in international radiology and radiation oncology including Helmut Diefenthal and Mack Roach. While in Tanzania, I was fortunate enough to climb Mount Kilimanjaro…a life-changing experience. The next GHOS will take place Spring 2016.

Dr. Dominello and Mira Shah, PGY5 in Radiation Oncology at Henry Ford Hospital at the GHOS

Challenge: Both in Malawi and for a connecting flight in Nairobi, the airline had no record of my ticket and I was initially told I did not have a seat on these flights. With visits to the actual provider “office,” they were able to rebook my reservation and print my ticket, though they required the confirmation email, which I had luckily printed out and brought along.

Lessons learned: Arrive at the airport with plenty of extra time as neither visit to the provider office resulted in quick resolution; thankfully I did not miss my flights. Also be sure to have a printed your itinerary and receipt as proof of purchase.

Barranco Wall

Challenge: Kili

Lessons learned: Despite what one might read online, this is a difficult climb, not technically difficult but grueling, especially once you find that oxygen has become a commodity. I did take acetazolamide to help with acclimatization and made it to the top successfully. Finally, bring waterproof gear!

Uhuru “Freedom” Peak, the summit of Mt. Kilimanjaro