We live in a world in which we need to share responsibility. It’s easy to say, “It’s not my child, not my community, not my world, not my problem.” Then there are those who see the need and respond. I consider those people my heroes. Fred Rogers

Humanitarianism

It’s a big word, with a lot of meanings. Oxford English Dictionary defines it as “the promotion of human welfare.” Why is this important to us? As urologic surgeons, we have a unique skill set that makes a significant impact in the quality of human life, through managing the conditions that affect the urinary and reproductive systems in adults and children. We are privileged by our choice and capacity to study and practice urology. We have personally benefited from the hard work we have committed to, to learn our craft and solve painful, life-threatening, and/or life-altering urologic problems for the benefit of the patients we serve every day in our diverse practice settings.

Humanitarianism isn’t asking us to sacrifice ourselves. It doesn’t mean we have to travel insurmountable miles or be subjected to threatening situations. It asks us to examine our capacity to give what we can. Everyone benefits when we collaborate sincerely. Honestly, humanitarianism meets us all where we are, whether in our home community’s free clinic for a couple of hours a month to care for worthy patients without access to our private services, or in an amazing place for a few weeks over your life’s years to connect with and support the development of faculty and trainees to bolster their capacity to better serve their communities. It could also look like a mentoring opportunity to help colleagues in resource-limited settings to conduct and publish research or process improvement that defines appropriate guidelines for urologic patient care in their specific limited setting that matches their resources rather than promoting the unattainable Western guidelines that cannot be universally applied. Maybe you can host students, trainees, or junior faculty from abroad at your hospital for a bidirectional academic experience! The possibilities here are endless, and your specific strengths will guide your path to humanitarian realization.

Figure 2. Urethral reconstruction workshop at San Fernando General Hospital with Jack Zuckerman working with hosts Kirk Goodens and Satyendra Persaud.

Figure 3. Urethral reconstruction workshop at HOGGY Hospital in Dakar, Senegal, with Maahum Haider and host urologist Mohamed Jalloh.

My journey with humanitarian work began when I was very fortunate to have been asked to go on an IVU (International Volunteers in Urology) trip to Jos, Nigeria, to treat women with vesicovaginal fistulas. This trip not only opened my eyes to the needs and disparity in the world, but also reminded me of my love for medicine and the need to give back. Going on that trip, I felt hopeful I would be able to help some patients. Never did I realize what benefits I would receive. Since then, I have grown and learned so much, not only as a person, but as an educator and a surgeon. There is a large burden of vesicovaginal fistulas in low- and middle-income countries but also a significant number of nongovernmental organizations focused on this. Being trained in urethral reconstruction, I was being asked to do some urethroplasties while there, and what I came to realize was the burden of patients with urethral stricture was also huge with few focused on training others. After going on a few trips a year and working with random surgeons, I realized to make a sustainable difference we needed to focus on centers to create centers of excellence. This has been our focus over the last 8 to 10 years, where we attempt to go back yearly to the same centers working with the same surgeons. Many of these hosts have become some of my and my family’s best friends. But not is it only rewarding personally from these friendships and the gratification of seeing our colleagues grow as surgeons, but we have published a paper showing the success rates for urethral reconstruction by the surgeons we work with in Dakar, Senegal, have increased 300%.¹

Winston Churchill has many quotes that should not appear here, but one we all should live by and likely why many of us went into medicine is, “We make a living by what we get, but we make a life through what we give.”

In Conclusion

What does humanitarianism mean to you? Every one of us has a unique skill set and perspective to offer. We can’t single-handedly save the world, but we can each participate through harnessing the good that is within each of us to support our commitment to our profession in a sustainable way, locally, regionally, and globally. You will make a difference.

Contact me with any questions (mccammka@evms.edu)!