March 11, 2026
Beyond the One-Week Mission; Ethical Evolution in Global Surgery
Joseph Vella,, MD, PhD
Assistant Professor at the Department of Otolaryngology-Head and Neck Surgery, specializing in head and neck reconstruction following cancer resection and trauma, and pediatric cleft lip/palate and craniofacial reconstruction
Anne Seltzer, introducer, and Dr. Joseph Vella
Minutes of the 22nd Meeting of the 84th Year
Old Guard President George Bustin called the meeting to order at 10:15 am and Frances Slade led the membership in the invocation. There were 114 members in attendance and no guests.
Ruth Miller read the Minutes of the March 4th meeting. President Bustin announced that the next meeting will be at the Princeton Jewish Center, the speaker will be Michael Gordin, Dean of the College at Princeton University and one of the world's leading historians of science, and that the Minutes for today's meeting are being taken by Kathryn Trenner.
Ann Seltzer introduced today's speaker, Dr. Joseph Vella, who came to Rutgers University and Robert Wood Johnson Medical School in 2019, who was educated at Phillips Exeter Academy, and the University of Pittsburg, both BS and MD degrees, specializing in materials science and facial reconstruction. He completed his medical residency at the University of Rochester. Since 2020, Dr Vella has been heading the Rutgers program in Global Surgery whose goal is to bring medical surgery and care to areas of the world where it is not available.
Dr Vella said that the current global model for Otolaryngology and Neck Surgeries (bringing a medical team to a poor country, preforming surgeries, and leaving after surgery) is not effective and is being changed. Data collected by the World Health Organization and the Institute of Health and Metrics and Population have made it clear that of the 8.3 billion people living on our planet 5 billion are of low and moderate incomes and lack access to proper medical care, including both surgical and post-surgical care.
In particular, people in central Africa and especially Tanzania, where people often live in remote villages, lack access to medical care for prenatal care, violence, congenital diseases, and communicable diseases. In the 1800's Christian Evangelism and Karl Gutzhoff, David Livingstone, and James Hudson Taylor brought medical missionaries to poor countries. However, there was little follow-up for patients and it became apparent that educating local medical teams would be the most effective plan: a partnership whereby medical skills were passed on to local medical teams (and not by surgical teams arriving for two weeks of surgeries).
Dr Vella talked about the Microtia/outer ear surgeries performed in high altitude countries such as Guatemala, Ecuador and Peru where it was discovered that a prenatal lack of oxygen could be causing these ear conditions--particularly in people of African ancestry. Surgical teams include anesthesiologists, nurses, surgeons, anesthesia techs and a lot of equipment. Surgery to correct deformities give a child the opportunity for a life of employability, social capabilities, and the ability to be wage earners for their families.
Dr Vella talked about Tanzania which had been colonized by two European countries, had a population of 10 million people in 1960, gained independence in 1964, and now has 71 million people with an average age of only 18 years of age (whereas in the United States the average age is 39 and in the world the average age is 31). Only 28% of Tanzanians have jobs and the rest are sustainable farmers/hunters-gatherers. The government is a one-party system with corruption. The average income is $1200 a year so people cannot afford the 32% of medical costs a patient must pay (the government provides 42% and donors pay 34% of the cost of medical care.)
Gayle Wooden and Tom Robinson are working to improve this situation at the Kilimanjaro Christian Medical Center in Tanzania. Rutgers now has 14 residents at this center, many from Africa, working on this program. Another 18 can be funded if Dr Vella and his work partner, Ryan Walker, and the rest of his team at Rutgers can get facility space for them.
In summary, Dr. Vella talked about the need for donors to provide support for (1) the building of partnerships in global surgery and (2) the training of local doctors and their staffs. Equipment, travel funds, shipping costs, fellowships, residencies, and visa costs are among the needed items.
Questions from members raised the following topics: the need for university systems to connect with each other and with local medical staffs; why tele-health is not viable; how AI can be very helpful; and the fact that lack of maintenance personnel makes donating complicated equipment such as robotics and microscopes questionable.
RESPECTFULLY SUBMITTED,
Kathryn Trenner
Ruth Miller read the Minutes of the March 4th meeting. President Bustin announced that the next meeting will be at the Princeton Jewish Center, the speaker will be Michael Gordin, Dean of the College at Princeton University and one of the world's leading historians of science, and that the Minutes for today's meeting are being taken by Kathryn Trenner.
Ann Seltzer introduced today's speaker, Dr. Joseph Vella, who came to Rutgers University and Robert Wood Johnson Medical School in 2019, who was educated at Phillips Exeter Academy, and the University of Pittsburg, both BS and MD degrees, specializing in materials science and facial reconstruction. He completed his medical residency at the University of Rochester. Since 2020, Dr Vella has been heading the Rutgers program in Global Surgery whose goal is to bring medical surgery and care to areas of the world where it is not available.
Dr Vella said that the current global model for Otolaryngology and Neck Surgeries (bringing a medical team to a poor country, preforming surgeries, and leaving after surgery) is not effective and is being changed. Data collected by the World Health Organization and the Institute of Health and Metrics and Population have made it clear that of the 8.3 billion people living on our planet 5 billion are of low and moderate incomes and lack access to proper medical care, including both surgical and post-surgical care.
In particular, people in central Africa and especially Tanzania, where people often live in remote villages, lack access to medical care for prenatal care, violence, congenital diseases, and communicable diseases. In the 1800's Christian Evangelism and Karl Gutzhoff, David Livingstone, and James Hudson Taylor brought medical missionaries to poor countries. However, there was little follow-up for patients and it became apparent that educating local medical teams would be the most effective plan: a partnership whereby medical skills were passed on to local medical teams (and not by surgical teams arriving for two weeks of surgeries).
Dr Vella talked about the Microtia/outer ear surgeries performed in high altitude countries such as Guatemala, Ecuador and Peru where it was discovered that a prenatal lack of oxygen could be causing these ear conditions--particularly in people of African ancestry. Surgical teams include anesthesiologists, nurses, surgeons, anesthesia techs and a lot of equipment. Surgery to correct deformities give a child the opportunity for a life of employability, social capabilities, and the ability to be wage earners for their families.
Dr Vella talked about Tanzania which had been colonized by two European countries, had a population of 10 million people in 1960, gained independence in 1964, and now has 71 million people with an average age of only 18 years of age (whereas in the United States the average age is 39 and in the world the average age is 31). Only 28% of Tanzanians have jobs and the rest are sustainable farmers/hunters-gatherers. The government is a one-party system with corruption. The average income is $1200 a year so people cannot afford the 32% of medical costs a patient must pay (the government provides 42% and donors pay 34% of the cost of medical care.)
Gayle Wooden and Tom Robinson are working to improve this situation at the Kilimanjaro Christian Medical Center in Tanzania. Rutgers now has 14 residents at this center, many from Africa, working on this program. Another 18 can be funded if Dr Vella and his work partner, Ryan Walker, and the rest of his team at Rutgers can get facility space for them.
In summary, Dr. Vella talked about the need for donors to provide support for (1) the building of partnerships in global surgery and (2) the training of local doctors and their staffs. Equipment, travel funds, shipping costs, fellowships, residencies, and visa costs are among the needed items.
Questions from members raised the following topics: the need for university systems to connect with each other and with local medical staffs; why tele-health is not viable; how AI can be very helpful; and the fact that lack of maintenance personnel makes donating complicated equipment such as robotics and microscopes questionable.
RESPECTFULLY SUBMITTED,
Kathryn Trenner