During the course of history, there have been extraordinary men and women who have made a difference in the lives of millions of people across the globe. Many of these individuals have come from the world of medicine, such as Madame Curie, Jonas Salk and Albert Schweitzer, among others.
Fast forward to the present and meet Dr. Dilan Ellegala, a neurosurgeon on a mission, a doctor who everyday saves the lives of patients residing in a place 8,000 miles and seven time zones from his home in South Carolina. Thanks to his vision, complex neurosurgery procedures are now performed by local medical personnel in a small hospital situated in the remote Tanzanian bush village of Haydom. A place with extreme droughts, rainy seasons, and spotty communications, Haydom is a land where only two percent of the population had access to neurological care before Dr. Ellegala entered the picture, finding just three brain surgeons for 40 million people.
Dr. Ellegala’s story is that of a brain surgeon on an unlikely mission to teach Tanzanians his surgical skills. It started in 2006, when after 14 grueling years of medical training and a prestigious fellowship at Harvard, Dr. Ellegala decided to take a break by traveling to Tanzania on a medical mission vacation.
He soon recognized that the old medical model, a holdover from colonial times, of dependency on visiting foreign doctors was not working. “Short-term medical missions save lives but they don’t cure the real disease, the country’s ailing health care system” he says. Faced with a dilemma, he determined that performing the surgeries himself and then leaving the country was not a practical solution to the problem; training local people to do complex procedures was the only answer. “Self-reliance is the goal, and success is having an exit strategy, not a permanent presence” Dr. Ellegala believes.
He wound up spending six months, with no income, sharing his knowledge and compassion while performing and teaching neurosurgery under extremely difficult conditions, often having to improvise by using whatever common items were available to perform a clinical procedure: flashlights instead of microscopes, camping headlamps to peer into damaged brains, wire saws, duct tape to hold tools in place and a plastic IV cut up so that the pieces could be used as shunts.
His first student was a promising clinician with no formal medical education, Emmanuel Maayegga. Against all odds, he succeeded and Maayegga became an accomplished neurosurgeon, the first of more than 100 that have been the beneficiary of this unique program. The ancient Chinese proverb, “Give a man a fish and you feed him for a day or teach him to fish and feed him for a lifetime” suddenly had new meaning.
The 6-foot 2 Ellegala keeps his head shaved and points to it often when describing an operation, a perfect aid for teaching neurosurgery. The program is paying off. Medical technicians can not only effectively perform brain surgery, but they are also training others, including Tanzanian university trained doctors, how to insert shunts and remove tumors with their progress being continually monitored. “You’re training one person, who can train another person, and it evolves and has a much larger impact” says Ellegala.
After returning to the US from his first trip to Tanzania, Ellegala considered joining up with existing medical teaching organizations but found they lacked exit strategies and so decided to form his own non profit. Madaktari, which is Swahili for “physician,”
But Ellegala’s real goal goes beyond East Africa. He wants to effect policy change by stopping the cycle of dependency on foreign doctors in developing countries by replicating the Tanzanian model worldwide. Nothing short of a paradigm shift in thinking about medicine in developing countries will satisfy him. And his exit strategy is that he will no longer be needed in the developing world. In the long run, he also hopes to save the US billions of dollars in foreign medical aid.
Dilantha Ellegala has a busy stateside career as well. He is the director of the prestigious Stroke and Comprehensive Cerebrovascular Clinic at the Medical University of South Carolina. He has created new ways to measure blood flow in the brain and authored dozens of papers. His is a unique story, a charismatic dreamer who is seeing his audacious dreams come true.
Dr. Ellegala met his wife Carin, a pediatrician from Holland, shortly after she arrived in Tanzania on a medical mission. They were married on the airstrip in Haydom with 5,000 villagers in attendance. They reside in Charleston, South Carolina with their daughter Else.
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