A patient was brought into the operating theatre at the University Teaching Hospital in Lusaka, Zambia. It was a child with a cleft palate.
Dr. Chris Kapeshi, the senior maxillofacial surgeon in the country, stepped aside to allow his visitor, Mercy Ships volunteer ENT surgeon Dr. Mark Shrime, to take the lead.
“I said, ‘No, you’re operating here,’” Dr. Shrime recalled with a laugh.
Dr. Kapeshi had performed many tumour removals, but cleft palates were relatively new. Dr. Shrime had been teaching him a cleft palate repair technique called a furlow.
Eventually, Dr. Kapeshi agreed to take the lead position and began the procedure. At first, Dr. Shrime said, his colleague was tentative.
“After 20 minutes, you could see it click in his head. Then, I’ll tell you, it was true knowledge transfer.”
When the surgery was over, both doctors knew something important had happened.
“He literally said, ‘I will start doing these cases now,’” Shrime said. “‘I’m going to start doing cleft palates now.’”
The moment was a highlight of Dr. Shrime’s two weeks in Zambia. He spent time working alongside staff at both the University Teaching Hospital and a CURE International Hospital.
He’s one of several Mercy Ships volunteers who have travelled to Africa during the COVID-19 pandemic, to continue serving while the ships are away. In 2021, Mercy Ships began partnering with CURE International to help support and staff their hospitals, bringing accessible surgery to patients across Africa.
“I’m really excited to just be part of that partnership,” Dr. Shrime said. “CURE needed a bunch of surgeons and anaesthesiologists. It was a neat, collaborative program.”
During more than a decade of volunteering with Mercy Ships, he’s both taught and learned from a global network of surgeons.
From Mercy Ships veteran surgeon Dr. Gary Parker, Dr. Shrime learned one of his biggest lessons: surgery is not just about a technique or a skill. It’s about confidence.
“As soon as you start getting scared, you start to pull back, and you stop doing this particular case and you stop doing that particular case,” he said. “And as a result, the more difficult cases just go untreated.”
When Dr. Shrime visited Zambia in 2021, he wanted to pass on this lesson.
In addition to working with Dr. Kapeshi, Dr. Shrime worked with two ENT residents: a doctor who had just finished his training, and a trainee at CURE. He also delivered a lecture to the Surgical Society of Zambia.
Although he did impart some new techniques, he said it’s important to avoid a “colonial framing” of medical partnerships in Africa. His relationship with Dr. Kapeshi is one example.
“Spectacular surgeon, he taught me some techniques that I really like and will incorporate into my practice,” Shrime said. “The man’s done, guaranteed, more surgery in his life than I’ve done in my life.”
The relationship, Dr. Shrime said, is one between colleagues. Not mentor and mentee.
“We have a WhatsApp group now and we’re sharing cases with each other,” he said. “There isn’t this idea that I am a fount of knowledge that I will bless you with.”
Within these collegial relationships, Dr. Shrime believes it’s important to teach new techniques–even to fully trained surgeons.
“The burden of disease is so large, and the number of surgeons is so small,” he said.
There are two maxillofacial surgeons in Lusaka, Dr. Shrime said. Dr. Kapeshi is one of them.
“You have excellent surgeons who simply haven’t seen the particular technique,” Dr. Shrime said. “So it’s not like you’re coming in and being like, ‘Let me teach you to be a surgeon.’ It’s, ‘Here’s a particular technique for a particular disease.’ And I think that’s really important, because otherwise, the burden of that particular disease isn’t necessarily getting treated.”
Learn more about how Mercy Ships strives to leave a lasting impact through partnership and medical training.