Get to Know the 2018 MedicalMissions.org Physician of the Year
Theodore Belanger, MD
Spine, Scoliosis and Complex Deformity Surgeon, Rockwall, TX
It doesn’t matter where you live or what kind of degree you have; anyone can make a difference in the life of someone less fortunate. That’s the view of this year’s winner of the Physician of the Year Award. Dr. Theodore Belanger is a spine surgeon from Rockwall, Texas, who has been performing medical missions since 2010 and is currently employed by the Texas Back Institute. With a life-long desire to serve the underprivileged around the world, he now devotes much of his professional and personal time improving the lives of patients with spinal deformities and conditions in Ethiopia through the nonprofit he cofounded and runs.
What drew Dr. Belanger into medical missions?
For most of his professional life, Dr. Belanger always felt a pull to respond whenever a tragedy struck and he’d see healthcare providers rush to take action, particularly during crises like the 2010 Haiti earthquake or 9/11. Around that time, he felt helpless as a spinal surgeon, thinking his particular skills and training wouldn’t necessarily be the most useful under the circumstances. He knew basic first aid and emergency medical care were most needed, not discectomy surgery or scoliosis expertise. He knew he couldn’t stand aside and ignore that pull to serve others in need. He decided to search for ways he could give back using his very specialized knowledge and experience in the surgical treatment of complex spine problems.
After a colleague returned from serving patients affected by the Haiti earthquake, Dr. Belanger met with him to discuss the experience and see how he could help in future medical mission work. This colleague believed Dr. Belanger’s niche skills could be valuable in a place like Ethiopia where he had a connection with a retired American orthopedic surgeon, Dr. Donald Pearson, who was doing a long-term mission with the aim of building an orthopedic surgery training program. Dr. Belanger eagerly jumped at the chance to accompany the surgeon in Addis Ababa in 2010, where the program to which he has become fully devoted was born. Dr. Belanger and Dr. Pearson formed a partnership with the organization Conscience International, along with physicians in Ethiopia. They started by creating some central infrastructure, including a local system of doctors and volunteers who have provided a way to work up and monitor patients for them year-round, which makes Dr. Belanger’s annual trip possible. Given the complexities of the surgeries his team performs, it is imperative there are local resources, including surgeons, to handle any complications or medical issues that arise when the team is not physically available. The network of help he has in Addis Ababa is essential, and the program could not be easily duplicated elsewhere.
What is the Conscience International Ethiopia Project?
The partnership in Ethiopia evolved into Dr. Belanger’s life’s mission. He is currently the physician team leader for the Conscience International Ethiopia Project, and his wife, Toni, serves as the Project Manager. Together, they work continually throughout the year planning, recruiting, fundraising, organizing and managing the annual trip. In 2018, a team of more than 20 participants was able to accomplish 27 surgeries in approximately two weeks. The purpose of the Conscience International Ethiopia Project is to provide complex surgical spine care to the indigent people of Ethiopia and the surrounding areas who need it. Most of the mission’s surgeries consist of complex spine deformities, treating conditions like tuberculosis of the spine, spine tumors, spinal infections, spine trauma and occasionally degenerative conditions. The majority of the cases Dr. Belanger and his team encounter are already in an advanced stage due to the near absence of such care and expertise in the country.
The average spine surgeon in the United States serves about 100,000 people. In Ethiopia, Dr. Belanger serves about 95 million people, who have little in the way of alternative treatment. More than half the country has no access to simple healthcare or even a Tylenol tablet, much less access to advanced spinal deformity care. He estimates there are tens of thousands of people who need such care, and he regrettably acknowledges he can only scratch the surface of these needs. Since 2015, his team has also brought five patients to the U.S. for surgery who had conditions too complex to perform with the resources available in Ethiopia. Since its inception, Dr. Belanger’s team has performed more than 125 surgeries, free of charge, through this mission, some of them representing the most challenging spine surgeries he or his colleagues have ever encountered.
How does he envision the organization will grow?
In an ideal world, Dr. Belanger has three major goals and hopes for the Conscience International Ethiopia Project in the future, given the proper resources.
- Dr. Belanger hopes other surgeons in the U.S. who are capable of providing complex spine deformity care will become involved and committed to the project, eventually duplicating what he does by leading their own trips separately to the same place and taking advantage of the resources and relationships his team has built up along the way.
- He also sees the possibility a local surgeon will be able to gain the proper training to perform this kind of work, and that they will commit to bringing their knowledge full-time to serve their home country. Dr. Belanger works with local surgeons to mentor them, but there isn’t enough exposure to fully train them enough to take on this work autonomously.
- If the project could gain enough financial support, he would be able to make more than one trip a year with his team and thus increase the number of people they could aid.
Why does this project and medical mission work mean so much to him?
He has been richly rewarded by these experiences, which now give him new reasons to continue, year after year. He discovers new motivations to be involved every time he makes a trip. There is the obvious gratifying feeling of helping some of the neediest people on earth. There is also a rejuvenating feeling of doing what he does there free from all the politics and entitlement that is inherent to healthcare in the U.S.
“It brings me back to the purest form of healthcare, providing aid to the suffering without concerns like declining reimbursement, on-call obligations, competition with others, politics, bureaucracy and customer dissatisfaction posts on the internet clouding the joy of providing medical care.”
It has also evolved not only his skills and ability to take on the most challenging of cases, but has also brought an opportunity to network with surgeons from all over the globe who share an interest in mission work.
The story of Haymanot, in the words of Dr. Belanger
“I am constantly amazed at the resiliency and strength of human beings. In Ethiopia, we encounter some of the neediest people with the most severe medical conditions, and they somehow manage to get by, even in the total absence of resources and all the programs and support we would take for granted in the ‘first world.’ One of our most dramatic patient stories is a young man I’ve known for over four years now. In 2014, Haymanot was a 20-year-old with a condition known as ankylosing spondylitis. His entire spine was spontaneously fused by the disease at age 10, leaving him severely bent over with a rigid, inflexible spine. He had been shunned by his family because of his deformity, which they thought was a curse. When I met him in 2014, he was a homeless orphan, malnourished and living on the steps of a church in Addis Ababa. He had traveled hundreds of miles from his village, because he heard about a doctor who could help people with ‘twisted backs,’ Dr. Rick Hodes, who lived in Addis. Dr. Hodes is not a surgeon, but he knows surgeons like me all over the world, and he introduced us.
Haymanot had no ability to provide for himself and would likely never be able to find a job, wife, family or do really anything much other than beg for food. After assessing him and his condition, Dr. Hodes and I arranged for him to travel to the U.S. for surgery to correct his deformity, and hopefully get him standing up straight. We started to immediately work on his nutrition, to make him a more suitable candidate for such a major surgery. We appealed to both the Ethiopian and U.S. government to allow him to travel to Texas for surgery. A host family agreed to let him live in their house for over six months, before and after his surgery. I was able to negotiate for the donation of spinal equipment and implants by Medtronic, and hospital and anesthesia services by Medical City Plano Hospital to permit me to perform his surgery and all his aftercare free of charge, with an estimated value of over $500,000. I could not do this without the donation of these valuable resources. I also recruited several other surgeons, including Dr. Andrew Simpson and Dr. Sandy Moore, to help with his procedures, who graciously donated their time.
In 2015, we performed a complex, three-stage procedure on his spine, with a total surgical time of over 14 hours. We achieved 84 degrees of correction of his spinal deformity, which was a personal record for me. Afterward, he was standing up straight, and now looks as though he is free of any spinal deformity. I have followed up with him regularly since his return to Ethiopia in 2016, and he can now read and write and is attending school. He lives with Dr. Hodes. I eagerly look forward to visiting with him whenever I return, and he gives me a warm hug and generous gifts every time I see him, which I know he cannot afford. Each time I see him I am overcome with emotion, rekindling the motivation to continue with my mission to serve.”
Dr. Belanger with Haymanot before and after spine surgery in 2015.
What advice does Dr. Belanger offer healthcare practitioners considering medical missions work?
For those considering mission work, Dr. Belanger stresses how important it is to realize there are resources to help you. Many volunteer medical organizations exist, and he has found partners in various industries (e.g., implant manufacturers, etc.), as well as colleagues who are very willing to provide aid. He is always amazed what tremendous support can come from simply asking for it. “Use your network and find a way!” is what he often suggests to other specialists who don’t know where to begin. Another piece of advice he often gives is you don’t always have to go down the most difficult path to make it fulfilling. “Do what you can, with what you have, wherever you are” is his motto when it comes to finding a way to serve others in need. Dr. Belanger is proof you can find a way to join a medical mission, even if you have to start it yourself.