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Surgeon leads a personal mission to send life-saving supplies to Kenya

Nov. 21, 2013

Saturday afternoons aren't usually a busy time in the back offices of the Regenstrief Building at the old Wishard Hospital. Yet weekend visitors might catch the sounds of activity coming from the office of Susan Cordes, M.D., associate professor of clinical otolaryngology-head and neck surgery at the IU School of Medicine.

Susan Cordes.

Susan and Kyle Cordes stand among the hundreds of pounds of medical supplies they've collected for doctors and patients in Kenya. | Erik Markov

Dr. Cordes; her husband, Kyle; and their terrier mixes, Moshi and Malaika, are no strangers to the office on weekends. But rather than catching up on paperwork, the Cordeses are busy sorting, packaging and repairing equipment -- all donations that will go into a shipping container for an annual trip to Eldoret, Kenya, the home of the Moi Teaching and Referral Hospital. The hospital is the primary clinical site for the Academic Model Providing Access to Healthcare, or AMPATH, a partnership between the IU School of Medicine and the Moi University School of Medicine aimed at improving health care in the country.

Since 2009, Dr. Cordes, a surgeon at Wishard-Eskenazi Health, has made nine trips to Kenya through AMPATH, performing surgeries and transporting hundreds of pounds of free medical supplies to physicians working in the extremely resource-limited environment. The supplies aren't collected through any formal program; everything is procured through word of mouth and the generosity of colleagues.

Students learn about careers in design and construction through the ACE program.

Susan and Kyle Cordes review parts for a piece of equipment bound for the Moi Teaching and Referral Hospital in Eldoret, Kenya. | Erik Markov

"The first time I went to Kenya, I came back with a long list and just started collecting things. They almost didn't know what they were missing because they didn't have the experience," Dr. Cordes said. "Early on we were looking for cautery units for the operating rooms and some basic disposables -- supplies to help coagulate blood vessels and stop the bleeding. These are some of the most basic, essential tools in the OR; I couldn't imagine life without it."

Every surgeon in the United States goes into the operating room with a standard operating "pack" -- a sterilized bag with blue towels, gauze, sponges, instruments -- "everything you might need," Dr. Cordes said. "Sometimes you use everything; sometimes you use almost nothing." If a surgery gets canceled at the last second, it's not unusual for unopened packs to get tossed. In America, after the surgery, "everything gets thrown away."

In Eldoret, where syringes and other basic medical equipment are frequently sterilized and reused, the contents of those packs could save a life.

"People just started saving things for me," Dr. Cordes said. "Word got around. Eventually, I started contacting some equipment companies for key items that we needed."

Susan Cordes.

The Cordes package specialized surgeon's chairs for the trip overseas as their terrier mixes, Moshi and Malaika, relax. | Erik Markov

One of their biggest "gets" was a "sinus tower" -- a stack of specialized machines and monitors commonly used to perform endoscopic sinus surgery -- provided by Stryker, a manufacturer of medical devices and medical equipment who learned about Dr. Cordes' quest for the machine through her interactions with local personnel.

Other equipment procured by Dr. Cordes and her husband include an audiology booth, a piece of equipment the size of a small closet used to accurately gauge hearing loss. Engineers at Moi created a custom housing for the unit, which Kyle helped install upon the Cordeses' trip to Kenya in 2010 using his expertise as an engineer for AT&T as well as a knack for eBay, using the site to find needed spare parts at a nearby music shop in Eldoret.  

Another key acquisition that will travel to Kenya this year is a pair of rolling adjustable chairs designed to reduce surgeon fatigue during long and complex operations. The chairs, originally marked for disposal by Riley Hospital for Children at IU Health, were reupholstered at no charge by Ruma Upholstering & Drapery, a Kenyan-owned company in Indianapolis whose proprietors provided the materials and labor after they learned why the couple was seeking the repair.

Susan Cordes.

Dr. Cordes labels boxes bound for the long trip to Kenya. | Erik Markov

Over time, the sheer volume of the materials collected by Dr. Cordes has expanded beyond the confines of her office, spilling into a supply room in the department -- part Santa's workshop, part mad scientist's lair. Shelves overflow with spare parts, wires and other pieces of highly specialized medical equipment. It's not unusual for her to hang onto items for years until she can find the missing piece to make the equipment function again.

"This was all going to end up in the trash," Dr. Cordes said. "It's amazing what happens when people learn you want this stuff. You just need to look in my office to see. I've got so many boxes of equipment and supplies … packs, gowns, drapes, so many other things. I love digging through huge boxes and hitting on some little nugget or missing piece to get excited about."

A native of Valparaiso, Ind., and an IU alumna, Dr. Cordes' first trip to Kenya came during her days as a medical student at the IU School of Medicine. "Back then, I just sent four or five letters to different countries and got a reply from a clinic in a little town called Lugulu," she said. "I took off and spent two and half months there." It wasn't until years later that she returned to the country armed with a medical degree and years of experience as a surgeon -- "after I felt I could really make a difference."

Susan Cordes.

Dr. Cordes teaches Kenyan ENTs how to use a flexible fiber optic laryngoscope donated by Olympus.| Photo courtesy of Susan Cordes.

The procedures most commonly performed by Dr. Cordes and her colleagues during these trips are thyroid surgeries; goiter removal; sinus, cleft lip and palate repair; and the removal of sinus polyps and tumors of the neck, salivary glands, voice box and jaw.

One of the most memorable patients was a man named Noah with an 18-pound "keloid," a form of abnormal scarring, hanging from his face. Dr. Cordes and her team first spotted the man as they walked into town; later they found him waiting at the clinic. The mass had caused disfigurement, warping the man's nose and facial features and rendering him unable to work or function normally for more than two years. Dr. Cordes said removal of the tumor essentially gave him his life back.

"The first time I went to Kenya I knew there was a need (for doctors), but you never truly comprehend it until you see it personally," she said. "It sounds cliché that you want to be a doctor because you want to help people, but in all reality that is why you do it. I think at some point you think: 'I want to do more.' You want to take your skills and you use them for something greater. But I had also wanted to wait until I had helped more at home before traveling halfway across the world."

Susan Cordes.

Michael Moore, M.D., assistant professor of otolaryngology-head and neck surgery at the IU School of Medicine, and Titus Sisenda, M.D., an ENT at Moi Teaching and Referral Hospital use the "sinus tower" procured by the Cordes from Stryker. | Photo courtesy of Susan Cordes.

Between time spent collecting supplies, repairing goods, contacting vendors and working with travel agents to arrange medical trips to Kenya, Dr. Cordes and her husband don't know how many hours they’ve poured into their volunteer efforts for AMPATH -- but they're not counting. Work and life blend together for the couple; when they're not using their vacation time to travel to Eldoret, they host visiting physicians from Moi or invite their friends over for parties to buy handcrafted goods from the Imani Workshops, a place where HIV-positive patients in Eldoret create products to regain their self-sufficiency.

"It's just been something that's grown over the years," Kyle Cordes said. "We've got the time and the capacity to do these things, and it's all felt quite natural -- the more you do, the more you want to do because it feels good. Plus we've made so many friends. When we travel to Kenya, I always say it feels like we're going to our second home. The sights, the sounds, the smells -- it just feels like a place we should be going."

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