Navajo Nation
In an area like metropolitan Washington, where so many services are readily available, it’s sometimes easy to overlook the scarcity of such resources as quality health care in other parts of the country, and of the world.
For decades, MedStar Orthopaedic Institute physicians have been among the thousands of medical professionals who seek to bridge these gaps through volunteer outreach efforts. They all strive to bring their knowledge to those for whom basic health care may be a luxury, and improve the quality of life for those patients, their families, and their communities.
Healing the hands of America’s first citizens
To reach the U.S. Indian Health Service’s Chinle Comprehensive Health Care Facility in northeast Arizona, Michael W. Kessler, MD, MPH, FAOA, flies to Phoenix or Albuquerque, then drives up to five hours through countryside—both scenic and sparsely populated.
Dr. Kessler, chief of the Institute’s Division of Hand Surgery, is one of several orthopaedic surgeons who periodically visit Chinle’s hand clinic to treat members of the Navajo Nation.
“Another physician who volunteered at Navajo facilities suggested I look into it,” he says. “I’ve come out at least once a year since.”
Dr. Kessler’s four-day visits combine clinic examinations with surgical procedures for chronic conditions such as carpal tunnel, trigger finger, arthritis, and cysts. An on-site staff member at Chinle coordinates his work with those of other physicians—an overlapping chain of examinations, diagnoses, and, when needed, a treatment recommendation to be performed by the next surgeon who comes through. Occupational therapists in the area provide care between physicians’ visits.
Although the 60-bed hospital offers only basic facilities, Dr. Kessler says most of his patients prefer to seek care close to home. Navajo translators assist with patients who speak little or no English.
“Working here makes you use your diagnostic and testing skills differently,” Dr. Kessler says. “You have to rely more on the physical examination because CT scans and MRIs aren’t readily available.”
Awareness of patients’ own limited resources is also important. Dr. Kessler recalls suggesting ice for a patient’s sore hand. “'Where am I supposed to get ice,’ the patient asked. His house had no electricity.”
As chair of Indian Health Services for the American Society for Surgery of the Hand, Dr. Kessler hopes to encourage other physicians to share their skills at Chinle and other Native American health care facilities across the U.S.
“Reservation outreach doesn’t have quite the same cachet as international work,” he says, “but the needs are no less critical. And considering what Native American populations have experienced over the centuries, we owe it to them to bring quality care any way we can.”