In the Loop

News and views from across Mayo Clinic

May 12, 2022

Mayo physician’s volunteer mission helps neurosurgeons in Nepal move mountains in surgical care

By In the Loop
Matthew Neal, M.D.

Matthew Neal, M.D., a neurosurgeon at Mayo Clinic in Arizona, volunteered his time to teach surgical techniques to neurosurgeons Tribhuvan University Teaching Hospital, a major academic medical center in Nepal. He shares his experience and his inspiration for the trip.

For Matthew Neal, M.D., volunteerism and outreach have always been close to his heart. When he learned of an opportunity to travel halfway around the world to teach surgical techniques to local neurosurgeons in Nepal, he jumped at the chance.

Dr. Neal, a neurosurgeon at Mayo Clinic in Arizona, learned about the volunteer mission through Richard Wohns, M.D., J.D., director and president of the Nepal Spine Foundation.

Nepal — a country of about 29 million people — has limited resources when it comes to neurologic and spine care. The Nepal Spine Foundation brings people to work with and teach neurosurgeons surgical skills to neurosurgeons at Tribhuvan University Teaching Hospital, a major academic medical center in Nepal.  

Working through Nepal Spine Foundation and Medtronic, Dr. Neal was able to join others in bringing the latest surgical knowledge and providing much-needed surgical equipment to help bridge the gap in care for the people of Nepal.

The News Center caught up with Dr. Neal to learn more about the inspiration and purpose of his trip. Learn more about the mission in this brief interview:

What was the purpose of the mission?

The primary purpose of the mission was to teach minimally invasive spinal surgery techniques to faculty neurosurgeons at Tribhuvan University Teaching Hospital in Kathmandu, Nepal. They have a very talented faculty that is eager to enhance the care of their patients. The major limitations are resources and training opportunities.

What inspired this work?

I have always enjoyed outreach work, and I wanted to use my neurosurgical skills in a voluntary capacity. It has been a major career goal to seek out opportunities for volunteer neurosurgery.

I began networking with neurosurgeons in the U.S. who have participated in international outreach work. And I began attending conferences on global outreach for the surgical specialties. I met a neurosurgeon, Dr. Richard Wohns, who practices in Washington state. He had a past interest in climbing and trekking, and he had spent many years traveling in Nepal. He had also developed relationships with the neurosurgery faculty at Tribhuvan University Teaching Hospital, a major academic medical center in Nepal. He started the Nepal Spine Foundation with the primary goal of providing medical education so the faculty may practice up-to-date techniques to benefit their patients. He kindly invited me to participate in their mission.

Matthew Neal, M.D.

Why Nepal and why now?

I felt that working in Nepal was an excellent opportunity. It is actually more challenging than you would think to find good opportunities for global outreach. While there are many places in need of enhanced medical care including neurosurgery, several key pieces have to be in place for a successful mission. The location has to be politically stable and safe. There have to be local contacts who can host you and who share your common vision. Nepal met these criteria. Also, this program is early in development so there is a greater opportunity to make a strong impact as opposed to a well-developed program. The country is also underserved in neurosurgical and spine care. I was told there are about 80 neurosurgeons for a population of 29 million in Nepal.

Tell us about the team involved?

For this trip, I went with Dr. Richard Chua, a faculty member in the Neurosurgery Residency Program within the Department of Neurosurgery at the University of Arizona College of Medicine — Tucson, and Joe Triano, a district sales manager with Medtronic. Triano was able to secure equipment and implants at no cost to the Nepalese hospital.

What kind of impact did the team make?  

We provided education during the academic resident conferences and rounds. We also performed minimally invasive spine surgeries and provided hands-on intraoperative education to neurosurgery faculty eager to learn the techniques. We also secured equipment, which we were able to donate, allowing the surgeons to continue performing the procedures.

"One of the talented Nepalese neurosurgeons took down his mask and said, 'I am ready to do this.' He could not hide the big smile on his face reflecting sheer joy and pride."

Matthew Neal, M.D.

Can you share a couple of the most memorable moments?

The most memorable moment was when we sat down for lunch after we completed one of the minimally invasive lumbar fusions. One of the talented Nepalese neurosurgeons took down his mask and said, "I am ready to do this." He could not hide the big smile on his face reflecting sheer joy and pride.

I was amazed at the complexity of the neurosurgical pathology in the hospital. They maintain a long list of patients with brain tumors and other complex problems who have prolonged hospitalizations while they wait for resources such as open ICU beds, funding or availability to get their care. Resources are the major limiting factor for them.

I was blown away by both the staff and residents. They have an impressive mastery of neurosurgery literature and technical skills. Despite the challenges in their health care system, they were extremely dedicated to their patients.   

What did you bring back with you to your work at Mayo?

It was wonderful to develop relationships with the residents and faculty at Tribhuvan University Teaching Hospital. They were very welcoming and eager to share knowledge and learn new skills that would benefit their patients. It was invigorating to see the thirst for knowledge and know that it would rapidly translate into enhanced spine care for Nepalese patients. I look forward to an ongoing collaboration. I am also hopeful to help the neurosurgeons in Nepal build ties with Mayo so that residents and faculty may be able to travel between programs for collaboration and education.

Learn more about Mayo's global outreach

There are more people like Dr. Neal bringing Mayo Clinic's expertise to others while building relationships around the world.

Visit the Mayo Clinic Global Health Program intranet site to find out who is involved and what they're doing.


Tags: Dr. Matthew Neal, Mayo Clinic in Arizona, Staff Stories

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