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Dr. Donald Lalonde

COLIN MCPHAIL TELEGRAPH-JOURNAL
Wednesday, April 18, 2015 (Page B2-B3)

Saint John • A Saint John-based hand surgeon has been honoured for his service in improving health training and professional development across the globe.

Dr. Donald Lalonde, who lives in Rothesay and works in the city, received the Golden Apple Award from Health Volunteers Overseas, an American non-profit that aims to better health care in developing countries, the organization announced in a release on Tuesday.

Lalonde was recognized for his work in teaching local staff wide-awake hand surgery at the Komfo Anokye Teaching Hospital in Kumasi, Ghana.

As opposed to sedating a patient for hand surgery or using a tourniquet, which prompts sedation because of how painful it can be, Lalonde said wide-awake hand surgery, a practice scarcely used outside of Canada, doesn’t require either.

A group of Saint John surgeons helped debunk claims that epinephrine was unsafe for hand surgery, instead proving that it be should the preferred choice for local anesthesia. With epinephrine, sedation or tourniquet is not needed, he said.

“Because you don’t you need a tourniquet, you don’t need to put somebody to sleep,” Lalonde said in a phone interview from San Diego on Tuesday.

“The safest sedation is no sedation."

“We proved that it’s quite safe to do that. That, plus many other research papers from the hand surgery in Saint John have led to the worldwide acceptance of this technique.”

On top of safety concerns, Lalonde said wide-awake hand surgery produces less garbage, yields higher patient satisfaction and is about a quarter of the cost.

“Most people on the planet can afford the hand surgery because it’s actually cheap,” he said. “What they can’t afford is the sedation and the general anesthesia for the hand surgery. If you take that out of the equation, the developing world can afford hand surgery.” The next step was teaching surgeons in the developing world.
Lalonde, who served as president of the American Association for Hand Surgery, was also recognized by Health Volunteers Overseas for establishing a reverse fellowship with the teaching school in Ghana. Rather than having doctors from developing countries visit North America for specialty training, he thought the trainees would be better served and less likely to leave their home country if volunteer surgeons travelled abroad.

The volunteers – surgeons and therapists who belong to the hand surgery association – would work in two-week stints in Kumasi, teaching plastic surgery, orthopedic and general surgery residents, he said.

Lalonde, a well-travelled native of Sudbury, Ont., who moved to Saint John in 1984, has a lengthy history of international volunteer work, including 26 trips overseas as a plastic surgeon to perform cleft lip surgeries.
He said Ghana was well-suited for the fellowship and wide-awake hand surgery training because it’s a stable democracy and English-speaking with a good safety record for visitors.

“It’s one of the very few poor African nations that has both a plastic surgery and orthopedic residency training program,” Lalonde said.

“West Africa is arguably the poorest place on the planet. And if there’s a place that needs help in terms of surgical training, it’s that part of the world.”

The association is also in the midst of organizing online seminars as part of the teaching program. Volunteers will provide lectures on hand surgery to the trainees, he said.

“They work very hard and they do a very good job, but they may need help in terms of training. Although, with the Internet, things have improved,” he said.

The Health Volunteers Overseas release stated Golden Apple Award recipients are honoured for demonstrating “a strong commitment to HVO’s mission to improve global health through the education, training, and professional development of the health workforce in resource-scarce countries.”

Lalonde, who is project director for the hand surgery component of HVO’s project, became involved with the organization in 2012 and volunteered for a teaching stint in Ghana on top of doing much of the legwork for the program back home. He also travels the globe offering lectures on the subject.

He is a professor of surgery at Dalhousie University Medical School and is an attending plastic surgeon at Saint John Regional Hospital, St. Joseph’s Hospital and Sussex Community Health Centre. The HVO award coincides with World Health Worker Week, which runs from April 5-11.

Dr. Donald Lalonde, right, poses for a photo with a member of the teaching school in Kumasi, Ghana. Photo: submitted