Q&A: How are UVA surgeons collaborating worldwide?

Q. What drew you to global health?

A. I started my training with that idealism common to medical students. It tends to take a backseat as the demands of residency and family-building set in. The collaborative nature of it is what’s sustained me. It becomes about working with your friends and chipping away at this corner of the world together. Seeing what works has taught me why some approaches succeed where others don’t. 

Global health grew out of late 19th and early 20th century campaigns against infectious diseases, saving millions of lives. But many of those efforts were very siloed and didn’t always leave behind stronger health systems. As the world becomes more industrialized, people live longer, and surgical conditions like cancer, heart disease, and injuries become more prevalent. That calls for a systems approach, so I work with health ministries, researchers, and like-minded surgeons to make that a reality. 

Q. Where have you worked?

A. I’ve spent the last nine years working in Mongolia with Dr. Ray Price, who has been teaching laparoscopy there for much longer. Together with our Mongolian partners, we trained rural surgeons and saw laparoscopic gallbladder surgery grow from about 4% of cases to the preferred technique around the country. Mongolia has a particularly high rate of gallbladder disease, so nomadic shepherds can get on with their lives much more quickly thanks to the commitment of local surgeons to spread those skills.

Nunez consults on laparoscopic gallbladder surgery with colleagues in Mongolia. He has consulted there for almost a decade. (Contributed photo)

Q. What does your role at UVA entail?

A. I’m co-directing UVA’s new global surgery program within the Department of Surgery with Dr. Adanna Akujuo, a cardiothoracic surgeon who works in Nigeria. We’re following the work of Dr. Sandra Kabagambe, who rekindled a partnership with the University of Rwanda and secured ACGME approval for an exchange rotation. 

We just selected the first resident in our global surgery track, who will spend a month in Kigali in their second year and return later in residency for a more advanced rotation. They’ll also work on research projects related to surgical access and health systems. The exchange formally begins next month, when a Rwandan surgeon will visit UVA to see how our residency program is structured and explore opportunities for collaboration. 

When I was in residency, there wasn’t a clear path for surgeons interested in global health to make it an academic career. Now, much due to the demands of trainees, it’s come much more to the forefront. It’s my job to facilitate that and to make sure that it’s mutually beneficial for us and our global partners.