Retired Mitchell doctor takes medical skills around the world

• Surgery in Haiti

Dr. Sandro Visani, at left, performs an operation during one of his 2011 trips to Haiti. Visani has traveled to six countries during the last 20 years to provide medical services to those in need. (Photo courtesy of Sandro Visani)

Talk about it

Dr. Sandro Visani doesn’t mind long hours away from home, hard work or living without amenities like air conditioning.

What he does mind is red tape, particularly when it prevents him from working.

Trinidad, for example, had a big, “beautiful” hospital, but paperwork kept the doctor from spending much time there.

In Haiti, on the other hand, Visani had a room with no air conditioning — but at least he got to work.

The retired urologist, 70, lives in Mitchell most of the time and enjoys pheasant hunting and Skyping with his family in Italy. That is, when he’s not traveling on medical mission trips, which he’s been doing for 20 years. It all started in 1992, when Visani went to St. Lucia for a month. He was hooked.

“I came back and I realized I really could not carry on doing full-time practice at the same time,” Visani said. Initially, Visani said he tried offering his services in-country, at American Indian reservations. He said after contacting seven or eight regional health care administrations, only one responded — to say his services could not be used.

“I was extremely frustrated with the bureaucracy,” he said. “It comes to a point where enough is enough.”

So, he started going overseas. He’s been back to St. Lucia once (for two total visits), to Honduras once, Trinidad three times, Tanzania three times, Uganda four times and Haiti four times.

He’s also picked up a few languages on the way. Six, to be precise.

Originally from Faenza, Italy, his first language is Italian. Not surprisingly, having lived in the United States since his early 20s, his English is superb, tinged only slightly with his Italian roots.

Visani also speaks Swahili, French, German and Spanish. It comes in handy, he said, during his travels.

Visani said he’s gone with groups and independently, and prefers to go independently, largely because he said most groups go for a week or two, giving him little time to do “meaningful work.”

“If I go, I go for at least a month, preferably two,” he said.

Two months, he said, is long enough to get something accomplished, but doesn’t keep him too long away from his wife, Brenda.

Visani said while it can be difficult being away from his family, technology has made it easier to stay in touch.

“At the beginning we were writing letters that took three weeks to go back and forth,” he remembers. “We sort of made a tacit agreement that two months is the magic number.”

Visani has seen a lot. He remembers being in Gulu, Uganda, during turbulent times.

“I was in that area while Joseph Koney was still being rambunctious,” he said.

Koney, the notorious leader of the Lord’s Resistance Army, has long been accused of abducting African children to become child soldiers in his guerrilla army.

During that time, Visani worked at Lacor Hospital, also called St. Mary’s Hospital, which he described as “one of the best hospitals between Cape Town and Johannesburg.”

Armed guards protected the hospital compound, and Visani said area children — an average of 5,000, sometimes as many as 10,000 — came in every night to sleep, for fear of being abducted from their homes.

“Twice I’ve heard gunfire, and once was in Uganda, the other was in Trinidad,” Visani said.

The gunfire, he said, was a nearby village being raided.

Still, despite the proximity to conflict, Visani said he never feared for his safety.

“Some precautions are appropriate,” he said. “You don’t want to go out at night. You definitely don’t want to go out alone.”

But the hospital, he said, was believed by some to be protected by the spirits of the missionary couple that founded it.

“On a more practical level, those rebels knew very well if they got hurt, that’s where they were being taken care of,” Visani said with a smile.

In that hospital, Visani said there were no sides, and people who might have shot at one another the day before might end up sharing a space.

“One in the bed right next to each other,” he said.

He remembers doing as many as six amputations in one day, to victims of gunshot wounds.

“We were cutting off legs left and right,” he said.

But Visani said warlords were often the least of his worries.

“The risk was greater for tropical diseases,” he said. “A good friend of mine died.”

That friend, Dr. Matthew Lukwiya, chief of internal medicine at the hospital, died of Ebola virus.

“That was the first time an Ebola outbreak was managed with modern sanitation,” Visani said. “It was Matthew himself who recognized it was probably Ebola.”

Visani said seven or eight hospital personnel died from that outbreak. Even so, he said his friend’s efforts “drastically reduced” the overall death toll.

It’s not all war and disease, though. Visani said he typically works closer to his specialty area, which in Uganda involved vesicovaginal fistula repairs.

He said vesicovaginal fistula is a condition in which pressure from the head of a baby jams against the mother’s pubic bone, causing a hole between the vagina and the bladder. From that hole, urine leaks continually.

“Surgical repair is difficult,” he said.

Incontinence aside, Visani said female fertility is very important in Africa, and the inability to have a baby makes a woman an outcast.

“There is great reluctance to accept a caesarian section even if it is available,” Visani said. “A ‘good woman’ should be able to deliver.”

Visani takes his own endoscopic equipment with him, but he said other conditions can still be limiting. He laughs as he remembers his introduction to the examination methods in Africa.

Visani said he wanted to observe a bit before jumping in, so he, a nurse, a colleague and an intern crowded into a small room furnished with a desk and a stool.

“We were a little bit packed,” he said.

As women came in to be examined, he said they had no qualms about undressing. Completely.

“Nobody cares … they figure ‘If I don’t care, he won’t care,’ ” he said. “One woman is putting clothes on, another is taking her clothes off.”

To top it off, Visani said these women — being examined for vesicovaginal fistulas — would leave traces of their visit behind.

“By now, there’s a little puddle of urine,” he recalls, laughing.

When Visani asked the nurse if the mess should be cleaned up, she quickly brought in the last patient and had her clean it up, he said, shaking his head at the memory.

Even though the work comes with challenges, Visani said it has its rewards.

In Haiti, Visani said a man came to show off the 4-month-old baby he fathered as a result of the operation Visani did.

“Male infertility is part of my specialty,” Visani said.

When asked why he has dedicated so many years to his mission work, he shrugs and gives a simple answer.

“They need the help,” he said. “I may be a drop in the bucket, but it’s one drop that before they didn’t have.”

His most recent trips have concentrated on Haiti, which is where the doctor said he will likely return in the spring.

“At the end of the day, I’m 70, so one of these days I will quit,” he said with a smile.

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