One Brain at a Time, part 2: Are medical missions doing more harm than good?

By Tony Bartelme
The Post and Courier
Originally published 12:00 a.m., July 26, 2010
Updated 02:25 p.m., July 26, 2010

More than 500 groups around the world run upward of 6,000 short-term medical missions a year.

The flight lands in Oregon, 9,500 miles from Tanzania. Dilan Ellegala fills his lungs. No smell of wood smoke here. He just spent the past six months volunteering in a small hospital deep in the sun-baked African bush. Now, in the summer of 2006, it's back to work in the lush green city of Portland, to a new job as director of neurotrauma at Oregon Health and Science University.

A challenge? That's a sure bet to fire the neurons of a brain surgeon, and Ellegala is eager to start this plum job. He'll disarm those deadly aneurysms, treat those emergency head wounds and share his skills with medical students at a top research university. He's in his mid-30s, on the star track, riding an elevator toward higher positions, higher pay, grants, recognition.

Not so fast; a rift formed inside his mind during those six months in Tanzania. On one side: dreams of becoming a distinguished neurosurgeon, dreams that fueled him through five years of medical school, eight years of residency, a prestigious but brutal fellowship in cerebrovascular medicine at Harvard.