'A Surgeon in the Village'

Post and Courier reporter Tony Bartelme has authored a new book called "A Surgeon in the Village."

Writers tend not to be numbers people, but Tony Bartelme did some quick math when he visited East Africa in 2010 to report a story on an MUSC neurosurgeon teaching there. In Tanzania he found an intoxicating landscape, intriguing people and a startling fact: this country of 42 million people had only three brain surgeons.

Even a writer knows that figure is out of whack.

And a writer as seasoned as Bartelme, a special projects reporter for The Post and Courier and three-time Pulitzer Prize finalist, knows when he’s found a good story.

“As soon as I landed in Tanzania and got a feel for it, especially for the village of Haydom, I realized there was an incredible richness and bigger story there,” Bartelme says.

He also was immediately struck by the charisma of his main character, Dr. Dilan Ellegala. He was a Sri Lankan Harvard-trained neurosurgeon who lived on Folly Beach, was on the faculty at MUSC, and did brain surgery in the African bush on the side, using crude tree saws and duct tape. Ellegala taught nonmedical Tanzanians how to do basic brain surgery, so the villages would have resources after medical volunteers, who swooped in for short visits, left.

“Sometimes you just kinda know,” Bartelme says. “Here’s this tall, striking guy with a shaved head. He has a surgeon’s clarity and leadership, but he’s a reluctant, flawed leader in some ways. I remember thinking this was a medical Michael Jordan. I knew I had a great person to write about.”

Bartelme’s recently published book, “A Surgeon in the Village — An American Doctor Teaches Brain Surgery in Africa” (Beacon Press), proves his instincts were right.

The book expands on the four-part series that Bartelme wrote for this paper in the spring of 2010 (earning him one of his Pulitzer nods), but takes readers deeper into the story, fleshing out characters’ personal histories that led them into medicine, to Africa, to being audacious enough to try to teach brain surgery to nonphysicians, and deeper into the broader issues of physician training and disparity of doctor supply.

“Once I met all the characters in the story and came back (from Tanzania) and wrote the series, I realized this large public issue of shortage of doctors has global impact,” Bartelme says. “OK, I’ve got more to say.”

But writing a book is “exponentially more difficult than writing a series,” Bartelme admits, and this book-writing journey entailed four additional trips to Tanzania and intense on-the-ground research.

“I really wanted to write a story that felt like reading a novel. Pulling that off means that if someone mentions they went to school under a tree, I had to find that tree to accurately describe it,” says Bartelme, who received a Harvard Nieman Fellowship enabling him to work on the project.

Bartelme’s investigative journalism background served him well, especially when he set out to find out how the patients operated on by Ellegala’s trainees fared. The patients were spread all across the bush, and Bartelme had no addresses to go on. Undaunted, he hired two guides, rented a hospital ambulance and set out to find them.

“I remember searching for one patient who’d been operated on after being hit in the head with a stick, and after hours of driving through muddy fields, hiking over hills and rivers, we find a hut and his wife says, ‘Oh he’s over there in another hut with his other wife,’ ” Bartelme recounts. “So more hills, more mud, more hikes, and the second wife tells us, ‘No, he’s over there, drinking with his buddy.’ So we go there, and a guy with spikes coming out of his sandals tells us our guy has been running from us all day. Finding the patients took days and days, and it was an absolute blast.”

Bartelme is pleased that this book is becoming part of a broader discussion on whether or not short-term medical mission trips are effective.

“The chorus is building that it’s better to teach essential surgeries than go in and do them and leave,” he notes.

And as a writer, the project was personally satisfying as well. “I like finding the stories that are hidden in plain sight,” Bartelme says. “Stories that people think they know but really don’t until they are portrayed in a certain way and the reader has that ‘a-ha.’ My ‘a-ha’ moment was realizing shortage of surgeons was one of the biggest global health stories that no one’s ever heard about.”