August 27, 2001

perating room technician Shirley Cooke likes to use her vacation time in Tobago and take some friends along with her.

For the past two years, she has talked several colleagues into visiting Tobago on medical missions. In the process, she has revolutionized health care on the small island, according to surgeon Kristen Zarfos, who went to Tobago with Cooke in April.

"The operating room on the island was closed until Shirley started coming with American surgeons," says Dr. Zarfos.

The missions began last year, when Cooke persuaded several practitioners from the Health Center to go to Tobago for a week and provide health care on the island where she was born. Orthopedic specialists John Fulkerson and Charles Kime volunteered, along with neurosurgeon Hillary Onyiuke, medical assistant Bruce Montella, and surgical technologist Maxine DeFusco. Working out of an antiquated hospital, they performed 17 procedures, including the first knee arthroscopies (internal examinations of the knee joint) and laminectomies (back surgeries) ever done on the island.

This year, Cooke has organized four more medical missions to the island. In March, she spent five days on the island with orthopedic surgeons Fulkerson and Kime on their second mission. They repaired several knee joints and screened patients for total joint replacements that will be performed - for the first time on the island - when the group returns in November.

In April, Cooke returned to the island with Zarfos. Their work focused on educating health care practitioners on breast health and treating women with breast cancer and other diseases of the breast. "Breast care on the island is limited, says Zarfos. "There is one mammography machine for 60,000 women; and the procedure costs about $60 or $70, which is expensive there. So the bulk of the women have no access to mammograms," she said.

Cooke also brought along laparoscopic equipment that was never available there before. With this equipment, tubal ligations can now be performed without open surgery - a great step forward, according to Zarfos.

More missions are scheduled in November and December with a neurosurgeon and orthopedic surgeons.

Cooke and the medical professionals pay all their own expenses for the trip and provide their services for free. Cooke scrounges medical equipment from wherever she can. "In the United States, lots of supplies and equipment are discarded because they're out of date or slightly less than perfect; but they're still serviceable and valued in Tobago," she says. She snaps up sutures, drapes, catheters, sponges and operating gowns that the Health Center or other area hospitals cannot use and sends them to Tobago.

She also asks for donations to support the missions. One company, Linvatech Corp., has donated about $40,000 worth of medical equipment and supplies. Last year, Cooke placed little buckets on the tables in the hospital cafeteria and collected $240 in donations. "It really helps with things like shipping costs," she says.

Organizing the trip and gathering supplies are monumental tasks, but it is a labor of love for Cooke, who grew up on the island and still has lots of family there. She has lived in the United States for 16 years. "We take so much for granted here, especially health care," she says. "This is something that gives me a lot of joy."

Kristina Goodnough