Our training focuses on urethral reconstruction – a procedure rarely attempted in the DR, despite thousands of Dominican men in need of urethral repair. Without the procedure, the men are forced to wear permanent catheters, creating debilitating challenges for them both professionally and personally. Many are treated as outcasts in their communities.
Causes of urethral damage vary. Most of Dr. Ledesma’s patients suffered damage from car accidents or post-surgery catheter mismanagement. Dr. Ledesma offers his patients an understanding of both their medical conditions and their personal circumstances.
“They are not treated like equals,” Dr. Ledesma says of his patients. “Sometimes their boss will notice that they have a catheter and then do not treat them as a normal person."
For young Dominican men, a permanent catheter can prevent them from dating or marrying.
“It is so difficult for them to get a partner", Dr. Ledesma explains. “The men face the same rejection as they do with their bosses, unfortunately. We, as doctors, know that they do not have a limitation or a disability, but people who are not trained in that area do not get it.”
Dr. Ledesma patiently watched each of the 72 reconstructive surgeries conducted by the Physicians for Peace International Medical Educators (IMEs), Dr. Ramon Virasoro and Dr. Jessica Delong. During the last training mission in June, Dr. Ledesma joined Dr. Delong in the operating room to conduct his first urethral reconstruction.
“He knew all the steps, he was really careful and he was really focused,” Dr. Delong said. “That’s the thing with reconstructive surgery, you have to be really focused and pay attention to the little things. And he did and the case went really well.”
Dr. Virasoro was also impressed. “For the first three missions, Dr. Ledesma observed us in the OR,” said Dr. Virasoro. “He was just watching, looking and getting things into his mind. On this mission, I said, ‘ok, this is your case.'”
Dr. Ledesma saves his praise for the training team.
“You can read a technique ten times, a hundred times, and you do not understand it as well as you do when you see the procedure. And when you see – you are not reading, you are internalizing the knowledge and finally understanding it,” he says. “And for the patients, these guys are superheroes because they are giving them the possibility to recover. Not being able to urinate is the biggest nightmare. These doctors come here and offer them the solutions to that problem.”