“There is an old Indian proverb, ‘many drops make a lake,’ ” says Chaitanya Mudgal, MD, a hand and upper extremity orthopædic surgeon at the MGH. “These are just some of those drops.”

These drops – Mudgal’s accomplishments and efforts to care for patients and better the field of hand surgery – are not confined to the walls of the MGH or to the city limits of Boston. They extend 12,000 miles across the world to the Guangxi Province in China and to the city of Hubballi in India.

Collaboration in China

Five years ago, Tan Haitao, MD, CEO of the Guigang City People’s Hospital in the Guangxi Province, met Mudgal while visiting the MGH. “One thing led to another, and he invited me to an orthopædic conference to speak about hand surgery,” says Mudgal.

While medical teaching differs vastly throughout Asia, Mudgal says his approach emphasizes the importance of asking questions and making teaching more interactive. “We have created a model where it is a free flow of ideas.”

After the success of the first forum, the Guigang City People’s Hospital renamed the conference the C.S. Mudgal Hand Surgery Forum in his honor. They also developed a mentoring program to send one of their hand surgeons to Boston to study with Mudgal for a year. Since then, six more surgeons have come to train at the MGH.

“I can learn more from here that will affect my life in the future,” says Hao Qin, MD, a current mentee, who has been shadowing Mudgal for the past six months.

“My job is not to try to influence cultural differences,” says Mudgal, of sharing his expertise at the forum and with the Guigang hospital surgeons. “My job is to impact surgical techniques and teach how to put them into practice.”

Slowly but surely, the orthopædics department at the Guigang City People’s Hospital has become “a little Harvard team,” says Haitao. “The future of this hospital has been changed for the better.”

Increasing education in India

Some 2,260 miles away from the Guangxi Province – in Hubballi, India – Mudgal is continuing to add drops to the proverbial lake, bringing his hand surgery expertise to the small city there.

“India is a country where hand injuries form a large percentage of occupational injuries,” Mudgal says. “And a smaller city like Hubballi is where the people are getting injured, in the farms and the factories. I thought, if they don’t have the access to technology and education there, why can’t we take the training to them?”

In February 2018, the inaugural Indo-U.S. Hand Surgery Course took place – an educational opportunity that became a reality thanks to Mudgal’s dedication and drive. With help from the Deshpande Educational Trust and a team of local orthopædic surgeons in India, Mudgal put together the two-day course covering topics ranging from tendon and nerve injuries, to injury prevention and splinting/casting techniques. The response, Mudgal says, was overwhelming, and the requests for him to return next year were immediate. Another course already is in the works for March 2019.

“If you look back at the history of hand surgery in India, it is not given the attention that it should,” says Mudgal. In a country with a population of more than 1.3 billion people, roughly only 10 fellowships exist in this field, a stark contrast to the hundreds of fellowships available in the United States, with a population of 325 million.

“It was just me and a dream,” says Mudgal. “Someone had to do it, and I’m happy to be the one to do so.”

Read more articles from the 08/10/18 Hotline issue.