Greater Latrobe grad takes surgical skills to underserved areas overseas

There was a time, before Dr. Marla Sacks received her 2009 high school diploma from Greater Latrobe, when she was considering a career as a veterinarian.

Patients in several countries are grateful that she instead earned a medical degree from St. George’s University School of Medicine, in the island nation of Grenada, and now is taking her operating skills as a general surgery resident to underserved areas around the globe.

Sacks grew up as a 4-Her caring for farm animals. But, seeing a childhood friend cope with a soccer injury and volunteering at hospitals in Latrobe and Jeannette tipped the scale toward taking care of human patients, she said.

“That stimulated me a little bit more,” she said, while noting, “I will still help animals.”

Since she also enjoyed taking part in crocheting and woodworking projects, it seems that surgery was in the cards for her.

“I liked working with my hands,” she said.

Underlying that, Sacks said, “My motivation for getting into medicine was that I wanted to help people and I enjoy solving problems.”

She acted on that intent while enrolled at St. George’s.

Taking part in an outreach clinic on a sister island, she learned how local doctors in a developing country cope with limited equipment and facilities.

“It kind of opened my eyes,” Sacks said. “They were still performing surgeries but in a MacGyver-like way.”

That included cleaning and reusing nasal oxygen tubes that would be a single-use item in a U.S. hospital.

“It empowered me to gain all the knowledge I can and go back to help communities like this that are struggling with what they have,” Sacks said.

First mission trip

That opportunity came in September 2021, when she took part in a surgical mission trip to Ghana. She joined a group from California, where she was engaged in research at Loma Linda University Children’s Hospital on an intestinal disease that affects premature infants.

The six-member team helped at a small community hospital in Ghana, performing more than 100 surgeries over five days.

Normally, Sacks said, “They had a surgeon who visited just twice a month. We all worked together as a team. We did some basic pediatric surgery and some adult surgical care.”

One of the most common needs was surgical repair of hernias, both for children who suffered with the condition since infancy and for adults. Sacks pointed out physical stress could enlarge a hernia, increasing the risk that it could entrap part of a patient’s intestines, causing a medical emergency.

“Everybody there is doing hard labor,” she said. “Nobody has desk jobs. There was a three-year-old carrying a stack of plates on her head.”

The team worked with five operating tables, three of them crammed into one room.

“We split up the work to make it go a little faster,” said Sacks.”We worked late into the night, but we were limited by the need of the nurses and staff at the hospital to clean up and get ready for the next day.

“It was exciting for me to do some independent work there while still under oversight. It was a big win for everybody.”

Alliance formed

That effort grew into Global Pediatric Specialists Alliance, an organization dedicated to providing medical care for children in remote areas of the world, through outreach surgery, while sharing techniques with local health care workers there.

Sacks is secretary of the group, which was founded by Dr. Andrei Radulescu. Associate professor of surgery and pediatrics at Loma Linda University School of Medicine, he supervised Sacks’ research work in California.

While completing her residency at the State University of New York (SUNY) Downstate Health Sciences University, Sacks has used vacation days to take part in more overseas surgical trips.

In 2022, she went with GPSA teams to Zambia, in April, and to Vietnam, in November.

In Zambia, in addition to repairing hernias, the team removed some tumors from children and also performed “tongue-tie” surgery. The procedure may be used on a young child whose tongue is held too close to the bottom of the mouth by a connecting string of skin.

“They can have trouble suckling or trouble talking,” Sacks said. “You cut the string and it can loosen the tongue to move better or so that they’re able to talk without a lisp.”

In the Zambian town they visited, the hospital staff was limited.

“The only doctor was a general practitioner,” Sacks said. “He would maybe do an emergency Cesarean section or abdominal surgery, but he had no training in surgery.”

While Sacks and her colleagues were on hand, that doctor got a crash course in several pediatric procedures.

“He trained with us, and after we left, he could continue to perform it,” she said. He also was able to care for patients who may have developed any post-surgical complications.

During a week in Da Nang, Vietnam, the GPSA team helped at a hospital focused on maternity and children’s care.

“We were working with a pediatric surgeon,” said Sacks. “For almost a full year leading up to the trip, we would meet on Zoom every three to four weeks and discuss difficult cases.

“They don’t have the same volume and experience and tools that we have. They could lean on us.”

‘It hit home for me’

In February 2023, Sacks spent five days on Catanduanes, an island in the Philippines, taking part in a medical mission trip organized by the University of the Philippines Medicine Alumni Society in America. She got involved through Dr. Francisca Velcek, a longtime surgeon who is an alumna of the Philippines university and is her academic adviser in New York.

Joining her on that trip was Dr. Monika Lay, a friend and former fellow SUNY resident who is completing a fellowship in critical care surgery at Jackson Memorial Hospital in Miami, Fla.

“It’s an hour away from Manila by plane,” Lay said of the island. “The patients we were operating on didn’t have as steady access to health care as we’re used to. Some had traveled for several days to get to the hospital. The youngest was a couple of months old, and we also operated on adult patients.

“It hit home for me to go back to the country where my mother is from, to give back to the community.”

From her current home base in Brooklyn, N.Y., Sacks normally works about 80 hours a week.

“I start at 6 in the morning, and the day ends when the surgery is over,” she said. “It varies a lot. You have to be flexible.”

Sacks returns to Westmoreland County when she is able, to visit her sister’s family in Hunker.

She’s also found time to contribute to more than 30 published medical research works. She holds an undergraduate degree in physics with a minor in psychology from Allegheny College in Meadville.

Looking ahead

Sacks is set for a return tip to Vietnam Feb. 19-24 to assist with more surgeries there.

She said her work with pediatric patients in other countries has reinforced her goal to focus on that specialty in the states as well. When she completes her residency in 2025, she hopes to begin a two-year fellowship in pediatric surgery.

The gratitude of patients and their families has been one of the most rewarding aspects of her work overseas.

She recalled landing by plane at her remote mission destination in Zambia.

“About 200 children came out of the grass and surrounded the plane,” she said. “They were singing and clapping; they were so happy to see us.

“We talked to the parents of the kids after the hernia surgeries, and they were so grateful that they had the opportunity to get this fixed for them. You could see that gratefulness in their eyes. It makes me feel my work there is definitely needed.”