Dr. Lewis Zirkle displays the metal cylinder with its line of neatly drilled holes.
The tube--made in Vietnam--looks like something you might use to repair an auto engine. Actually it's an external fixator for inserting pins into broken bones. A Vietnamese doctor made it at his home.
"It's ingenious," Zirkle said. "We don't have anything like this here."
In Vietnam, ingenuity is a necessity.
Decades of war have damaged that country's medical infrastructure, and Zirkle is one of many U.S. doctors who travel to Vietnam to help train other doctors.
An orthopedic surgeon, Zirkle traveled to Vietnam first as an Army doctor in 1968, and has been back for three monthlong trips since 1990. He sandwiches in hundreds of patients each time.
"They have 200 orthopedic surgeons for 60 million people," Zirkle said. "In this country we have one per 20,000 people."
Zirkle, 51, is the Vietnam program chairman for Orthopaedics Overseas, a Washington, D.C., program that seeks to train doctors in underdeveloped countries.
"They have two medical schools in Ho Chi Minh City," he said. "They have no access to the latest literature.
"They need telecommunications and Boeing airplanes," he said. "We could help them by being a trading partner."
But Zirkle's real expertise is damaged bones and joints, and he helps train 20 doctors and 80 medical students during his trips.
These days many of the injuries are caused by traffic accidents, he said. But wounds left over from the war, or caused by leftover weaponry, also must be treated.
Zirkle was asked several times after the war to go to Vietnam and help train doctors. The call that finally pushed him to do it came from a former South Vietnamese military pilot who had moved to Seattle.
During the war, the pilot was shot down and brought to Zirkle's hospital with an infected leg. "I took off his leg," Zirkle said.
He is planning another trip early next year. His partners in Richland cover for him during his absences, and Zirkle pays his own expenses.
The overseas training programs were started by Dr. Thomas Dooley, who established five hospitals in Southeast Asia during the 1950s before dying of cancer in 1961 at age 34. The programs have expanded to other parts of the world.
"What we like to do is go in and teach," Zirkle said. "We bring in equipment and leave it there."
The goal is for Vietnam to produce enough orthopedic surgeons in five years, Zirkle said.
He works with Vets With a Mission, a group of veterans who feel they should help Vietnam recover. They revisit their old battlefields and offer manual labor such as building medical facilities, orphanages and vocational centers.
"There is a healing on both sides," Zirkle said. "There are no old animosities."