Spotlight on Dr. Charlotte Rajasingh

During the last few months of her general surgery residency at Stanford, Dr. Charlotte Rajasingh spent four weeks on an elective rotation at Parirenyatwa hospital in Zimbabwe. We spoke to her right before graduation.

Tell us all about your rotation in Zimbabwe, and what it meant to you.

I’ve been at Stanford for more than 12 years, starting with medical school and continuing through surgical training, and I have seen the Zimbabwe program come and go as the global landscape changed. Working with Dr. Wren and Weiser, I learned that we had an existing relationship with the University of Zimbabwe training program and that several of their faculty have come to Stanford, including Dr. Godfrey Muguti, Mr. Mbanje (the attending surgeon whom I worked closely with in Zimbabwe), and others. This was an encouraging factor because having a mentor who carries US credentials is an important factor to do rotations in foreign countries.

I also learned that Drs. Sherry Wren, Cara Liebert and Wendy Su had repeatedly participated in Zimbabwe-based training programs, especially at Zimbabwe’s International Centre for Surgical Simulation (UZiCSS). This is a fascinating collaboration that I wanted to be part of.

When I started my rotation there, I joined one of the general surgery teams and we did the full spectrum of general surgery cases including breast surgery, trauma and emergency, endocrine, colorectal surgery and some laparoscopic surgery. On weekdays, I would go to the hospital at 7:30 AM to do rounds with the team, which consisted of junior residents and medical students. After that—and depending on the day—I would either go to the clinic or go to the OR. On weekends we would be on call, so I would see the patients on rounds and then do any cases that we had to do.

Among the healthcare professionals at the hospital, English is the predominant language. However, many patients and their family members preferred to speak Shona, which is the language of the community in Zimbabwe, so a colleague helped translate for me many times.

The timelines were a bit more flexible compared with the US, and there was less time pressure. For example, the OR starts at 8:30 AM but could some days start at 9:00 AM.

So, I had more time to spend with my family [husband and two children] who came with me to Zimbabwe for the whole five weeks that I spent there, from March 31^st to April 27^th [2025]; my dad and brother also joined us in the last two weeks. After I finished the rotation, we enjoyed a short vacation in this lovely country, before our trip back home.

This valuable experience luckily happened in the end of my residency, and it gave me a chance to operate more independently. It was great way to push myself in these final months and take advantage of everything that I learned.

What did you learn, and what did they learn from you?

The culture around supervision at the hospital is different from Stanford. Their residents are given the opportunity early on to operate independently and the senior residents at my equivalent level are quite independent. While I felt I had the skills and knowledge to operate independently and confidently, I also wanted to be careful that I didn’t step beyond the bounds of what I would feel comfortable doing in the United States by myself. I asked myself this question with each case, had to be honest about my own limitations, and proactively ask for help when a complex case was scheduled. I was thankful every day for the incredible training I received at Stanford.

The situation was an opportunity for a lot of professional growth on my part but was also a place where I felt I had to be intentional to maintain a standard of care equivalent to my home institution.

There was a great balance of bidirectional learning, with me bringing skills that I have, such as laparoscopic surgery, and them teaching me new things. For example, they don’t have staplers for the bowel (everything is sewn) so they showed me the techniques that they use in their setting. I also learned how to be more creative and thoughtful on how to use resources and reduce waste, and I become more confident in making decisions even when I don’t have all the information I need.

Can you please elaborate more on the challenges that they experience in providing healthcare to patients at the hospital, and the specifically the OR?

Yes, in the operating room they don’t have all the things that we have here like bowel staplers or certain laparoscopic instruments. Even if they do, they tend to re-use things for as many cases that they can possibly can, things that we only use one time or discard even if we just open and don’t use it. They must do that to overcome a lack of funding and ability to purchase things, and they try every possibility such as to re-use and recycle in order to be good stewards of the limited resources that they have.

Many things were hard for me to come in terms with while I was there. For example, there is only one oxygen monitor available in the post operative ward so they had to move it from one patient to another, or the fact that patients and their families had to buy all supplies and medications that the patient will need and bring to the hospital because the hospital doesn’t provide it.

Even simple things like glucose strips to check the blood sugar when you give insulin needed to be separately purchased; if the family doesn’t provide it, the patients cannot get their sugar levels checked. I was surprised to see that when a patient has elective surgery, the hospital gives them a list ahead of time of all the things you want them to bring, including the sutures.

Another example is that the CT scanner at the hospital was not working, so when a patient needed a CT scan, they would have to leave the hospital to go somewhere else to get the scan done and pay for everything out of pocket. Not all families could afford it, so we had to work around that, like operating without knowing what we’re dealing with because we were not able to get all the information we needed.

One other thing that they learned from me was how to utilize all available clinical information and collect every possible piece of patient health history, social background, family history in addition to the physical exam to help compensate for the lack of other diagnostic information we might need to operate.

How will this experience help you in your future career? 

When I think about my future career, I see opportunities to bring additional expertise in surgical sub-specialties to this beautiful country by doing some teaching and mentorship of general surgeons. One example is that there are no colorectal surgeons in Zimbabwe, although there are many general surgeons who are interested in colorectal. It is something that I hope I can contribute to in the future.

Thank you, Dr. Rajasingh, for your dedication and commitment to patients and the global surgical community.

Dr. Rajasingh completed her general surgical training in June 2025 and has started her colorectal surgery specialty fellowship at Cleveland Clinic.