Blog

Leaving Bangladesh

I didn’t have internet access for a few days so this is the first time I’ve been able to put an entry. Thursday night they threw a party for us as a thank you for coming. The following day was a Friday and a holiday but we were still operating. The staff agreed to work on their day off for us. The last day at LAMB hospital was amazing. We did a Turner-Warwick scrotal inlay on a person with BXO involving the urethra. I’ve never seen that before. I also did another adult hypospadias and a meatal advancement and chordee. The people here are very friendly and dedicated to the people. I’m sad to be leaving.

On Saturday we made the 7 hour drive again to Dhaka and dropped off Dr. Ganesh at the airport. We stayed at Dr. Das’ friends’ house in Dhaka. On Sunday we went to the Dhaka Medical College and met with Dr. Sayeba a prominent gynecologist and the best vesicovaginal fistula surgeon in Bangladesh. She showed us her fistula program. We visited the ward and their training center. It’s amazing what she’s built here and it’s appalling what these women had to go through. We met several during our tour. Now we’re on our way to Bhopal and the next part of our trip. Will write more later. I’m running out of internet time.

~Jhtamola

Read More

Goodbye….

We made rounds at the Maternal and Pediatric Hospital this morning. All of the patients are doing very well, which is great. Dr. DeVries is a highly revered person. When we walk down the halls people look at her with gratitude and wonder. As one of the patients wrote on a thank you gift to her: “You are an angel sent down to us from heaven.”

The Hospital No. 1 doctors came to the hotel late morning for final goodbyes. They also brought some lovely and generous gifts for us. They already want to know which of us will be back. Every single person on this team wants to return someday. Of course it’s a long trip…but worth every moment of flying and layovers.

Dr. DeVries, Dr. Hamilton & Dr. Reddy left this morning. The remaining team members went to the black market and had an opportunity to see some of the sights in the city including a palace, the Parliament building and the National Theater. This evening we will go to another concert. This time in addition to music there will be contortionists.

There is a saying: “It’s not where you go, it’s what you do when you get there.” We stand in awe of Dr. DeVries, Dr. Hamilton, Dr. Reddy, Dr. Kuritani, Janet Vogt & Pam St. Louis for all they have done for the people of Mongolia. They will be long remembered.

Signing off in Ulaanbaatar,

Ellen & Edd Thorp, Trip Secretaries

~Mongolia2008

Read More

Friday….last day of surgery

Both teams had excellent days. Thirty seven surgeries were performed in five days — WOW! It was sad to say goodbye to the staff at the Maternal and Pediatric Hospital, but it was wonderful to see how much better the children felt. Dr. Sujith Reddy joined the team there today in order to experience both locations. The local surgeons were very happy to have mastered some new techniques. They were also pretty thrilled with the donations we were able to leave behind.

Our days have been long but we have been very lucky to have had two young ladies as interpreters — Zaya and Ayuna. They have been our lifesavers in and out of the hospital; staying by our side through late dinners and shopping. Everyone here has taken excellent care of us.

We were able to take the whole team to a Mongolian concert this evening. It was fascinating. We were all mesmerized by the “throat singers”. They make multiple sounds at once, all with different tones. Remarkable! We also enjoyed listening to the Mongolian National Orchestra and watching folk dancing. Things are not very expensive here: the entire 1.5 hour show cost $10.00. Meals cost about $5.00-$10.00. Cashmere…..well, that’s a different story. It’s cheaper here than in the US, but it still can be a little pricey.

The local doctors are already looking forward to IVUmed’s next visit.

~Mongolia2008

Read More

Bangladesh Day 3

Bangladesh day three is another busy OR day. We planned 3 cases today but we were only able to do 2. The first case is our 8 year old patient with extrophy. We removed his extrophied bladder, re-tubularized his penis, created a ureterosigmoidostomy for him and closed him with a rectus flaps. It was a very interesting case and the first extrophy I have operated on. The second patient was a young girl with incontinence and female epispadias. We did a Young-Dees bladder neck wrap and a Burch colposuspension. Both of these cases were new ones for me. I’ve also never seen a female epispadias. We operated past the time when the OR staff was supposed to go home. We’re lucky that they were nice enough to stay late for us. Tomorrow, Friday, is a holiday for them and they’re working just because we’re in town. We have smaller cases tomorrow so hopefully we’ll be done in time. At the end of the evening, we were invited to Dr. Bower’s house for dinner. We met more new friends. The people here were really happy that we came, especially Dr. Ganesh because of all the reconstructive cases. Dr. Das joked that instead of sending patients to Velore hospital (Dr. Ganesh’s hospital), he brought Velore here to LAMB. I’m really learning a lot from both Dr. Ganesh and Dr. Das. I’ve seen a Young-Dees before but never really understood the operation until now. Dr. Das has such a calming presence and has been able to negotiate the longer operating hours for us. I keep thinking that this is a rare experience and I’m soaking up as much as I can.

~Jhtamola

Read More

Thursday – Firing on all cylinders

Hospital Number One, Day 5 in Mongolia.

I have been working closely with Dr. Hamilton. His experience in endourology has served as a great resource for me as well as the local doctors. We have been performing kidney stone surgery this week in attempts to help improve the techniques of local surgeons. Early in the week we struggled with a few cases and realized the technology available was the problem. We have sicne made adjustments and emphasized the need to make the best use of resources available. Today we felt our surgical cases were performed with efficiency and success. We are excited at the vast differences from Monday to today. We hope that our few days in teaching will allow many years improved patient care.

Today, we also presented scopes donated by the Storz endoscope company to the local doctors. They were most grateful as the last donated scopes were showing their age. The local doctors are compassionate and skilled surgeons and have been adaptable to the equipment available to them. With modern equipment, they have the ability to provide patients with minimally invasive procedures with great surgical prowness.

I find the mongolian people to be friendly and happy people. The local doctors and nurses, the patients, and our translator have all been great hosts. We even have found time in our busy day to laugh, share stories and culture, and even family pictures with the local people.

The team at the Pediatric hospital also had a productive day. The patients’ families have been most gracious and shower the team daily with praise and gifts. It is touching to see such display of gratitude. Late in the day we met the team and headed to the local department store for souvenier shopping. We then headed back to the hotel and met for dinner at the Japanese restaurant in our hotel. Nori, our pediatric anesthesiologist, showed us a great time and introduced us to his favorite cuisine. We did have to say goodbye to one of our wonderful nurses. She had an unexpected family matter and had to rush home. We are sorry to see her leave us early but have shared some great times. All in all another great day in Mongolia.

~Mongolia2008

Read More

Bangladesh Day 2

Day 2 in Bangladesh is a surgery day. I woke up and had breakfast with Dr. Das and Dr. Ganesh. Then I packed up some of my supplies and headed to the operating rooms. As a side note…Differences in culture are always interesting. We had to take off our shoes to go into the ORs. The shoes they had there were flip flops. Luckily, I found a pair of clogs. They had two OR rooms. The schedule was cleared out just for us. We were able to do our big cases in the main room and smaller cases in the other. They had one cystoscope set that Dr. Das had donated the last time he was here but no camera. They had a decent stock of supplies which Dr. Bowers said was all donated. They still lacked several things like new light bulbs for the cystoscope, good tape, and they really need decent surgical instruments. We did a hypospadias repair with instruments that that would shock our pediatric urologist, Dr. Joyner. We had 5 cases today. I scrubbed in for a redo urethroplasty and an adult hypospadias with Dr. Ganesh. Dr. Das worked on 2 UC fistulas and a cysto on our epispadias patient for tomorrow. The OR staff are really nice except I keep getting the wrong instruments when I ask. I think I don’t speak up enough in the OR. I’ve been working really hard on saving suture. Dr. Koyle and Dr. Joyner would be proud of me. At the end of the day, we walked out of the operating room to find 2 young men waiting for us. They were patients of Dr. Ganesh who heard he was in Bangladesh and wanted to come see him. They came all the way from Dhaka just to catch a few minutes with him. The patient was a young orphan who had a urethral stricture from a pelvic injury. It was operated in Bangladesh and restructured then Dr. Ganesh operated on him. I was able to use my new bladder scanner to check his PVR. I thought that was cool. He had <50cc. We wrapped up our day by meeting four new friends. We have new roommates at the guest house, Mitch and his family. The family is American but has lived in Bangladesh in the last 7 years. They have two kids both born here in LAMB. His daughters are beautiful and ran around the house with a lot of energy speaking both English and Bangla. I’m going to bed early because we have big day tomorrow. Good night. ~Jhtamola

Read More

A very long day…..

Ellen Thorp, trip secretary here. Today was a long and wonderful day. The first surgery at the pediatric hospital began at 8:am and the last surgery ended at 7:30. Dr. DeVries is amazing to watch. Her last case was four hours and she remained highly focused in spite of the hour or fatigue. We all stand in awe of her abilities, including the Mongolian staff. We are all a little more comfortable with each other as the days go by. Today we showed them pictures from home and the Mongolians were really interested and curious. They spent a lot of time studying the map that Janet Vogt (nurse) brought, asking where we were born, where we live now and how long it takes to get from city to city. We have a terrific interpreter, Zaya, but we are also finding ways to communicate without words.

Dr. DeVries completed five surgeries today. One of the surgeries was slightly delayed when the local folks plugged in our Bovie machine and it started to smoke…a lot! The cameras whipped out to document the event as if we were at Disneyland. Anyone want to donate a new machine???

Our day at the Maternal and Pediatric Hospital ended in a very touching manner. At the end of our clinic day (Sunday) there was a dad who had waited in the hallway and wanted to carry our bags down the three flights of stairs for us. His little boy ended up being our first case yesterday. We remembered the child well because he was very upset and crying before he was put under. The child did very well. I had the pleasure of seeing him this afternoon when a few of us handed out crayons, coloring books and Beanie Babies (all donated). Hours later the father and mother met us as we were leaving the hospital. We were pretty tired but our spirits and our hearts were lifted when they approached us with flowers, chocolates and Mongolian dolls. Then the dad insisted on carrying our bags out again. I don’t think we’ll ever forget them.

Hospital No. 1 had a visit from the new Minister of Health today and that slowed things down a bit. They completed three surgeries, one of them a five hour kidney stone procedure. The doctors at that hospital speak more English than at the Pediatric hospital so it’s easier for them to form personal relationships. The Hospital No 1 staff took all of us out to dinner at a Mongolian restaurant. One of our members ordered horse ribs (they were out). Dr. Nori Kuratani order a soup that had many different organs in it; we renamed it “Donor Soup”. The evening was lovely including a musical performance by one of their doctors and another by our own Dr. Blake Hamilton.

We are all looking forward to tomorrow!

~Mongolia2008

Read More

Bangladesh Day 1

My name is Josephine and I am a 4th year resident from University of Washington. I’m traveling with Dr. Sakti Das to the LAMB hospital in Parbatipur, Bangladesh and Bhopal, India. I left Seattle on 9/20 with an XL REI duffel bag full of sutures, gloves and catheters plus a brand new bladder scanner and glidescope from Verathon. My trip to Bangladesh took a total of 19 hours of flight time and plus 11 hours stop over in San Francisco and Singapore. I arrived in Dhaka, the capital, at 11pm in the middle of a thunderstorm and stayed at the LAMB guest house in Dhaka. The following day, I met Dr. Das and Dr. Gopalakrishna at the Dhaka airport. I was standing outside the car when I hear a cry “Josephine” and saw a tall Indian gentleman walking towards me. Together, the three of us and 2 other LAMB employees drove to the hospital. It was a 7 hour trip through a beautiful countryside with a lot of rice fields. The LAMB complex consists of several buildings around the hospital. It provides comprehensive medical care for the surrounding areas. When we arrived, we went straight to the hospital to meet our patients for tomorrow. One young man has recurrent stricture disease who will need a redo posterior urethroplasty. A young woman has urinary incontinence and female epispadias. After seeing the inpatients, we walked to clinic and were surrounded by patients asking to come in. Since there is no in house urologist, patients with urological problems are either referred to other hospitals or wait until Dr. Das’ yearly visit. In clinic, we saw an 8 year old with cloacal extrophy, adult hypospadia, urethrocutaneous fistulas and others. We made a list of patients for surgery and management plans for non-operative patients. As our list of surgical cases grew, I became more excited. This is only the first day. I can’t wait until tomorrow.

~Jhtamola

Read More

Day 2

Today the teams separated to their designated hospitals. At the pediatric hospital Dr. deVries did 4 successful surgeries and 4 consults, ending the day around 6pm. Children were each given a handmade donated blanket for warmth after surgery. The local nurses were very greatful. Dr. Hamilton did 4 surgeries and 3 consults ending the day after 7pm. We have identified a great need for basic equipment maintanance and troubleshooting. By the second half of the day we finally procured a light source that enabled the surgeon to actually see what he was doing thereby reducing the need for exposurre to x-rays. We have lovely and gracious interpreters for each site making life simply wonderful. Our patients here are very stoic and forgiving of the amount of time they must wait for their procedures. The number 1 hospital was visited this morning by the new Minsiter of Health, causing much delay in the start of our surgery schedule. Hopefully this new Minister can bring many needed improvements to the Mongolian health care system.

Nurse Pam

~Mongolia2008

Read More

Monday – day one of surgery

The entire team spent the day at Hospital No. 1. We were greeted by the Director, Dr. Sonin Sodov. He gave us an overview of the hospital history as well as some background information regarding medical availability in Mongolia. Hospital No. 1 opened in 1925. It is the largest hospital in Mongolia. There are 21 provinces and each has a general hospital with about 200 beds. The villages have hospitals with 10-15 beds. According to Dr. Sodov there is a great shortage of doctors in rural areas but a surplus in the capital, Ulaanbaatar. There is also a shortage of nurses so the doctors often do nurse’s work. He was very kind and expressed gratitude for IVUmed’s visit and acknowledged the power of volunteerism.

Drs. DeVries, Hamilton and Reddy performed a total of seven surgeries today. The sanitation conditions are very different from those in the US. For example, there are many items used during surgery that are thrown out in the US but reused in Mongolia. The autoclave machine was an antique according to one of the nurses. It was covered with rust and had an open lid. It was more like a bubbling pot than an autoclave.

Patients in Mongolia are responsible for carrying their records with them. I even witnessed a patient holding onto a disposibile camera on her way into surgery, perhaps with the hope that anything that needed to be in her record would be photographed. The families take a lot of responsibility for the patient’s care and nutrition. I guess they can’t complain about hospital food with that being the case!

Tomorrow we will split up in to two teams: one will go to Hospital No. 1, the other to the pediatric hospital. There is an ambitious case load and it seems the local doctors would like to add even more. IVUmed is so highly regarded here that the local physicians really want to maximize our staff’s time. Although our hectic schedule doesn’t leave much time for rest it is invigorating to think of the positive results the IVUmed team is accomplishing.

Ellen Thorp, Trip Secretary

~Mongolia2008

Read More
IVUmed is committed to making quality urological care available to people worldwide.