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Notes from the Field: Hue, Vietnam – Part 2

Lawrence Jenkins, II, M.D. , an IVUmed resident scholar, volunteered with our general urology workshop in Hue, Vietnam on March 10-22, 2014. This is the second half of selections from his field notes:

Notes from the Field:  Hue, Vietnam

 

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Day 5

There was a ceremony with the university directors and urology senior staff where Dr. Hampton was given the title of Visiting Professor. It was nice yet very formal and Dr. Petrossian and I received small wooden plaques with the university and hospital name on it to commemorate our trip. Drs. Hampton and Petrossian left to go back to the US.

Day 5-7 – I took a bus to Hoi An, which was 4 hours south of Hue. I arrived in town at night and went into town to see a lantern festival where they turn off the lights and businesses only use candlelight and lanterns, and people place paper lanterns in the river. The next day, I took a tour to My Son Holy land, a sanctuary dating from the 4th to 13th centuries. We stopped at island on the way back to see sculptures and carvings being made. Later, I walked around the old town for a bit, then found a cooking class and made some delicious meals. In the morning before leaving I took an 8.7 mile / 14 km bike ride into the countryside and saw life outside of the tourist area.

 

Day 8

I met Dr. Kahan, from New Hampshire, who was the faculty mentor for the second week. This was his fifth or sixth trip to Hue. There were several open stone surgeries that day, one renal and two ureteral. The technique that the Vietnamese doctors had was superb and they were able to efficiently remove the stones without unnecessary manipulation. The afternoon surgeries were performed in the same room and at the same time as a general surgery case, which is unheard of in the US at the present time with infection concerns.

 

Day 9

We performed another nephrectomy, this was for a kidney with chronic infections. That evening the urology staff took us out for dinner and drinks. It was fun and we were able to socialize not only about urology but about life in Vietnam vs life in the US.

 

Day 10

We did 2 percutaneous nephrolithotomies with new renal access gained with the assistance of fluoroscopy. Both were for lower pole stones. The only method they have available for lithotripsy is laser; however, in the US we have pneumatic and ultrasonic lithotripsy as well. They were having difficulty gaining access and I was able to show a different method that I learned during residency. It felt good to be able to show them something new since they were showing me so much about open stone surgery.

 

Day 11

I did my third presentation for their morning conference. Most people seemed interested and had some good questions. We then went to see some surgeries and in the afternoon I spent some time in the clinic with one of the attendings. The clinic was one room amongst a group of many clinic rooms that likely rotated specialty. In the evening, we had a closing dinner on the river with the department. It was very nice to see everybody again and enjoy the authentic Vietnamese cuisine.

 

Day 12 – 13

Dr. Kahan left to go back to the US. I rented a scooter and rode around the countryside with one of the Vietnamese doctors, Dr Fu. We went to see several Buddhist temples and a lookout point with a great view over the Perfume River. That evening, I left for my extremely long trip back home.

Overall, it was an amazing experience that changed my perception of not only urology but the general delivery of healthcare. Seeing what they were able to do with much less equipment makes me appreciate what we have so much more. In Hue, medicine is pure, not overwhelmed by the need to order extra tests in fear of malpractice lawsuits. The Vietnamese doctors were very welcoming and I hope to go back one day.

 

 

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Notes from the Field: Hue, Vietnam

Lawrence Jenkins, II, M.D.  Dr. Jenkins, an IVUmed resident scholar, volunteered with our general urology workshop in Hue, Vietnam on March 10-22, 2014. These are selections from his field notes:

 

Notes from the Field

Lawrence Jenkins, II, M.D.:

Day 1

I arrived in Hue after 23 hours of flight time. I really did not know what to expect, so everything was new. The first thing that was very apparent was that I was at least six inches taller than everybody else and people would often stare at me. I arrived just before noon and we traveled to meet up with the rest of the American group, Drs. Lance Hampton and Albert Petrossian from Virginia Commonwealth University, who were already at the hospital. There were no surgeries scheduled for the afternoon when I arrived so we decided to do some sightseeing. We went to see the Citadel and Imperial palace.

 

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Day 2

We went to the morning conference where there were approximately 6 Vietnamese attendings and residents but 10-30 medical students. The small room rarely made use of the air conditioning unit so it was often very hot and humid. We went to surgery that day… That was my first time seeing open surgery to remove large kidney stones. I was more accustomed to seeing this performed through percutaneous methods. It was very interesting to see this performed, especially through the small incision that they used. The operating rooms did not come with many extra features but luckily they did have air conditioning. Sadly, the scrub uniforms only came in one size and did not come close to fitting me but I luckily brought my own scrubs to wear. It was also interesting to see that most people wore sandals in the operating room and were otherwise barefoot. After the day of surgeries, we went exploring in the neighborhood by the hospital. We found a market which sold everything you could possibly need, from meat and spices to clothing and shoes. The merchants were very ambitious to make sales and negotiate over prices.

 

Day 3

We prepared for a laparoscopic cystectomy, a procedure which none of us had a great amount of experience with. We knew it would be challenging without the equipment we were used to in our institutions. The Vietnamese team was able to guide us through the procedure while utilizing multiple brands and types of tools to make up for what we were used to. The biggest difference was not having an energy-based device for vessel sealing i.e. Ligasure or Harmonic scalpel…  That evening we met up with some international medical students (one from New Zealand, two from Germany, and one from Belgium) and talked about medical training in the different parts of the world. One does not often hear what happens elsewhere.

 

Day 4

We went to morning conference and Dr. Petrossian gave a talk to the urology staff and medical students. After, they gave us a tour of the inpatient ward where they also housed preoperative patients. It was not the most comfortable establishment. There were at least 4 patients to a room and often of mixed gender. The beds were wooden cots with a half inch cloth pad on top. Some people looked worse than others but many were chatting with their roommates. Later in the day, we walked around the city and went to a traditional Vietnamese water puppet show which was entertaining.

 

Enjoy the second section of Dr. Lawrence’s field notes in our next blog post!

 

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World Impact: IVUmed President in the News

IVUmed president and founder, Dr. Catherine de Vries, was honored as a feature in the July issue of Salt Lake Magazine.

 

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Here are some highlights from the article:

 

“Pediatric urologist Catherine deVries sees patients at Salt Lake City’s Primary Children’s Hospital, but as president and founder of IVUmed, she sends doctors and urology residents around the world to train local medical professionals in countries with few resources. “

“…In 1994 DeVries started her own nonprofit, IVUmed, in Honduras and Vietnam. Today, it provides medical care to kids in Asia, Latin America, Africa and the West Bank in the Palestinian territories.

“When we started in Vietnam, they had done less than 80 pediatric urological operations—total—in the year we started,” she says. “Now, 20 years later, they not only do a full range of surgery serving all of South and Central Vietnam, but also have a teaching program of their own—it’s exactly what we hoped for.”

“Beyond IVUmed, deVries’ supports global healthcare in other ways. She is the director of the University of Utah Center for Global Surgery, a member of the Global Alliance for Elimination of Filariasis, a parasitic disease spread by flies and mosquitoes that can lead to blindness, and she shares her experiences with students as a professor of surgery at the University of Utah.”

Read the full article here on the Salt Lake Magazine website.

Thank you to Salt Lake Magazine for this excellent article and interview with Dr. de Vries, for recognizing her personal commitment to global surgery and global health, and the efforts of the organization she founded and continues to lead today.

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