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Bonjour from Dakar

This week a team of IVUmed volunteers is in Dakar, Senegal focusing on teaching pediatric urology and urologic oncology.

Here are a few notes from IVUmed board member and volunteer nurse, Barbara Montagnino, RN:

Bonjour from Dakar!

Everyone arrived on time as did our luggage and supplies. On Sunday we received a warm welcome from the head of department, Professor Serigne Gueye.  Our team has both pediatric and uro-oncology volunteers.  On the first day, the uro-oncologist volunteers booked several patients for surgery who have complex urological tumors.  The team also saw 22 pre-selected kids in clinic and booked 13 for surgery.  With limited time and resources for the week, we unfortunately can’t operate on all.  There are some sad cases with many families traveling from surrounding countries who were not chosen for surgery.  Hopefully the local urologists will be able to help them with their improved skills after the team is gone.

This is a multi-national workshop. There are urologists from Senegal, Morocco, Ivory Coast, Burkina Faso, Niger, Cameroon, Mauritania all in attendance.  The impact of this training will be far reaching!  The colorful IVUmed hats are a hit and a coveted item.

There is good interaction between our team and our hosts who have been welcoming to us. There is sincere willingness to learn but language is a barrier. We are all learning a few French phrases and fortunately team member Dr. Toren speaks French.

We are getting used to seeing goats on the side of the streets all over the city as well as the local mode of transportation: brightly painted van packed to the max than two or three people stand in on bumper and hanging on while texting.

 

You can support the team and their efforts by donating online HERE.

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IVUmed Resident Scholar, Dr. Kabra, Helps Teach Laparoscopic Nephrectomy in Trinidad

Resident:  Kabra Aashish, MD (University of Texas Health Science Center) 

Location: San Fernando, Trinidad; March 18-25, 2017

Mentor:  George Martin, MD

Sponsors:  South Central Section of the AUA

 

Dr. Kabra reported, “This workshop was well organized. There was so much planning, so many details, that despite limited communication before, you can tell how much effort went into it. All their residents played an active process in organizing, getting to know us, and overall setting up for a successful week. We got to know almost each one individually which was a treat. Aside from urology itself, we were able to learn so much about the country, hospital, culture, individual stories, healthcare, and urologic issues. It was great to pick their brains to compare the differences to America.

“We focused the entire week on working towards having the urologists master the laparoscopic nephrectomy.  After Dr. Martin and I presented the basic techniques from setup to dissection and extraction in the first case, we quickly transitioned to coaching Dr. Ramsoobagh and his partner through the cases. Eventually, they were performing them on their own, and it was truly amazing to see it all happen within one week. After we left, they booked additional laparoscopic cases the following week when we were gone to keep their momentum going and hopefully maintain everything they had learned. It was a true pleasure once they emailed us a few days after we left with the good news of them having finished their first laparoscopic nephrectomy on their own. I think the impact of this type of training really makes these mission trips vital, even more so than simply doing a handful of cases in that time as well. The department of urology in San Fernando can now apply everything they’ve learned for years, even generations of training, to make an extremely large, immeasurable impact.

“Through IVUmed, I now have a clear goal in sight in the next few years after I establish my own practice…to become an IVUmed mentor myself one day and contribute to these wonderful opportunities. I sincerely thank my scholarship benefactors for allowing me to have this life changing experience.  I plan to be back, and will see you hopefully as an IVUmed mentor next time! Thank you!”

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Resident Scholars, Drs. Chouhan and Reddy travel to HCMC, Vietnam

Residents:  Jyoti Chouhan, MD (SUNY Downstate Medical Center) and Thanmaya Reddy, MD (University of Alabama at Birmingham School of Medicine)

Location: HCMC, Vietnam

Mentor:  Joel Gelman, MD

Sponsors:  Dr. Chouhan:  New York Section of the AUA; and  Dr. Thanmaya:  Southeastern Section of the AUA and University of Alabama at Birmingham.

Dr. Chouhan’s Report:

“My trip to Vietnam through IVUmed was a special trip for several reasons.  Participating in international medicine has been a professional goal for me since I was a pharmacist. However, this was difficult for me to accomplish in my prior career. When I found out about IVUmed, I jumped at the chance to apply for the traveling resident scholar program and crossed my fingers that I’d be chosen! This trip has allowed me the firsthand experience to see the benefits as well as challenges related to helping patient populations in a different geographical and cultural setting.

The focus of our trip was male reconstruction. Dr. Hung Do Lenh has been practicing male reconstruction in Ho Chi Minh City for the past few years and these trips help him hone his skills to help the many patients there with urethral stricture disease. As much of the country travels on motorbikes, the risk of motor vehicle accidents leading to pelvic fractures and associated urethral injuries is high. The IVUmed mission of “Teach One, Reach Many” was a strong theme during the trip. Taking into account the hospital and cultural differences, we were able to give patients there the best surgeries possible.

We were also able to observe and participate in general urology cases that were done by the staff urologists at the government hospital. One interesting observation was that they did not have flexible ureteroscopes. This meant they performed a high volume of laparoscopic and open stone surgery; this is a rare event in the US.

The hospital there serves a large volume of patients from Ho Chi Minh City and the surrounding areas. Interesting aspects of their health system included patients being able to pay more to have their surgery on the same day or on a Saturday. As many of these patients come from far distances, they are hesitant about leaving before they feel they are fully healed. Dr. Hung Do Lenh explained that all patients in their hospital can stay as long as they want until they are comfortable with discharge.

I cannot thank IVUmed and the New York Section enough for providing these opportunities for residents. They are valuable and life changing both for the physicians and patients in the countries that are served, but also to the US based residents, fellows, and physicians that participate in these trips. I can definitely say that my experience in Vietnam strengthened my resolve to participate in international medicine upon completion of my urologic training.”

Dr. Reddy’s Report:

Dr. Reddy reported, “I joined a team of three other Urologists from the United States on this trip: Dr. Jyothi Chouhan, an IVUmed resident scholar from SUNY Downstate; Dr. Kristi Hebert, a reconstructive Urology fellow from UC-Irvine; and Dr. Joel Gelman our mentor also from UC-Irvine.

Dr. Gelman travels to Ho Chi Minh City for two weeks every year to share his expertise and skill in urethral reconstruction with the physicians of Binh Dan Hospital. Every year, Dr. Gelman and our host physician, Dr. Hung Do Lenh organize two weeks of urethral reconstructive cases to advance the reconstructive surgical capabilities of the local Urology department to allow them to treat patients with complex urethral disease in Vietnam that would otherwise be managed with chronic catheters or live with a lifetime of voiding issues.

My week began by a welcome reception hosted by the hospital administration. I learned that they have been very supportive of Dr. Gelman’sefforts to establish Binh Dan Hospital as a leader in urethral reconstruction in this part of the world. Dr. Gelman took his time to review details of the cases, turning simple case presentations into an in-depth learning exercise in how to evaluate and decide on management of patients with complex urethral stricture disease. I learned from Dr. Hung Do Lenh that many patients in Vietnam whohave urethral stricture disease are mismanaged due to the lack of physicians with formal reconstructive training in rural areas. Many of the patients who end up at Binh Dan Hospital have undergone multiple prior failed endoscopic and open attempts at urethral reconstruction. Often presentations were also delayed due to financial and transportation reasons.

The remaining week was spent in the operating room, where Dr. Gelman guided Dr. Do Lenh and other physicians through fundamentals of urethral imaging, cystoscopy, and urethroplasty. Through this I could appreciate IVUmed’s message of “Teach One, Reach Many” as many of the procedures were not only directly observed by multiple other physicians but surgeries were also live broadcasted for remote audience members who were able ask questions real-time. During time spent in the operating room, I learned the unique limitations and challenges of working in a setting with restricted resources. After our scheduled urethral cases, I took time to observe and scrub in with local physicians. Due to lack of flexibleureteroscopy and minimal training in percutaneous techniques, many of these patients were managed with open or laparoscopic surgery for stone removal. Costs of procedures played a large role in determining operative approach as many patients were required to pay themselves.

This trip opened my eyes to the strengths and weaknesses of health care systems outside of the United States. It also furthered my appreciation for the amenities we often take for granted in America. I learned that through sharing experiences and knowledge, we as physicians can impact many patients worldwide. I hope to continue participating in global health endeavors in the future and will be forever grateful to IVUmed and the Southeastern Section of the AUA for giving me this opportunity and a foundation in global medicine to build upon.”

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