Building Access to Care in Mongolia
By Dr. Jill Patel
Sain uu (hello) and bayar-laa (thank you)—the first two words I learned from a kind college student on my flight to Mongolia. Looking back, they foreshadowed the warmth and generosity I would experience throughout the trip. I arrived with six medically talented strangers to work in a new healthcare environment but quickly found myself a new member of a vibrant community.
On our first day, despite the fatigue of travel, we headed to clinic to evaluate 16 patients awaiting surgical consultation. One by one, patients shared their concerns and hopes for treatment. After reviewing their histories, examinations, and imaging, we developed surgical plans and identified additional diagnostic studies. I initially tried to bring the structure and familiarity of the U.S. medical workflow into Mongolia, but I quickly learned that successful global health work requires flexibility, humility, and adaptation to local systems.
The following day, I worked alongside Dr. Buckley and Dr. Metro performing diagnostic studies. Despite many patients having suprapubic tubes, the local GU team previously never performed anterograde cystoscopy, making it a meaningful opportunity to share not only the technique but also the value it provides. In the radiology suite, I performed multiple VCUGs and RUGs, gaining a deeper appreciation for the procedural aspects of workup that are often performed by technical staff in the U.S. This experience strengthened my understanding of not only what evaluations are needed, but also how to perform them. Dr. Patel was mentored during the experience by Drs. Michael Metro and Jill Buckley.
The remainder of the week exposed me to a breadth of reconstructive cases. With a strong interest in lower urinary tract reconstruction and limited reconstructive exposure at my home institution, I joined this trip eager to learn. I prepared extensively beforehand, but nothing could have matched the combination of excitement, humility, and growth I experienced in the operating room. I learned various urethroplasty techniques, including Barbagli, ventral onlay, McAninch, EPA, and posterior repair with inferior pubectomy.
My most memorable operative experience was performing a non-transecting EPA for a short bulbar stricture with Dr. Buckley. Given the distal bulbar location, we proceeded with a penoscrotal approach, which I had not previously performed. Dr. Buckley incorporated anatomy teaching and step-by-step guidance, allowing me to build both technical skill and surgical reasoning. That evening, I wrote down every lesson and operative pearl, so I could carry the experience forward.
However, this experience transcended outside the four walls of the hospital. Through traditional meals, museums unraveling Mongolia’s history and legacy of Chinggis Khan, and countless hours traveling through the countryside, I gained a deeper understanding of how medicine is influenced by culture, politics, and history. Jonathan and Sanchi, local residents turned friends, shared their lives with us—from celebrating with Altan Gobi to showing us rural communities and traditional homes. Their kindness and humor transformed this trip from a clinical experience into a true cultural exchange.
Reflecting on my medical journey, some of the most meaningful lessons have come from outside the hospital walls—providing meals to the unhoused community on Skid Row, listening to the experiences of a veteran survivor of sexual assault, and witnessing the ingenuity of Floating Doctors delivering care with limited resources. Mongolia now joins these experiences as a defining part of my global health journey. Each has shaped my commitment to becoming a physician who is skilled, adaptable, collaborative, and grounded in service.
This trip represents an important step in my pursuit of reconstructive urology and global health. I learned from local communities, collaborated with local providers, and participated in a partnership built on creativity, respect, and cultural humility. I aspire to be part of a community of physicians who not only treat disease, but also expand surgical education, empower local providers, and promote sustainable health equity.