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IVUmed Resident Scholar Dr. Liam Macleod Reports from Mozambique

Dr. Liam Macleod’s IVUmed scholarship experience in Mozambique was made possible by the generous support of Verathon.   During his time there, Dr. Macleod was accompanied by mentor, Ryan Terlecki, MD.  The visit occurred in parallel with a conference arranged for African urologists including several well-known surgeons and other urologists from Nigeria, Zimbabwe, Guinea-Bissau, Kenya, Niger, Liberia, Angola and local urology and general surgery residents. Picture2

Upon arrival in Mozambique Dr. Macleod was able to quickly scrub in to assist with surgeries.  He noted, “Needless to say, the OR was very crowded with observers when I arrived.  Nonetheless Dr. Terlecki invited me to scrub in immediately.”

He observed, “There were numerous cases of urethral strictures, urethral distraction injuries, obstetric fistulas and congenital anomalies.  The northern part of the country is less developed and the roads are typically small and narrow.  Thus, when patients come to Maputo (or an urban center) for care it requires a long and arduous journey often taking several days.  The result is that many patients reside in the ward for an extended time while awaiting surgery.  We met one young lady that had been living there for a year (during which time she had undergone a fistula repair and two revisions but was awaiting a final repair).

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Of all the components of the trip—operating, caring for patients, seeing the way wards, hospitals and operating rooms are run in another country, listening to talks and participating in discussions—I think that the newly formed relationships will have the most lasting impression.  I have remained in touch via email with a number of people since being back in the U.S.  I am hopeful that these relationships will serve as a conduit for future trips and a mechanism to divert resources for improving urological care into capable hands.”

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Dr. Timothy Brown, IVUmed Resident Scholar, Travels to Bhopal, India

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Dr. Timothy Brown

Dr. Timothy Brown’s IVUmed scholarship experience in Bhopal, India was made possible by the support of the Resident Scholar Alumni Fund. During his time in India, Dr. Brown was accompanied by mentor, Sakti Das, MD, another IVUmed Resident Scholar, Kerri Brown, MD, and many other doctors that participated in the 75th Mega Free Urology Camp.

Regarding his experience in India, Dr. Brown reported, “Although we wouldn’t begin operating until the next day, the Urology camp was well underway.  The hospital was filled with patients completing their preoperative evaluations and imaging.  This was the first time I began to appreciate the magnitude of this camp and its dependence on a remarkable group of local physicians.  It is this group of doctors that made this operation possible by providing countless hours of pre- and post-operative care.  In total, 646 patients were evaluated and 156 of them would end up undergoing surgeries over the next 3 days.”

“Not surprisingly, we operated without the same level of technology and resources at our disposal that I have grown accustomed to while training at a major medical center in the U.S.  Who knew you could still practice medicine without a CT scanner?  While we were forced to use older equipment and deal with occasional power outages, the experience reinforced the notion that while technology changes, surgical principles remain the same.  Meanwhile, while the facilities and resources may have been of lesser quality to what is available in the U.S., the ability of the Indian urologists was far from inferior.  What they lacked in equipment, they more than made up for with skill.”

“My experience with the Bhopal urology camp has drastically changed my view of international medical volunteerism.

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Surgical Team

Prior to this trip, I envisioned international medical work as expeditions to remote corners of the earth to deliver needed care.  The Bhopal Urology Camp was far more than this.  It is a finely orchestrated operation.”

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IVUmed – Helping Children Around the World

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IVUmed in Rwanda

IVUmed’s Pediatric Urology Capacity Building Program makes quality surgical care available to children around the world – especially in low-resource areas. We accomplish this by building a global network of train-the-trainer centers of excellence. There are no pediatric urologists in sub-Saharan Africa, Haiti, and many places in India, leaving millions of children without access to care for debilitating urological conditions.

Pediatric urology diseases, malformations and injuries are among the most common conditions affecting children worldwide, and are up to 10 times more common than cleft lip and palate. In the US, when a baby boy is born with a condition such as hypospadias (a congenital condition in which the opening of the urethra is situated on the underside of the penis instead of at its tip), surgery can be performed before the child is even out of diapers, and there are few to no lasting effects. In countries where this type of surgery is not available however, shame, poor self-esteem and secrecy surround this condition, which often results in adult infertility if left unrepaired.

IVUmed’s teams of volunteer physicians, nurses, and anesthesiologists provide hands-on surgical workshops, lectures, online educational materials, telehealth consultation, and impact measures to equip doctors and nurses with the skills they need to care for children in their communities. In turn, these newly trained medical professionals build future capacity for care by passing along IVUmed training to their colleagues, fulfilling IVUmed’s motto, “Teach One, Reach Many”.

IVUmed’s focus on education stands out among global health organizations, as does our focus on urology. Another unique element to IVUmed is our collaborative model. While IVUmed is guided by a dedicated board and staff, leadership of our programs stems from the dynamic doctors and administrators at our many partner hospitals around the world. Their priorities lead our efforts, which are put into action by our volunteer doctors and nurses. Together, and with the generous donations of many benefactors, we are building a worldwide system of pediatric training programs, ensuring that children everywhere will have access to the care they need.

With the help of supporters like the Ronald McDonald House Charities, the Societe Internationale d’Urologie (SIU), the American Urological Association (AUA), the Pan-African Urological Surgeons Association (PAUSA), and regional surgical associations, IVUmed is building a strong global network. Teaching hospitals throughout the world, skilled medical volunteers, ministries of health, local community leaders, international medical societies, regional colleges of surgeons, and charitable foundations combine strengths to give children everywhere the opportunity to lead the healthy, productive lives they deserve.

You can be involved too, whether a physician, engineer, photographer, philanthropist, medical student, etc.  We invite you to explore our volunteer opportunities here.  http://www.ivumed.org/how-you-can-help/

IVUmed patient in Vietnam

IVUmed in Vietnam

 

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Women’s Month Feature: Kristin Chrouser

 

IVUmed Board Member and Volunteer:  Kristin Chrouser, MD

 

Dr. Kristin Chrouser was IVUmed’s first fellow and has been an IVUmed board member since 2004.

 

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Dr. Kristin Chrouser has trained and assisted doctors in Nigeria, Namibia, South Africa, India, and elsewhere. Of her reconstructive urology work for women of Namibia, Dr. Chrouser stated, “the smiles and often spontaneous dances of joy that erupt when a woman leaves the hospital cured and dry make it all worthwhile”.

She became involved with IVUmed when she traveled to India as a Traveling Resident Scholar. She spent two weeks at a urology camp in Bhopal, India organized by local Hindu charity Jeev Sewa Sansthan (JSS), which translates as “Service to the Living”. The organization, founded on the principle that God is seen in all people, has founded several schools, an eye hospital, and provides several short-term urology and general surgery “camps” each year. IVUmed partners with JSS to provide US urologists and resident volunteers for JSS camps.

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Dr. Chrouser and mentor Dr Sakti Das, a veteran IVUmed mentor and long-time India camp participant, scrubbed in together on dozens of cases.

About her experience in India, Dr Chrouser reflected:

“Surgically, I had an amazing experience. There were moments of frustration—language barriers, incorrect suture, no sterile forceps with teeth, scissors that refused to cut, inadequate anesthesia, but overall, given the environment, things ran very smoothly… I learned that a dorsal lumbotomy incision can be used to access the collecting system in an adult (with minimal need for post-operative analgesia), as long as you’re willing to work in a hole! I found that almost anything can be done under spinal anesthesia—as long as you don’t mind your patient watching you operate…Despite my inability to speak Hindi, I saw in the eyes of my patients a message of hope. It made me forget the small inconveniences of working in India and remember the real reason for service to others.”

 

 

Read more about Dr. Chrouser’s work on her website: www.freewebs.com/chrouser.

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Common, Costly, & Critical: January is National Birth Defects Prevention Month

“Birth defects are common, costly, and critical.” is the National Birth Defects Prevention Month theme for January 2014.

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Every 4 ½ minutes in the United States, a baby is born with a major birth defect. Birth defects are a leading cause of death among U.S. infants, causing roughly 20% of mortality in the first year of life. Babies born with birth defects are also more likely to have more illness and long term disability than babies without birth defects. National Birth Defects Prevention Month raises awareness about the frequency of birth defects occurring in the United States and the efforts to prevent them. While not all birth defects are preventable, women can do many things to prepare for a healthy pregnancy. The Center for Disease Control suggests:

  • Be fit. Eat a healthy diet and work towards a healthy weight before pregnancy.
  • Be healthy. Avoid alcohol, tobacco, and illicit drugs. Be sure to consume at least 400 micrograms of folic acid every day before and during early pregnancy.  Work to get health conditions, like diabetes, in control before becoming pregnant.
  • Be wise. Visit a health care professional regularly. Consult with your healthcare provider about any medications, including prescription and over-the counter medications and dietary or herbal supplements, before taking them.

 

Awareness efforts offer hope for reducing the number of birth defects in the future. The National Birth Defects Prevention Network (NBDPN) suggests these additional prevention strategies:

  • Manage chronic maternal illnesses such as seizure disorders or phenylketonuria (PKU)
  • Avoid toxic substances at work or at home
  • Ensure protection against domestic violence
  • Know their family history and seek reproductive genetic counseling, if appropriate

 

Leslie Beres, MSHyg, President of National Birth Defects Prevention Network, said, It’s also important to remember that many birth defects happen very early during pregnancy, sometimes before a woman even knows she is pregnant, so planning a pregnancy is key and can also help make a difference.  Managing health conditions and adopting healthy behaviors before becoming pregnant increase a woman’s chances of having a healthy baby.

While approximately 1 in every 33 babies born in the United States has a birth defect, the international birth defect statistics are even more disheartening. According to a March of Dimes report, 6 percent of total births worldwide – almost 8 million children – are born with birth defects, with over 4 million infant deaths occurring annually due to birth defects and preterm birth.

When IVUmed started in 1992, our first programs were dedicated to pediatric urology.  Reproductive and urinary tract malformations are among the most common birth defects affecting children worldwide.

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IVUmed addresses the lack of available care through specialized intensive trainings and distance learning opportunities.  Due to continued demand, we have conducted these workshops in over 20 countries since the program first began.

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IVUmed has various pediatric urology training workshops scheduled for 2014, including visits to India, Kenya, Ghana, Honduras, Vietnam, Senegal, the West Bank, Mongolia, and Zambia.

 

Resources for this article:

March of Dimes

Center for Disease Control

National Birth Defects Prevention Network

 

 

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Resident Scholar Reflections

Dr. Marc Bjurlin, DO – Bhopal, India

Through the generous sponsorship provided by the North Central Section of the AUA, Dr. Marc Bjurlin traveled to Bhopal, India with mentor Dr. Gopal Badlani. Dr. Bjurlin and his mentor participated in a free urology camp organized by the local Indian organization Jeev Sewa Sansthan (“Service to the Living”). During the camp, over 140 patients received much-needed urological care.

Reporting on his experience, Dr. Bjurlin stated:

“The urology camp patients of Bhopal came from miles away to receive their care. Graciously they would await their turn, one at a time, slowly moving up in the line, until it was time for surgery. There was no complaining of the long wait, no one complained that they wanted to be operated on first. There were no irritable patients being hungry from not eating prior to surgery. Everyone sat patiently with a face that expressed their gratefulness even though I knew no Hindi to communicate.

“The hours of surgery were long but the time passed at the blink of an eye. The pathology, scope and variety of urologic cases was remarkable. Equally remarkable was the efficiency of evaluating patients preoperatively based almost entirely on symptoms, urine analysis and a select intravenous pyelogram.

“Over the course of the urology camp, I learned much about the urologic diseases of India, their ailments, and surgical treatments. I expanded my knowledge of urology in a culturally sensitive manner. Yet, as my knowledge of urology grew through interaction with patients, my understanding of the human spirit matured. Instead of simply operating on patients who had urologic diseases, we provided respect, dignity, and compassionate urologic care to a community that taught me an indispensable lesson.”

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