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IVUmed – Helping Children Around the World

IVUmed Rwanda

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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“Movember” is Here!

As you probably know, “Movember” is a global movement each November aimed at raising awareness of men’s health risks, especially prostate and testicular cancer and mental health challenges. Using the mustache as a catalyst, Movember encourages men to invest in their own health by more openly talking about their health concerns and more proactively seeking necessary medical care.

This is important stuff!  Did you know that the WHO (World Health Organization) expects the number of prostate cancer cases to double to 1.7 million in less than 20 years?  

IVUmed experts provide education for treatment of common urological cancers such as bladder and prostate cancer all around the world.  

Go get checked, and if you need to, get treated.  In countries that IVUmed serves, these treatable conditions go undiagnosed and can cause untold suffering and death.  

You can help! 

Encourage your man to grow a mustache…unless you don’t like them.  If that’s the case, just encourage them to make an appointment and get a physical.  Women get mammograms – let’s get guys to take their health seriously too!

You can also make a donation to the life-saving work of IVUmed in honor of the man in your life.  Instead of new mustache wax for the holidays, make a gift to IVUmed in your guy’s name. 

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Go here for more information regarding the Movember movement.

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Deadlines for Abstract Submissions

 

The 34th Congress of the Société Internationale d’Urologie (SIU) will be held in Glasgow, Scotland from October 12-15, 2014.

Abstract submissions are due before April 1st.

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The Pediatric Urology Fall Conference will convene in Miami Beach, FL from October 24-26, 2014.

Abstract submission are due before Friday, May 30, 2014 at 11:59 pm EST.

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February 28th is Rare Disease Day

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Rare Disease Day is an international annual campaign to raise awareness among the general public regarding the world’s rarest diseases and how they impact patients’ lives. According to www.rarediseaseday.org, Rare Disease Day “is also designed for patients and patient representatives, as well as politicians, public authorities, policy-makers, industry representatives, researchers, health professionals and anyone who has a genuine interest in rare diseases.”

 

 

 

IVUmed volunteer physicians and nurses often assist in the treatment of especially difficult or rare cases while training and serving in low-resource environments worldwide. One disease that is extremely rare in the United States but seen more often in tropical climates is lymphatic filariasis (LF), commonly known as elephantiasis, a painful and disfiguring disease. LF is most often acquired in childhood, though its visible manifestations occur later in life, causing temporary or permanent disability.

 

 

Rare Disease Day was first launched by EURORDIS and its Council of National Alliances in 2008 and has since hosted over 1000 events worldwide, with over 70 countries participating in the 2013 events. Check out the 2014 Rare Disease Day events list here for awareness events in your area.

 

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Dr. Robert Edelstein: Friend of Haiti

Dr. Robert Edelstein first traveled to Haiti for humanitarian service after the catastrophic 7.0 earthquake in 2010. However, his commitment to helping improve medical training and patient care in Haiti was not satisfied through a single visit. He has just returned from his fourth IVUmed surgical workshop in Deschapelles, Haiti, working with fellow IVUmed volunteers to build sustainable urology capacity there. 

  Dr. Edelstein answered a few questions regarding his experiences volunteering with IVUmed and his insights on the benefits of educational and humanitarian medical service for the givers and receivers:

 

1. What has kept you inspired to volunteer in Haiti and work with IVUmed?  I first went to Haiti after the earthquake in 2010, because I felt a very strong need to help out in any way that I could.  I really didn’t know what to expect, but it ended up being a very productive trip.  While there, I felt that I had to return. The need for urologic services in Haiti is profound, and the strength and resourcefulness of the Haitian people is very inspiring. I had always wanted to work with IVU due to its experience, urologic focus, and commitment to teaching, and I have been lucky enough to do so in the years since.

2.  What have been the most challenging and most rewarding aspects of your IVUmed service so far?  The most rewarding aspect to me is having the opportunity to work with Haitian health care professionals. The trip gives an excellent opportunity to learn from each other’s experiences. There are many challenges, of course, but finding solutions together can be a great part of the experience. 

3.  What insights can you share with other medical professionals considering working with IVUmed or other humanitarian organizations?  The opportunity to serve outside of the United States is a uniquely challenging and deeply satisfying experience. Many of the things that we take for granted daily don’t exist in rural Haiti, and often new ways must be found to solve problems using the local resources. The depth of knowledge and resources that IVU has to work with is inspiring and reassuring on these trips.

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Anesthesia Open House: March 13th

Attend a volunteering open house for anesthesiology providers:

  • Learn about where IVUmed serves around the world

  • Hear current IVUmed volunteers share personal experiences from their service with IVUmed

  • Discuss the logistics and rewards of humanitarian medical service with IVUmed staff

  • Discover current opportunities to teach fellow physicians and bring quality surgical care to resource-poor communities worldwide!

 

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IVUmed is dedicated to building urological capacity in resource-poor areas of the world. Anesthesiologists are a crucial element of patient care and a valuable asset to the medical education we provide. Anesthesiologists are invited to join IVUmed medical teams to improve medical care and education in resource-limited parts of the world. For more information, please visit our website: www.ivumed.org or contact Amy at amy@ivumed.org.

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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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Pediatric Urology: A Mother’s Experience

This is a personal blog post from a Zambian mother of a little boy born with hypospadias. Brillian Izukanji Kaona generously shares the details of her experience with her local doctors and then of her son being treated by the visiting IVUmed team and the doctors and nurses who were training with them. She shares her perspective here to give hope and encouragement to other mothers of children with similar conditions. We are grateful to hear her perspective to better understand the thoughts and feelings of those we care for through our work Zambia and around the world:

 

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My name is Brillian Izukanji Kaona; I’m aged 31 and live in PHI, Lusaka. I am a single mother of two boys aged ten and three.  I am an entrepreneur in the catering industry. My son was born with hypospadias; I was keen to share my experience especially the important lessons I learnt that I hope other parents with children born with the condition can learn from…

 

Three days after having been admitted in hospital with pre-eclampsia, I finally left for home with my newborn son, Ninza. The next day, my mother noticed his penis wasn’t straight while bathing him and his urethral opening wasn’t in the right position. During my postnatal visit at Nkwazi Clinic in Lusaka, I asked my doctor to check my son and tell me if he was OK. He advised me to take him to UTH (University Teaching Hospital) where it could be fixed.

 

The doctor diagnosed my son with hypospadias and said he couldn’t have an operation until he was two. He explained that he’d need two operations: one to cut and make it straight and the other, a year later, to close the hole and open another. Since he was only a month old, I was advised to return him to the hospital when he was older than a year.

 

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A lot of things went through my mind: “What if he dies during operation?”; “What if operation isn’t successful?” ; “What if he grows up like this and becomes the object of women’s mockery?”…

 

Read more about Brillian and Ninza’s experience here on Brillian’s blog.

 

All Photos by Brillian Izukanji Kaona.

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A Privilege: Final Entry from an IVUmed Nurse in Zambia

The final entry from IVUmed volunteer recovery nurse, Michael Felber, regarding his recent IVUmed humanitarian service in Zambia, shared from his travel journal:

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The last patients of the day seem to wake up more slowly. Often they have been under anesthesia longer, since shorter cases are usually scheduled earliest. I think by the end of the day they are also just more tired and hungry. By 6pm the local nurses and porters are ready to go home to their families, and I am sure are also a little concerned about missing the last bus home.Yesterday, Malasa, one of the nurses, was laughing and trying to wake up the patients. My patient wasn’t interested in waking up until she tugged on his earlobe and said “Boy, do you want to go see your mother?” He sat right up.  Douglas was still not interested in waking up, despite Malasa’s best effort. I told Malasa that I was going to wake her up at home on her day off, and she laughed. Finally, Douglas started to stir. We put a syringe of orange Fanta in his mouth and when the bubbles hit his tongue he startled. Then he began expertly sucking down the Fanta. By 6:30, everyone was on their way home.

 

So far, today has been pretty upbeat. For morning lecture, the residents played urology jeopardy. Everyone seems pleased with the number of children we have been able to treat.

 

Throughout the week, one operating room has remained open for emergency pediatric cases. They have ranged from routine appendectomies, removal of foreign bodies, to more complex cases. Yesterday a 5 day old baby was brought in with a malrotated bowel, like a twisted garden hose. By the time of her surgery her entire small intestines was necrotic from loss of circulation. The bowel had to be removed. She would need IV nutrition and ultimately a small bowel transplant, neither of which is available here.We watched her in recovery until she could be transferred to the ICU, where she will stay with her parents and receive comfort care. Today, a one week old premature baby was brought in for closure of gastroschisis, a condition where the stomach or bowel protrudes from the abdomen. In developing countries it is treated initially by suturing a sterile “silo” over the protruding bowel and gradually pushing it back into the abdomen. For this patient they used a sterile IV fluid bag and gradually compressing the end of it, like squeezing a tube of toothpaste. The baby weighed about 2.5 pounds, but was breathing well. It is amazing that he survived this far, but he still has huge obstacles ahead. Still, miracles don’t happen by themselves.

 

Complex patients and surgeries are scheduled in the beginning of the week so the team is available to deal with complications. Still, we are here to work, so a full day is planned. The last patients are as important as the first, so nobody can afford to let their guard down.

 

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By the end of today we will have treated over thirty children. It’s hard to measure results, though. Certainly numbers of patients treated and people trained are important, but you can’t measure up front how a surgery will affect an individual patient’s life, or what someone has learned from your teaching and your example, and what they will do with their knowledge.In medicine, you work with people and then you both move on. You rarely see the long term results of your work. There are far more built in obstacles than any individual or organization can change, but in the long run change is possible. Johnny Clegg, a South African musician, says in one of his songs that if you want a better future you have to “fetch it” yourself.

It’s also hard to measure the effect on ourselves, but I think it is overwhelmingly positive. At least most people I meet on these ventures want to come back. The imprints of experiences and people stay with you. Working with limited resources teaches you to be appreciative and creative. You learn not to waste your time or energy focusing on what you don’t have.And you learn again and again to regard your work as a privilege.

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Zambia Blog: A Kind Word and a Smile

The continued account of IVUmed volunteer recovery nurse, Michael Felber, regarding his recent IVUmed humanitarian service in Zambia, shared from his travel journal

 

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We are on the fourth day, a beautiful, warm day. Surgeries are going well.

 

The nurses’ strike is still officially going on, but more nurses are trickling in. This morning there was no running water in the hospital. Luckily the surgical instruments had already been sterilized. There is a large blue tank of water with a spigot for hand washing. By the end of the morning the water was running again. People just sort of go with the flow here.

 

David was a very nice 8 year old boy who had surgery this morning. He was frightened as he went to sleep, but tried mightily not to cry. He held it together until the mask went on, then struggled and cried out “I am dying!”  In recovery he woke up with a smile. He was mildly pleased when we brought him toys, but when I gave him a banana he just about jumped off his cart with excitement.

 

There is the usual big city traffic on the way in to the hospital, but it is quiet. I haven’t heard a car horn since I got here, unlike other countries where the horn is a substitute for a brake. People here are exceedingly polite. Zambia is a poor country, with 50% unemployment. But so far, unlike many other countries I have visited, the people standing in traffic selling newspapers, cell phone minutes, and candy have been adults.

 

The University Teaching Hospital of Zambia, our host, is an 1800 bed facility. When you walk on the wards, you see that all the beds are full, and more patients are sleeping on the floor.

Someone called me Sister yesterday. I guess there aren’t too many men in nursing here. A couple of the surgeons were discussing starting an internet teaching program that would use video to teach urological surgery techniques. You could say live “streaming” video…

In the United Kingdom 10% of available food is wasted. I imagine the figure for the US is the same or worse. It would be enough to feed the entire population of Zambia. Fasting for surgery is tricky here. Kids are often chronically hungry to begin with. After surgeries their blood sugars are low. We had a two year old who was in surgery for 6 hours. We mixed our own intravenous dextrose solution, and when he woke up we fed him orange Fanta with a syringe. Not quite a breast, but he liked it.

I love watching the porters with the patients here. They do all the patient transport. They seem to always have a kind word and a smile, and can often calm a frightened child just with their presence. On Sunday I noticed an iron on one of the stretchers in the recovery room. It seemed out of place, but it isn’t. Nobody is allowed to wear scrubs or shoes that have been outside the operating room area, so they wash and iron their scrubs here.

 

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