Dr. Maggie Lovin Shares Her Experience in Mongolia

Thanks to the generous support of the Southeastern Section of the American Urological Association, Dr. Maggie Lovin had an outstanding experience in Ulaanbaatar, Mongolia, where she worked with local urologists and patients at the National Center for Maternal and Child Health from October 20-28, 2018.

Dr. Lovin shares her experience:

“Our team was composed of two pediatric urologists, Dr. Carlos Angel and Dr. Angela Arlen and two pediatric anesthesiologists, Dr. Scott Stenquist and Dr. Laurie Steward, and myself. Our group bonded immediately, making working together effortless and enjoyable.

“We were hosted by the Pediatric Urology Department at National Center for Maternal and Child Health under the direction of Dr. Kurelbaatar Lkhagvademberrel. The 1500 bed hospital in the capital city is the main government referral hospital in Mongolia and provides free medical services to its patients through the national government insurance plan. There are six pediatric urologists serving approximately 1.2 million children in the country.

“After our flights, we got to work immediately the day we arrived to Ulaanbaatar. We conducted a busy 40 patient clinic that Sunday afternoon, booking 28 cases for the following week’s operating room schedule. We encountered a great variety of disease pathology including proximal hypospadias, ureteropelvic junction obstruction (UPJO), vesicoureteral reflux (VUR), urethral stricture, nephrolithiasis, epispadias-exstrophy complex, posterior urethral valves and disorders of sexual differentiation. We concluded our clinic Monday around mid-day, seeing 81 children in total.

“Monday afternoon, we began our surgical cases. We operated simultaneously with two surgical teams in separate operating rooms. This allowed ample time to teach the Mongolian surgeons the intricacies of several pediatric urologic procedures. The pediatric urologists were very eager to learn, and their enthusiasm for the workshop and their patients alike was contagious. In addition, this trip would not have been possible without our incredibly hard working operating room team, including the anesthesiologists, nurses and surgical scrub technicians. Together, we were able to treat several children with proximal hypospadias, ureteropelvic junction obstruction, vesicoureteral reflux and posterior urethral valves.

“On the last day of the workshop, we made rounds handing out soccer balls and toys to our patients to thank them for allowing us to be a part of their journey. The Mongolian parents presented us with Mongolian cashmere scarves and a traditional Mongolian game to thank us for helping their children. It was very touching to see people with so little to give, give so much.

“The Mongolian pediatric urologists made a conscious effort to make us feel at home in Ulaanbaatar. We worked hard all week, but took the afternoon of the last day off to have some fun. The Mongolian urologists took us sightseeing in the countryside. We rode camels, held eagles, and visited the Genghis Khan equestrian statue. The day ended with a Mongolian barbeque with our entire team.

“While this was my first global health mission, it certainly will not be my last. The people I met and the experiences I had in Mongolia have made an everlasting impact on my life. While there is great need for further pediatric urologic care in Mongolia and worldwide, organizations such as IVUmed are helping to bridge that gap. I would like to thank IVUmed and my physician mentors for this opportunity and I hope to use this experience as a stepping-stone to a lifelong commitment to international service.”

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.

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.

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.

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

Global Surgery Matters

According to the World Health Organization, the statistics are staggering:

• 11% of global burden of disease can be treated with surgery
• 2 billion people worldwide have no access to basic surgical care
• 30% of the world’s population receive 75% of surgical care

IVUmed is trying to change that by training more surgeons where they are needed most.

Dr. Sherry Wren discusses the importance of surgery as a global health priority:

Visit our website to find out how you can help and get involved. 

“Repairing the Surgery Deficit”

Zambia currently has 44 licensed surgeons to serve its population of 13 million.  That is less than one surgeon (.33) per 100,000 people.  To put that in perspective, in the United States, there are about 45 surgeons per 100,000 people.  

Next month we have a team of volunteers heading to Lusaka, Zambia to conduct a pediatric urology workshop.  The volunteer experts will work at the University Teaching Hospital there, focusing on training and transferring skills to the local surgeons and professors so that they in turn can train more surgical students.

To read more about this pressing need for surgical training in Zambia, please read this recent article:

Repairing the Surgery Deficit
By SARIKA BANSAL
The New York Times

There are solutions to these problems.  IVUmed is committed to making a difference both in Zambia and throughout the world through surgical education.