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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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Notes from the Field: Hue, Vietnam – Part 2

Lawrence Jenkins, II, M.D. , an IVUmed resident scholar, volunteered with our general urology workshop in Hue, Vietnam on March 10-22, 2014. This is the second half of selections from his field notes:

Notes from the Field:  Hue, Vietnam

 

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Day 5

There was a ceremony with the university directors and urology senior staff where Dr. Hampton was given the title of Visiting Professor. It was nice yet very formal and Dr. Petrossian and I received small wooden plaques with the university and hospital name on it to commemorate our trip. Drs. Hampton and Petrossian left to go back to the US.

Day 5-7 – I took a bus to Hoi An, which was 4 hours south of Hue. I arrived in town at night and went into town to see a lantern festival where they turn off the lights and businesses only use candlelight and lanterns, and people place paper lanterns in the river. The next day, I took a tour to My Son Holy land, a sanctuary dating from the 4th to 13th centuries. We stopped at island on the way back to see sculptures and carvings being made. Later, I walked around the old town for a bit, then found a cooking class and made some delicious meals. In the morning before leaving I took an 8.7 mile / 14 km bike ride into the countryside and saw life outside of the tourist area.

 

Day 8

I met Dr. Kahan, from New Hampshire, who was the faculty mentor for the second week. This was his fifth or sixth trip to Hue. There were several open stone surgeries that day, one renal and two ureteral. The technique that the Vietnamese doctors had was superb and they were able to efficiently remove the stones without unnecessary manipulation. The afternoon surgeries were performed in the same room and at the same time as a general surgery case, which is unheard of in the US at the present time with infection concerns.

 

Day 9

We performed another nephrectomy, this was for a kidney with chronic infections. That evening the urology staff took us out for dinner and drinks. It was fun and we were able to socialize not only about urology but about life in Vietnam vs life in the US.

 

Day 10

We did 2 percutaneous nephrolithotomies with new renal access gained with the assistance of fluoroscopy. Both were for lower pole stones. The only method they have available for lithotripsy is laser; however, in the US we have pneumatic and ultrasonic lithotripsy as well. They were having difficulty gaining access and I was able to show a different method that I learned during residency. It felt good to be able to show them something new since they were showing me so much about open stone surgery.

 

Day 11

I did my third presentation for their morning conference. Most people seemed interested and had some good questions. We then went to see some surgeries and in the afternoon I spent some time in the clinic with one of the attendings. The clinic was one room amongst a group of many clinic rooms that likely rotated specialty. In the evening, we had a closing dinner on the river with the department. It was very nice to see everybody again and enjoy the authentic Vietnamese cuisine.

 

Day 12 – 13

Dr. Kahan left to go back to the US. I rented a scooter and rode around the countryside with one of the Vietnamese doctors, Dr Fu. We went to see several Buddhist temples and a lookout point with a great view over the Perfume River. That evening, I left for my extremely long trip back home.

Overall, it was an amazing experience that changed my perception of not only urology but the general delivery of healthcare. Seeing what they were able to do with much less equipment makes me appreciate what we have so much more. In Hue, medicine is pure, not overwhelmed by the need to order extra tests in fear of malpractice lawsuits. The Vietnamese doctors were very welcoming and I hope to go back one day.

 

 

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Notes from the Field: Hue, Vietnam

Lawrence Jenkins, II, M.D.  Dr. Jenkins, an IVUmed resident scholar, volunteered with our general urology workshop in Hue, Vietnam on March 10-22, 2014. These are selections from his field notes:

 

Notes from the Field

Lawrence Jenkins, II, M.D.:

Day 1

I arrived in Hue after 23 hours of flight time. I really did not know what to expect, so everything was new. The first thing that was very apparent was that I was at least six inches taller than everybody else and people would often stare at me. I arrived just before noon and we traveled to meet up with the rest of the American group, Drs. Lance Hampton and Albert Petrossian from Virginia Commonwealth University, who were already at the hospital. There were no surgeries scheduled for the afternoon when I arrived so we decided to do some sightseeing. We went to see the Citadel and Imperial palace.

 

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Day 2

We went to the morning conference where there were approximately 6 Vietnamese attendings and residents but 10-30 medical students. The small room rarely made use of the air conditioning unit so it was often very hot and humid. We went to surgery that day… That was my first time seeing open surgery to remove large kidney stones. I was more accustomed to seeing this performed through percutaneous methods. It was very interesting to see this performed, especially through the small incision that they used. The operating rooms did not come with many extra features but luckily they did have air conditioning. Sadly, the scrub uniforms only came in one size and did not come close to fitting me but I luckily brought my own scrubs to wear. It was also interesting to see that most people wore sandals in the operating room and were otherwise barefoot. After the day of surgeries, we went exploring in the neighborhood by the hospital. We found a market which sold everything you could possibly need, from meat and spices to clothing and shoes. The merchants were very ambitious to make sales and negotiate over prices.

 

Day 3

We prepared for a laparoscopic cystectomy, a procedure which none of us had a great amount of experience with. We knew it would be challenging without the equipment we were used to in our institutions. The Vietnamese team was able to guide us through the procedure while utilizing multiple brands and types of tools to make up for what we were used to. The biggest difference was not having an energy-based device for vessel sealing i.e. Ligasure or Harmonic scalpel…  That evening we met up with some international medical students (one from New Zealand, two from Germany, and one from Belgium) and talked about medical training in the different parts of the world. One does not often hear what happens elsewhere.

 

Day 4

We went to morning conference and Dr. Petrossian gave a talk to the urology staff and medical students. After, they gave us a tour of the inpatient ward where they also housed preoperative patients. It was not the most comfortable establishment. There were at least 4 patients to a room and often of mixed gender. The beds were wooden cots with a half inch cloth pad on top. Some people looked worse than others but many were chatting with their roommates. Later in the day, we walked around the city and went to a traditional Vietnamese water puppet show which was entertaining.

 

Enjoy the second section of Dr. Lawrence’s field notes in our next blog post!

 

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World Impact: IVUmed President in the News

IVUmed president and founder, Dr. Catherine de Vries, was honored as a feature in the July issue of Salt Lake Magazine.

 

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Here are some highlights from the article:

 

“Pediatric urologist Catherine deVries sees patients at Salt Lake City’s Primary Children’s Hospital, but as president and founder of IVUmed, she sends doctors and urology residents around the world to train local medical professionals in countries with few resources. “

“…In 1994 DeVries started her own nonprofit, IVUmed, in Honduras and Vietnam. Today, it provides medical care to kids in Asia, Latin America, Africa and the West Bank in the Palestinian territories.

“When we started in Vietnam, they had done less than 80 pediatric urological operations—total—in the year we started,” she says. “Now, 20 years later, they not only do a full range of surgery serving all of South and Central Vietnam, but also have a teaching program of their own—it’s exactly what we hoped for.”

“Beyond IVUmed, deVries’ supports global healthcare in other ways. She is the director of the University of Utah Center for Global Surgery, a member of the Global Alliance for Elimination of Filariasis, a parasitic disease spread by flies and mosquitoes that can lead to blindness, and she shares her experiences with students as a professor of surgery at the University of Utah.”

Read the full article here on the Salt Lake Magazine website.

Thank you to Salt Lake Magazine for this excellent article and interview with Dr. de Vries, for recognizing her personal commitment to global surgery and global health, and the efforts of the organization she founded and continues to lead today.

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In the News: Dr. Steven Kahan in Vietnam

IVUmed board member and long-time volunteer, Steve Kahan, MD, was recently featured by the online media outlet, Seacoastonline.com. Their article covers Dr. Kahan’s work on our recent general urology workshop in Hue, Vietnam, the progress IVUmed has made in providing quality surgical training to our Vietnamese partners, as well as Dr. Kahan’s his service history with IVUmed. We thank Dr. Kahan for his generous service to IVUmed and Seacoastonline.com for covering this story!

 

Enjoy the full article below:

 

Vietnam 1

Doctor returns from mission trip to Vietnam

EXETER — Seacoast resident Steven Kahan, MD, recently returned from a surgical mission trip to Vietnam organized through International Volunteers in Urology.

Dr. Kahan, who practices at the Portsmouth location of Core Physicians’ Atlantic Urology Associates, was part of a group that volunteered during a two-week mission to Hue Central Hospital in Hue, Vietnam. During the trip, he educated other doctors, consulted on patient cases and conducted surgical procedures.

Kahan is a board member of IVU Med, a Salt Lake City, Utah-based organization that works to make quality urological care available to people in developing countries. Its services have been requested in more than 30 countries in Africa, Asia, Central America and South America. Kahan has traveled on six mission trips with the group to locations in both Vietnam and India.

“When you go and take part in something like this, it’s the purest form of medicine,” Kahan said. “This is the reason I went to medical school. This was about working one on one with students, caring directly for patients and teaching other doctors new techniques so that they can in turn treat patients on their own when we leave.”

The hospital in Hue where Kahan spent his time has 2,030 beds and serves as the main referral hospital in the central region. Kahan assisted with an average of six to 10 general adult urology patient cases per day. The Hue Central Hospital is also the key practical hospital for the Hue Medical College and University, the primary medical school in the region. During his trip, Kahan gave a handful of lectures on general urology and medicine to medical students from the university.

“Those of us on the trip were ambassadors for American medicine and the United States,” Kahan said.

There are only 1.2 doctors per 1,000 people in Vietnam, according to IVU Med. When the organization first began its volunteer missions to Vietnam in 1994, fewer than 100 pediatric urology patients were treated annually. Today, thanks to ongoing training from volunteers with IVU Med, Vietnamese partner surgeons now run their own training programs and treat more than 1,000 patients each year.

Kahan said he is considering a future mission trip to a hospital in Laos. However, he is also eager to return to Hue, where he has formed relationships with the Vietnamese doctors, some of whom have even consulted with him on cases after his return to the United States.

Core Physicians’ Atlantic Urology Associates has locations in Exeter and Portsmouth, offering patients state-of-the-art diagnosis and treatment of disorders of the male and female urinary tract. The practice treats patients with benign prostatic hyperplasia, hematuria, kidney cancer, incontinence, voiding dysfunction, prostate cancer, bladder cancer, testicular cancer and kidney stones.

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Vietnam: An Enduring Partnership

 

A team, including IVUmed board member, Steven E. Kahan, MD, JD., is wrapping up our latest workshop today – a general urology workshop at Hue Central Hospital, in Hue, Vietnam. IVUmed has a long, successful history of partnership in Vietnam.  Our volunteers began working with Vietnamese pediatric surgeons in 1994, predating our official incorporation in 1995.

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Vietnam has a population of approximately 95.5 million people, but have access to only  1.224 doctors per 1000 people. In 1994, fewer than 100 pediatric urology patients were treated annually there.  After many years of successful training, our partner surgeons now run their own training programs independently and treat over 1000 patients annually.

 

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IVUmed specialty workshops in Vietnam have included general urology, pediatric urology, and endourology. Dr. Kahan shared this photo taken at the classroom lecture portion of the workshop at Hue Central Hospital:

 

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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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Jonathon Wu, MD
Stanford University
Hue, Vietnam – February 17 – March 4, 2012
Mentor: Dr. Walter Beh, MD
Sponsored by: The Western Section of the AUA

Through the generous sponsorship provided by the Western Section of the AUA, Dr. Jonathon Wu traveled to Hue, Vietnam with mentor Dr. Walter Beh. Dr. Wu and his mentor collaborated with Dr. Hung and his colleagues of the urology department, focusing on 19 patients with difficult cases. Dr. Wu was able to perform his first open pyelolithotomy under the supervision of a Vietnamese colleague, Dr. Tuan.
Reporting on his experience, Dr. Wu stated:

“In our two weeks of working mainly with Dr. Hung, I was very impressed by his surgical technique. Open surgery involved tediously dissecting out important structures and controlling all bleeding quickly with cautery or ligatures. He moved very quickly in the OR but was very purposeful with his movements. No suture was wasted as instrument tying was performed whenever possible. Bigger cases would often involve 2 attending surgeons intertwined in a well-rehearsed ballet.“What was even more impressive was the efficiency and resourcefulness of the hospital.
We mostly worked with Dr. Hung who has been on the urology staff for 6 years. He is quite motivated and very enthusiastic.
“This disparity was made much more obvious to us when we observed a kidney transplant on our last day.… During the course of our 2 weeks, we were able to see the kinds of needs our Vietnamese colleagues had.”
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Resident Scholar Reflections

Julie Riley, MD

University of Missouri
Hue, Vietnam – February 17 – March 4, 2012
Mentor: Dr. Walter Beh, MD
Sponsored by: South Central Section of the AUA

Through the generous sponsorship provided by the South Central Section of the AUA, Dr. Julie Riley traveled to Hue, Vietnam with mentor Dr. Walter Beh. Dr. Riley and her mentor collaborated with Vietnamese colleagues

Reporting on her experience, Dr. Riley stated:
in the urology department. During her time in Hue, Dr. Riley was able to experience the differences in international healthcare.
“I did enjoy that we were able to give daily presentations. The conversations following these topics were very interesting to further understand the culture as well as understand some of the limitations on the Vietnamese surgeons. In addition most of the Vietnamese doctors wanted improved English particularly medical English and this provided a forum for them to practice.

I feel that the experience was very positive and I look forward to continuing international urology through active patient care as well as education and support to local urologists. I am very grateful to both the South Central Section and International Volunteers in Urology for
allowing me to participate in such a remarkable program. In addition, I am very glad that I was able to experience the culture and the medicine of Vietnam and to provide the local urologists with equipment and all knowledge that I could.”
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IVUmed is committed to making quality urological care available to people worldwide.