Mary Frances James, MD

Eastern Virginia Medical School

Nairobi, Kenya – March 3 – 13, 2012

Mentor: Dr. Kurt McCammon

Sponsored by: The Mid Atlantic Section of the AUA

Through the generous sponsorship provided by the Mid Atlantic Section of the AUA, Dr. Mary Frances James traveled to Nairobi, Kenya with mentor Dr. Kurt McCammon.  Dr. James had the opportunity to experience grassroots surgery and its value in a developing nation.

 Reporting on her experience, Dr. James stated: 

“At the time of our arrival there was a nursing strike going on throughout the city including Nazareth Hospital.  This situation was very stressful for the sisters and added strain to the daily hospital management as the patient census continued to increase each day. …Despite this ongoing struggle within the hospital we were graciously welcomed by the FIHM sisters on our arrival.”

“The operating room staff was very hospitable and allowed us to use one of the two main operating rooms.”

“The first couple of days consisted of several second stage urethroplasties.... This was a wonderful experience as it was the first time I had seen this operation.”

“Overall my IVU trip was a wonderful experience. Traveling to Africa and working within the constraints of limited resources was an eye-opening and humbling experience.  In a field such as urology that has transformed with development of robotics and minimally invasive care I think it is important to remember how different healthcare is throughout the world.  I am extremely grateful for having had this opportunity and look forward to a lifelong commitment to urologic mission work."

Resident Scholar Reflections

Judith Hagedorn, MD

Stanford University

Hebron, West Bank – March 15 – March 24, 2012

Mentor: Dr. Scott Eggener

Sponsored by: Verathon

Through the generous sponsorship provided by Verathon, Dr. Judith Hagedorn traveled to Hebron, West Bank with mentor Dr. Scott Eggener to learn and assist surgeries at Hebron Hospital. Although in a politically turmoiled area, Dr. Hagedorn was able to develop an understanding of the diversities in healthcare due to limited resources.

Reporting on her experience, Dr. Hagedorn stated:

"Every morning we got picked up with the Ambulance of the Hebron Hospital. Our Palestinian driver made a daily pit stop, either to get some strong Arabic coffee or freshly fried falafels. 

"The hospital was quite simple, but clean. The staff was very friendly and showed

their appreciation for our visit. In addition, the patients were overly thankful and there was never a day we didn’t leave the hospital without a small present from one of the patients’ families.

"The clinical decision-making was also quite interesting and different from what I had learned in the Western World…. I had a wonderful, eye-opening, and rewarding experience, which definitely strengthened my passion to contribute to global health, and I am already looking forward to my next international medical/surgical trip."

Interested in learning more about our resident scholar program?

Find more information at our website, www.ivumed.org.

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."

A Dynamic Paradigm in Global Health and Surgery

Innovation, collaboration, sustainability were common themes of discussion at the first annual "Extreme Affordability: Innovative Solutions of Surgical Care" conference hosted by the Center for Global Surgery at the University of Utah School of Medicine. Focusing on providing affordable surgery globally, this conference called together surgeons, policy makers, bioengineers, anthropologists and non-governmental organization leaders to discuss the need and accessibility of surgical care to the international community.

Mark Harris, M.D., co-founder of the International Anesthesia Education Forum writes about his experience at the conference, “I am left with a sense of enthusiasm, optimism and community. There are so many people from different fields and countries collaborating and using innovative approaches to the myriad problems facing the low resource world.”

Speakers from around the world shared their perspectives on these current themes of global health and surgery. Keynote speaker, Clayton Christensen, Kim B. Clark Professor of Business Administration at the Harvard Business School, discussed the decentralization of healthcare providers and technology to develop affordable and sustainable healthcare in resource-limited and rich settings. Christenson is regarded as one of the world's top experts on innovation and growth.

With a pattern recognition-based concept, Christensen's message was well-received by conference attendees.

"The speakers were thoughtful and captivating which was no small feat!" Rhiana Menen, resident with the East Bay Surgery Program at UCSF, commented. "I am so grateful to have had the opportunity to attend this wonderful conference. As someone early in my career but very much trying to incorporate an emphasis in global surgery, I now have a much better idea on how to proceed and have made some invaluable contacts."

As one of the few non-governmental organizations presenting at the conference, IVUmed was able to share its perspective on global health. Josh Wood, executive director, provided an in-depth look at how to develop and sustain global partnerships for dynamic change in an economical and efficient manner.

During his presentation, Wood explains, "When you start to become aware of surgery, how much need there is and the potential we have to relieve that need, it may seem overwhelming; but there are extensive opportunities, especially if programs are carried out in a sustainable manner so we can get more bang for our buck."

A staggering one million African infants are estimated to die in the first 4 weeks of life and there are only 24 urologists for the 9 million people living in Haiti. With these, and other outstanding statistics, the developed world recognizes a preventable epidemic. Through technology and innovative collaboration, these leaders are truly developing a paradigm shift in global health.

Discussing the role of surgery in global health, Steve Alder, Chief of the Division of Public Health at the University of Utah, comments, "You have to talk about the elephant in the room; is it the scalpel or the syringe?"

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.”

Oreoluwa Ogunyemi, M.D.

University of Wisconsin

Accra, Ghana - January 14, 2012 - January 22, 2012

Sponsored by: Oceana Pharmaceuticals

Through the generous sponsorship provided by Oceana Pharmaceuticals, Dr. Ogunyemi was accepted as a Traveling Resident Scholar to work in Accra, Ghana under the supervision of mentor, Dr. Sunny Mante. During the trip, Dr. Ogunyemi was able to give back to an area that faced similar issues as her home country, Nigeria.

Reporting on her experience, Dr. Ogunyemi stated:

“During medical school, I traveled to Central America to volunteer in Guatemala in obstetrics and family medicine, but I have never had the opportunity in the field that I will devote my career. I have always known, as an immigrant and child of immigrants, that it would be vital to provide to me to provide care globally and foster relationships that would make this possible. IVUmed is my opportunity to begin this work.

“Clinic was a fast and furious experience. Each few moments, one of the charts from the stack was pulled, a patient appeared and a story was told.

“My week in Accra was a wonderful experience and one that I will cherish for the rest of my professional career. I truly appreciate the opportunity from IVUmed to make this a reality and look forward to repeating similar endeavors in the future.

“The patients, with teeth gritted and anxious faces, put their care into our hands despite the language barrier between us. It was gratifying to be able to care for these patients and provide comfort.

“My arrival at the halls of 37 Military Hospital was welcoming. I found welcoming smiles and genuine interest in my urologic perspective and actively encouraged to challenge ideas and bring forth alternative treatment plans and opinions. There was a true collegial excitement at exchanging ideas and patient experiences and learning from each other.
"

Resident Scholar Reflections

Jessica Casey, MD

Northwestern Univeristy

Mahuva, India - November 4-28, 2011

Mentor: Dr. Sakti Das

Sponsor: Resident Scholar Alumni

Through the generous sponsorship provided by the Resident Scholar Alumni, Dr. Jessica Casey traveled to Mahuva, India with mentor Dr. Sakti Das to participate in a free urology camp organized by the local Indian organization Jeev Sewa Sansthan (“Service to the Living”). During the camp, over 130 patients received much-needed urological care

“During my six days in Mahuva at Sadbhavna Trust Hospital, I operated like crazy – running back and forth between the 6 operating beds that filled 2 operating rooms. As I was finishing one case, a patient behind me was getting their spinal anesthesia injected and being prepped by assistants for me to operate on in a few minutes.

of the work being done while I was there.During those short six days, I participated in 34 operations which ranged from delicate hypospadias work to minimally invasive percutaneous nephrolithotomy to a reconstructive extrophy repair; and this was only a fraction

“In Mahuva they did not have all of the fancy equipment we have in the states; there was no fancy LigaSure, no argon beam, no laser lithotripsy. They had a scalpel, cautery, suction, a light and a patient who needed surgery. If something is bleeding, quickly put an “artry” (i.e. hemostat) on it and move on. If the suction isn’t turned on, use one of your two laps to stop the bleeding and move on.

If they don’t have the needle driver you want, make do with another.

“If I was struggling with a maneuver and blaming everything around me (the lighting, the instruments, the angle, etc), Dr. Das would calmly remind me to focus on my own skills and not blame my sur

roundings. Dr. Das’s influence made me reflect at my own actions. Often at Northwestern, surgeons complain about not having the right gloves, the right assistant, the best light, etc. in order to make excuses for their own

skills. It’s best to just focus at the task at hand, not make excuses, and just get the work done.”

For more information on getting involved with our Resident Scholar Program, please visit our website at www.ivumed.org.