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SUMMER 2009
ISSUE IV
PROJECT DIRECTOR
Carl E. Bartecchi, M.D.
ckbartecchi@comcast.net
PROJECT MANAGER
Dana Dawkins
TOXICOLOGY & DENVER COORDINATOR
Scott Phillips, M.D.
MAYO CLINIC COORDINATOR
Robert Joyce, FACHE
PROJECT SPONSORS
ST. ANTHONY’S HOSPITALS AND HEALTH FOUNDATION
CENTURA HEALTH
CATHOLIC HEALTH INITIATIVES (CHI)
GLOBAL HEALTH INITIATIVES
Bach Mai Hospital Project benefits from private donors. Donations are used to support the education programs for Vietnamese physicians. Recent donors include:
Mark H. Carson, Boulder, CO.
Xuan Le Family, Denver, CO.
Robert Joyce, Rochester, MN.
Captain and Mrs. Thomas Granahan, Falls Church, VA
Karl Ohaus Family, CT
Future Programs Planned for Bach Mai Hospital Project
November 2008 - Toxicology Symposium organized by
Scott Phillips, M.D. and Richard Dart, M.D. and featuring the faculty
of the Rocky Mountain Poison and Drug Center and Denver Health
November 2008 - Teaching program in Emergency Neurosurgical Procedures arranged by St. Anthony's Neurosurgeon, A. Stewart Levy, M.D.
April 2009 - Emergency Medicine Symposium arranged by St. Anthony's Hospital and the Mayo Clinic
April 2009 - Cardiology Symposium
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Cardiology Symposium
Our first cardiology symposium, held in
association with the Mayo Clinic and the Vietnam Heart Institute, was
a huge success. Over 400 physicians attended the two day symposium at
the Bach Mai Hospital in Hanoi, Vietnam. Seven cardiologists from the
Mayo Clinic provided state of the art lectures on a
variety of cardio-vascular topics. During their one week visit,
doctors Leslie Cooper, Jr., Michael McGoon, Vuyisile Nkomo, Malcolm
Bell, Thomas Allison, Charanjit Rihal and cardiovascular surgeon,
Rakesh Suri, provided a steady flow of answers to the many questions
posed by the Vietnamese cardiologists. Dr. Bell, an Aussie soccer
enthusiast even gave the (Aussie soccer) shirt off his back to a
delighted Vietnamese cardiology resident. Dr. Nkomo provided valuable
on-site echocardiographic training to a grateful group of echo
enthusiasts. Dr.Rihal was kept busy in the Cath Lab (see his report)
and Rakesh Suri spent most of his time performing complex
cardiovascular surgeries. Dr. Suri is well known at the Mayo Clinic
Cardiovascular Surgery Program for guiding the DaVinci Robot which is
capable of performing heart valve surgery under
his skillful control. Dr. Allison drove home the prevention medicine
principles so important in cardiology. Dr. Bartecchi provided still
another lecture dealing with the cardiac problems related to smoking
and second-hand smoke. Dr. McGoon’s lectures stimulated questions
and interest in his specialty area, pulmonary hypertension. All the
cardiologists expressed interest in returning to Vietnam for future
programs, and our Vietnamese hosts were delighted with that
possibility. We were all impressed with the enthusiasm and
willingness of the Mayo cardiologists who “jumped right in” and
helped with the actual management of difficult patient problems,
teaching management principles at the same time. Our cardiology
symposium was attended by Michael Iademarco, M.D., MPH, the Health
Attaché at the U.S. Embassy in Hanoi. Michael and the U.S. Embassy
has been most helpful in assisting our Vietnamese visiting physicians in obtaining the necessary
visas for travel to the U.S. We appreciate their help and their
support for our Bach Mai Hospital Project.
One Cardiologist's Observation
For a westerner, walking into Bach Mai
Hospital in Hanoi, it was an amazing experience. This is the largest
hospital in Vietnam, and hosts the Vietnam Heart Institute. The
hospital was bombed during the war and has been reconstructed since,
with the support of theVietnamese and certain foreign
governments. This is a large multi building facility, home to 2,000
beds holding 3,000 patients. Doing the math, one realizes that many
beds hold more than one patient. Family members are present in
abundance in the hospital wards, helping to provide front-line
patient care and food for their ill relatives. The cardiac
catheterization lab is a busy facility, having two single-plane
digital imaging systems. Interventional cardiologists at Bach Mai
perform about 500 congenital heart treatments and 900 coronary artery
procedures each year. There is a large base of rheumatic heart
disease, and multiple, non-operative mitral valve disease procedures
are performed on a daily basis. I was asked by our host to scrub in
on cases – this was a fascinating experience. The first case that I was asked to
perform was an acute anterior wall myocardial infarction with a
borderline shock picture. The diagnostic coronary artery dye study
showed that the major coronary artery was occluded. It was a huge
tortuous, calcified vessel. We were able to open the occluded vessel
only with great difficulty. With removal of the blockage in the
coronary artery, the shock picture immediately reversed. Following
that experience, I felt that I was back in the saddle and ready for
my second case. This was an 87 year-old woman who also had an occlusion of the major coronary
artery. She was told that she was inoperable and would probably die.
Fortunately, this was not the case and the procedure went well, I was
able to share some techniques for rapidly opening such blockages. It
was a very rewarding experience meeting the family, who were most
appreciative. They spoke excellent
English and were very warm to us. On
the third day of our visit, I availed myself of the
opportunity to scrub in with some of
the world’s busiest mitral valvuloplasty operators, and performed a
number of mitral valvuloplasty procedures under their watchful eye.
The approach taken in Hanoi is vastly
different than what we use in America, and perhaps the best term to
describe it would be “bare-bones” approach. The procedure is done
with a balloon catheter. These catheters are used seven or eight
times – unacceptable here in the U.S All in all, the experience
scrubbing with my Vietnamese colleagues in the cath lab was very
rewarding, and clearly was a mutual learning experience. I would
highly recommend this experience to individuals wanting to do medical
missionary work in a rapidly developing Asian nation, with a history
that is inextricably intertwined with that of the United States.
Foundation President Visits Vietnam
In April, St. Anthony?s Hospitals, Centura Health, and Catholic Health Initiatives in cooperation with the Mayo Clinic and the University of Colorado School of Medicine, sponsored a Critical Care Medicine Symposium at the Bach Mai Hospital. The 700 physician attendees made it one of the most successful medical conferences ever in Vietnam. Sean Caples, D.O., Joseph C. Farmer, M.D. and David Maldonado III, M.D. from the Mayo Clinic, Joe Heit M.D., and Joshua Solomon, M.D. from the University of Colorado provided state of the art lectures on a variety of subjects related to Critical Care Medicine. The program was very well received by a responsive audience that wanted more of such presentations in the future. Our hosts claimed that this conference will make a major difference in how Critical Care Medicine will be practiced in the future in Vietnam. We were especially pleased that all the lecturers expressed a desire to return to Vietnam to continue to help the Critical Care Program at the Bach Mai Hospital. Dr. Heit has already signed on for this coming November.
Emergency Department Specialists Provide Ongoing Assistance
Bob Joyce, our Mayo Clinic coordinator and the Administrator of the Emergency Department of the Mayo Clinic and Karl Ohaus of the world renown consulting group, Lean Transformations, returned to the Bach Mai Emergency Department in April to continue their efforts to streamline the massive Emergency Department of the Bach Mai Hospital. Considerable progress is being made such that we can envision their achieving their goal of having the Bach Mai Emergency Department as a model for all Emergency Departments in Vietnam. We certainly appreciate the time and financial commitments of these two individuals and their organizations.
Major Donations of Equipment and Supplies Made to the Bach Mai Hospital
Thanks to the generous funding of Catholic Health Initiatives/Global Health Initiatives we were able to provide large quantities of much needed equipment and supplies to the Bach Mai Hospital. These supplies included ventilators, defibrillators and critical parts for many ICU machines that had been out of commission. Successful grant requests resulted in an Olympus Bronchoscope from Olympus America, Inc., thanks to Marci Barner, and two sophisticated ventilators from Pulmonetic Systems, thanks to Jean Marchant. The Evergreen Colorado Rotary Club, thanks to the efforts of Bob Wallace, donated $10,000.00 for the purchase of oximeters, blood pressure monitoring equipment and stethoscopes, which were badly needed by the nurses at Bach Mai. Patrick Brandon donated 22 more stethoscopes. Dr. Bartecchi received 2 cases of medicines from MAP International, which he brought to the Bach Mai Hospital for patients who couldn?t afford medicines. BioSite continues to provide our program with diagnostic testing equipment.
(Above: Dr. Xuan receiving Evergreen, CO. Rotary gifts.)
Diane Jones Visits Bach Mai Hospital Administrators
Diane Jones, Vice President, Healthy Communities, Catholic Health Initiatives, along with Bob Wallace, St. Anthony?s Central, accompanied the physicians that presented the April, Critical Care Medicine Symposium at the Bach Mai Hospital. Diane and Bob met with Bach Mai Hospital Administrators in an effort to determine how we might best be able to assist that facility in the future. Diane?s global health experience and work with health care issues of medically indigent populations was most useful.
As most of the leading health care administrators in Vietnam appear to be females, it was good for them to see that our system also recognize quality health care administrators. Diane has continued to be an outstanding source for consultation and direction for the Bach Mai Hospital Project.
(Above: Diane Jones [second from left] meeting with Bach Mai Hospital Administrators)
Dr. Bartecchi Receives Vietnam Government Medal
Much to his surprise, during the Critical Care Symposium, Dr. Bartecchi was called to the stage where he was presented with the People?s Health Medal, by the Ministry of Health. It is Vietnam?s highest health honor. It was his impression that this honor was a reflection of the Vietnam Government?s satisfaction with the entire Bach Mai Hospital Project and the accomplishments of the Program?s volunteers and it?s many supporters. In his acceptance comments, he acknowledged the tremendous support that he has received from St. Anthony?s Hospital, Catholic Health Initiatives/Global Health Initiatives, the Mayo Clinic, the University of Colorado School of Medicine and the large number of physicians and nurses who volunteered their time and expertise to make the program a success.
New Class of Bach Mai Fellows Arrive at St. Anthony's Hospital
(Above: Dr. Tuan, Mr. Van, and Dr. Ngoc, Nurse Hoan, and Dr. Giang.)
In past years, we have trained Vietnamese physicians who were to return to the Bach Mai Hospital as teachers in their particular specialty. To date, we have trained eleven such physician/teachers. Our review of the needs of the now 2000 bed Bach Mai Hospital suggests that training of physicians alone will not allow us to accomplish our goals. We have noted a tremendous need for advanced training for specialty nurses, technicians, respiratory therapists, and Paramedics. We have thus decided that the future trainees, representing all medical disciplines, will be called Bach Mai Fellows. Our goal, depending on funding, will be to expand the number of trainees that we bring here for advanced training. This year, we have brought five Bach Mai Fellows to St. Anthony?s Hospital for training (no more that three in past years). The five Bach Mai Fellows are Bui Thi Huong Giang, M.D. (Critical Care Medicine), Ngo Duc Ngoc, M.D. (Toxicology), Nguyen Anh Tuan, M.D. (Emergency Medicine), Hoang Minh Hoan (Critical Care Nurse Specialist) and Nguyen Hoang Van ( Medical Technician).
They will be trained at St. Anthony?s Hospital, University Hospital, Denver Health and the Mayo Clinic. Mr. Van will receive an intense course in repair and maintenance of ventilators, monitors and other medical equipment, under the direction of the St Anthony?s Hospital Bioengineering program and Brian Wilson. At present, he is one of only two such technicians at the 2000 bed Bach Mai Hospital. Before departing for Hanoi, Mr Van said that ?before I came here, I would just push machines to the side when they broke down ? now I feel confident that I can fix them.? We suspect that the return of this particular group will have a major impact on the various programs at the Bach Mai Hospital.
Vietnamese-American Family Provides Support for Bach Mai Fellows
Many members of the Denver Vietnamese community have shown kindness and generosity to our Bach Mai Fellows who are far from home, family and in most cases, their young children. One Denver Vietnamese-American family has been especially kind and generous to our Vietnamese visitors. The family of Xuan Le, her husband Chuong, her daughter Linhdan Nguyen and her son David Nguyen have contributed greatly to our efforts to make our Vietnamese visitors feel at home here in Colorado. They have provided wonderful meals, travel, trips to the Asia Market, laundry services, and even a washing machine for their use. Linhdan and David, both pre-med students, volunteer as translators for our Vietnamese nurse.
John Covert Retires from St. Anthony Foundation Position
John Covert, a long time supporter and worker for the Bach Mai Hospital Project retired from his position at the St. Anthony Health Foundation. John performed many services for the Project, but will be most remembered for his overseeing of the lives, programs and activities of the visiting Bach Mai Fellows. John will be missed. We wish him well in his new consulting role. Dana Dawkins will assume John?s duties for the Project.
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