Mike Taylor, MD, MPH, CTropMed®

Director, Global Pediatrics Education

Global Instructor Update

Cassidy Huun, MD, Tanzania

Faculty Update

Kristina Krohn, MD, Laos January 8, 2024 - January 14 and Vietnam January 14th - January18, 2024

Returning to Laos:

I returned to Laos after 5 years to reconnect with colleagues from when I lived in Laos. Everywhere I went the effects of the pandemic were evident. Inflation had destroyed the exchange rate. Where previously I got 8,000 kip for my 1 dollar, I now got 20,000 kip. Lao  physician colleagues who had previously been paid $300 a month were now being paid $125 a month. It made sense that many doctors also sold hand woven silks or homemade bakery goods in addition to their day jobs.  

Change occurred in other ways too. I now took an elevator to the 4th floor to get to the pediatric department in a new building in the Mahosot Hospital created with the Chinese government. I donated breast milk, by packaging and labeling milk I pumped while away from my not yet 1-year-old, and left the bags in a freezer in the new NICU. I was surprised by all of the emotions of leaving my own little ones, and by the logistics of pumping while traveling. I needed to find a private space to pump on a 14 hour flight (the changing table in the bathroom), which necessitated waking my row partners every few hours. Then I also needed to explain what breast milk was as a liquid in multiple languages going through airport security in multiple places. I honestly do not know if Mahosot had a freezer for breast milk when I was last there, which reminds me that I have frequently overlooked this simple and yet essential component of pediatric care.

Two of my former residents have completed full cardiology fellowships in Thailand and are doing their best to provide specialized pediatric cardiac care using an endovaginal probe to do their fetal echos. Somehow they’ve got to get a decent pediatric echo. They aren’t the only former residents whose roles have changed. The head of pediatric ID, the two pediatric hematologist/oncologists, the pediatric nephrologist, the pediatric gastroenterologist and the pediatric endocrinologists will soon be joined by a pediatric intensivist, all of whom were my former residents and all would be great people for our current residents to rotate with. 

I was both humbled and honored when the head of the pediatric emergency department at the free standing children’s hospital (also a former resident) asked me to help him and other junior faculty. They are now the heads of departments, or the first of their specialties, and they are asked by their seniors to lead the way. The idea of faculty development exists, but there is no office of faculty affairs at the medical school, nor a Mike Pitt in their department who is tasked with that role. Even the idea that this could be someone’s job was a little strange. We decided to start a junior faculty peer support group. We’ll meet once a month via zoom. We’ll talk about our projects and identify difficult areas. I’ll reach out to our faculty development folks (so watch for emails from me) and see what additional resources we might be able to provide. But mostly we will just problem solve together. I haven’t been this excited about something in years.

On to Vietnam:

After staying up late with my former residents eating a mix of Lao and American foods, I went to VinUni - a University started by a tech giant who became the first billionaire in Vietnam. In 2020, the first medical students and the first pediatric residents started at VinUni. Medical students from Vietnam and around the world paid to start in a fairly empty brand new university with giant statues of white men – who I think might be greek or roman philosophers or some such – and a state of the art simulation lab with real medical oxygen and other gasses so that in an outbreak, or a pandemic, it can become a field hospital. The goal of “the chairman” and the medical education staff is to create a state of the art medical education destination training center. 

One day the taxi driver dropping me off at the main entrance was visibly shaken as I gave him directions for where I’d been dropped off on previous days. It turns out that area is reserved for photoshoots, from people’s weddings to Vogue.

The residents spend most of their time either at the National Children’s Hospital - a 2,000 bed children’s hospital - or at VinMec, the private hospital created by the same billionaire, which is also where they are required to work for some years after finishing their residency. Teachers  from VinUni do not have clinical privileges at these hospitals, but rather show up for extra teaching rounds several days a week. The attending of record is the hospital staff in the respective ward. I was woven into this same structure and asked to help round on just a few interesting patients. These rounds happen in English, and often the VinUni teachers also round in English, with the goal of helping the residents become sought after teachers around the world once they finish. As my first trip to Vietnam, Hanoi, and VinUni, it was definitely an interesting experience.