International
Children's Heart Fund

Mongolia
2003 - 200
7, 2009, 2010

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 information about Mongolia

 

In September, 2003 the ICHF, in collaboration with Project Open Hearts from Denver, Colorado,  and the World Heart Foundation, did a team visit to Shastin Medical Center (Hospital #3) in Ulaan Bataar, Mongolia.  A series of open heart operations were performed with the local cardiac surgery team.  Dr. Pezzella subsequently  made two solo visits in May, 2004, and October, 2004, to work again with the local team.  Contact with the Trauma, Cancer, and Infectious Disease Centers was also productive in identifying future projects.

 

 

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    In October 2005, under the auspices of the ICHF, Dr. A. Thomas Pezzella, made his fourth trip in two years to Ulaanbaatar, Mongolia. While roughly the size of Alaska, Mongolia has a population of less than three million people. It is in the process of transforming from a totalitarian state to a democratic republic and from a state-run to a free-market economy. Like its social and economic systems, its healthcare system is in flux. Government funding for healthcare is waning. While the government covers basic hospital and physician costs, individuals must pay for advanced surgical procedures, disposables such as suture, valves, drugs, and cardiopulmonary bypass components. Advanced graduate medical education does not exist. Foreign NGOs provide short-term education and training, but efforts are not coordinated.

Because Mongolia has a small population, there is only one established cardiac care center—Shastin Hospital #3. With the help and cooperation of a few foreign NGOs, particularly project Open Hearts and recently Samaritan’s Purse, the open-heart surgery program there is evolving slowly. Visiting cardiac surgery teams have been coming to Shastin Hospital #3 for the past ten years. A cardiac surgical team consists of ten to twelve professionals and performs five to ten procedures over the course of a week. During the visits, the engagement of the local host team is stressed. It is hoped that over the next five years, essential local personnel will receive additional training in anesthesia, perfusion, and critical care nursing.

The majority of cases seen at the cardiac care center involve rheumatic valve disease and congenital heart disease. However, as the population becomes more urbanized and the Mongolian diet becomes more westernized, coronary artery disease is becoming more prevalent.

Preparing Ice
Surface Cooling

Interestingly, a few older cardiac procedures, including closed mitral commissurotomy (CMC), and surface cooling with inflow occlusion for repair of ASDs and small VSDs, are routine. In addition, a midline sternotomy with a gigli saw is typical. With the gradual improvement of the economy and health care system, the ultimate goal is a fully functional open-heart surgery center that performs 400-500 cases per year.

The open-heart surgery program in Mongolia has the following short-term needs:

Long-term needs include the strategic reorganization of the Mongolian health care system with the support of sophisticated/advanced medical care.

In addition to the support of the open-heart surgery program, help has been directed and is still needed in Thoracic surgery, especially in lung and esophageal surgery at the Mongolian Cancer Center, and tuberculosis surgery at the Infectious Disease Center. An Advanced Trauma Life Support (ATLS) training system is being implemented at the Mongolian Trauma Center.

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On Location - Ulaan Baatar, Mongolia, 2005

Under the auspices of the International Children’s Heart Fund, Dr. A. Thomas Pezzella made his fourth trip in two years to Ulaanbaatar, Mongolia. While roughly the size of Alaska, Mongolia has a population of less than three million people. It is in the process of transforming from a totalitarian state to a democratic one and from a state-run to a free-market economy. Like its social and economic systems, its healthcare system is in flux. Government funding for healthcare is waning. While the government covers basic hospital and physician costs, individuals must pay for advanced surgical procedures, disposables such as suture, valves, drugs, and cardiopulmonary bypass components. Advanced graduate medical education does not exist. Foreign NGOs provide short-term education and training, but efforts are not coordinated.

Map with focus on MongoliaBecause Mongolia has a small population, there is only one established cardiac care center—Shastin Hospital #3. With the help and cooperation of a few foreign NGOs, particularly project Open Hearts and recently Samaritan’s Purse, the open-heart surgery program there is evolving slowly. Visiting cardiac surgery teams have been coming to Shastin Hospital #3 for the past ten years. A cardiac surgical team consists of ten to twelve professionals and performs five to ten procedures over the course of a week. During the visits, the engagement of the local host team is stressed. It is hoped that over the next five years, essential local personnel will receive additional training in anesthesia, perfusion, and critical care nursing.

The majority of cases seen at the cardiac care center involve rheumatic valve disease and congenital heart disease. However, as the population becomes more urbanized and the Mongolian diet becomes more westernized, coronary artery disease is becoming more prevalent.

Preparing ice
Surface Cooling
Preparing Ice
Surface Cooling

Interestingly, a few older cardiac procedures, including closed mitral commissurotomy (CMC), and surface cooling with inflow occlusion for repair of ASDs and small VSDs, are routine. In addition, a midline sternotomy with a gigli saw is typical. With the gradual improvement of the economy and health care system, the ultimate goal is a fully functional open-heart surgery center that performs 400-500 cases per year.

The open-heart surgery program in Mongolia has the following short-term needs:

Long-term needs include the strategic reorganization of the Mongolian health care system with the support of sophisticated/advanced medical care.

In addition to the support of the open-heart surgery program, help has been directed and is still needed in Thoracic surgery, especially in lung and esophageal surgery at the Mongolian Cancer Center, and tuberculosis surgery at the Infectious Disease Center. An Advanced Trauma Life Support (ATLS) training system is being implemented at the Mongolian Trauma Center.


Visit, 2007

In May 2007, a two week trip by Dr Pezzella was made to Ulaan Baatar, Mongolia. Operations at Shastin Hospital and the Tuberculosis Center were performed. In addition, in cooperation with the Swanson Foundation from Utah (USA), medical equipment and surgical instruments were donated to the Trauma Center, Cancer Center ,and the Tuberculosis Center.

A cooperative program with Yonsei University in Seoul, South Korea included additional training in cardiac surgery, cardiology, and perfusion.


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In May 2010, cooperation with Yonsei University and Shastin Hospital was discussed. Additionally a program with Frontier Lifeline in Chennia, India was developed to harvest equine pericardium.

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Summary Report

 

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