Advice received before departure
.. The lecture one might prepared to give may not be the lecture they want to hear. Operating facilities are limited. Patient privacy and modesty concerns are decidedly not Western. Mongolian surgeons, nevertheless, accomplish a great deal. The visitor has much to learn and should be quick to compliment and slow to criticise. If an attitude of love is amplified by lecturing, operating, rounding etc..then all the better, but the basic motive of love in Christ must be expressed.
First prostatectomy by vaporisation
We started out meeting the top surgeon in all of Mongolia, a gracious older gentleman of about 70 years, who is still considered everybody's teacher. Doug had examined two patients, but after they had been given a time slot on Tuesday's schedule they both informed the Mongolian urologists that Tuesday would 'not be a good day ' for surgery. Even comparatively minor events only take place with concurrence of religious practitioners, who consult charts and books. The patients had been switched unbeknownst to Doug!
A senior urologist had come by bus across town to watch the procedure. No interpreter was available among the 25 plus people milling around in the OR but the chief of urology spoke English a bit better than Doug speaks Russian. The OR and Nancy worked as a team by sign language. Men and women change clothes together in the coffee room for the surgery. Mongolia's single television station videotaped the operating theatre for two-hourly nationwide broadcast for the subsequent 24 hrs !
Drapes and gowns were in tatters. Gloves in only one size are re-used until they break.. Blood pressure monitoring and ventilation is done manually by a second anaesthetist. Our instruments were soaked in 'spirit' in a glass, such that about half of each instrument was not in contact with the antiseptic. There was no prophylactic antibiotic given. The grounding pad (to prevent electrocution or severe burning of the patient) remained a source of anxious concern right up to the last moment.
'Lights, camera, action! Everything worked smoothly ... minimal bleeding, excellent view for everybody on the monitor, no patient complaints. The hospital has all the equipment it needs to do the procedure, save for a $140 electrode which can be used 10 -15 times. Between the two cases of the day we remove gloves, wipe our hands with alcohol and don new gloves. The surgical gowns are not changed. The second case went more smoothly and quickly.
Urban poverty
In the afternoon we loaded clothes from churches in the States into a van. Traffic was chaotic and speedy, with near misses of vehicles and pedestrians exceeding one a minute. Among dilapidated buildings and potholed roads, the sunshine was a sharp contrast to the black, white and grey of the city. Trolley buses, dangerously overloaded, chug down the thoroughfares.
Having negotiated the potholes and large rocks of an alleyway we spotted a young lad perching atop a manhole as a sentry. The van halted and soon the occupants - a group of children, an older man and two middle-aged women - all had scrambled up ladder rungs to the light of day. One lad came up shirtless - it had snowed the night before. What joyful faces as the parcels (typically a sweater and a jacket) were passed out. Gospel tracts were included. The old man said the children could read.
Dining with our hosts
Thursday evening our entire team hosted our hosts at the Ulaanbaatar hotel. We reserved the private dining room with a single table for 52 people. Exactly 52 turned up! What a wonderful evening of camaraderie! Doug explained our mission in some detail with a chief surgeon through a translator who turned out to be a senior manager. We capped the evening with a contest of song between our team and the various Mongolian speciality teams. The nationals won hands down!
The national cancer centre
The Soviet-built building is spare by any standards. Patients mostly present late and are admitted for the duration of their radiation the therapy. They receive totally free care from the Government. Common cancers include liver (secondary to viral hepatitis, and, thus preventable), lung (smoking and heavy pollution contribute), oesophageal, stomach and cervix. Futile surgery occurs regularly while chemotherapy and radiotherapy are applied quite aggressively. No palliative care unit exists. Doug lectured on bladder tumours to a very eager audience of about 50. The evening temperature had dipped to well below freezing, and heat had not yet been turned on centrally by the government so that we had to change venues three times before we could find some reasonable comfort from the cold.
Lasting memories
Later off to fellowship with 100 or so exuberant young folk. An English teacher, in Mongolia for seven years, has offered to train the entire urology group (eight in a country of 3 million) in English free of charge. They are on cloud nine. Recall that their salary maxes out at $50/month, which makes private tutoring totally out of the question. They wish to study the Word in Mongolian as they learn English.
Just 20 minutes ago a young paediatric urologist came to our room as we were packing to tell of her spiritual journey. We are overwhelmed, with needs of every kind being met by our gracious, loving, and merciful Father.
Doug and Nancy Soderdahl are based in Georgia, USA
.. The lecture one might prepared to give may not be the lecture they want to hear. Operating facilities are limited. Patient privacy and modesty concerns are decidedly not Western. Mongolian surgeons, nevertheless, accomplish a great deal. The visitor has much to learn and should be quick to compliment and slow to criticise. If an attitude of love is amplified by lecturing, operating, rounding etc..then all the better, but the basic motive of love in Christ must be expressed.
First prostatectomy by vaporisation
We started out meeting the top surgeon in all of Mongolia, a gracious older gentleman of about 70 years, who is still considered everybody's teacher. Doug had examined two patients, but after they had been given a time slot on Tuesday's schedule they both informed the Mongolian urologists that Tuesday would 'not be a good day ' for surgery. Even comparatively minor events only take place with concurrence of religious practitioners, who consult charts and books. The patients had been switched unbeknownst to Doug!
A senior urologist had come by bus across town to watch the procedure. No interpreter was available among the 25 plus people milling around in the OR but the chief of urology spoke English a bit better than Doug speaks Russian. The OR and Nancy worked as a team by sign language. Men and women change clothes together in the coffee room for the surgery. Mongolia's single television station videotaped the operating theatre for two-hourly nationwide broadcast for the subsequent 24 hrs !
Drapes and gowns were in tatters. Gloves in only one size are re-used until they break.. Blood pressure monitoring and ventilation is done manually by a second anaesthetist. Our instruments were soaked in 'spirit' in a glass, such that about half of each instrument was not in contact with the antiseptic. There was no prophylactic antibiotic given. The grounding pad (to prevent electrocution or severe burning of the patient) remained a source of anxious concern right up to the last moment.
'Lights, camera, action! Everything worked smoothly ... minimal bleeding, excellent view for everybody on the monitor, no patient complaints. The hospital has all the equipment it needs to do the procedure, save for a $140 electrode which can be used 10 -15 times. Between the two cases of the day we remove gloves, wipe our hands with alcohol and don new gloves. The surgical gowns are not changed. The second case went more smoothly and quickly.
Urban poverty
In the afternoon we loaded clothes from churches in the States into a van. Traffic was chaotic and speedy, with near misses of vehicles and pedestrians exceeding one a minute. Among dilapidated buildings and potholed roads, the sunshine was a sharp contrast to the black, white and grey of the city. Trolley buses, dangerously overloaded, chug down the thoroughfares.
Having negotiated the potholes and large rocks of an alleyway we spotted a young lad perching atop a manhole as a sentry. The van halted and soon the occupants - a group of children, an older man and two middle-aged women - all had scrambled up ladder rungs to the light of day. One lad came up shirtless - it had snowed the night before. What joyful faces as the parcels (typically a sweater and a jacket) were passed out. Gospel tracts were included. The old man said the children could read.
Dining with our hosts
Thursday evening our entire team hosted our hosts at the Ulaanbaatar hotel. We reserved the private dining room with a single table for 52 people. Exactly 52 turned up! What a wonderful evening of camaraderie! Doug explained our mission in some detail with a chief surgeon through a translator who turned out to be a senior manager. We capped the evening with a contest of song between our team and the various Mongolian speciality teams. The nationals won hands down!
The national cancer centre
The Soviet-built building is spare by any standards. Patients mostly present late and are admitted for the duration of their radiation the therapy. They receive totally free care from the Government. Common cancers include liver (secondary to viral hepatitis, and, thus preventable), lung (smoking and heavy pollution contribute), oesophageal, stomach and cervix. Futile surgery occurs regularly while chemotherapy and radiotherapy are applied quite aggressively. No palliative care unit exists. Doug lectured on bladder tumours to a very eager audience of about 50. The evening temperature had dipped to well below freezing, and heat had not yet been turned on centrally by the government so that we had to change venues three times before we could find some reasonable comfort from the cold.
Lasting memories
Later off to fellowship with 100 or so exuberant young folk. An English teacher, in Mongolia for seven years, has offered to train the entire urology group (eight in a country of 3 million) in English free of charge. They are on cloud nine. Recall that their salary maxes out at $50/month, which makes private tutoring totally out of the question. They wish to study the Word in Mongolian as they learn English.
Just 20 minutes ago a young paediatric urologist came to our room as we were packing to tell of her spiritual journey. We are overwhelmed, with needs of every kind being met by our gracious, loving, and merciful Father.
Doug and Nancy Soderdahl are based in Georgia, USA
