Sites of Collaboration
Ho Chi Minh City
Childrens Hospital #1
Childrens Hospital #2
Service Trip #6 March 11-16, 2012
Karen Fernandez, MD, Amy Ly, Pharm.
Pediatric General Surgery:
Ai-Xuan Holterman, MD (Group Leader), Mark Holterman, MD, Allen Browne, MD, Nancy Browne, PNP, Mike Chen, MD, Elizabeth Beierle, MD, Linh O'Connor, MD, James Hopkins, MD.
David Vandersteen, MD, Victoria Vandersteen, RN, Yuri Reinberg, MD, Moira Dwyer, MD, Be Ho, CNOR.
James Sidman, MD, Brianne Roby, MD, Phuc Ly, RN.
Angelina Bhandari, MD, Minh Thai, MD, Kelly Ryan, Elizabeth Ross, MD.
Global Health Initiatives:
Tim Erickson, MD
Logistics & Translation:
Leanne and Damin Hoang
IPSAC is back once again in bustling Ho Chi Minh City despite delays from solar flares.
Accomplishments for this trip include:
1. PEDIATRIC ONCOLOGY: collaborative programs for physicians at the Oncology Hospital and Children's Hospital #1, or Nhi Dong 1 (ND1) to streamline patient
2. OTOTLARYNGOLOGY: ENT sinus courses, as requested by ND1 and attended by 30 local physicians from area hospitals, including the former ND1 Chief of Otolaryngology.
Didactic sessions on pediatric airway obstruction. Joint surgical procedures including crico-tracheal resection with tracheostomy, endoscopic sinus surgery, laryngotrachial reconstruction with
anterior rib graft, advancement flap for facial trauma reconstructions.
3. UROLOGY/PEDIATRIC SURGERY: Follow up of patients operated last year and complex joint procedures among which several cloacal exstrophy repairs, total UG sinus mobilization with genitoplasty
for congenital adrenal hyperplasia, abdominoperineal repair of obstructed vagina with proximal vaginal agenesis in addition to bladder augmentations, and previously failed uroplasties,. .
4. A visit to Hue Central Hospital to continue discussions for academic affiliations and the new IPSAC initiative: the International
5. A visit to Qui Nhon to meet with the Bishop and discuss IPSAC partnership to provide outreach surgery for the highlanders of central Vietnam at the future hospital.
6. A meeting with ND1 hospital directors to discuss the future of IPSAC-ND1 collaboration.
7. Preliminary agreement with the Dean of Pham Ngoc Thach Medical School for collaborative training of US pediatric surgery fellow at ND1
Service Trip #5 March 11-19, 2011
Ai-Xuan Holterman, MD, Group Leader, pediatric surgeons Elizabeth Beierle, Mark Holterman, Mike Chen, Allen Browne and Linh O'Connor, pediatric urologists David Lashley and David Vandersteen, pediatric anesthesiologists Angelina Bhandari and Kelly Ryan, pediatric otolaryngologists Jonathan Grischkan James Sidman, pediatric surgery nurse practitioners Nancy Browne, PNP, family practitioner Joseph Whitson MD, nutritionist Ai-Lan Whitson, pharmacist Huynh Thao, nurse Be Ho, surgical resident Jamie Schwartz, and volunteers Nguyen Bang, Isaac Holterman, Ai-Thanh Le, Kim Nguyen, Tran Vu Bui, Khanh Vanna Vu and Ben Whitson.
Prior to the arrival of the main clinical team, the Holtermans, Brownes, Mr. Bang, Ms. Thao and Tran flew to Hue for a one day visit of Hue Central Hospital; meeting with its leadership to explore opportunities for expanding Hue health care systems, research, education and pediatric surgical training. A tour of the health care complex which includes the medical, nursing, pharmacy schools, the clinical and research facilities, the new Education building was conducted.
The next day, the Hue team joined the main clinical team at Nhi Dong 1 (Childrens Hospital 1) in Ho Chi Minh City. The multi-specialist team's activities included collaborative clinical surgeries and guest lectures from ENT, Urology, General Surgery, Anesthesia, Nursing, and Pharmacy specialists.
Volunteers toured ND1 clinics and distributed donated stuffed animals and toys to the patients.
In follow up of IPSAC last year's visit to Pham Ngoc Thach Medical University, IPSAC team returned for its first invited lectureship. Topics in pediatric anesthesia, fluid and electrolytes management of the perioperative patient were presented. Future avenues for academic collaboration were discussed with the Medical School Directors over lunch.
Mission Outreach to Danang
While the Pediatric ENT, Pediatric Urology and Pediatric General Surgery teams (Drs. Chen and Beierle) remained at ND1 for their clinical and teaching activities; the remainder of the team traveled to Danang hospital for outreach clinical and educational activities. IPSAC-VN team visited the future home for Da Nang Pediatric Surgery section at the modern Danang Women's and Children's Hospital.
Service Trip #4 June, 2010
Pediatric surgeons Ai-Xuan Holterman, Mark Holterman, Mike Chen, Elizabeth Beierle, Allen Browne, Linh O'Connor, pediatric surgical nurse practitioners Nancy Browne, Rona Mahor, medical student Chris Hoover, and other volunteers Anna Lee, Laura Lee, Nathan Holterman, Alex Holterman, Matthew Gallo and Patrick O'Reilly.
The trip began at Nhi Dong 1, Ho Chi Minh City, VN with an introduction of IPSAC team to Nhi Dong 1 leadership, review of schedule and assignment of duties. IPSAC presented the Nhi Dong 1 library with textbooks (including the latest edition of "Ashcroft's Pediatric Surgery") and Nursing and Laparoscopic professional journals; donated by Elsevier. The Operating Room staff was presented with surgical endoscopic supplies and silo bags donated by Specialty Surgical Products from Victor, MT.
Other activities during the mission week at Nhi Dong 1 included:
>> clinical activities of our surgeons consisting of operative procedures, rounds and consultation on the surgical wards
>> Nurses workshops: Pediatric congenital diaphragmatic hernia, chest tube management, wound/stoma management
>> IPSAC surgeons delivered lectures on the role of thoracoscopy in congenital diaphragmatic hernia repair; the role of primary vs multi-stage repair of neonatal imperforate anus; and gastroschisis with silo management.
>> Drs. Mark and Ai-Xuan Holterman, and Nhi Dong 1 surgeon-in-chief, Dr. Dao Trung Hieu met with the leadership at the Pham Ngoc Thach University of Medicine school in follow up to our last November 2009 discussion of IPSAC-VN support of the medical school curriculum and the pediatric surgery academic section.
As IPSAC's first outreach trip, the team traveled to Da Nang Hospital. We toured the facility with the chief of surgery, Dr. Nguyen Phi Phong, discussed IPSAC support of the surgical section. The team plans to return to Danang to perform day surgery on a future trip.
Service Trip #3 November, 2009
Team Members for this visit included the surgeons Mark Holterman, Ai-Xuan Holterman, Linh O'Connor, the pediatric anesthesiologists Lisa Gramlich, Kendell Sullivan, and nurses Kathy Breadel, and Stacey Gley.
We returned to Children's Hospital #1 in our new non-profit NGO capacity as International Pediatric Specialist Alliance for the Children of VN (IPSAC-VN.
The highlights of the visit were the official ceremony for the signing of the Memorandum Of Understanding between Nhi Dong 1 and IPSAC-VN; the joint reception with Nhi Dong 1 surgeons, IPSAC team, and IPSAC supporters at a private home; and celebration dinner of Nhi Dong 1-IPSAC collaboration, jointly with the Vietnam-Denmark Pediatric team and participants for the Scientific conference on the occasion of the 30-year celebration of Vietnam-Denmark relations.
During the week, the Pediatric Anesthesia, Surgery and Nursing team gave lectures and workshops to clinicians from HCM and from outside the province. These activities were mixed with joint clinical activities between Nhi Dong 1 and IPSAC team. Our lectures placed emphasis on advances in neonatal surgical care and recognition/management of abdominal compartment syndrome in premature infants. Clinically, we spent the majority of the time rounding on Neonatal intensive care surgical patients and performing neonatal surgeries for patients with major congenital malformations.
IPSAC donated textbooks, operating room and surgical supplies, advised Nhi Dong 1's surgeons on manuscript and abstract preparations for international meetings and research projects.
We made our first visit and discussion with Pham Ngoc Thach University of Medicine to explore the potential of assisting with academic support for the Medical School and its faculty.
Service Trip #2 April, 2009
Trip Members: The members of the team for this trip include pediatric surgeons Mike Chen, Elizabeth Beierle, Allen Browne, Mark Holterman, Ai-Xuan Holterman, pediatric nurse practitioners Nancy Browne, Erin Hederman, and our administrative leader Joseph Dao.
The team's activities were centered at Nhi Dong 1 (Childrens Hospital 1) in Ho Chi Minh City. The focal points of this visit were the surgical and nursing workshops. The US surgeons all presented to an audience of 20 regional surgeons. The surgical topics addressed the educational theme of the management of complex congenital malformations and the applications of laparoscopy to present day surgical conditions. The nursing symposium attracted an audience of about 100 local and regional attendees with topics such as retinopathy of prematurity, prevention of medication errors and pain management.
During the visit, the team collaborated with their Vietnamese colleagues in performing complex surgical cases such as repair of cloacal malformations, laparoscopic choledochal cyst excision, resection of hepatic hemangioma, and many neonatal cases include resection of a sacrococcygeal teratoma. We also helped the surgeons from the University Hospital with academic activities such as manuscript editing, abstract and publication submission. The team presented Nhi Dong 1 with needed clinical donations such as Bentec silo bags and Broviac central venous catheters and gave directions on their use.
Of note, prior to this visit, our Chicago team hosted Dr. Hieu and his young colleagues, Dr. Bang for a week of professional visits in Chicago in November. They visited the clinical facilities and observed our clinical activities at RUSH University Medical Center, U of Illinois Medical Center, Loyola University Medical Center and University of Chicago.
Service Trip #1 July, 2008
Trip Members: Pediatric surgeons Micheal Chen, Elizabeth Beierle, Mark Holterman, Ai-Xuan Holterman, pediatric anesthesiologists Larry Berman, Snow White, Erica Cook, pediatric nurses Nancy Browne, Kevin Rice, several medical students, a surgical resident and several administrative support personnel including interpreters, headed by our local representative Vu Dao.
The team spent the week at Nhi Dong 1 (Childrens Hospital 1) in Ho Chi Minh City. Nhi Dong 1 is a 1,000 bed-pediatric hospital, under the surgical directorship of Dr. Hieu with a surgical volume nearing 30,000 cases/year. Our team was divided into 2 surgical units for the week; one unit in the main pediatric operating room and the 2nd unit in the neonatal operating room. Our surgeons and anesthesiologists worked hand in hand with our Vietnamese professionals, exchanging our experiences in patient management, providing anesthesia care and performing surgical procedures in the inpatient and outpatient operating room facilities. Inpatient procedures which we participated in are complex elective head and neck and abdominal surgeries, ranging from surgeries for newborn malformations such as intestinal atresias, tracheoesophageal fistula, total colonic and rectosigmoidal Hirschsprungs' disease, to laparoscopic or open repair of hepatic cysts, choledochal cysts, esophageal strictures, retroperitoneal teratoma, esophageal fibrosarcoma excision. Our other activities included clinical rounds on the surgical patients, delivering didactic lectures to the surgical residents. The team also donated pediatric surgical nursing textbooks and operative materials to our hosts.
At the conclusion of our visit, we agreed to develop formal collaborations via a Memorandum of Understanding to continue our exchange program and deliver surgical workshops. We offered to host our Vietnamese surgical colleagues in US medical centers in order to provide them an opportunity to understand US approach to patient care delivery and surgical training, and a broader perspective on their needs.