An invitation to participate…

Pediatric and Adult Complex Cardiology & Cardiac Surgery to Yangon, MYANMAR at the PinLon Hospital, Yangon. March 8-22, 2015

CardioStart announces its first mission to Yangon, Myanmar, during March 2015. The mission will focus on adult and pediatric surgery at PinLon Hospital, with a pediatric evaluation of Yankin Children’s Hospital.

Myanmar, which has a population of 55 million, was under military rule and essentially closed to outside influence until 2011 when President Thein Sein was elected and major changes toward democracy were instituted.

Since 2011, Myanmar has welcomed tourists and new trade. While westernization and modernization are progressing rapidly, there are many aspects of this beautiful country that retain the untouched qualities of the world before mechanization.

Myanmar is a predominately Buddhist country and agrarian, using animal power for tiling the land, weaving on hand looms, and fishing from dugout teak boats. It has a beautifully diverse culture, and its natural resources are rich in gold, gems and natural beauty.

Yangon is the largest city in Myanmar, with a population of about 7 million, on the southeast edge of the Irrawaddy Delta, in a tropical climate zone. The December to March period is dry and hot, with temperatures averaging 90 – 100 degrees F.

Cardiac Surgery Status in Myanmar

Myanmar cardiac services are currently limited. Four hospitals do cardiac surgery in Yangon. There is a public hospital, Yangon General (YGH), which does fewer than 200 adult cases per year; a public children’s hospital, Yankin Children’s, which, under the direction of a cardiac surgeon, Prof. Win Win Kwaw. Yankin performs about 60 cases of basic ASDs and PDAs each year; the Defense Services Hospital (DSGH) run by the military, (250 adult cases per year;) and PinLon Hospital, a new private hospital just starting its program. CardioStart has been advised that to ensure assistance to the poor in the community at this stage in the development of cardiac services.

The PinLon Hospital will be the location chosen to receive the early growth and development of services and personnel training. The cardiac surgical teams at PinLon and DSGH use essentially the same personnel and have similar equipment, with both programs headed by Dr. Tin Maung Aye. Dr. Tin is requesting assistance at PinLon with advanced adult cardiac surgical techniques and basic pediatric cardiac surgery, education in pediatric nursing, biomedical engineering and respiratory therapy. They need assistance with outdated and inadequate equipment, including ventilators.

The hospital’s cardiac team, headed by Dr. Tin, includes three qualified surgeons and four in training. There are two cardiologists at a Siemens Cath Lab, who have just started doing primary PCI at the military hospital. PinLon has a seven bed CVICU and a medical ICU with ten beds, which supports liver and kidney transplants. A cardiac surgical team from Open Heart International, based in Australia, has been going to Myanmar for the past ten years to assist with both pediatric and adult cases, working at the military hospital, the children’s hospital, and the YGH.

The Yankin Children’s Hospital is headed by Dr. Win Win. Her program is currently sufficiently well funded with equipment but they are interested in having a small nuclear team help them with advanced nursing and medical training in all areas of cardiac surgery management – particularly in taking on more complex surgical procedures.

The Mission: Adult and Pediatric Cardiac Surgery.

Surgery for both adult and pediatric patients will be done at PinLon Hospital, and evaluation and pediatric surgery will be done at Yankin Children’s Hospital subject to mutual planning and equipment availability checks.

CardioStart’s role in this mission will be to offer:

1) Priority assistance to help increase the number and skills of cardiac surgical teams in Myanmar. We will teach basic pediatric operative skills with particular emphasis on post-op recovery. During the two-week period, we will take on complex adult cases including re-operations, late-presenting congenital heart disease, and valve repair techniques. While local medical and surgical teams are advanced in their knowledge of adult CABG and valve replacement operations, and basic ASD and PDA repairs, policies in the past have limited financial capability to expand and provide available healthcare services. The mission affords new opportunities for training, in-servicing, and acquisition of equipment.

2) Advanced anesthetic and perfusion techniques.

3) Intensive care nursing education and development of protocols and algorithms of care.

4) Specific assistance in pediatric ventilator set-up, use, and management.

5) Biomedical engineering assistance with both old and new equipment. (This is critical; there are no biomedical engineers available). All volunteers should assume they will be required to help with bedside teaching, daily lectures, and advanced techniques in all relevant areas. The teams will be divided

The Team

Recommended Personnel Requirements:

CardioStart Mission Director will select the team with both adult and pediatric expertise:
One Pediatric Cardiologist
One Adult Cardiologist
Two Adult Anesthesiologists (1 Pediatric)
Two or Three Cardiac Surgeons (1 Pediatric)
One Echo Tech
Two Perfusionists (1 Pediatric)
Six Cardiovascular ICU Nurses (2-3 Pediatric)
One -Two Respiratory Therapists (1 pediatric)
Two Education Coordinators (1 Pediatric)
Two OR Scrub Nurses
Two data base research coordinators
One case manager (Nurse)
Two Scribes
Two experienced Biomedical Engineers
Four Outreach Members

Outreach

Preliminary outreach evaluations and planning will be done with both local help and Myanmar natives living in the U.S. The exact numbers of the team and focus will be determined based on information provided by Dr. Tin and his assistant, Sandar Ko. More information will follow in the next three months. Coordination will be made also by Mrs. Sophie Stone, collaborating with CardioStart Outreach Director, Mrs. Donna Doxey-McGrew. Assisting with rural clinic development will be emphasized.

Mission Travel Details

Applicants are welcome to apply by completing our volunteer interest form. Team selections will be made based on team needs and professional experience. Mostly, selections will be made on a first come, first served.