Part of UNMC’s mission is to better the lives of Nebraskans.
Edward O’Leary, M.D., and Ward Chambers, M.D., have taken this concept a step further.
One might say a leap further.
The cardiac specialists spent the first part of December in separate countries, trying to do what they could to help improve the health of the citizens there and the delivery of health care services.
Whether that meant ‘making rounds’ to patients in their homes in Afghanistan or teaching health care workers in Bangladesh how to perform cardiac procedures. Both doctors paid their own travel expenses, brought medical supplies, gave lectures and have made plans to go back.
“The medical staff and health care workers in Bangladesh work hard to deliver the best care they can with very little,” said Dr. O’Leary, an assistant professor of internal medicine, cardiology at UNMC. “I have a tremendous amount of respect and admiration for the work that they do.”
Everything that can be re-used is, he said, from the cloth surgical gowns that are washed and hung on clotheslines in the hallways to dry, to the angioplasty balloons and catheters.
Abidur Ramen, M.D., a vascular surgeon from Illinois, invited Dr. O’Leary to accompany him, Ishti Ali, M.D., a cardiology fellow at UNMC, and Andrea Hilger, a registered nurse at UNMC, on the humanitarian trip to Bangladesh. Dr. Ali’s parents and Dr. Ramen are immigrants from Bangladesh.
Dr. O’Leary spent two weeks at the National Institute of Cardiovascular Diseases in Dakau. While there he participated in many procedures, including one on a 13-year-old heart-attack victim.
“She was poor, from a rural part of the country, and had suffered a heart-attack a week before I arrived,” Dr. O’Leary said. “The main artery on the front of her heart was completely blocked and an artery on the right side was 75 percent blocked.”
Dr. O’Leary said it took two stents to open the front artery and one drug-coated stent, which he promised to replace, to open the other artery. “People over there have to pay out of their own pocket for stents. If they don’t have the money then they don’t get a stent. This little girl’s family didn’t have any money to pay for stents.”
Dr. O”Leary said they were only able to bring a limited supply of donated non-drug coated stents and used two for the artery in the front of her heart. “We wanted to use drug coated stents which have been shown to have a much better long-term patency rate than the non-drug coated stents for her other artery,” he said. “I had to wheel and deal just to get one drug-coated stent for her artery on the right side. It became evident how vital this one artery was as we almost lost her during surgery.”
Limited supplies are only one part of the problem for health care providers in Afghanistan, said Dr. Chambers, associate professor of internal medicine, cardiology, UNMC. “They lack the resources necessary to update their curriculum and train the next generation of health care providers,” Dr. Chambers said. “The newest cardiology textbook is from 1989. The best educated cardiologist is in his seventies and he trained in Britain.”
War with the Soviets, warlords in their own country and the Taliban regime set back any advances in academics for the past 30 years, Dr. Chambers said.
The December excursion was Dr. Chambers sixth trip to Kabul, Afghanistan. In 2002 he spent a month in Afghanistan working in one of the hospitals; in 2003 he brought textbooks and medical supplies donated by UNMC and for 10 days in December he worked with officials from Kabul Medical University on a faculty development course.
Several UNMC faculty accompanied Dr. Chambers to Afghanistan including: Mary Haven, associate dean for the School of Allied Health Professions, Nahia Amoura, M.D., assistant professor in obstetrics and gynecology; and Robert Muelleman, M.D., chief of the section of emergency medicine.
Dr. Chambers is hoping to take another group to Kabul next month.
“Afghanistan is full of contradictions,” he said. “They have no medical equipment, but they’ve got all four drugs to treat tuberculosis.”
There are only five medical schools in the country, and of the 117 hospitals, a quarter have no water or electricity or both. “Some of the hospitals are in really poor condition,” Dr. Muelleman said. “One of the surgeons I was following couldn’t operate because the overhead light was not functioning.”
While their resources are minimal, the physicians are well-trained, knowledgeable and very dedicated, the UNMC employees said.
“The people are optimistic and hopeful,” Dr. Muelleman said.
Everyone who participated in the humanitarian trips said they would recommend others do the same if given the opportunity. “It was a really good experience,” Dr. Muelleman said. “I really felt I got more than I gave.”