Supporting Outreach work in Yangon – round two!



Dr. Philippe Jeanty and team in Yangon (from left to right: Dr Gwan Ju, Dr. Jeanty, Dr. Ya Chiao, Dr. David Berck and Dr. Federico Badano)

Last year, ISUOG Outreach supported the work of dedicated Outreach Committee Member and renown expert, Dr. Philippe Jeanty in launching a program in Yangon, Myanmar. Now returning for Trip II with his team (Federico Badano from Argentina, Gwan Ju of South Korea, Ya Chiao from Taiwan and David Berck from USA), Philippe reports from the field midweek to share with our followers some updates from training.

“The second course to Myanmar has started, with all the previous students minus four, delivery, maternity leave and two who were not able to get replacement (the obstetrician who came to the course had to be cross-covered by a surgeon for the emergency C-section section). One of the students, whom I like very much, is one of six obstetricians for a city of 4 million people!!

We had asked the students to fill a spreadsheet with all the findings they made during the year and they did a remarkable job at it: probably a first in ISUOG Outreach history!

I like how no one could find cardiac or skeletal dysplasia ( so not a defect on me 😊 )

This table is big, but it shows the constant efforts they did during the year.

Today, we started with the second set of lectures we were provided by from ISUOG, of which Federico enriched very substantially with many video clips. I added some cases related to the lectures and to insure participation, we got four students to come to the front of the class and answer each case. Nothing like being in the hot seat to focus attention! They did pretty well.

The afternoon and the end of the morning we actually did scan. We had not pre-selected the students and some were still fairly hesitant, so we redistribute them into basic, intermediate, advanced level so that the teaching could be more focused; that worked out to be better.

Most of the patients had not undergone ultrasound in pregnancy before.  Our cases included numerous twins, suspected growth restriction, and placenta accreta.

The more interesting case was a hydranencephaly with retinal detachment and it was their first time seeing retinal detachment (a nice case )

On the second and third day, we went on with the lectures. We had asked all the students ahead of time to prepare a 5-minute presentation and with the firm hand of Dr Yin Yin Soe and Dr. Khin Latt (our local contacts) they had all prepared one or several cases, including many ectopic pregnancies, ovarian masses and pre-eclampsia with IUGR. The 2 more striking cases were an abdominal pregnancy and a 38 weeks tubal pregnancy in which the location had not been correctly recognized. This was great way to re-emphasize the routine exam: after the first sweep always document the cervix, size, competence and vasa previa.

The students were very comfortable giving the presentations and very organized in doing so. Mostly their images were poor, often too gained, with depth too far, and captured with cell phone. To remedy this, we went over the depth setting, the gain, and Ya Chiao Hu gave them a short presentation on how to save images digitally on a memory stick!

Dr Gwan Jun Kim, who was with us last year and participated during all trips of the Outreach program in 3 Mongolia, gave the CNS and cardiac lectures with his usual brand of humor and animated descriptions. He is always popular!

Dr. Federico Badano also lectured with great calm and a ton of videos to the ISUOG.

Dr. David Berck, who is also a veteran from Mongolia, was with us as well. In the end, we ended up all adapting Gwan Jun technique of abundantly moving around, using the many dolls that Dr Khin Latt had prepared.

We had a very large supply of patients, and even an extra ultrasound machine. The course is sponsored by Mindray and the local distributor “Concordia” and Dr Than Win had really gone out to make sure we had all that we needed. The extra machine allowed the students to practice under less time constraint. Ever efficient Justin Liu was going from machine to machine making sure everyone was alright with the knobology. He was part of it group last year too but was much less shy this year and has remarkably improved his fluency in English. By the way, all the students speak perfect English but with a British flair (liquor.. for amniotic fluid) and an accent sometime difficult for my deficient ears.

The only really problem was that it is incredibly hot here and the Air Conditioning could not keep up with the 30 people in the room, plus the patients and six ultrasound machines. I was dripping over my students who would provide me wipes and water every three minutes. So sweet!

The students are very comfortable with us. Last year, being shy, I had asked them to write their questions on paper and leave the questions on our desk for us to answer. This year, there was no problems at all. I think that getting them to come answer the cases in front of everyone, although terrifying at first, gave them much more confidence. It helped that Thao and Ya rewarded the correct answers with a gold medal of chocolate. A old trick I used in Mongolia too.

On to the fun part where David was interested in the local dress that men wear here, called Longi. Dr Khin Latt generously gave one to each of us!! Resulting in a rather unique picture (as see at beginning of blog).

Tomorrow is it last day and we are already nostalgic about leaving our students for a year.”

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