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The
medical project of GCVOA sponsors periodic visits by medical
teams from MetroHealth Medical Center in Cleveland, Ohio to
educate and train medical personnel in Volgograd Region hospitals.
It also hosts visits by medical professionals from those hospitals
to MetroHealth Medical Center. The project's current activities
are directed toward financial and technical assistance to the
Volgograd Regional Prenatal Center and maternity hospitals in
the region.
2003 report
In October of 2003, Dr. John Moore and, head of neonatalogy
at MetroHealth Medical Center, and Dr. Graham Ashmead, head
of he fetal diagnostic center at Metro traveled to Russia to
present papers at a conference sponsored by the Volgograd Regional
Perinatal Center in Volzhsky. Edward Brown of GCVOA, a lay member,
accompanied them and organized the trip from the US side.
Dr. Moore has made two previous trips to Volzhsky, and recruited
an obstetrician at MetroHealth, Dr. Graham Ashmead, head of
the fetal diagnostic center there, to accompany him in 1999.
Dr. Ashmead, in turn, has plugged into other Metro physicians
who are willing to help, but do not want to take out two weeks
of vacation time to trek to Russia. Drs. Moore and Ashmead have
also arranged to provide training for young Russian physicians
from the area at the residence program at Metro. One of the
big obstacles to this program has been language and now barriers
to getting visas. In 2003 this team spent 10 days in Volzhsky,
Russia, a city of about 400,000 persons. Their host was again
the Perinatal Clinical Center; an operation supported by the
regional government. Dr. Mikhail Kirichenko, director of he
Perinatal Center, and Dr. Alexander Bukhtin, the assistant director
wee the chief organizers on the Russian end.
The two American doctors, each gave four lectures to an audience
of some 140 obstetricians and neonatalogists throughout the
region. The regional authorities had called for two representatives
from each of the region's hospitals, whether regional or city,
to attend. Eleven doctors from neighboring Kalmykia also attended.
They stayed in local hotels near the city conference center,
so that they could attend each lecture at the four-day conference.
Besides the two American doctors, various regional health officials,
including the vice chairman of the regional health committee,
and the region's head obstetrician, along with academics from
the Volgograd Medical University, also spoke at the conference.
Dr. Ashmead presented lectures on Prenatal Care, Prevention
of Smoking During Pregnancy, Induction of Labor and Delivery,
and Obstetric Hemorrhaging; Dr. John Moore, head of neonatalogy
at Metro, presented lectures on the latest Resuscitation techniques,
Respiratory Distress Syndrome, Intraventricular Hemorrhaging,
and Fluids and Electrolytes. All but the last of these lectures
were projected in Russian onto a large screen from a computer
using Power Point. Dr. Moore presented his lecture on Fluids
and Electrolytes as a black board talk, posing problem situations
and asking the audience members for suggestions in treatment
procedures.
In addition, two video lectures by Metro's Chief obstetrician,
Dr. Leroy Dierker, on External Cephalic Versions and use of
Steroids to Accelerate Fetal Lung maturity, and one on Anesthesia
and analgesia during late labor and delivery by Metro's obstetrical
anesthesiologist, Dr. John Fisgus, were played and projected
onto the screen during the conference. All three of these had
built in Russian translations.
Drs. Moore and Ashmead also made rounds with the staff of he
Perinatal Center. Through the efforts of the director of the
Perinatal Center, Dr. Mikhail Kirichenko, and the assistant
director, Alexander Bukhtin, the two American doctors also had
extensive conversations with members of the staff from the director
on down. They also met with the chairman and vice-chairman of
the Regional Health Committee, Dr. Evgenny Anishshenko and Dr.
Vladimir Lomovsky, with the Chief Regional Obstetrician, Dr.
Alexander Raevsky, and with the Vice Chancellor for International
Affairs at the Volgograd Medical University, Dr. Alexander Spasov.
In the meeting with the Chairman of the regional medical committee
Dr. Moore made three recommendations:
a) Inauguration of a program to educate sexually active women
to quit smoking because of potential harm to their infants;
b) Use of progesterone injections weekly or progesterone suppositories
daily from 20 weeks to 34 weeks for mothers at risk of premature
delivery;
c) for second-time mothers where there has been a previous history
of Rh incompatiblity with the infant, use of RhoGham, not only
within 72 hours of delivery, but also at 26 weeks of pregnancy.
A follow up letter along with medical articles on issues relating
to progesterone and Rho Gham have been sent to the regional
medical representatives. Dr. Ashmead's translated lecture on
Prevention of Smoking and excerpts of the WHO Framework convention
on Tobacco were also included along with Dr. Ashmead's lecture
on Prenatal Care.
2001-2002 Report on Medical Project
The work in 2001 and 2002 work focused on implementation of
a training program for young physicians at the Center by affording
them two months of residency experience at Metro; The exchange
began inauspiciously as the 2001summer chill in US/Russian relations
resulted in a visa denial to one of the young Russian physicians.
As those relations changed in the early fall, the first of the
physicians, Dr. Timur Azhibekov, trained in Russia in handling
critical care infants, started two months of training at Metro
in the second week of October under the supervision of Dr. John
Moore, chief of neonatalogy at Metro. Recently, Dr. Azhibekov
advised the GCVOA board of some of what he has learned in the
last month or so:
"During my training I am learning new methods of respiratory
care in neonates, modern approaches to neonatal nutrition, parenteral
and enteral feeding. Also I am getting experience in the management
of critically ill newborn infants, in using special diagnostic
and medical procedures: radiological studies, blood sampling,
transillumination and catheterization of the central and peripheral
vessels, and
applying new medicines, indomethacin in PDA cases*, surfactant
in RDS (Respiratory Distress Syndrome) **."
The second trainee, Dr. Elena Zhavaronkova, an obstetrician
with skills in performing laparoscopies, on a second try received
her visa and arrived in late January of 2002. She took a two
month course of intensive English at CWRU and then begin her
two month training at Metro under the supervision of Dr. Graham
Ashmead and Dr. Leroy Dierker. Dr. Zhavoronkova learned, among
other techniques, how to perform an external cephalic version
for fetuses in the breach position, thereby reducing the need
for Caesarian section. Since returning to Volzhsky, Dr. Zhavoronkova
has performed more than 30 cephalic versions there in 2003.
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