Click Not just Repair of Club Feet, Hypospadias, Cleft Palates and Lips
By Hoshang J. Khambatta, MD
Children’s Hospital, Columbia University, New York
There is an abundance of volunteer medical missions going to various medically underserved destinations throughout the world. I have had the privilege of working for three such groups over the past 14 years.
These sorties have included the care of children with congenital cardiac disease, genitourinary problems, orthopedic problems and plastic surgery for cleft palates and lips. The group that stands out most to me is the Children of China Pediatrics Foundation (CCPF). Since 1998, this group has sponsored yearly trips to China where I have participated seven times working with children mainly in orphanages.
Child with club foot and polydactyly
The Surgeon in Chief and Medical Director for these trips by CCPF for the past 12 years has been Professor David Roye, Chief of Pediatric Orthopedic Surgery at Columbia University and the Children’s Hospital at Columbia Presbyterian Medical Center in New York City. Dr. Roye has a different vision. He believes in the old adage, “give a man a fish and he will eat for a day, but teach a man to fish and he will have a meal every day”…however, we did refrain from taking a six pack along as then he (the man) would drink beer all day as well.
Dr. Roye has a charismatic approach and recruited the best among the local surgeons to assist him with the surgeries so they could learn as well. CCPF also brought these surgeons over to New York and exposed them to more complicated procedures. It is interesting to note that the indigenous anesthesiologists have a different approach and were rather underwhelmed by what we did. They do the majority of their surgeries under regional anesthesia supplemented with minimal intravenous sedation.
At closer look, this technique makes sense, as there was minimal monitoring available at the orphanage clinics. Most operating rooms have only blood pressure and electrocardiograph monitoring available. Oxygen saturation monitors are available in a few rooms and end tidal carbon dioxide perhaps in one in ten rooms. Though we took our own monitors along, better monitoring was available when we had the privilege of working in bigger hospitals. The inhalational agents comprised of only oxygen and isoflurane. Thus for these conditions, regional anesthesia is perhaps the safest method, and these local anesthesiologists are good at it. Obviously not all complicated surgery can be performed with this anesthetic technique.
Dr. Roye set up an ongoing program of teaching local surgeons from Chinese Universities and CCPF sponsored their visits to the U.S. Then in 2006, Dr. Roye had one of those electric light-bulb moments, namely, the implementation and the use of healthcare policy to improve healthcare. Thus was born the International Healthcare Leadership Program with David as its Chief Executive Officer.
The missions of this organization are to provide tools and training specific to China in the areas of healthcare policy and management, to provide forums to facilitate the discussion of incorporating public health policy into health care reform and to encourage implementation of lessons learned through development of leadership networks. Thus was established a partnership between the Mailman School of Public Health at Columbia University in New York and the faculty of Renmin University in Beijing. This partnership develops executive level programs to meet the policy management needs of the Chinese healthcare delivery system.
Potential students include mid-level Chinese executive healthcare leaders, those already enrolled in Chinese MBA programs, and Columbia University students with an interest in China. Currently, there is a five-week program at the Mailman School of Public Health and Columbia University Medical Center where mid-level healthcare professionals participate. The curriculum is focused on topics specific to healthcare policy and management in China with specific topics selected through discussions with the faculty of Renmin University. On completion of the program, participants are issued a non-credit course certificate by Columbia University. A long term goal for this endeavor is the development of a Chinese Executive Masters degree in Public Health Program with top priorities in hospital management, primary care, program evaluation and public health surveillance.
In January 2008, the faculties of the two universities met in New York to identify specific topics to be included in the curriculum. For the 2008/2009 school year, four case studies including research, data analysis and writing were developed. In school year 2009/2010, case studies were first field tested in New York and in the summer of 2010 in Beijing. The goals of Dr. Roye and The International Healthcare Leadership organization are indeed very lofty, but the progress has been significant.
From a humble start of repairing club feet 12 years ago, with cooperation between Columbia University in New York and Renmin University in Beijing, a new joint University program is about to be established. Needless to say, we at CCPF still continue to repair club feet, hypospadias, cleft palates and cleft lips on a yearly basis.
All work and no play makes Hoshi a dull boy. Dr. Khambatta with Eda Chao, MD
and Kathryn Boulin, RN
Contact Information, for CCPF: http://www.chidrenofchinapediatricfoundation
For International Health Leadership: http://www.ihleaders.org
