AMDA Endoscopy Training in Mongolia: FY 2024 Activity Report
Publication date:2024-10-16
Project period: 30 September – 5 October Place: The Mongolia-Japan Hospital of MNUMS (Mongolian National University of Medical Sciences), Ulaanbaatar Participating specialists: -Dr. Takeyuki Shirai (Doctor, Head of Gastroenterology Department, Kokura Kinen Hospital) -Dr. Takushi Sato (Doctor, Chairperson of the Board, AMDA Japan) -Ms. Tae Namba (Coordinator, Vice Chairperson of the Board, AMDA Japan)
Project overview:
Since its inception in September 2019, AMDA’s endoscopy training program has significantly contributed to the development of endoscopy in Mongolia. The program aims to enhance the practical skills and knowledge of Mongolian doctors in endoscopy through hands-on guidance and instructions from Japanese specialists. The project has been conducted annually, with the exception of 2021, when it was cancelled due to the COVID-19 pandemic.
This year, under the supervision of two Japanese specialists (with each holding a Mongolian medical license), a team of Mongolian doctors from the Mongolia-Japan Hospital of MNUMS (led by Dr. Tsogt-ochir Byambajav) participated in the training. The training focused on the following medical procedures:
-Gastric varices treated with Histoacryl (3) -EISL (1) -EISL for esophageal varices (6) -Double-balloon enteroscopy (1) -Upper/lower gastrointestinal endoscopy (6)
Other than what has been noted, Dr. Shirai delivered a lecture on portal hypertension, while Dr. Sato provided training on lower gastrointestinal endoscopy (colonoscopy) using a surgical simulation model for medical fellows.
Dr. Shirai’s commentary on the FY 2024 project:
Having participated in the project for the last three sessions, I have come to realize that there are many people in Mongolia that are suffering from hepatic cirrhosis, thereby requiring esophagogastric varices treatment. During my time in Mongolia, I observed numerous cases of abnormally large varices in a short period, a phenomenon rarely seen in Japan. In addition, it was evident that the techniques, medical strategies, equipment, and medications available were not sufficient to match the level of treatment we provided in Japan. These observations motivated me to offer my expertise to improve varices treatment in Mongolia.
In the first training I joined in 2022, my scope was to provide local doctors with a medical strategy to allow efficient treatment of patients using available local equipment. The following year, I introduced EISL to Mongolia, marking the first time this practice was implemented in the country. As part of the clinical training which was arranged during the Mongolian Digestive Disease Week, we performed the actual procedure on patients during a workshop organized by the Mongolian Gastroenterology Association, utilizing medications and equipment we brought from Japan.
This year, my training focused on teaching local doctors how to safely perform a procedure that incorporated Histoacryl (a liquid skin adhesive) in the treatment of gastric varices. In addition to a lecture, participants gained practical experience by performing the method on actual patients.
Furthermore, we also took care of a number patients, who were in need of EISL as the previous year, patiently waiting for their turns. I was relieved to complete my work without any issues, although there were a couple of instances that made me nervous due to the large varices, which could entail higher risks.
Based on the fact that there has been a significant advancement in both knowledge and techniques among aspiring local doctors, I am confident that the new methods we introduced will take root in Mongolia. Through discussions and lectures with the local doctors, I emphasized the necessity for new medical practices that have yet to be implemented in the country. These interactions helped me clarify the next steps needed to enhance the treatment for varices in Mongolia.
Last but not least, I am truly grateful for the hospitality extended by the local doctors and staff members during each of my visits. It goes without saying that the training has been mutually beneficial for both parties. Thank you.
GPSP Medical Mission (Promotion of Health)
Mongolia
2024
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