Day 7 into our trip, and day 4 at the children’s hospital completed! I continue to be amazed by this country, the city of UlaanBaatar and its people. Especially the people. At first they seem stoic but then you learn how open, caring and animated they can be. This was most evident as I met and began to work with the GI team at the children’s hospital. There are 6 GI physicians, each with their own well defined duties but working as a team to improve the care of their patients. The level of care is admirable considering the challenges they face: limited pharmacy formulary, limited laboratory and imaging (families must pay and go to a private adult hospital for a CT scan!), virtual absence of nutritional care, and a high  patient acuity level by the time they arrive at the only children’s hospital in Mongolia. Yesterday I met an infant with advanced biliary atresia who had to travel by car over 1000 miles to receive care. And these are but a few of the challenges that the dedicated staff face on a daily basis.

The hospital, with the exception of the new hem-onc wing is old and of Russian design. It is well worn and busy with narrow halls, low ceilings at times and buckled linoleum floors. It is however clean and appears efficient and orderly despite the high volume of patients.

The GI team is insular and eager to interact with same specialty colleagues. They presented troublesome patients daily, each time asking many questions about diagnosis and clinical care. The families themselves appeared very appreciative. My 3 lectures were well attended by the GI staff and residents, some lasting over 90 minutes.

As we begin to wrap up our clinical week and look forward to 4 days in the Gobi desert, I cannot help but think that this has been a profitable experience for all involved included the many Mongolian families that I have met. HI can only hope that the progress made and efforts expended will be ongoing and fruitful.

-Jonathan Evans

Mongolia Bound!   Bound being the word that should define our trip. No, I am sure that it doesn’t mean tied up and dragged by Eric S to the far reaches of our planet. Rather for me it means to have developed a bond with a land for which, at this point, I know little about. What will this bond mean to me? What will it mean to the people I meet?

I have been fortunate to have been placed in this situation before. Growing up as a minority in a culture that I was not born into and providing medical aid in impoverished Haiti come to mind. However, this will be a new situation for which it is unclear how well past experiences can prepare me.

Developing that bond will come at a price, the least being travel, the barriers of language and being out of one’s western comfort zone. The rewards however can be great: learning about a well rooted but mysterious (at least to me) culture, learning new customs, sharing conversations with people of different upbringings and perspectives. My curiosity about the “medical establishment” in Mongolia will further strengthen that bond. Does the medical profession view what we consider simple and common medical problems (e.g. chronic abdominal pain) and complex medical issues (e.g. chronic liver disease) the same way? What are the expectations of the patients and their families in regards to the medical care they receive?

As I explore these areas, and the others that will emerge once we are there, this bond will develop and strengthen. I am optimistic that it will be positive and durable on my end; hopeful that  it will be the same for the people who receive us.