Missions 2005
Dr René Fritsch and Jacques Garron, the ophthalmologist-surgeons part of the team, have realised about 470 consultations. Most of the patients had never been seen by an ophthalmologist. The presence of French doctors giving free quality care encourages them to finally come to the hospital, even if, for some of them, it was already too late to conserve a correct visual acuity. Regarding the operations, 30 interventions (most of them were for cataract treatments) took place, of which a few had been ran by Dr Kuliza, who is now ready to practise these kind of operations.
415 consultations lead to a computerised list, from which we could draw the most recurrent cases:
- In addition of cataract operations, most of the consultations are for conjunctivitis resulting from allergies, sometimes chronically and, in most of the cases, never properly treated.
- We finally noticed the very bad correction provided by the glasses: they are all sub-corrected and women have recurrent headaches. Glasses are identically equipped on the right and on the left side… There are also a lot of children with optical disability failed at school.
Thanks to our action, this hospital’s equipment was completed. A Volk Lens, an ocular tonometre, and all we provided means that Olgii’s hospital begins to have the basic required equipment. There is no reason to blush about the comparison of this installation and the one in Ulaan Baatar, which trains future Mongolian ophthalmologists. In both cases, we need to plan to equip both of them with the proper equipment.
Finally, thanks to the donation made by Théa Laboratory, we supplied antibiotic eyewashes, healing eyewashes and anti-glaucoma in order to preserve the patient’s vision.
Altaï Mission 2005
Our friend Yves Prunier (general practitioner) realised at our side in the Altaï, his fourth mission in Mongolia, in Olgii during a week, and in the dispensaries of Soum the next week (Soums are administrative subdivisions of aimak area). 400 consultations were performed in two weeks.
Olgii’s hospital situation
282 persons work for Olgii’s hospital, including 60 doctors. There are 242 beds dispatched between 11 different services: Paediatrics, Neurology, Gynaecology, Otolaryngology (Mr. Sirjane), Stomatology-dentist (Mrs Lkhagvasuren), Intensive Care, Digestive (Mrs Aïjane and Mrs Arjakhin), Ophthalmology, Childbirth, Dermatology, Psychiatry, and Cancer ward (Mr Kabel). 800 operations are performed every year. More than half of them are for appendicitis.
The doctors are relatively well trained. Most of them showed themselves very interested in our approach. This competence and this curiosity are a very encouraging point, even if there is an important lack of means. All the services are under-equipped and sometimes in regression because of their non-working equipment which are not replaced or repaired. Means are missing in order to provide medicines, even if they are free, because their supply is not provided. They are globally all late about hygienic systems: asepsis and maintenance. This hospital lacks of analysis materials. Diagnoses are hard to produce, requiring clinical qualities of high levels. Do not forget that we are 2570 miles (1600 km) away from Ulaan Baatar, ie 4 days of walking. We realised 151 consultations and a training about hypertension in Olgii.
Situation of soums’ hospitals
We visited three soums: Tolboo, Beluun, Bulgan, at the rate of one and a half dayS for each one. This time was not sufficient to get a precise idea about how competent the local teams were. The places’ states are between barely correct (Deluun) and brand-new (Tolbo). However, the equipment IS trivial. For example, we have seen no dentist outside of the city of Olgii. The further populations have to walk 8 hours to reach the first dentist (distance between Bulgan and Olgii). The only objective of soums’ hospitals is to practise appendicitis and delivery operations. None of those hospitals have running water, although, all of them have a generator to provide electricity.
Regarding medicines, there ARE only a few standards from the Mongolian materia medica are freely provided in these remote places, letting a substitution commerce grow.
The consultations we have done (226 in the soums) have concerned firstly the hospital crew, then the teachers and the politics. After 24 hours, the news was spread enough to bring up some more important cases. We draw a log with Excel that shows a neat predominance of executives and unemployed in comparison with the nomadic population. This is not really representative of the actual population from these areas. 71% of our patients were women while 29% were men. We totalised 10% of hypertensive people and we noticed a real lack of tooth and ophthalmological care in the young population. The main domains are gastro (most often benign), cardiology. There are not much infectious cases during summertime, but we know that they become predominant during winter. We lastly notice an average of 4.26 children per woman, decreasing in current generations (from 6 to 7 children per woman for the 55 – 75 years-old generation. Record: Densma, in Bulgan, has 13 children.
Thanks to Pharmacie Humanitaire Internationale and to the help provided by a few drugstores from Lyon, we could bring in these backed-off places 30 lbs (13 kg) of medicines which were very useful to help the population.
Every soum is divided into bags, generally extremely vast, in which a “sub-doctor” (sort of health officer) is in charge of healing the local population. He owns a motorbike, but he rarely carries a stethoscope or any kind of basic equipment.
Reception of Mongolian patients
Our settlement in this area is not really recent (a preparatory mission took place in 2002). That year however, it was the first time we were recognized and expected (the press related our arrival). The region’s governor supported us as well as the speaker (equivalent of the Conseil Régional).
Since this year, this support resulted in the financing of our accommodation, of our food, of our intra-regional transportations, and in a commune work convention.
In the soums, where no one expected us, we were really welcomed.