NPO HEART SAVING PROJECT

We visited Bayan Khongol in Mongolia  this spring in 2019 to conduct local examination of children. The last time we have visited there is in June 2010.

Visit Bayan-Khongol for the first time in nine years, it takes long time indeed

Bayan Khongol Province is located approximately 640km southwest of Ulaanbaatar, with the southern border bordering China. Surrounded by the South Khangai Mountains and Gobi Altai Mountains, there are numerous lakes and rivers in the central area, and deserts, hot springs and oases in the south. There are also wildlife specific to the area such as wild donkeys, wild camels and gobi bears. The main industry in this area is nomadic. As of May 2019, the domestic scheduled flights from Ulaanbaatar to Bayan Khongol did not fly, so we moved by cars. As it was too far to go at a stretch of 640km one way, so we set the itinerary of one night at Arvaikheer and one night at Kharhorin on the way back. In fact, as we understood later, this was still a fairly hard plan.

In this inconvenient traffic, it may not be easy for patients and their parents to come to Ulaanbaatar for a close examination, even if they are suspected of having a heart disease in the local area.

After arriving at Ulaanbaatar, drive directly to destination

The staff composition of the Bayan Khongol examination team is the below;
5 members traveled from Japan;
Dr. Eichi Yamamoto, Director of department of Pediatrics, Ehime Prefectural Central Hospital
Dr. Kazuya Terada, Department of pediatric cardiology, Adult and Child Hospital of Shikoku,Kagawa
Dr. Takamichi Uchiyama, Department of Pediatric, Takatsuki Hospital
One student from Ehime University Graduate School of Medicine, fifth grade
One student from Kanazawa University Collage of Medicine, fifth grade
5 members Cooperated from Ulaanbaatar;
Dr.Undral, National Maternal and Child Health Center of Mongolia   
                                                                      4 people from Mongolian NPO organization
                                                                     The team was total 10 members.

Sandstorm occurs on way

Each members from Japan left Japan from Okayama Airport and Fukuoka Airport on the morning of April 28 and joined at Incheon Airport of Korea and arrived at Ulaanbaatar Chinggis Khaan Airport at 17:00 local time (18:00 Japan time). After a meeting such as confirmation of the itinerary at the airport for about an hour, we immediately left Ulaanbaatar by car. The destination is Arvaikheer, which is a relay point. After a while, however, a large sandstorm occurred, and it lasted for about 2 hours, forcing the car to stop. In Mongolia, even on paved roads, asphalt is broken due to the cold after one winter, so there are many places where construction is needed in spring. The road to Arvaikheer was also under construction, and it was 3 a.m. to arrive 3 hours later than planned.

After sleeping for several hours, we left Arvaikheer at 8:30. The cars arrived at 11:30 am at Bayan Khongol Central Hospital, which is 210 km away. One way took 11 hours of car movement!!!  We made a greeting to the hospital director and the hospital staff, and after lunch, we started screening from 2 p.m..

First day coming 105 patients

On the 29th of April, the first day of the checkup, 105 patients visited the hospital and we conducted a checkup using two portable echocardiographs brought from Japan and one adult echocardiograph owned by the local hospital. At this hospital there was an adult cardiologist who had received training at the Maternal and Child Center Children’s Cardiology Department, and it was also equipped with an echocardiograph adult specification. This is a part of the recent decided Ministry of Health and Welfare’s policy. At the same time as placing an echocardiograph at a regional priority hospital, echocardiograph screening training conducted at the National Maternal and Child Health Center several times a year for the doctor of that hospital to acquire the echocardiograph. It was said that the mechanism to make it participate in was done recently. Because of this, coordination with the Mothers and Child Centers and Children’s Cardiologists is good, and the management of children with heart disease has been carried out fairly well compared to other areas. It is felt strongly that if this system spread to various places in the future, it will be a great light of regional cardiovascular medicine. 

In addition, the doctor of the village health center brought children with suspected heart disease to medical examination as we arrived, and the relationship between the prefectural hospital and the village health center was good, It turned out that the information was transmitted properly.

After the medical treatment on the first day, we enjoyed the dinner while talking with the local staff.

Driving of this day is 330 km

On the second day, echocardiographic examination was performed on 19 people and the examination ended in the morning. The examination time was not enough at all, but can not be changed because there is a date of return. The total number of consultations in two days was 124 people. After lunch, we left Bayan Khongol city at 2 p.m. We traveled 330 km and arrived at Kharhorin at 310 km remaining distance to Ulaanbaatar at 7 p.m..We stayed at the tourist camp on this day.

Hard schedule but memorable local examination

The next day, May 1st, in the morning, explored the nearby Erdene Temple and the Kharhorin capital castle ruins and left Kharhorin after lunch. We came back to Ulaanbaatar at 7 o’clock in the night. At a restaurant near Chinggis Khan Airport, we joined a catheter treatment team operating in Ulaanbaatar and had a two-hour conference while eating. Then we headed to the airport and boarded a return flight. The plane departed from Chinggis Khaan Airport at 23:15 (0:15 JST) and arrived at Incheon Airport at 3:25. After a nap at the arrival lounge, each member returned to the nearest Okayama Airport, Fukuoka Airport, and Kansai Airport on the flight from Incheon Airport.

This screening examination was really a hard schedule. Long time travel by car was pretty harsh on the body. Some voices said “the hips and back have become stiff.” On the other hand, it was a regional examination that reminded us of the importance of extending medical care to areas with poor infrastructure in Mongolia.

Outline of Bayan Khongol examination results

Total number of consultations 124

No heart problems 52 

For patients with confirmed heart disease, we provided plans for future consultations and treatments, and introduced them to the upcoming hospital and National Maternal and Child Health Center.