Local Screening Activity in Uvs
The following is a report from Director Takashi Higaki, who participated in the medical examination activities Uvs Province, Mongolia in August 2019.
Report on medical check-up activities in Uvs Province in August 2019
The Heart Saving Project Board Member/Graduate School of Medicine, Ehime University,
Regional Pediatric Perinatal Studies,Professor Takashi Higaki
In August 2019, the Heart Saving Project traveled to Mongolia in three units, consisting of the Catheter Team, Uvs Screening Team, and Uvurkhangai Screening Team.
The medical check-up teams departed early in the morning on August 7, 2019. We all gathered at the Narita Airport from all over Japan and flew to Ulaanbaatar by MIAT Mongolian Airlines. At Narita Airport, the departure was delayed by 4 hours due to the aircraft maintenance, thinking that the travel would be something like this. We arrived in Ulaanbaatar late at night. However, it was a touching reunion when the other staff of the Heart Saving Project Mongolia came to meet us at the airport.
Its time to go
The next morning, after performing an echocardiographic check of the catheter treatment scheduled patient at the National Maternal and Child Center, the screening team split into two units and departed to Uvs and Uvurkhangai respectively. Our unit went to Uvs Province via “Hunnu Air”. I myself have been involved in this activity since 2002, but after a long absence to the local medical check-up activities, I was a little nervous and excited at the same time.
The members of the Uvs Screening Team consisted of ten people, including Dr. Undral (the National Maternal and Child Center), Dr. Kazuya Terada (Department of Cardiology, Shikoku Children and Adult Medical Center), Dr. Takayuki Oku (Ehime University Pediatric Cardiology), Takako Nishiyama (Edward Co.,Ltd.), Tokumoto Mr. Daiki (fourth-year student, Faculty of Medicine, Ehime University), Mr. and Mrs. Otsuka (interpreter), Ms. Altantuya (Secretariat), Mr. Amilaa (Secretariat) and me.
However, we had trouble here. While I was nervously observing the suspicious activities of the secretariat at the airport, they informed us that our return flight was canceled. “Hunnu Air” informed us to choose between delaying the flight by one day, arranging a different route, or to go 1400km by car. Here, Mrs. Oyuna acted heroically. She coordinated with the airline and made them fly as scheduled.
I’m writing this sentence in the airport waiting room, but I’m still skeptical if the return flight would fly. The “Hunnu Air” aircraft departed Ulaanbaatar and arrived safely at the Ulaangom Airport as “scheduled”. However, will it fly back as it scheduled?
The Lake Uvs
Uvs Province is located in the northwestern part of Mongolia, 1336 km from Ulaanbaatar, and it is said that the province was named after its Lake Uvs (Увс нуур), the largest lake in Mongolia. Lake Uvs is 759 m above sea level with an area of 3,350 km² (the area of Ehime Prefecture is 5,678 km², and Tokyo is 2,188 km²). This lake is a shallow water lake with high salt content, and it is said that the sea had spread over this area thousands of years ago. The largest city on the shore is the capital Ulaangom, where the Uvs General Hospital is located.
After checking in at the hotel in Ulaangom, we visited Uvs General Hospital. After greeting the Director of the hospital and the Director of the Department of Insurance, we were taken to the Lake Uvs, where the name of the province was derived, before it gets too dark. Mongolian summer nights are comfortable and very long. After an hour of rough driving through the meadow, we arrived at the Lake Uvs (the car was actually a hospital ambulance car).
I was impressed by the beauty of Lake Uvs, as it was very large and very clean. The Director of the hospital and the Director of the Department of Insurance have begun to swim in the lake and invited us to the same. I was told that the northern part of Mongolia is rather cold even in summer times and I had prepared every other cloth but swimming suits. But, we did swim in the late, without the swimming suits! It was a bit cold in the beginning, but it was fine once we entered. The shallow Lake Uvs was very comfortable and we enjoyed the nature while tasting the salty water.
After the swimming, a dinner party began with the desk arranged in the shallow water of Lake Uvs. Lamb meat dishes, local potatoes, and carrots were very delicious. The usual Arhi (Mongolian distilled vodka) also made its presence and excitements followed. Following the songs of the Directors of the hospital and the Insurance Department, the Japanese side also sang the Japanese oldies “Furusato”. It was a wonderful evening on the shore of Lake Uvs. Thank you so much. Бид Увс Нуур их сэтгэг хөдөлсөн. Өнөөдөр маш их баярлалаа. (we expressed our gratitude in Mongolian).
Uvs General Hospital
The next morning, the heart examination began at Uvs General Hospital. The medical checkup was conducted on August 9 and 10. A total of 155 children had heart check-ups with 114 children on the first day and 41 on the second. Six of them were scheduled by us to conduct catheterization in Ulaanbaatar. There were two children who could not be cured, but we performed a medical examination with the hope of making the most accurate diagnosis possible and provide the best possible proposal to them.
Dr. Terada’s polite explanation to the family and Dr. Oku’s hard work helped to proceed with the medical checkup. Mr. Nishiyama attracted the children with his charm, and he has folded the Japanese origami for them and put a sticker on their cheek to cheer up the children and encourage smiles.
Dr. Agiima, a pediatric cardiologist at Uvs General Hospital, was also very active. Together we did a diagnosis by echocardiography to the children. We were giving guidance on how to take echocardiograms and diagnoses while instructing Dr. Agiima.
Students also had a challenge. One of the students diagnosed a patient with an arterial canal deposit and I assisted him. I was impressed with his word saying that “I can’t do anything on my own and I want to come back after becoming a doctor, after becoming more useful”. I have a high hope for him that he will definitely become a doctor one day and work hard in the future. I express my gratitude to Ehime University for sending their students to participate in the Heart Saving Project and make them gain valuable experience and opportunity.
Having conducted a medical checkup at the regional main hospital, I felt again that it was very important to communicate and teach diagnostic techniques to local doctors. Patients who are waiting for their turn may have a slight delay, but if you could spend enough time educating Mongolian doctors, especially local Mongolian doctors, it would be a forgivable sacrifice. More Dr. Agiima better understands the diagnosis and medical condition of Uvs patients, more the local patients could feel safe and eventually give them proper treatment and make arrangements for referrals to Ulaanbaatar and abroad.
Uvs is the hometown of Dr. Bayarmaa, a pediatric cardiologist at the National Maternal and Child Center. I couldn’t work with her this time, due to my schedule. However, I strongly felt the urgency of setting up a system that enables cooperative medical treatment between Dr. Aguima, who works hard at Uvs General Hospital in Ulaangom and the National Maternal and Child Center in Ulaanbaatar. Although it is a long-distance of 1,400 km, I would suggest establishing an educational system of doctors throughout Mongolia.
At the Ulaangom Airport
After the checkup, we were all heading back to Ulaanbaatar. But I was still worried if the plane would fly. After arriving at the Ulaangom Airport, we discovered that the plane was rescheduled to fly from Uvs to Ulaanbaatar via Khovd and Murun city. I was surprised when the scheduled flight was canceled, but was more surprised when the flight schedule and route is not decided until the last moment.
Happenings are described as “unexpected sudden events or incidents”, according to Google. All the happenings we had on the way, which were settled with the strong support of the secretariat each time, were a powerful stimulus. The return flight, which flew like a shared bus, arrived in Ulaanbaatar at midnight after flying across large Mongolia. When I saw the lights at Genghis Khan Airport, I was not the only one who felt reassured that we had actually returned to Ulaanbaatar.
After joining the Uvurkhangai Team and the Catheter Team, we will start catheter therapy activities in Ulaanbaatar from the next day. This project began as a sole heart checkup of children. Today its scale has been expanded and operating as a two-wheeled project of catheterization and local city medical screening. We aim to make as many children with heart disease in Mongolia as healthy, and at the same time to make Mongolia’s pediatric cardiovascular sector to become independent.
Through the activities of Heart Saving Project, including the screening of Ovs, I met many people who are purely committed to the happiness of Mongolian children and I learned a lot.
I would like to express my sincere gratitude for providing this opportunity.
Above all, I’d be happy if I could get involved in the Heart Saving Project activities as much as possible while empowering the children’s smiles.
Thank you very much.