Monday, November 23, 2009

Ulaanbaatar, Mongolia

By: Jakub Langer

I recently traveled to Ulaanbaatar, Mongolia, as part of my chief year orthopaedic international experience. I spent two weeks at the National Trauma and Orthopaedic Research Center of Mongolia, assisting with operative cases, seeing patients in clinic, and attending conferences. I had the opportunity to give several talks about very common put poorly understood topics, including non-unions and distal radius fractures. I was able to procure some much-needed equipment for the Mongolian surgeons prior to my travel, and brought 30-some pounds of nails, screws, drill bits and plates with me. I had the privilege of assisting with the placement of the first two locking plates in Mongolian history.

The Mongolian surgeons were very welcoming, taking me into the countryside to tour traditional ger camps. I was lucky to experience some of the local Mongolian culture, including food and drink. The Mongolians eat a largely protein and fat-filled diet. I sampled goat boodog, a meal made by stuffing a goat's intestines with hot stones and cooking the carcass amidst hot coals with the skin and all. I drank traditional fermented mare's milk, ate horse stomach salad, and washed it all down with the ubiquitous Mongolian salt tea.

ABOVE: Ger Camps

BELOW: Goat Boodog
Almost a third of Mongolia's population still follows the traditional nomadic lifestyle; herding livestock and living in round, felt tents. Falls from horses are much more common in the countryside than motor vehicle accidents. The nomadic lifestyle greatly complicates access to orthopaedic care. A large number of injuries can go undiagnosed or untreated because of lack of education, and many patients suffer a devastating delay in treatment due to a lack of infrastructure. Much work still needs to be done in Mongolia, and many other countries around the world. I am happy that I was able to experience orthopaedics in this developing country, and know that this trip is only the first in hopefully many I will make during my career.

LEFT: Performing an operation with Dr. Jargalsaihan, Orthopaedic Trauma Director at the National Trauma and Orthopaedic Research Institute in Ulaanbaatar, Mongolia.

BELOW: Photo of me on a hike above Ulaanbaatar.

Monday, October 12, 2009

Phnom Penh, Cambodia

The opportunity to work overseas is a highlight for many in Washington University's orthopaedic surgery residency training program.

Bethany Gallagher, M.D., a 2009 graduate of the residency program, traveled to Cambodia for her international experience.

The photo above is of Kossamak Hospital, a 3-story open-air facility without an elevator.

Ambulances that pulled up to the hospital did not have any monitors or lifesaving equipment in them.

Instead of providing food for the patients, the hospital provided open flames and hot plates at the patient's bedside. Entire families stayed at the patient's bedside providing nursing care (shown below to the left).

The cost of care differed immensely from treatment in the United States.

Cost of Care:
$0.50/day for sheets
$2.00/day semiprivate room
$7.00/day private room with TV
$20.00 CT scan

The Operating Room is shown to the left.

During Bethany's time in Cambodia, she treated fractured hips, femurs, tibias and missed compartment syndromes. The experience was life-changing for Bethany, as for many of the residents in the program.

Friday, October 9, 2009


Welcome to the Washington University Department of Orthopaedic Surgery- Residency Training Program's travel blog.

The International Orthopaedic Surgery Experience

Residents in our program have the opportunity to work oversees during a 2-week rotation. Residents have traveled to the following locations:

Bhutan - General Orthopaedics
Cambodia - General and Orthopaedic Trauma
China - Club Foot Deformities
France - Shoulder Surgery
India - Pediatric Orthopaedics
Myanmar - General Orthopaedics
South Africa - Joint Replacement