One doctor’s 17-year mission to bring quality urological care to kids in Vietnam. By Sarah Dallof. Photos by Fred Wissink.
The pre-op consultations have been going on for two hours now and the crush of parents holding young patients in the hallway of the urology department of Children’s Hospital 2 doesn’t seem to be thinning. Still, Dr Le Tan Son’s energy doesn’t wane for a second as he presents case after case to a visiting team of American doctors with IVUmed, a group he’s been working with for 17 years.
“This is a difficult case,” he says as a teenage boy climbs up onto the bed.
In fact, all the cases Son and his team are reviewing today with IVUmed are complex. They’re the teenagers and children with conditions less familiar to the Vietnamese doctors, or ones where they want second, in-person opinions from fellow physicians. The Vietnamese and American doctors sit side by side holding the teen’s x-rays up to the light and animatedly discussing his condition as he lies there patiently, a tube sticking out of his abdomen. Medical students, jockey for position. A nurse stands on tip-toe snapping photos.
After much review, the team decides the teen’s last operation was too recent and he needs to wait several more months before undergoing another. Son claps his patient on the shoulder and asks when IVUmed will be back. This case will be an excellent learning opportunity.
“He’ll be right here waiting for you,” Son jokes.
The ease with which the two groups of doctors work together comes from the trust and respect that has built steadily between them since 1994. That was the year IVUmed, an NGO dedicated to providing pediatric and adult urological care worldwide, came to Vietnam. At the time there were no pediatric urologists in Vietnam. IVUmed found a perfect in-country partner in Son, then a pediatric surgeon who would go on to dedicate countless hours to learning this new specialty and training local doctors.
“Before 1994, no one could deal with these situations,” Son says. “Sincerely at first I was really worried because no one could help me.”
Today any nerves are long gone. Son has helped build a thriving pediatric urology program at Children’s Hospital 1 in District 10 and has moved onto Children’s Hospital 2 in District 1 to develop a high-tech surgical program with an emphasis on laparoscopic surgery. He has also authored two articles in major medical journals and teaches classes at the Medicine and Pharmacy University in Ho Chi Minh City, where he serves as head of the Pediatric Surgery Department.
“He’s a great teacher and his students are wonderful surgeons who learn fast,” Catherine deVries, founder and president of IVUmed, says. “They’ve taken everything we’ve done and amplified it. In fact, they’ve done so many more of some of these cases than we have because the volume is so high.”
Thanks to this international collaboration there are now 13 pediatric urologists in Vietnam, 10 in Ho Chi Minh City and three in Hanoi. Focus is turning to building a strong pediatric urology program in central Vietnam so patients and their families in more rural areas will not have to trek north or south for treatment, hundreds of kilometres by bus.
It’s dark outside by the time Son has presented all 45 of his cases at the hospital, but early the next morning he’s walking around the operating suite with a smile. A group of eager students and residents trail him. Those who can’t fit into the operating room will watch on a television nearby.
The first patient is a little boy born with two urethras, one of which is blocked by scar tissue. Son examines guide wires as IVUmed’s Dr Chad Wallis shows how to get a catheter across the scar tissue, allowing the child’s bladder to drain and subsequently healing an infection. He’ll need additional surgery to reconstruct his urethra, but for now his quality of life is improved.
The next procedure is not as simple and takes more than double the time. The patient is Nguyen My, a two-year-old boy who is carried wide-eyed into the operating room before undergoing anesthesia. He has a blockage in his urinary system and needs a pyeloplasty to remove the blockage and reattach the healthy part of his kidney to the healthy part of his ureter. Everyone presses forward to observe the procedure. In the past, the surgeon would access the area using a big incision. IVUmed is making a small cut. Students pepper Son with questions as they watch Dr Lars Cisek demonstrate the operation.
When it’s over, My’s parents are waiting for him outside the operating room. His father transfers him to a gurney and helps the nurse push him along the sidewalk to a building a couple doors down and to his new hospital bed. His mom drapes a blanket over his small body and strokes his face as he wakes up. She’s hopeful the recurring pain caused by his condition will now be gone.
“The doctors are very good,” she says through a translator.
This is the reason Son dedicates so much time and energy to his work. A child with a treatable condition like My’s would not have received the same quality of care 17 years ago. Today, however, he was given top of the line treatment and future doctors were able to observe a new surgical technique that will help future patients heal faster and with minimal scarring.
“I love, I love my job,” says Son.
Between surgery, teaching, and special projects like his work with IVUmed, it’s hard to imagine Son has free time, but he insists he does. He and his wife have two children, both currently studying in the US. He enjoys television, music and, he says with a wink, fishing — the joke being that while he balances several jobs he only gets paid for one and has to find creative ways to eat. His true compensation is the knowledge that when he one day retires, he’ll leave behind a legacy of quality pediatric urology care and dozens of trained doctors and nurses to continue his work.