Mongolia: Bringing Cutting Edge Surgery To A Million Nomads

Ira Pastor, ideaXme life sciences ambassador, interviews Professor Sergelen Orgoi,MD, PhD, general surgeon from Ulaanbaatar, Mongolia, who is best known for pioneering and developing low cost liver transplantation and laparoscopic surgery in Mongolia. Ira Comments Today we are going to…

Mongolia: Bringing Cutting Edge Surgery To A Million Nomads

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Ira Pastor, ideaXme life sciences ambassador, interviews Professor Sergelen Orgoi,MD, PhD, general surgeon from Ulaanbaatar, Mongolia, who is best known for pioneering and developing low cost liver transplantation and laparoscopic surgery in Mongolia.

Ira Comments

Today we are going to be continuing on this interesting journey.

At over 1.5 million square kilometres, Mongolia is the 18th largest, but the most sparsely populated sovereign state in the world, with a population of only around three million people. It is also a landlocked country, with very little arable land, as much of its area is covered by grassy steppe and the Gobi Desert.

Approximately 30% of the Mongolian population is nomadic or semi-nomadic, and when it comes to modern surgical care, there have been many challenges over the years due to it’s rugged geography, serious political and financial constraints, and this large nomadic population.

Professor Sergelen Orgoi, MD, PhD,is a general surgeon from Ulaanbaatar, Mongolia, best known for pioneering and developing low cost liver transplantation and laparoscopic surgery in Mongolia.

She is an Honorary Fellow of the American College of Surgeons (ACS), Professor of Surgery and the Head of Surgery Department at the Mongolian National University of Medical Sciences, and Vice President of the Mongolian Surgical Association.

Professor Orgoi earned her Bachelor of Medicine, Master of Clinical Medicine, Doctor of Medicine (MD), and Doctor of Philosophy (PhD) from the Mongolian National University of Medical Sciences (MNUMS) and completed medical fellowships in developed countries such as South Korea, Switzerland, USA, and Finland.

She has led several projects that are presenting impressive examples of possibilities, not just for Mongolia, but for other low- and middle-income countries (LMICs) by addressing this absence of basic surgical care, leading the Mongolian World Health Organization’s (WHO) Global Initiative for Emergency and Essential Surgical Care (GIEESC).

This coordinated effort, addressing absence of adequate capacity for emergency and essential surgical care services in LMICs resulted in dramatic improvements in surgical and anesthetic care capabilities in more than 300 isolated rural communities in Mongolia. The World Health Organization designated Mongolia as the first WHO GIEESC Collaborating Center, with goals to expand the Mongolian success regionally in Central and Southeast Asia.

In 2005, when nearly half of the population was still nomadic and only 4 percent of gallbladders were removed laparoscopically, Professor Orgoi orchestrated the expansion of laparoscopy. Now laparoscopic cholecystectomy is available in 17 of Mongolia’s 21 provinces.

With trauma as the third leading cause of death in Mongolia, she oversaw the introduction of the Advanced Trauma Life Support program.

Professor Orgoi led the development of lower-cost liver transplants and orchestrated inclusion for all transplantation into the government health plan in Mongolia, where liver cancer is the most prevalent cancer. This initiative improved intensive care unit capability, pathology, gastrointestinal support, and pharmacy, strengthening their overall health care system.

In 2011, Professor Orgoi and her team of surgeons did the first successful liver transplantation in Mongolia at the First Central Hospital of Mongolia, and since then, her team has done 47 liver transplantations in Mongolia. Recognizing that liver cancer is the most prevalent and economically disastrous cancer in Mongolia, she led the development of low-cost liver transplants in Mongolia. Now liver transplants cost only around US $3-5 thousand. She also proposed that the Mongolian state health budget cover all liver transplantations and now the state budget covers 75 percent of all liver transplantations in Mongolia.

On this show we will hear from Professor Orgoi:

How she pioneered such a successful model for laparoscopic training in a poor country like Mongolia with such a widespread nomadic population. How Mongolia, which has the world’s highest rate of liver cancer due to chronic hepatitis (400,000 of Mongolia’s 3 million citizens are diagnosed with a hepatitis virus) is dealing with this underlying liver cancer / cirrhosis driver via drugs and vaccines. How Mongolia is dealing with the problem of human echinococcosis (a parasitic disease caused by tapeworms and parasite eggs in contaminated food, water or soil, or after direct contact with animal hosts) which is anther local driver of expensive drug therapy and extensive surgeries. About how Mongolia is dealing with and controlling the local Coronavirus pandemic. Her future plans for kidney and pancreatic surgeries in Mongolia.

Credits: Ira Pastor

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