REI/AAO-HNSF Humanitarian Trip to Ho Chi Minh City, Vietnam
Stanley W. McClurg, MD University of North Carolina Humanitarian Travel Grant Awardee Five patients in the examining room at the same time, extreme emphasis on footwear, but not so much on sterile instruments. These were some of the culture gaps I observed on a recent medical humanitarian trip to Ho Chi Minh City, Vietnam. On the plus side: We all got a tea break right before surgery. As a rhinology, endoscopic skull base, and allergy fellow at the University of North Carolina, I travelled to Vietnam February 28 through March 8 with a group under Brent Senior, MD, as part of REI Vietnam. We worked at multiple hospitals there, including the ENT hospital and Gia Dinh Hospital. I was able to give presentations to the physicians there on sinus surgery and some of my research on fluid dynamics of the nasal airway. It was a great opportunity for me to teach and also to see a different perspective on ENT and rhinology practices in another country. I personally performed four sinus surgeries and one endoscopic pituitary surgery with my neurosurgery colleagues. These included mostly endoscopic sinus surgery procedures for mucoceles, chronic sinusitis, nasal polyposis, septal deviation, and pituitary adenomas. I did take some of my own sinus instruments along, but overall, they had most of the appropriate instruments that were needed for sinus surgery. The monitors, facilities, and beds, however, were not optimal. The sterility practices were fairly odd, placing extreme emphasis on footwear, and not so much on actual sterile techniques for instruments. I do feel that the overall care that is being given at these hospitals is adequate, and at times superior to practices in the United States. There is a large emphasis placed on seeing as many patients as possible. This does provide care for the extremely large volume of patients, but it did appear that patients were not given adequate attention and focus at times. Patient confidentiality was also not high on their priority list. At some times, there were as many as five patients in the same room being examined. This just seemed like the normal way of doing things, and no one seemed to feel violated at all. Interestingly, they also put a high priority on making sure that everyone had a tea break prior to surgery, and once during the afternoon. My biggest misconception before the trip was the overall exceptional knowledge of endoscopic sinus surgery that the ENT doctors in Vietnam already had. They had a significant knowledge base, but were willing to learn new techniques. Many doctors were able to see me do sinus surgery, and learned many different and new techniques. I had many questions that were asked of me during the course, and feel that I made a true impact on their practice. I do feel that future focus on neurosurgical interventions would be beneficial for the people of Vietnam. We were able to take two neurosurgeons with us there, and the facilities and overall operative techniques of the neurosurgeons in Vietnam were suboptimal. Many of the ENT physicians there had never had any experience with endoscopic pituitary surgery, and this is an important area to address in future endeavors. I would definitely recommend this humanitarian trip to other ENT physicians. It is well established by Dr. Senior, and definitely provides an academic and immersive experience in a third world country. I would like to personally thank the AAO-HNSF Humanitarian Efforts Committee for the grant that was provided for my travels.
Stanley W. McClurg, MD
University of North Carolina
Humanitarian Travel Grant Awardee

Five patients in the examining room at the same time, extreme emphasis on footwear, but not so much on sterile instruments. These were some of the culture gaps I observed on a recent medical humanitarian trip to Ho Chi Minh City, Vietnam. On the plus side: We all got a tea break right before surgery.
As a rhinology, endoscopic skull base, and allergy fellow at the University of North Carolina, I travelled to Vietnam February 28 through March 8 with a group under Brent Senior, MD, as part of REI Vietnam. We worked at multiple hospitals there, including the ENT hospital and Gia Dinh Hospital. I was able to give presentations to the physicians there on sinus surgery and some of my research on fluid dynamics of the nasal airway. It was a great opportunity for me to teach and also to see a different perspective on ENT and rhinology practices in another country.

I personally performed four sinus surgeries and one endoscopic pituitary surgery with my neurosurgery colleagues. These included mostly endoscopic sinus surgery procedures for mucoceles, chronic sinusitis, nasal polyposis, septal deviation, and pituitary adenomas. I did take some of my own sinus instruments along, but overall, they had most of the appropriate instruments that were needed for sinus surgery. The monitors, facilities, and beds, however, were not optimal. The sterility practices were fairly odd, placing extreme emphasis on footwear, and not so much on actual sterile techniques for instruments.
I do feel that the overall care that is being given at these hospitals is adequate, and at times superior to practices in the United States. There is a large emphasis placed on seeing as many patients as possible. This does provide care for the extremely large volume of patients, but it did appear that patients were not given adequate attention and focus at times. Patient confidentiality was also not high on their priority list. At some times, there were as many as five patients in the same room being examined. This just seemed like the normal way of doing things, and no one seemed to feel violated at all. Interestingly, they also put a high priority on making sure that everyone had a tea break prior to surgery, and once during the afternoon.

My biggest misconception before the trip was the overall exceptional knowledge of endoscopic sinus surgery that the ENT doctors in Vietnam already had. They had a significant knowledge base, but were willing to learn new techniques. Many doctors were able to see me do sinus surgery, and learned many different and new techniques. I had many questions that were asked of me during the course, and feel that I made a true impact on their practice.
I do feel that future focus on neurosurgical interventions would be beneficial for the people of Vietnam. We were able to take two neurosurgeons with us there, and the facilities and overall operative techniques of the neurosurgeons in Vietnam were suboptimal. Many of the ENT physicians there had never had any experience with endoscopic pituitary surgery, and this is an important area to address in future endeavors. I would definitely recommend this humanitarian trip to other ENT physicians. It is well established by Dr. Senior, and definitely provides an academic and immersive experience in a third world country. I would like to personally thank the AAO-HNSF Humanitarian Efforts Committee for the grant that was provided for my travels.