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Message from the President    PresidentMessage

Greetings!
               

Greetings from Down Under! I had the pleasure of recently representing Kybele at the 71stNational Scientific Congress of the Australian Society of Anaesthetists' meeting held in Hobart, Tasmania September 28-October 2, 2012. The theme of the meeting, "Pushing the Boundaries", was indeed that, as friends and distinguished speakers from across the globe came to discuss improving healthcare standards in low and middle resource settings.

Medge with mama and baby kangaroo
in Australia.
Dragica Kopic (Croatia program host), Roger Goucke (pain specialist, past president of Australian Pain Society, Univ of Western Australia), Amanda Baric (Mongolia program leader), Medge Owen

Prior to traveling to Hobart, I attended the 3rd "Global Burden of Surgical Disease" meeting in Melbourne. The goal of the meeting was to assemble surgeons, anesthesiologists, policy makers and others to discuss challenges facing surgery and anesthesia in developing countries.

From left: Haydn Perndt (past chair of the WFSA Educ committee, University of Tasmania), Medge Owen, Angelia Enright (Victoria, BC, past-president WFSA), Kelly McQueen (Vanderbilt, Chair ASA Global Humanitarian Outreach Committee), Rob McDougall (Pediatric Anesthesiologist, Royal Children's hospital in Melbourne, Chair of the Overseas development and education committee Australian Society of Anaesthetists

On a global scale, few people actually receive the surgery they need, including emergency cesarean section and obstetric care, resulting in premature death and disability.  This gravely impacts the individual family, as well as society, in many parts of the world. 

Both venues offered rich opportunities for networking with other organizations and individuals passionate about improving the quality and capacity of global health. As a community, we need to learn and discuss which interventions really work! In September 2013, Kybele will have the opportunity to help shape a future interdisciplinary global health meeting as the Alliance for Surgery and Anesthesia Presence will be organized by Kybele secretary, Dr. Holly Muir, at Duke University Medical Center.  

Stay tuned.

Medge Owen Sig  

Medge Owen, President

Kybele, Inc.  

IN THIS ISSUE

 

SERBIA:  Exploring a New Location   Serbia      

Compiled by Helen Akinc from emails sent by trip leaders Ivan Velickovic, MD and Curtis Baysinger, MD

The August 31-September 8 Kybele visit to Serbia was extremely successful and productive, according to the participants.  The team of 4 included two OB Anesthesiologist, one OB, and one Neonatologist.  Dr. Ivan  Velickovic reported that in four days, the team taught the use of a variety of procedures and medications. Additionally, "We have been interviewed by TV, spoke with numerous surgeons, nurses have learned to give new medications, host is taking us to events every night, we are active all the time. We are working 8 am to 5-5:30 pm, local docs are staying well over their working hours..." Dr. Curtis Baysinger mentioned in an email what a difference the pre-planning effort done by the host, Dr. Pujicwas and Dr. Velickovic, made to the success of the overall trip. It sounds like this was a top-notch effort. Kudos to the whole team!!  Look for details regarding future plans in 2013. 

Portrait of a Host Country Leader: Ashot Amroyan, MD   Ashot    

Article by Helen Akinc.  Photo by Shahla Namak.

A key element of Kybele's success in projects around the world is the host country's project leaders. Without strong planning, organization, support and follow through by these individuals, the Kybele team's effectiveness may be limited. Over the next few months we will be bringing you short profiles of host country leaders who have made a difference and contributed significantly to the project's success. I asked Dr. Ashot Amroyan, M.D., host country leader for Armenia, a number of questions which you will find below. His responses are in italics.

Dr. Ashot Amroyan (2nd from Left) and members of the 2012 Kybele Armenia Team.

1. How did you become interested in medicine? During my school years I wanted to become a doctor.I was very interested in human anatomy.

2. When did you first learn about Kybele? How?  In 2006 I learned about Kybele from colleagues of Armenian Society of Anesthesiologists. Later, I have met with Kybele president Medge Owen and other team members during a Kybele visit to Armenia.

3. How has working with Kybele changed medicine in your hospital?  After the Kybele visit in 2006 and my visit to the SOAP conference in 2007(with Kybele help) the rate of regional anesthesia in obstetric(labor epidurals and spinal CS) progressed from 40% to 95%(2012)-spinal CS and from 2% to 16%(2012)-labor epidurals.

4. What has been most difficult to change?  The most difficult change was to change the minds of doctors and patients.

5. In the future, what do you hope to achieve?  I hope that we will have national guidelines and protocols for OB anesthesia with Kybele help.

6. In Armenia, what conditions or attitudes make change easy? What conditions or attitudes make change difficult?  It is easy to teach doctors regional techniques, but the difficult part is equipment, monitoring, anesthesia machines, drugs, and doctors' salaries.

7.  Please tell us the most important change you have seen since your hospital began working with Kybele.  The most important thing is progress in the practice of our colleagues-anesthesiologists, neonatologists, and obstetricians.

 KYBELE ANNUAL FUNDRAISING DINNER PuertoRico

Birthing Customs in Other Cultures     BirthingCustoms 

Article by Helen Akinc.  Photos courtesy of Kybele. 

A new mother in Mongolia cradles her swaddled infant. 

Many cultures have practices surrounding childbirth that are different from that of the United States and Western Europe, although Western Europe and the United States approach childbirth with some variations. In Western Europe and the United States, mothers and at times fathers participate in classes that prepare the couple for the birth process as well as basics in newborn care. In other cultures, there is more of an emphasis on traditional methods and an expectation that members of the extended family, often experienced in childbirth and newborn care, will be on hand to assist the new parents.

In parts of Western Europe, especially England, the Netherlands, and Germany, and possibly others, but those were the countries about which I read, the use of midwives is extensive, and physicians may or may not be on hand for the actual birth, unless there is a serious complication. In Germany, a midwife is required to be present at birth, whereas a doctor's presence is optional.

In many parts of the world, the pain from childbirth is seen as a natural part of the process. In Japan, being able to withstand labor pains without epidurals or other drugs, is seen as an important test for the mother. In Brazil and Turkey, many mothers opt for Cesarean sections, as epidurals are not used widely and the laboring mother may see the general anesthesia administered for the c-section as an option preferable to birthing without any pain medication. Recently, however, the Turkish government controversially banned c-sections for "convenience", permitting them only to save the life of the mother and/or baby.

A new Ghanian Mother leaves the hospital with her newborn.

Cultural differences in doctor-patient relationships as well as in gender roles can also play an important role in labor and delivery. Differences in power between doctor and nurse as well as between doctor and patient can significantly affect the services offered by the doctor and what types of requests the laboring mother may make and what she will feel comfortable communicating. The role of the nurse is very different in various cultures. The status of being a health care provider may vary significantly from culture to culture.

In many parts of the world, husbands essentially interface for their wives with the outside world. This is especially true in Saudi Arabia and other parts of the Muslim world. The husband will protect his wife's purity and honor in accordance with cultural norms. A husband may prohibit his wife from getting treatment, even when her life is at risk, when suitable accommodations for modesty (i.e. same sex doctor, nurse) are not made, in accordance with what his culture deems appropriate.

Kybele works closely with host country staff to understand local norms and culture. New treatments and medical practices are adapted to the host culture as much as possible, as the latest method will have virtually no lasting benefit if it violates the host cultural norms. Kybele team members are provided with orientation packets to familiarize them with key aspects of host culture to maximize the collaboration.   

Sources: 

Watch for future articles on how different cultures approach baby-naming and the early days of  

newborn and mother going home.  

Hands and Hearts Working Together: Youth Helping Youth       CLSProject

Article by Helen Akinc  
Students in Ghana received running water at their school as part of this ongoing collaborative project. 

Community building takes many forms. At its best, it is comprised of young and old, representing the entire community. Children and adults from Cash Lovell Stables Riding Academy and Forsyth Country Day School have spent many hours planning and working towards their 2012 Service Project to help school children in Ghana, West Africa, scheduled for November 16-23. While service projects often focus on raising money to provide monetary assistance to the targeted recipients, this project goes way beyond fundraising as connections are being built that will create strong community ties, both among the group travelling to Ghana, as well as between the Ghanaian hosts and the visitors. The Kybele association and community connections in Winston-Salem provided the spark of the idea as well as the knowledge and networking to make this program possible. As of this writing, there are twelve travelers going to Ghana, including five young people, ranging in age from elementary school through high school. Additionally, seven adults plan to go on the trip, both medical and non-medical participants, even involving a businessman from Turkey. The group has raised money for furniture, computers, and such basics as electricity and running water for the school. Forsyth Country Day School is providing fourteen computers for the school. Medical supplies for the health room and art supplies will also be donated. The young people have already been forging connections with the Ghanaian students through a letter-writing exchange. Upon return from the trip, the students will do presentations to share the trip experience with others. No doubt, this will be a pivotal experience for many, and one which will help build community across the ocean. 

VIETNAM:  Upcoming Site Visit    Vietnam 

Article by Marge Sedensky, MD

 

In the first week of November, Kybele will conduct a site visit to a city in the Mekong delta, called Can Tho.  The visit originated after Dr. Rob Gertler expressed a desire for Kybele to get involved in maternal health there.  Dr. Gertler, an anesthesiologist in Seattle who spent time in Vietnam as a child, has been traveling twice a year to Vietnam for many years.  Besides personally providing anesthesia care, he has gradually evolved into "a concierge service" for other groups that would like to participate in educational programs there. For example, his efforts have led to the beginnings of hospice care in Vietnam, something that is not traditionally been part of their health care system.  He knows the country very well, and has forged many excellent friendships there over the years.

 

The itinerary for the Kybele site visit has been orchestrated through Dr. Gertler's many contacts in Vietnam.  Can Tho, south of Ho Chi Minh city, has multiple hospitals and delivery units.  There is an opportunity for Kybele to help shape obstetric care at a newly created medical school there. The itinerary for the site visit includes this new OB service as well as very busy obstetric units in the city.  Rob has also arranged for a dedicated translator for Kybele this first visit.  Drs. Dennis Shay and Margaret Sedensky will be seeing, during this November trip, what Kybele may be able to accomplish in the several hospitals in the city.  If the opportunities are there, a full Kybele team will travel in April to begin hands on teaching.

Update on 50@50 Campaign  Update50at50

A special thank you goes out to the following individuals for being monthly donors in our 50@50 Campaign.  It is never too late to support Kybele with an ongoing monthly gift of $10, $25, $50 or $100.   

 

Monthly donors play a significant role in sustaining the work of Kybele and for that we are extremely grateful.

    

  Helen Akinc

Terry Allen, MD

Valerie Arkoosh, MD

Karen Bartoletti

Curtis Baysinger, MD

Sarah Bodin, MD 

  Ferne Braveman, MD

Vicki Clark, MD

Brittany Clyne, MD

Camille Dunlap

Ellen Flanagan, MD 

Pamela Flood, MD

Ronald George, MD

Ashraf Habib, MD

Drs. Matt and Amber Hatch

Gillian Hilton, MD

Thomas Ivester, MD

Frank James, MD 

Nancy Jenner

Rehana Kauser, MD 

Shannon Koontz

Ellen Lockhart, MD

Virgil Manica, MD

Richard Month, MD

Holly Muir, MD

Rodney Nash, CRNA 

Yemi Olufolabi, MD

Medge Owen, MD

Rohit Ramaswamy, Ph.D. 

Lauren Reavis

Michael Rieker, CRNA

John Schultz, MD

Marge Sedensky, MD

Robin Sizemore 

Richard Smiley, MD

Leigh Stanfield 

Sebnem Ucer   
Kybele on the Move KybeleonMove
Kybele people have been super busy over the past few months.  Here's a partial listing of what's been happening since the Summer Newsletter came out:
  • Serbia Trip (August 31-September 8)  Look for photos in the winter newsletter. 
  • Kybele Board Meeting (September 8) Members of the Kybele Board of Directors met in Winston-Salem for the annual fall board meeting.  The board discussed a wide range of topics about Kybele programs, the state of the organization, fundraising, and future plans.  The Kybele board of directors meets 4-5 times annually both in-person and in audio conference meetings.   
  • Ghana Trip (September 15-30) Look for story and photos in the winter newsletter,  
  • Vietnam Trip (November 4-11) Look for story and photos in the winter newsletter.  

UPCOMING TRIPS & EVENTS

 

GHANA -  November 2012 and Jan 2013

Contact team leader Dr. Yemi Olufolabi if you are a returning participant.

   

ARMENIA - October 5 - 19, 2013

Contact team leaders Simon Millar or Gordon Yuill if you are a returning participant to any program.   

 

EGYPT - 2013 

Several Kybele Team Members have been invited to participate as speakers and panel members of the 2013 All Africa Anesthesia Congress held on April 7-10 in Cairo.  This world-class event is organized by Africa Regional section of the World Federation of Anesthesia Societies (WFSA) in collaboration with the Egyptian Society of Anesthesiologists (EgSA).  The congress will include speakers from the USA, UK, Canada, and Africa who will provide the latest tips and updates on hot topics in Anesthesia, Intensive Care Medicine and Pain Management.

If you have any questions about upcoming programs, you may contact Program Coordinator, Lynn Snyder.

Kybele Crisscross - Try your hand at this fun Kybele Crossword Puzzle     crisscross


CLICK HERE TO PRINT PDF      ANSWERS AT BOTTOM OF NEWSLETTER            Puzzle created by Helen Akinc

Kudos and News Bits     Kudos

Nurse Anesthesia Graduates pictured here with Kybele Coordinator and Instructor, Michael Rieker, CRNA
  • The Nurse Anesthesia School at Ridge Regional Hospital recently graduated their 2nd class of nurse anesthestists.  21 students received recognition of their accomplishment during the recent Kybele Ghana Trip in September.  Congratulations to the hardworking graduates!  Ridge Regional Hospital Nurse Anesthesia Training School is only the 2nd school of its kind in Ghana.  A 3rd Nurse Anesthesia Training School recently opened in Tamale in September as part of Kybele's work in Accra and Tamale. 
  • Dr. Medge Owen has been invited to speak about Kybele at Wake Forest University as part of the Women's and Gender Studies Colloquium Series. This lecture series is coordinated by the Research, Development and Advancement Committee of Women's and Gender Studies at Wake Forest and is attended by faculty, students, and the general public. October 30 -  4:30 - 6:00pm. Kybele will also have a merchandise table at this event.
  • Dr. Owen has also been invited to speak about Kybele at the annual Gravidas at Risk Conference in Hickory, NC on November 7-8. Nancy Pearson will be the keynote speaker. The conference is sponsored by Wake Forest University School of Medicine. Kybele will also have a merchandise table at this event.  
  • Dr. Holly Muir (Duke University), recently spoke about Kybele programs at the 2012 Maya Angelou International Women's Health Summit in Winston-Salem, NC on September 28th.  Dr. Muir's talk was titled "International Maternal and Child Mortality: US/Canada and Abroad
  • Kimber Whanger, Kybele Office Administrator, recently spoke about Kybele programs at the September 2012 Perinatal Resources Conference in Columbus, Ohio.  
  • If you would like to nominate a person or person(s) for the Board of Directors or would like more information about Board or Committee Membership, please contact a board or staff member.       

We Thank The Following for Their Support    

SOAP Logo   WFSA Logo
Society for Obstetric Anesthesia and Perinatology  |  The Obstetric Anaesthetists' Association     
The International Association for the Study of Pain  |  The Lacy Foundation  |  World Federation of Societies of Anaesthesiologists

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 Kybele merchandise is on display at various events in the Winston-Salem, NC area.  Contact us if you are interested in purchasing merchandise or have an event that is appropriate for us to display/sell our items. 

Board of Directors

Medge Owen, MD

President & Founder

Helen Akinc  

VP Strategy & Newsletter Editor  

Margaret Sedensky, MD 

VP Program Development

Frank James, MD 

Treasurer

Holly Muir, MD

Secretary 

Karen Bartoletti 

Brittany Clyne, MD

Ronald George, MD 

Thomas Ivester, MD

Shannon Koontz 

Virgil Manica, MD

Yemi Olufolabi, MD

Rohit Ramaswamy, PhD  

Michael Rieker, CRNA  

Robin Sizemore

Leigh Stanfield 

   
Kybele, Inc. is a non-profit 501(c)3 humanitarian organization dedicated to improving childbirth safety worldwide through educational partnerships. The role of Kybele is to bring professional medical teams into host countries, to work alongside doctors and nurses in their home hospitals, to improve healthcare standards. Kybele volunteers provide hands-on training in medical techniques during the actual care of patients in labor wards and in operating rooms. Kybele volunteers model teamwork and compassion in real life and death situations, sharing knowledge when it matters the most.
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www.kybeleworldwide.org   |  3524 Yadkinville Road #124 Winston-Salem, NC 27106

Crisscross Answers