Hue, Vietnam 2025 (Mission # 27)
February 24- 28, 2025
Arpan Global Charities recently returned from Hue in Vietnam after completing its 27th International Medical Mission from 24- 28 February 2025. This was Arpan’s fifth mission to Vietnam. The Arpan team served our host hospital, the Hue University of Medicine and Pharmacy (HUMP). Hue University is the third largest Medical University in Vietnam (after universities in Hanoi and Ho Chi Minh City). This hospital, and local community clinics, provide medical services to a large population covering the city of Hue, the highland provinces, and Central Vietnam. Our multidisciplinary team was comprised of 17 individuals: physicians and surgeons, a nurse, a nurse practitioner and non-medical volunteers.
Anesthesiology and Pain Management Procedures
Dr. Afshin Shabanie and Dr. James Nassiri collaborated with colleagues from the Hue University College of Medicine and Pharmacy (HUMP) to mentor and demonstrate a variety of new epidural and facet injection procedures for pain control. They completed, mentored, or performed over 20 procedures. They worked together to collaborate with HUMP anesthesiology residents to refine their skills by selecting suitable patients, creating a systematic approach for history and physical exams, and demonstrating individual techniques, addressing prior gaps in knowledge and experience for the procedures. The participation of three HUMP neurosurgeons was a further significant step since it represented their commitment to the development of a Pain Control service at the hospital. Neurosurgeons at HUMP will offer 2-to-4-week neurosurgery rotations for anesthesiology residents interested in pain management to enhance their skills. In the week that they were there, Drs. Shabanie and Nassiri established the foundation for the HUMP Pain Control Service.
Ophthalmologic Plastic (Oculoplastic) Surgery
Dr. Peter Truong worked with HUMP on advanced procedures, such as tear duct reconstruction for trachoma patients, cosmetic improvements for sunken eyes, and techniques to fit ocular prostheses in patients with aged eye removals. He brought a drill to open scarred tear ducts of trachoma patients and provided ocular prostheses he had ordered for the hospital. Many of the procedures he performed were novel to HUMP ophthalmology department and involved adapting instruments that were available. He performed over 15 procedures during the week, many of which significantly improved the daily lives of his patients, from providing properly fitting prostheses, improving facial appearance, and correcting the continuous tearing from the eye of a patient. Dr. Truong has also decided to stay an extra week in Hue to provide post operative care for his surgery patients. In the additional week, he also performed more than 15 additional surgical procedures, many of them, again, complex oculoplastic surgeries that significantly improved the patients’ lives.
Orthopedic Surgery
Dr. Paul Beck conducted over 15 surgical procedures, including several that were challenging due to the time elapsed since the injury or the extent of anatomic abnormalities. Particularly difficult, and a recurring theme this week, was the need to adapt the available equipment and the challenge, in some cases, of getting hip prostheses into deformed and unusually enlarged hip sockets for hip joint replacements, as well as complex femur reconstructions. Dr. Beck’s work included mentoring surgical procedures and teaching at the bedside, continuing the core component of the Mission of sharing clinical information collaboratively.
Thoracic Surgery
Dr. Brian Palafox worked with the thoracic surgery team at HUMP to participate in many advanced procedures, including lobectomies (one for an advanced pulmonary fungal infection), wedge resections, and a novel approach to the Nuss procedure for pectus excavatum. As was the case for his other Mission surgical colleagues, Dr. Palafox combined long days in the operating room with mentoring of procedures, and bedside teaching. He significantly influenced the lives of more than 12 surgical patients, as well as numerous surgical residents and attending physicians.
Minty-Tam Phap Hai observed several of the procedures that Dr. Palafox performed
and was able to report back to the group about the efforts he made to adapt the
available instruments and to demonstrate new approaches to thoracic procedures. She
was also an essential part of the community health clinics and two children’s
orphanages, providing both warmth and Vietnamese language skills.
Pharmacy
Tony Phan delivered a lecture on compounding techniques, specifically tailored to the ingredients available in Vietnam. The event was attended by over 100 pharmacists and successfully addressed a significant technological gap. Furthermore, he contributed to the health fair by updating the labeling and packaging of medications provided to both pediatric and adult patients, who previously received pills and powders without specific instructions. He provided guidance on the essential steps for properly administering medications, including compounded ones, in a system change that aims to improve patient outcomes in the future.
Prenatal and Obstetrical Care
Sue Dragoo, who has a doctorate in nursing practice, is a nurse practitioner who introduced the concept of this crucial role to her colleagues at HUMP. She gave a presentation on diabetes in pregnancy to OB residents, midwifery students, and OB faculty members that was very well attended and popular. In addition, she saw over 12 obstetrical patients during the Health Fair and mentored third year medical students in obstetrical care, including determining fetal gestational age and position by external palpation of the abdomen. One of her students exemplified the core vision of the Mission by telling Sue, “You taught me how to talk with patients.”
Pediatrics and Neonatology
Drs. Sudeep Kukreja, Claire Noltemeyer, and Carole Kohen visited the neonatal unit at HUMP to share insights from CHOC NICU and Neonatal Resuscitation Program protocols. They delivered 5 CME-credit lectures on pulmonary hypotension, pulmonary hemorrhage, neonatal hypotension, and congenital infections to over 100 residents and faculty.
Mission Impact
This Mission, like the three previous ones to Hue, was a labor of love for Dr. Paul Beck and his wife, Dr. H. Thi Duong Beck, who is an internist with a family heritage from Hue. The AGC team participated in a three-day health clinic in a rural area that serves over 1500 people, 95% of whom are ethnic Katu. Over 100 adult and pediatric patients were seen for a variety of complaints, and many were given medications, appropriately labelled by Tony Phan, that had been provided by AGC. In addition, on the third day, Claire, Carole, Sudeep, Thi, and Sue attended a total of 4 home visits. These were the first visits for a pilot program that has been designed by HUMP to provide health care to the underserved Katu community.
On the final two days, the Mission concluded with a visit to a center for disabled children in Hue that included a sheltered workplace for several of the older children at a local coffee shop.
The last day concluded with a visit to an orphanage for children with disabilities that also provides education to children from a local ethnic community, run by the Sisters of Mary Immaculate. Many of the sisters have an affiliation with the sisters of St. St. Joseph’s. Mission staff saw the children in their classrooms and visited them in an assembly. The children were given donated stuffed toys.
Non-Medical Volunteers
The non-medical volunteers, William and Tiffany Phan (the children of Tony Phan), William and Michelle Dragoo (husband and daughter of Sue Dragoo), and Theresa Truong (wife of Dr. Peter Truong), participated, singly and together along with their AGC colleagues, in extensive community outreach to an orphanage, a preschool for disabled and impoverished children, and the community health clinics. William Phan provided
daily IT support, including PowerPoint presentations, wi-fi, and ride-sharing apps.
Tiffany Phan was the videographer for her father, Tony Phan’s, lecture. Both Tiffany and William observed surgical procedures. Michelle Dragoo participated in the community health clinic and offered her unique perspective as an anthropologist on the collaboration and cooperation of our Vietnamese and American nursing, resident, and physician interactions.
Our mission would not have been possible without the dedication and hard work of Drs. Paul Beck and Huong Thi Duong, and our liaison with the Deputy Head of the Hue University of Pharmacy and Medicine, Office of Science, Technology, and International Relations, Dr. Nguyen Thi Anh Phuong.
