RAMA Neonatal Intensive Care Project

[Boris]

When it rains - it pours (old English saying).

I just finished talking to Vladimir Burdjalov - who is the Chief neonatologist - Intensive Care specialist at the Hillcrest Hospital (that is a part of the Cleveland Clinic). His group is interested in developing an international project in their specialty. I will meet with him and Dr. Rodriguez to discuss the details of our potential cooperation.

The Russian side of this project is Yaroslavl. I talked to Sergey Vakhrukov who was recently elected as the Governor of the Yaroslavl Region. He asked me to write a proposal for medical cooperation between RAMA and the Department of Health of the Yaroslavl Region. They have the money to spend on this project. All over sudden everything becomes real.

We will need a lot of help.

[Boris]

Actually, this project is already in development, we just need to combine our efforts with other people working in the same direction.

Dr. John Moore from Metro Hospital in Cleveland has been traveling to Volgograd for 11 years and already has an observership program established at his hospital. Doctors from Volgograd come for 4 months - 1 month of intensive English classes and 3 months of following a pediatric/neonatal fellow. Tomorrow we are having a dinner with Dr. Olga Kornyushina from Volgograd, who is an observer in 2008.

We will meet with Dr. Moore to discuss our work together.

[Boris]

We plan to meet with the CEO of the Cleveland Clinic Foundation - Dr. Delos "Toby" Cosgrove in May to discuss potential participation of the CCF in this project. Cleveland Clinic has brunches in Florida, Arizona, Toronto, Canada, Abu Dhabi, UAE and Vienna, Austria. There is no reason why CCF cannot open a branch in Russia.

http://blog.cleveland.com/metro/2008/01/cleveland_clinic_has_its_eyes.html

[VI]

Boris,

I am the 2nd year fellow in neonatology. Please, let me know if I could be of any help. My boss has some contacts with neonatologists in Kazan, but his project there is not active now.

BTW, we are kind neighbors - I am in Lansing, MI

V.I.

[Nick]

Great idea. We may combine it with other invasive pediatric specialties such as pediatric surgery, including cardiac surgery during first year of life. There is no need for proposing complex open-heart repairs. There are many kids back home who need just PDA ligation or BT shunt in 1st month of age with specialized NICU post-op care.

[Igor Bulatov]

We plan to meet with the CEO of the Cleveland Clinic Foundation - Dr. Delos "Toby" Cosgrove in May to discuss potential participation of the CCF in this project. Cleveland Clinic has brunches in Florida, Arizona, Toronto, Canada, Abu Dhabi, UAE and Vienna, Austria. There is no reason why CCF cannot open a branch in Russia.

http://blog.cleveland.com/metro/2008/01/cleveland_clinic_has_its_eyes.html
Boris,there is multiple reasons why CCF can not and will not open its branch in Russia.
One of the reasons,that Rissia is not quite in line with the listed above states and countries(economically and politically).Another reason is that Russian bureaucracy is totally convinced,that they have sufficient resources (intellectual and financial) to bring russian medical care system in line with civilized countries.And because of that,they will not allow any foreign medical entity to operate on its territory.Especially for profit.And CCH is not a charitable organization.
As far as pediatric cardiac surgical care is concerned:of course,we can rase
money,bring a team of surgeons,intensivists,cardiologists,anesthesiologi sts to teach local specialists to work in accord with the western standards.But they have to have appropriate infrastructure and basic training and understanding of their respective specialties.Of course,2-3 months observership is better than nothing.But it does not even come close to the level of training in high tech specialties (pediatric cardiac surgery,pediatric cardiac anesthesia,critical care,pediatric cardiology,neonatology,etc).Team of specialists may spent 1-2 weeks amusing russian colleagues by their ability to work efficiently and with good results.And then what?
Surgical closure of PDA in children <1 year of age does not require cardiac surgeon.Any pediatric surgeon,trained in the US can do it.Surgery takes 10 to 45 min.The only requirement-to have an appropriate ultrasound diagnosis and referral of patient before arrival of the surgeon(s).Diagnostic part is a problem.Most of the russian funcionalists are poorly trained and cannot
make appropriate judgement.That is why,children with relatively simple and
and often not requiring surgical attention congenital heart defects have forced to travel thousands of kilometers to Moscow's Bakulev Center.
Which is also very picki and very frequently refusing care to children with complex congenital heart disease.Therefore,BT shunt is not an option,because it requires next stages of palliative surgical treatment (Glenn and Fontan),and even Bakulev center routinely declares children with potential single ventricle physiology as inoperable.Parents of those kids seek
help elsewhere (Berlin). http://www.dhzb.ru/ By the way,Berlin pediatric cardiac center is not a charity either.But they operate hundreds of russian children annually,who refused care at Bakulev,Mehsalkin etc.centers.Surgeries are paid for by russian charity organizations.
Needles to say,premies <32 weeks have dismal chances of survival almost anywhere in Russia.

[Nick]

Игорь, читая Ваши посты на этом и некоторых других форумах, хотелось спросить, когда Вы последний раз были в России, общались со своими российскими коллегами на месте? Вы когда-нибудь были в Центре Бакулева, в Новосибирске? В стране очень много происходит, пусть медленно, очень-очень тяжело, но происходит - и на уровне районных больниц, и в ведущих федеральных центрах. Да и "бюрократы" есть очень не похожие на Ваши описания. Наши коллеги хотят сделать жизнь российских больных лучше. И мы помогаем им в этом, и будем помогать.

По поводу CCF, филиал в Абу-Даби планируеться открыть в 2010 году. С колоссальными ресурсами ССF и с неограниченным финансированием, это занимает столько времени. Мы не говорим, что собираемся открыть СС Moscow через год, но обсудить эту идею считаем интресной. Кстати, Берлиский центр обдумывал(ет) открытие филиала в России.

Вы хотите СДЕЛАТЬ что-то конкретное, пожалуйста, предлагайте.

[Boris]

From: Vladimir Burdjalov, MD
Sent: Friday, April 25, 2008 4:08 PM
To: Ricardo Rodriguez, MD

Subject: International NICU project

Hi, Rick

Yesterday, I met with Dr. Boris Vinogradsky, Chairman of the Board of the Russian American Medical Association - RAMA (he is also a General Surgeon on the East side of Cleveland). One thing came out in our discussion was a potential project in Central Russia. There is a great need for neonatal - perinatal care in the area called Yaroslavl Oblast and they do need a lot of help. It is a big area (more then a half of Ohio, I believe). The Yaroslavl city is about 250 miles north of Moscow. It sounds like the governor of that area is ready to finance any project from our side as long as he receives a good proposal. Besides there are potentially plenty of businessmen who are ready to invest in health care projects (esp. children health care) for their own purposes. Boris has a lot of connections there (it was his hometown). I thought, we can offer them to build up something like a 10-15-bed NICU, help with equipment and provide some education and training to their nurses and physicians. I believe, it could be a very interesting and exiting project for us, CCF and RAMA. What do you think? If it is something you are interested in, all three of us can meet together and discuss all details and potentials.

Thank you,

Vladimir




This is awesome. Let's meet. Regards, Rick

Ricardo Rodriguez, MD
Chairman, Department of Neonatology
Cleveland Clinic
9500 Euclid Ave.
Cleveland, OH 44195 | (216) 444-0297

[Dr. Mom]

Check with Victor Dovgan from medico.ru - they have pretty active neonatology forum. I will re-post the initial information from this thread there.

[Boris]

Yaroslavl is building the Perinatology Center of the 21st Century. They are interested in cooperation with us in this project. In a way it is similar to what is planned in Kemerovo. Again, it will require a lot of effort from many people, if we want it to be successful.

[Boris]

I talked to Marina Filshtinsky from Medmir.com recently. Her e-mail about the project:

Пишу по поводу неонатологичекого проекта, который мы обсуждали Борисом Виноградским, когда он был в Бостоне. С Ярославлем пока ничего не получается, как я понимаю, в том числе и по причине того, что перинатальный центр еще только строится. В то же время у нас есть выходы на Ивановский перинатальный центр, который значительно крупнее. Это так называемый НИИ Материнства и детства, он федерального значения, большой - 600 коек, считается, что ему 25 лет, но на самом деле на федеральный бюджет он переведен не так давно, а как раз после этого центр и начал развиваться. Я задала вопрос, интересно ли им сотрудничество с RAMA и Сleveland Clinic. Директор центра отвечает, что очень интересно. Иваново хорошо еще тем, что там прогрессивный губернатор, с которым также есть связи.

Dr. Burdjalov, Marina and me will start working on that project after Vladimir's return from Nicaragua Medical Mission.