Mark Duster, MD
Mark Duster, MD
Pediatric Cardiology · Salida, CO


Training Pediatric Residents


February 1st
Angkor Hospital for Children, Siem Reap, Cambodia

Project Description

This will be my third visit to Angkor Hospital for Children as a volunteer pediatric cardiologist. The hospital is a NGO that serves the poorest children in Cambodia. The hospital also has a pediatric residency training program with a mission to resolve the national shortage of specialty trained physicians. I serve as a consultant and in house resident instructor in pediatric cardiology giving lectures, seminars, inpatient consults and mentoring young faculty members.

Approximately 500 outpatients are seen per day of these approximately 20 will be patients with severe cardiac problems, the inpatient ward has 50 beds, PICU 12 beds

In a resource challenged environment, primary care physicians deliver the majority of subspecialty care. The goal is to adequately prepare these physicians for the challenge. The additional impact is consulting with the faculty on complex cardiac patients.

I travel with my wife who works for another NGO. We will also be working for one month in Bhutan. Any assistance in helping to defray the costs of these trips would be greatly appreciated.


Trip Photos & Recap

Thanks to generous support from the Dox Foundation, I recently returned from a month-long volunteer assignment as a Pediatric Cardiologist at Angkor Hospital for Children (AHC) in Siem Reap, Cambodia.

I have worked as a volunteer in multiple Southeastern Asian countries but what draws me back to AHC is not only the warm, welcoming Cambodian culture but also the friendships that have developed during previous visits.

AHC is a non-profit pediatric teaching hospital that provides free, quality health care to the impoverished children in a country that is still recovering from a horrific history. AHC works closely with the Ministry of Health to train health care providers and implement best practices in pediatric healthcare. During this visit, I was tasked with mentoring three “pediatric cardiology fellows”. These physicians have a tremendous amount of on the job training. Their diagnostic clinical skills are remarkable and I was able to add a better understanding of the pathophysiology, pharmacology and the rationale of various treatment protocols.

Together, we saw patients in the always busy cardiac clinic, PICU, NICU and inpatient wards. Lectures were given to pediatric residents on cardiac related topics. We even had the opportunity to use the newly purchased cardiac defibrillator for the first and the second times. In between my visits, we continue to discuss challenging patients via email.

Anyone who volunteers in a resource challenged environment will tell you the reason they keep coming back is that they “get much more than they give”. The challenge of treating large numbers of patients with extremely complex conditions is truly intellectually stimulating. Sometimes I believe that senior physicians, like myself, are uniquely qualified to work in these environments. We remember an era that was not only devoid of EMRs but also lacked, CT, MRI, PCR, miracle drugs, and complex surgeries. We remember treating conditions that younger physicians know only from texts. When was the last time you treated a patient with cyanotic congenital heart disease, thalassemia and acute tubular necrosis? How about congestive heart failure secondary to beriberi? Uptodate on my laptop is my dearest friend.

If you are culturally sensitive, extremely flexible, remain non-judgmental but at the same time willing to share your own experiences with peers who are working under difficult circumstances; then volunteering in a resource challenged environment may be your calling.

+++

Health Volunteers Overseas is dedicated to improving the availability and quality of health care through the education, training and professional development of the health workforce in resource-scarce countries. (hvousa.org)

AHC accepts volunteers in pediatric healthcare from IT support and Social Work to Pediatric Subspecialists. (angkorhospital.org)