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	International Society for Maxillofacial Rehabilitation
			Home Page Membership Dues & Information Membership Roster Presidents Letter Officers and Executive Council ISMR Slide Show (PowerPoint presentation) Outreach & Research Programs ISMR Educational Courses (members only) ISMR Partners Administration Office / Donations	Outreach Programs ISMR doctors volunteer their services to patients from around the world who might not otherwise receive sophisticated treatment. Medical supplies are donated to assist with treatment and rehabilitation. Clinical Outreach Programs have been established in Viet Nam, Mongolia, Bolivia, Thailand, and Sierra Leone, and the USA.
International Conferences Next Meeting Bangkok, Thailand (2008) Past Meetings Maui, Hawaii (2006) Maastricht, Netherlands (2004) Okinawa, Japan (2002) Kauai, Hawaii (2000) Turin, Italy (1998) Seoul, Korea (1996) Palm Springs, CA USA (1994)		Mongolia December 17-23, 2004 School of Dentistry Health Sciences University of Mongolia Ulaanbaatar, Mongolia
An international ISMR Outreach Mission was recently completed (December, 2004) in conjunction with the University of Mongolia Medical Dental Schools. Our hosts were Drs. Entuvshin and Odondemeg, both professors with the Health Sciences University of Mongolia in Ulaan Batar. Drs. Robert van Oort of the Groningen University Hospital, Netherlands; Gianfranco Gassino of the University of Turin, Italy; and Ian Zlotolow of the University of the Pacific in San Francisco, USA volunteered to represent the ISMR for a week-long program treating patients with unrepaired cleft palates, facial trauma (burns), congenital missing ears (microtia) and head and neck cancer patients requiring obturator prostheses. Dr. Zlotolow has previously made two trips to Mongolia in 1998 and 2001, working with Drs. Odondemeg and Entuvshin in their National Prosthetic Center. Prosthetic supplies and equipment were generously donated by Factor II and Memorial Sloan-Kettering Cancer Center. Thirty Mongolian patients were treated and 16 maxillofacial prostheses were fabricated. These included orbital, auricular, nasal and ocular prostheses, maxilloctomy obturators, cleft palate fistula stents, a total cleft one month old baby feeding appliance and unrepaired cleft palate speech bulbs. Valuable education lectures were given to prosthodontists, dental students and laboratory technicians on restoring the maxillofacial patient, and maxillofacial clinical rehabilitation and laboratory technology was introduced to our Mongolian colleagues. Due to the generously donated supplies, maxillofacial supplies were able to be left for future use in possibly 20 facial appliances and 30-50 intra-oral prostheses. The International Society for Maxillofacial Rehabilitation would like to thank our volunteers, gracious hosts, students and patients who made this Outreach Mission such a wonderful success. Report from Dr. Robert van Oort Dr Enktuvshin Gavaa, School of Dentistry Health Sciences University of Mongolia Ulaanbaatar, Mongolia co- workers, Dr Odno Odonchimeg Demid, Dr Otgonbayar Bold, Dr Sapar and Dr Oyun Dr Bazar Amarsaikhan, PhD, Dean of School of Dentistry A Six day clinical program in the clinic for Maxillofacial Prosthetics, based on first impressions, on formal and informal discussions and clinical work with patients. Basic Facilities- in the prosthetic/orthodontic department. Two dental chairs, technical units with equipment in a low basic but functional condition, one pantomographic room, 2 combined doctors/secretary rooms. The electricity of the equipment is connected by multiplier outlets. Hazardous for personnel in relation to the water-units in direct neighbourhood. The Dean expressed, during the first day a dream to build a new dental school. This would solve the facility problem. Personnel- Three enthusiastic young dentists under the supervision of Dr Odonchimeg. (She had also a second appointment in the Maternal and Child Hospital?s dental clinic). The School of Dentistry is one part of HSUM. Department of Prosthodontics has 4 lecturers: Dr.Odno,DDS,Ph.D., Dr.Tuvshin,DDS, MDS., Dr.Otgo, DDS,Ph.D., Dr.Sapar,DDS,MDS., The Dean of Prosthodontics Department is Prof. Purevjav. He is also director of State Dental Clinic. Technicians- are very eager to work and learn new technologies. - Personnel is focussed on solving the problems of the disabled patient. - Education building of personnel has taken place in the past in Russia, Japan and Cuba. Dr Tuvshin is doing a research project in Seoul for his PhD in the field of dysostosis and growth-factors. - The MFP-clinic is now under supervision of Dr Odno and the younger Dr Otgo. Dr Otgo is bright and talented in learning new treatment modalities if sufficient material for treatments are available. - Dr Oyun has been busy with facial prosthesis and ocular prosthesis in the past. Materials are too limited for a consistent result. - Many students were present on Saturday, during the first day of our program. The students were very eager to learn and to make contact with doctors from abroad. - Language is for some doctors a limitation in communication to western prosthodontists (English and German) Patient Care- is directed by patient-needs and not healthcare directed. From Saturday till Thursday we have consulted 26 patients with a variety of severity of disabilities, (congenital, oncology and trauma). Dr. Gassino has organized the laboratory to function with the work of our mission. Dr. Zlotolow and van Oort have consulted with the patients, together with the clinic doctors. No overview of the origins of the patients. Some from Ulanbaatar, some from far distance. Patient-records were not always available or written in Cyrillic. About 40% of the patients asked for advice, the other 60% needed treatment in maxillofacial prosthetics. The youngest was 1½ month, bilateral cleft palate, the oldest was 82 years, orbital oncology defect. The second appointment for treatment was not honoured by 10% of the patients. Materials- Limited number and limited diversity of materials were present. The sponsored materials from Factor II were more than welcome. How to use the materials was demonstrated during the program by the Outreach Team. Implants are not available. The local prosthodontists knew the functions for reconstruction, but have no experience in application. Reconstruction plates for the oral surgeon were desperately needed as was expressed by Dr Odkhuu on Tuesday-afternoon. Alginate and gypsum are available, and some RTV acrylics for dentures. The material sponsoring by the Foundation and from some particular instrumental/wax/ocular sponsoring of Dr. van Oort amounted in total to $2,000 (USA). Working atmosphere- Respect for the eldest determines the whole pleasant atmosphere in the clinic and society. Most of the colleagues are at the moment not accustomed to work in a high pressure. Teaching to dental students or technician-students is their main job. Although the work-tension during the outreach program of 6 days was high, the doctors/technicians were always very willing to finish the technical work even late in the afternoon and early evening. At 7 p.m. the electricity was shut down. Everyone was very excited to learn new techniques and surprised getting compliments. Patients- No regular patient-records were present from the MFP clinic. Patients take most of their records from past treatment from other clinics for consultation. - ?No show? of the patient?s not uncommon. Patients are not insured for treatment. Children are treated in the Maternal and Child hospital in UB paid by the government healthcare. - The MFP unit of Health Sciences Centre is the only unit of Mongolia. Organising the patient care is a complicated management problem, because of money and distance for the patients. No insight in the financial situation of the MFP-clinic for self-support next to the limited teaching-task in MFP. Doctors- of the unit have a relatively mediocre salary. All the staff work from the bottom of the heart. It is rare to have a second job for the staff. Students- during the day from 8:00 till 19:00 you always meet a numbers of students in the public area. Very enthusiastic and very applied to their study. Advices from Dr van Oort after a short, intensive and productive outreach mission: 1. Establish a MFP-unit according to European standards support on a regular basis need to be given. The patients ask for help, the doctors and technicians are very much involved in giving care. 2. The MFP-Unit of the dental school needs continuous support by email-answering of Frequently Asked Questions 3. Support for patient care problems and education and training by means of internet. - Material support on a regular basis by postal service. - Equipment support for the future, for example donation of revised dental units and laboratory equipment. 4. Scholarships for dedicated doctors to visit laboratories and clinics for an apprentice in MFP to learn how to plan methodologies, to learn technologies with the limited availability of materials. 5. In a next or follow-up mission there is a task for a surgeon (f.e. Interplast) and a technician in the team. Robert P van Oort, DDS, PhD, DDS- Maxillofacial prosthetics. Corrections: by Dr Enkhtuvishin, Dr Odno and Dr Otgo back to top of page
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