Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Tuesday, March 17, 2015

The Global Health Arena

"I felt having this knowledge and this technique, I have an obligation to share it with other doctors in other countries, where it could have such a meaningful impact."
"There wasn't a day that went by ... when I didn't think, 'How can I improve this, make it safer, minimize discomfort. When you focus all your energies on one or two surgeries, you have a lot of mind space to continue to innovate."
Dr. Neil Pollock, Vancouver, British Columbia

"Within twelve years, most newborn males born today will be protected with circumcision, which has an impact similar to that of a vaccine."
Dr. Jerry Bonhomme, Haitian physician
Handout    Dr. Jerry Bonhomme, foreground, practices newly learned circumcision techniques as Vancouver's Dr. Neil Pollock looks on in Port au Prince, Haiti.
At the Gheskio Health Center in Port au Prince, which is the largest AIDs and tuberculosis hospital in the capital city, the walls crawled with mosquitoes. These mosquitoes are vectors for chikungunya, a virus that causes severe joint pain, epidemic in Haiti. There it was that Dr. Pollock who brought his expertise in circumcision, demonstrated and taught medical trainees from Haiti how to use this swift, almost painless method of detaching the foreskin from a baby boy's penis.

Dr. Bonhomme is now in a position to make use of the skills transferred to him by Dr. Pollock, and in turn to teach others in his profession to do the same. The circumcision of babies in Haiti is a practical solution to a difficult problem. In that country the average age of first sexual encounter for boys is roughly thirteen years of age. And it is estimated that 2.5% of teenage sex partners contract the AIDs virus, according to Dr. Bonhomme.

Dr. Pollock flew to Haiti by invitation. A medical professor at the University of California at Los Angeles, Jeff Klausner, who was formerly a Centres for Disease Control official in Africa, thought it imperative that something be done in the poverty-stricken country to stop the spread of HIV which is regarded as an epidemic there, affecting one in 50 people. Since there is ample scientific-medical evidence that circumcision can cut HIV spread by 60%, it seemed a timely intervention.

He discussed the idea with some of his colleagues in Haiti, then committed to bringing someone to the country prepared to teach the necessary skills to perform the minor surgery. He was informed that Dr. Pollock, from Vancouver "had a reputation for being the best in the field and a great trainer". There was no funding for the venture, however, which led Dr. Pollock to raise $25,000 from friends and family, himself contributing ten thousand of that total.

Circumcision is hugely controversial in the medical world. The Canadian Pediatrics Society claims the benefits of removing a boy's foreskin don't outweigh risks, citing pain and possible complications. On the other hand, the American Academy of Pediatrics and the U.S. Centers for Disease Control recommend circumcision as a preventive for HIV and other sexually transmitted diseases.

Dr. Pollock has developed a skilled method using special techniques to administer the local anesthetic and other modifications he has pioneered for circumcision, and to which he has dedicated his practise, along with a "no-scalpel, no-needle" protocol for vasectomies at  his clinic in Vancouver. He is able to perform a circumcision in about 30 seconds, he says, almost painlessly. He spent some time in Rwanda in 2009 teaching doctors there his procedure.

Handout Local Input ~ Dr. Neil Pollock, with Charlize Theron in Port au Prince, Haiti recently, says he is working with the actress to deliver a training program on circumcision to doctors in her native South Africa
His visit to Haiti was almost concluded when he received a text message from Sean Penn who then visited Dr. Pollock at the hospital, accompanied by Charlize Theron. The pair of Hollywood celebrities, engaged in humanitarian charitable work, are acquaintances of Dr. Klausner. Ms. Theron has persuaded Dr. Pollock to deliver a training program on circumcision to doctors in her native South Africa.

"I got a very strong feeling of sincerity and authenticity from both Sean and Charlize and I would say they were both very strategic thinkers, very bright. Charlize was also a very sensitive and compassionate woman ... I got a sense they wanted to make a big difference in the global health arena", explained Dr. Pollock.

Handout Dr. Neil Pollock with actor Sean Penn, who observed as he trained doctors in Port au Prince, Haiti, how to perform circumcisions.

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