Broadening perspectives in India
As an American of Indian origin, I resolved long ago to contribute to the laType equation here.nd of my ancestors in some way in those early years, and the AUA allowed me to fulfill that dream as the first AUA/USI Exchange Scholar.
My hope was that the AUA would be my vehicle to learn, observe, question and provoke, while the non-profit organization, International Volunteers in Urology (IVU,) would facilitate direct, hands-on service where I could perhaps be of some help. My training as a pediatric urologist is valued in India—a nation of a billion that lacks in not having a single fellowship-trained pediatric urologist.
The dream became a reality
On January 18, 2010, we traveled to the beautiful city of Cochin, where I began my exchange in earnest with the Department of Urology at the Amrita Institute of Medical Sciences and Research Centre. I delivered a grand rounds lecture on Antenatal hydronephrosis and spoke on “Robotics in Pediatric Urology” that evening.
On January 23, we arrived in Ahmedabad and welcomed the arrival of Drs. Richard Grady and Anjana Kundu of Seattle Children’s Hospital. Dr. Kenneth Smith, a chief resident in urology at the University of Minnesota also arrived as we commenced an 8-day intensive bladder exstrophy-epispadias and hypospadias workshop. With our extremely capable and dedicated hosts, Dr. P.K. Dave, head of the Department of Pediatric Surgery at the B.J. Medical School, Dr. Rakesh Joshi and Dr. Sudhir Chandna, we rounded on thirty patients with severe variants of closed, unclosed, fistualized, and dehisced bladder exstrophy and epispadias.
We made decisions on the children we would operate upon with great care and heartbreak as many parents realized we would be unable to repair their children on this visit. We prioritized infants whose exstrophy had never been closed and older children who had an urgent need to be continent of urine and have their epispadias repaired to reintegrate into schools and their society. We pledged to other families that we would return in 2011 to repair those that we could not assist on this visit.
We selected the most challenging patients for surgery, and over the next four days, Dr. Grady and I performed 18 major reconstructive procedures working into the late evening each night.
On January 29, 2010, our team traveled to the famed Muljibhai Patel Urological Hospital in Nadiad. I performed a live broadcast transverse preputial island onlay hypospadias repair for an infant with a penoscrotal hypospadias repair while our host, Dr. Mehesh Desai expertly completed a laparoscopic adrenalectomy and percutaneous nephrolithotripsy in two boys.
Challenge after challenge
Next we progressed to the capital city, New Dehli, where I had the pleasure of visiting the prestigious All India Institute of Medical Sciences and was given the privilege of delivering an update on Vesicoureteral Reflux. The final destination was the city of the Taj Mahal, Agra. As a faculty speaker at the Urological Society of India National Conference, I spoke on complications after Total Urogenital Mobilization and on advances in pediatric endourology and enjoyed unparalleled hospitality, glorious dinner buffets and excellent networking opportunities.
In the end, I am grateful to the AUA for enabling an experience that was at once exhilarating, exhausting, challenging and relaxing. I truly feel that the experiences of the last three weeks have broadened my perspectives and stimulated ideas for real collaborations with my new colleagues in India. I look forward to the years ahead as I build upon the friendships and continue our interactions into the future. This was truly an exchange, and I have gained more than I can ever hope to return.
- Story courtesy of Dr. Aseem Shukla