On the Road with Dr. Hubner

In support of EUCOM’s efforts to do more interagency partnering, I found myself driving through the pouring rain out of Tirana, Albania to visit a remote hospital in Kukes. Kukes is one of 14 hospitals in Albania we would like to connect to the main Albanian hospital through telemedicine. This project would combine the efforts of USAID, an NGO and the DoD to link the hospitals by using the internet for training, counsel and a second opinion via a program like Skype. It will allow Albanian citizens with complex or rare medical conditions to receive high quality care from Albanian and potentially world-wide specialists. This is a major feat for a country with a poorly developed transportation system and difficult living conditions.

Interagency team made up of: J4-Medical Readiness, Army Corps of Engineers, Regional Minister of Health of Kukes, University of Arizona, Tucson, director, Kukes Regional Hospital, J4-Humanitarian Assistance. (Photo by Tara Clark)

First stop Albania

We experience the tribulations first hand as we found the tunnel leading to Kukes was closed due to heavy rain, forcing our team and their local driver to follow secondary roads over the mountain. Once into the bush we lost our way among the many switch backs that crossed the range. Fortunately help arrived in the form of two local men from a mountain village who accompanied the team over the ridge and showed the way to the Kukes valley below. Before beginning their 90 minute hike back to their own village the men only requested a phone call upon safe arrival in Kukes.

These are the same qualities of patience and dedication it’s going to take to get telemedicine up and running. USAID is purchasing the necessary equipment and hiring the NGO to set-up, train and sustain the program while DOD is funding the improvements needed at the hospitals to house the system and maintain internet connections. Once complete, this network will be used to improve the quality of general medical care as well as provide an important piece in the nation’s disaster response network.

Building in Kukes Regional Hospital complex which needs renovation for the telemedicine project. (Photo by Tara Clark)

However, it’s not going to be easy to get all the agencies on the same timeline and ensure all the details are covered by one of the three vested parties. But, there is no way that any of these agencies ALONE could make a dent in the national medical needs of Albania. In Albanian fashion, we’ll work together with patience as we traverse the unknown paths of interagency cooperation.

Second stop Slovakia

For close to a year DoS has been working with an outreach project in a Roma settlement outside of Bratislava, Solvakia. On a recent visit, Ms. Susan Ball, Political Affairs Officer at the Embassy, was told of two children who were sick. One was in the hospital and had undergone a number of surgeries. She called EUCOM humanitarian assistance to ask for advice and help.

I arrived on October 15 in the capital city and was given a background brief on the complexity of the Roma situation from a local Non Governmental Organization (NGO) that works with the Roma throughout Slovakia. An update on the children revealed that one 17 year old boy had been released from the hospital and was now home. He had been diagnosed with the parasite/roundworm Toxocara Canis (caused by ingestion of the parasite eggs) and had suffered significant complications from the infection requiring chest surgery.

To gather more information, I traveled to the settlement with partners from DoS and the local NGO. The settlement is a group of rough, self-built houses lacking in water and sewage. The ‘streets’ are dirt and mud paths that wind through the jumbled community. One is immediately struck by the number of dogs and youth; each wandering the streets clustered in tight little knots, eyeing any outsiders simultaneously appearing scared, curious and defensive.

We were spontaneously invited into a family’s home who were eager to share their story. The home was sparse, clean and warm, being heated by a wood stove working hard to overcome the early frost in the area. Afterward, we visited the boy recently released from the hospital. His impressive thoracotomy scar ran from the left side of his chest around to his mid back looking like a well healing shark bite.

Clearly there are no immediate or quick fixes to raise the quality of life for the Roma population. The challenge now is to develop a savvy Public Health project that will be sustainable, build local capacity, involves local “buy-in” and a lot of interagency partnering. Not to mention paying due attention to the sensitive cultural issues of both the Roma population as well as the surrounding non-Roma Slovaks. Yet another difficult but worthwhile partnering opportunity, that could not be addressed by a single agency acting on its own.

Dr. Mark Hubner,
ECJ4-Medical Readiness