Tuesday, March 22nd

Today we visited the National Cancer Hospital in Ulaan Bataar. It is a very dated facility going back to the time of the Soviet Empire. Mongolia has had a hard time recovering from the withdrawl of the economic impetus to its economy that existed during that period. Things are beginning to improve, and it appears that there is a political awakening occurring in a better educated and growng middle class. Mongolia has incredible mining riches in coal, copper, gold, and uranium, which are being developed aggressively. It is expected that these resources will provide the funding necessary to moernize the economy, and particularly the healthcare sector. There are many opportunites, however, while this is happening, to respond to current needs.

The most notable issue at the Cancer Hospital is the very high incidence of primary liver cancer due to an epidemic of hepatitis B in the 1950's before the advent of disposable syringes and a complete understanding of transmission of this disease. The infant immunization rate is nearly 100% now, which will take 2 generations to eradiciate maternal-child transmission, in spite of the fact that 2/3ds of the population is either nomadic or living in very remote areas. In association with this, infants and choldren receive all of the current WHO recommended vaccines. The development of primary care services to achieve this level of care has been a focus of the government, and is accomplished by increasing the pay of primary care providers in these locations. An idea that might benefit our system.