U.S. Doctors Fight Air Pollution In Mongolia’s Capital

A team of doctors from the U.S. is fighting air pollution and lung disease in Mongolia’s capital city, Ulaanbaatar, whose air quality is among the worst in the world.

AsianScientist (Jul. 29, 2013) – A group of California-based health professionals that has been working to improve public health in Ulaanbaatar for more than fifteen years has just received a five-year US$1.25 million grant to fight air pollution and its health impact in the Mongolian capital.

Volunteers from the Children’s Hospital Los Angeles (CHLA) received the grant in April from the Fogarty International Center of the National Institutes of Health (NIH) and the National Institute for Environmental Health Sciences (NIEHS).

According to David Warburton, MD, of CHLA’s Saban Research Institute, they will use the grant to continue their research into air pollution and to train child health experts and government agencies in Mongolia about lung health.

“We have already published a paper showing that lung health in rural Mongolian children is 50 percent better than in urban Mongolian children. We think this big difference is driven by cleaner air on the steppe. So we would like to see what happens if we can clean the air in the city,” Warburton said in an interview with Asian Scientist Magazine.

Warburton and his colleagues will continue their work in improving children’s health in Mongolia, which is at the heart of the California Mongolia Medical Program (CaMMP), a medical exchange program founded in 1995 to establish state-of-the-art pediatric and adolescent health and medical care in Mongolia.

To study the impact of air pollution on children’s respiratory system, Warburton said they will work with local scientists, physicians, students, public health officials, civil servants, politicians, and development workers on a defined research project.

“Hopefully, we will find a way to stop the epidemic of chronic lung diseases that is already costing up to four percent of GDP in Mongolia according to government statistics,” he said.

For the last few years, Mongolia has been transitioning from a centrally planned to an open market economy. Such a transition has also led to rapid urbanization, which has damaged its natural environment through deforestation, air pollution, and a growing garbage problem, he said.

In a March 2013 article published in the journal Air Quality, Atmosphere & Health, the World Health Organization (WHO) said air quality in Ulaanbaatar is one of the worst in the world. Emissions from power plants, an increasing number of cars, and the widespread use of coal stoves for heating by families living in traditional round felt tents called “gers” have polluted the air, contributing to dangerously high levels of carbon monoxide, sulfur dioxide, and nitrogen dioxide in the air.

It is the worsening air quality in Mongolia that pushed Warburton and his colleagues to focus on lung health, starting with seminars on research design and basic medical statistics that were held this month. Warburton’s team hopes to continue CaMMP’s work to improve public health in Mongolia, with a specific focus on children and adolescents.

The beginnings of CaMMP

CaMMP is one of the projects established by the California-based Ulan Bator Foundation. Established in 1991 by Arnold Springer, Professor of Russian History at the California State University in Long Beach, the Foundation aims to promote cultural exchange between Mongolia and Southern California.

The medical exchange project was launched in 1995, an offshoot of Springer’s visit to Mongolia in 1993 to evaluate Russia’s impact on Mongolian culture. It was supposed to be just a cultural study, prompted by the dissolution of the Soviet Union, but Springer couldn’t help but witness the dilapidated and tragic state of medical institutions and the care provided especially to children and adolescents.

Frustrated by what he saw, Springer returned to Los Angeles, intending to do something to reform the health system in Mongolia. He sought the help of the Los Angeles County Medical Association (LACMA), and it was through LACMA that he met Dr. Richard Mackenzie, Director of the Division of Adolescent Medicine at CHLA and organizer of several medical missions to Guangzhou, China.

“I was curious and of course altruistic in my desire to help,” Mackenzie said in an interview with Asian Scientist Magazine. He later joined Springer and traveled to Mongolia to do an informal needs assessment.

A distressing yet most enlightening visit

Mackenzie recalled that the initial visit to Ulaanbaatar was “distressing yet most enlightening.” He was already informed of Mongolia’s meager supply of medical supplies, and so he brought surgical sutures, dressings and other medical items donated by CHLA.

But his tour of Mongolia’s hospitals convinced him that donating supplies will never be enough. While he admired Mackenzie the commitment of the Mongolian physicians and surgeons, he was also frustrated by the deteriorating physical structure of the Maternal and Child Research Center – the main source of tertiary care for Mongolians. He also noticed that urgent and emergent surgeries were being carried out with outdated equipment, all but the simplest of lab tests were unavailable, and that essential medications, especially antibiotics, were in scarce supply.

“Since my resources in the U.S. were going to be entirely voluntary, any hope of providing significant amount of equipment, medication or supplies was limited. But we could provide education, scientific stimulation, library resources and connection with the greater scientific and medical community through collaborative efforts and eventually presentations and publications,” Mackenzie said.

It was this visit that gave birth to CaMMP, where Mackenzie now serves as Co-Director. And so far, this program has helped to improve public health in Mongolia in a variety of ways.

Mackenzie said it was through CaMMP that Mongolian hospitals such as the National Center for Maternal and Child Health (NCMCH) in Ulaanbaatar received essential medical equipment like respirators and microscopes; community based health programs for high risk and disadvantaged youth like orphans and street children were introduced; new licensing standards for the general practice of physicians and surgeons were established; and lectures and further education in the U.S. for Mongolian doctors to upgrade their skills were made available.

He added that CaMMP’s participants networked and raised awareness among the non-professional communities about the poor conditions of the hospitals and need for support for both improvement and professional advancement of physicians and surgeons.

Mackenzie said the Fogarty grant will allow them to fulfill CaMMP’s mission, which is to help Mongolian health professionals enhance their research and academic skills that will not only increase their stature in the international medical community but also benefit Mongolians.

He told Asian Scientist Magazine that CaMMP is advocating for the construction of a new women’s and children’s hospital in the capital.

“We provided several proposals and architect’s plans for appropriate structures. We also indicated that this would have to be an in-country effort, drawing not only on the needs and resources of the Mongolian people (and their government) but also the increasingly invested expat population of workers. We left them with that challenge,” he said.


Copyright: Asian Scientist Magazine; Photo: Children’s Hospital Los Angeles.
Disclaimer: This article does not necessarily reflect the views of AsianScientist or its staff.

Prime Sarmiento is a Manila-based travel and science journalist. She specializes in reporting on health, environment and agriculture in Southeast Asia.

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