GCVOA, working with the neonatal and obstetrical units at MetroHealth Medical Center, provides technical assistance and financial support to the Volgograd Regional Perinatal Center. This year’s work focused on two activities:

1. implementation of a training program for young physicians at the Center by affording them two months of residency experience at Metro;
2. restoring to operational use a used blood gas machine which Metro had donated to the Center and which GCVOA had arranged for export to Russia three years ago.

The first activity began inauspiciously as the summer chill in US/Russian relations resulted in a visa denial to one of the young Russian physicians. As those relations changed in the early fall, the first of the physicians, Dr. Timur Azhibekov, trained in Russia in handling critical care infants, started two months of training at Metro in the second week of October under he supervision of Dr. John Moore. Recently, Dr. Azhibekov advised the GCVOA board of some of what he has learned in he last month or so:

"During my training I am learning new methods of respiratory care in neonates, modern approaches to neonatal nutrition, parenteral and enteral feeding. Also I am getting experience in the management of critically ill newborn infants, in

1. using special diagnostic and medical procedures: radiological studies, blood sampling, transillumination and catheterization of the central and peripheral vessels, and
2. applying new medicines, indomethacin in PDA cases*, surfactant in RDS cases**."

The second trainee, Dr. Elena Zhavaronkova, an obstetrician with skills in performing laparoscopies, has on the second try received her visa and is due to arrive in late January. She will take a two month course of intensive English at CWRU and then begin her two month training at Metro under the supervision of Dr. Graham Ashmead.

The second activity this year involved assistance with the repair and operation of the blood gas machine, a machine that measures the level of oxygen, carbon dioxide, hemoglobin and pH of human blood. It is used to evaluate diseases and conditions of lungs and kidneys of infants, pregnant women, and mothers and the effectiveness of oxygen therapy.

GCVOA assisted the Center in finding an appropriate, authorized representative of the machine’s manufacturer in Russia, and financed the repair and the ongoing solutions used by the blood gas machine. In a report to the GCVOA board, Dr. Alexander Boukhtin, supervisor of critical care operations for expectant mothers, recently advised:

"Our NICU uses widely the Blood Gas Machine which we got from MetroHealth Center and then repaired with your help. This year we developed more than 1000 analyses of blood gases."

This year the Center has expended a total of $3565 donated to them by GCVOA and its supporters, of which $1739 was used for travel expenses by the three Russian physicians, and $1726 was used for evaluation, repair and the solutions for ongoing operation of the blood gas machine. Major expenses in the near future are expected to be Dr. Zhavoronkova’s air fare to the US and the costs of her language training at CWRU.

These expenditures have begin to bear fruit as the Center has now reduced the infant mortality rate in the nine districts of 33 districts in the Volgograd Region, which the center is responsible for, to 9.9 per thousand in 2000. This compares with 12.1 per thousand in the entire Volgograd region, 14.3 per thousand throughout Russia, and 18.1per thousand in Volgograd Region in 1992. It approaches the rate of 9.4 per thousand that was measured last year in Cuyahoga County.