ASH News Daily 2017 - Issue 3 - B-4

Page B-4

ASH News Daily

Monday, December 11, 2017

HVO: Challenges Giving Way to Opportunities

SH partners with Health
Volunteers Overseas (HVO),
a nonprofit organization
dedicated to improving global
health through education, to bring
invaluable consultation and training to hospitals in the developing
world. Training provided by ASH
members takes the form of rounds
in the clinics, bedside consultations,
classroom lectures, training in laboratories, and more. The objective is
to develop sustainable improvement in the management of hematology patients at these institutions.
ASH member and HVO volunteer Dr. Michael Linden (University of Minnesota) talked about his
work with hematologists in Arequipa, Peru, and shared his experience
imparting knowledge to a capable
and enthusiastic group of trainees.
As to the status of hematology
care in Peru, Dr. Linden remarked
on the country's advanced capability, yet variability from center to center as far as resource allocation (e.g.,
therapeutic options and diagnostic
equipment/reagents). He noted
that by and large, hematologic malignancies seen in Peru are similar
to those seen around the world, but

notes that incidences of B-cell acute
lymphoblastic leukemia, natural
killer cell lymphoma, and EpsteinBarr virus-driven lymphoproliferative disorders/lymphoma appear
to be more commonly encountered
there than in his practice in Minnesota.
There are some other challenge
areas that Dr. Linden points out as
possible areas of focus for HVO volunteers traveling to Peru. Training
is one example. "Graduate medical
education in Peru is less structured
than in the United States. There is
formal hematology training but no
formal hematopathology training
to emphasize subspecialty diagnostic pathology," he said. He also
lists other key areas of knowledge
that volunteers may be able to impart to their Peruvian counterparts:
1) providing didactic lectures, 2)
sharing knowledge and expertise
both locally and remotely, and 3)
emphasizing standardization of
hematopathology diagnoses and
treatment.
To illustrate this third point, he
offered the following example: "If a
patient has a bone marrow aspirate
and biopsy for a new diagnosis of

hematolymphoid
neoplasm," he began, "the hematologist
reviews
the stained aspirate and records
a differential and
diagnosis in a
notebook. A clinical
pathologist
performs a flow
study and drafts a
paper report, and
an anatomic pathologist reviews
the core biopsy
and drafts a sepa- (L to R): Drs. Martha Delgado (Honorio General Hospirate paper report. tal), Patricia Huamán Castro (EsSalud - Carlos Alberto
Though some of Escobedo Seguin Hospital), and Michael Linden (Unithese data enter versity of Minnesota) in the Flow Cytometry Laboratory,
a basic electronic EsSalud - Carlos Alberto Escobedo Seguin Hospital,
lab database, there Arequipa, Peru.
are opportunities to improve inte- among the onsite pathologists was
gration of all these data into a syn- collegial and welcoming, and there
optic report to standardize disease were numerous opportunities to
diagnoses."
bring people together for dialogue
In terms of his working relation- and sharing. To get the most out
ship with the on-site hematologists of an HVO experience, Dr. Linden
and other staff during his visit, advises potential volunteers to alDr. Linden was thrilled with his ways stay flexible. "Though the
"delightful and enthusiastic" host
hematologists. The environment
»» HVO Page B-6

Table of Contents for the Digital Edition of ASH News Daily 2017 - Issue 3