Through the generous support of UCLA’s Operation Armenia, a team of pediatric anesthesiologists traveled to Yerevan, Armenia, in early May 2023. The doctors made the trip as representatives of the division of pediatric anesthesia of the David Geffen School of Medicine at the University of California Los Angeles (UCLA).
The team consisted of Pediatric Anesthesiology Fellows Dr. Shatira Wilson and Dr. Daniel Salazar and UCLA Chief of Pediatric Anesthesia Dr. Ihab Ayad. The purpose of their introductory visit to Armenia was to gain more insight into the practice of pediatric anesthesiology in the country and to assess ways that UCLA might collaborate with pediatric anesthesiologists there in pursuit of a shared goal of improving anesthesia services.
The ultimate goal of their visit was to develop meaningful collaboration with one or more pediatric institutions in Yerevan through a formal fellowship or attending-level rotation as part of a global health initiative. The ground for such collaboration has already been set, as the American Board of Anesthesiology has approved the incorporation of visits by pediatric anesthesia fellows as part of an elective rotation during their training.
The UCLA team was welcomed by hospital CEOs, surgeons, nurses, trainees and anesthesiologists at multiple children's hospitals in Yerevan. They toured facilities, viewed equipment and observed how professionals in Armenia deliver anesthesia for a multitude of surgical procedures at Wigmore Hospital for Children, Arabkir Hospital for Children, Muratsan Hospital, St. Astvatsamayr Hospital and Nork Marash Medical Center.
The UCLA team learned that many of the techniques and types of anesthesia used for certain cases were identical to those used in the United States for similar cases, e.g., general vs. regional vs. monitored anesthesia care (MAC). The anesthesiologists they met in Armenia worked diligently, competently and safely, making decisions similar to those the UCLA team would make if they were in the same situations.
The visiting doctors were impressed by the anesthesiologists in Armenia, who provided quality care in an environment without as many resources enjoyed by physicians in the U.S. The broad principles of delivering safe anesthesia appeared to be the same; however, due to limited resources and the unavailability of some medications, some areas could benefit from improvement. Furthermore, the team noted certain practices used in Armenia that could be considered for implementation at UCLA.
For instance, due to the unavailability of oral narcotic formulations, specialists in Armenia have acquired mastery of regional anesthesia techniques to control post-operative pain. This practice is not routinely used in the U.S., opening a window of opportunity to learn from the Armenian experience to decrease narcotic usage among children. Conversely, certain techniques used to monitor patients during procedures done with sedation are not always used in Armenia; universal implementation of these relatively simple techniques may further improve safety and outcomes. These are just a few examples of differences in practice. An ongoing collaboration would be an ideal way for these specialists to continue to learn from one another, exchange ideas and jointly improve patient care.
In addition to working with surgical and anesthesia colleagues, the UCLA physicians also had the chance to learn about Armenia and visit sites of historical significance. They enjoyed exploring the culture, food, entertainment and natural beauty of Armenia, together with the hospitality of her people.
The working visit of the UCLA doctors was made possible by their colleague, Dr. Shant Shekherdimian, and the Operation Armenia team at UCLA Health. Drs. Wilson, Salazar and Ayad look forward to continuing the exchange by welcoming their colleagues to the U.S. and continuing the dialogue they began in Yerevan.
UCLA’s Operation Armenia is a coordinated effort of a dedicated interdisciplinary team that provides immediate medical disaster relief and long-term humanitarian aid and infrastructure support to Armenia and Artsakh. It operates under the umbrella of The Promise Armenian Institute at UCLA and is implemented thanks to the generosity, advocacy, and support of UCLA Health.