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Thursday, April 24, 2014
Trinidad & Tobago Guardian Online
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Improved healthcare for digestive disease patients
Dr Anthony Kalloo has been in the medical field since he was 19, and has worked as a doctor and medical researcher in the United States for much of his life. He is one of the world’s pre-eminent gastroenterologists, and is the director of that division at the renowned Johns Hopkins Hospital in Baltimore.
Kalloo has not forgotten his home, and wants to make a contribution to T&T’s healthcare system, starting with improved treatment for digestive diseases.
“I’m from Trinidad, I’ve spent all my training and my life in digestive diseases, I would like to see care for patients with digestive diseases improve,” Kalloo said.
He said wealthier patients sought him out in Baltimore for treatment, but he would like the type of care he specialises in to be available in T&T, for everyone.
“They don’t have to come to the States to get good care,” he said, adding it was not necessarily that healthcare was not good in T&T, but some of the specialised and high-end procedures were unavailable locally.
The Woodbrook native, now 58, was in T&T for a few days earlier this week, finalising an initiative with the Ministry of Health that ultimately seeks to improve the care of patients with digestive diseases.
A handful of specially selected local doctors will get the opportunity to travel to Johns Hopkins Hospital for a gastrointestinal (GI) immersion programme, where they will shadow Kalloo and other GI specialists.
The programme will expose young doctors to the latest procedures and newest techniques in GI surgeries, specially by using endoscopy.
“Endoscopy refers to taking a tube with a light, like a long telescope, and we could put it through the mouth and we can look inside the stomach and intestine and diagnose things like ulcer disease and cancer. Similarly we can insert it and look at the large intestine and diagnose precancerous conditions,” he explained.
This non-invasive procedure therefore eliminates the need for cutting into patients’ skin and muscle, and reduces their recovery time.
He said there have been major advancements in endoscopic treatment in the last two decades because of improvements in technology.
“The idea is to bring these advanced technologies to Trinidad. That’s why Johns Hopkins has this relationship with the Ministry of Health to improve the care of digestive disease patients.”
It is not the first partnership, as entities have previously worked together since 2008 under the T&T Health Sciences Initiative, on a diabetes programme and training for cardiologists.
Kalloo, a regular masquerader for Carnival to this day, attended Fatima College and taught sciences at St Joseph’s Convent, Port-of-Spain, for a year before going to medical school at the University of the West Indies, Mona campus.
He did a year-long internship at Port-of-Spain General Hospital, completed his residency training in three years at Howard University, a fellowship programme for three more years at Georgetown University, then joined the faculty at Johns Hopkins.
“I was in school for a long time,” he laughed.
Kalloo commented on the healthcare system in T&T, saying there were good doctors, and the Ministry of Health was working hard to make changes where needed.
“There are lots of infrastructural changes that you have to make. For example, when I go work, I go for 7.30 in the morning, and I am there till six or seven in the evening. That’s a different mentality to here...But if you want to make a meaningful change, you really have to be committed.”
He said everyone had to make a concerted effort to build and maintain a working system.
“You cannot have a specialised piece of equipment and when it goes down you don’t have it for six months.”
Kalloo conceptualised and pioneered a type of intricate abdominal endoscopic procedure called natural orifice translumenal endoscopic surgery (Notes), which is an incision-free alternative to laparoscopic surgery and allows gastroenterologists to access abdominal organs without cutting through skin and muscle. Instead, organs are accessed via the mouth or another orifice and then through the abdominal wall.
Patients recover faster, have less pain and get back to work quicker, which also means tremendous health care costs savings.
“It takes the concept of laparoscopic surgery a step further,” he said.
Fifteen years ago there was much scepticism about Kalloo’s idea, but today the technique is done worldwide, with over 3,000 patients undergoing the procedure.
“It’s still slow in terms of evolution, because we’re still developing new equipment and devices to make it safe.”
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