Above left, Stanford surgeon Rochelle Dicker, Cleveland Clinic surgeon Julie Adams, and Stanford pathologist Yasodha Natkunam pose in front of a Hindu temple during a layover in Singapore during a service journey by physicians to provide post-tsunami assistance in Sri Lanka

Letter to the Editor:
Yasodha Natkunam, assistant professor of pathology and associate director of the medical center's Hematology Laboratory, spent two weeks earlier this year in her native Sri Lanka offering medical services in the wake of the devastating tsunami which struck the region in December 2004. She was accompanied by a team that included Stanford faculty surgeon Rochelle Dicker, assistant professor of surgery. Natkunam offers these thoughts to her medical staff colleagues:

Tragedies such as last December's Asian tsunami illustrate that the greatest contribution we at the Medical Center can make to third world recovery and improvements in the medical infrastructure is educational. It is neither necessary for us to travel across the Pacific Ocean nor even to contribute money to help.

During my trip and through ongoing contact, I have seen and learned that every tier of the Sri Lankan health care community (physicians, medical students, technologists, physical therapy/rehab, psychotherapists, PAs, nurses, especially those with a public health background, etc.) could benefit from information and training that we could provide. For example, we could relatively easily put together a medical school or technologist training curriculum on CD-ROMs. (We would need to deal appropriately with copyrighted material, of course).

Departments or divisions could partner with overseas hospitals or medical schools to provide staff training. For example, since my return I have been working with nonprofit organizations to find funding for medical personnel who can be brought to U.S. medical centers such as Stanford for short training sessions (2 weeks to 2 months). The idea is that the trainees will return home and then recruit and train additional personnel. This could have a tremendous impact on the health care infrastructure over time.

Technology, even those considered esoteric for the developing world (such as PCR, flow cytometry, certain radiologic or diagnostic procedures), may be avenues to inexpensively screen diseases without building an entire laboratory or a surgical or oncology program. Sending radiologic or pathology images through the web to experts here may be more efficient than transporting patients for diagnosis in a home country where the logistics of travel and health care access are difficult.

By the way, the efforts we have already made have been a collaboration. I want to extend a very sincere thank you to several members of the Department of Pathology, and particularly to our chair, Steve Galli. I am grateful for their general support of my efforts but also for donating microscopes, time to cover my service responsibilities, as well as monetary contributions. Microscopes were also donated by Ed Jasinsky of Scientific Instrument Company, Sunnyvale. I had the blessing of Medical School Dean Pizzo, hospital president and CEO Martha Marsh, and LPCH President and CEO Chris Dawes, who all called or e-mailed to express their support.

Staff members who want further information are welcome to contact me (yaso@stanford.edu). Yasodha Natkunam, MD, PhD. assistant professor of pathology, associate director, Hematology Laboratory, Stanford University School of Medicine.