Volume 5, No. 9, October 2007
From Your Colleagues
Michael Berryhill, HQE
Interested in a subinternship / externship / observership
I am a graduate from Royal College of Surgeons in Ireland and would like to apply for a subinternship/elective in general gynaecology and obstetrics with Indian health organization.
I have completed my medical training in Ireland and have done one year of internship in medicine and surgery.I wish to be in the field of OBGYN,and would very much be greatful if you could allow be to be attached to one of your fellow OBGYNs for an observership or subinternship.
Sincerely,
Dorcus Ye CV available from Michael.Berryhill@ihs.gov
Scott Giberson, HQE
New items on IHS HIV website
As a reminder, please continue to check the IHS HIV/AIDS webpage as there are continual updates to the site. Our ‘web-hits’ report shows a trend of increasing website usage over the last 6 months, which is very encouraging news. Currently, here are some of the items that can be found on the site:
- National Clinical Guidelines for the Treatment and Care of HIV/AIDS
- Ryan White information, links and resources specific to the AI/AN population
- Marketing tools, posters, PowerPoints and tribal advocacy kit
- Continuing medical education links specifically for free CME in HIV/AIDS
- Published research dealing with HIV/AIDS specifically in the AI/AN population
- Numerous links to interagency and native organization resources and websites
- Announcements of trainings
- “Antiretroviral Corner”. Up-to-date art les on clinical topics with a focus on HIV/AIDS treatment. ic
www.ihs.gov/medicalprograms/hivaids
Amy Groom, IHS Immunization Program
2007-2008 Influenza Vaccine
As we head into September, the IHS-NSSC is also heading into preparation mode for the 2007-2008 Flu Season. Last flu season (2006-2007) the delivery and distribution of the influenza vaccine to the IHS was delayed by the industry as a result of production issues associated with the identified strains of the virus that make up the vaccine. Delivery of the vaccine came to the NSSC in multiple (4) allocations last year. Much of Indian Country did not receive the completion of their order until December. This created many problems for facilities and providers in the field.
Each year the IHS-NSSC works with the Department of Veterans Affairs to include influenza vaccine requirements in the VA National contract solicitation. This is done to ensure:
Increased chances to receive the vaccine in the event of production & distribution issues & dilemmas.
The best price is available to the IHS & the Tribal community.
The product is shipped and received prior to the private sector.
In January of this year, after seeking, listening to, and evaluating your concerns and frustrations from the 06-07 flu season, the IHS-NSSC worked with the VA to inform the industry and worked to include language in the solicitation for 2007-2008 flu vaccine to eliminate, or at least reduce multiple allocations and provide guaranteed delivery dates. In April the VA awarded their 07-08 vaccine contract to Novartis (formerly Chiron) for the adult multiple dose 10ml vial. Glaxo-Smith-Kline was awarded the 1 ml single dose syringe, and Sanofi-Pasteur was awarded the pediatric single dose contract.
This year, there is great news to report. There appears to be no anticipation of a shortage. The FDA has approved this year’s vaccines and released LOT shipments from all 3 manufacturers to the United States. The NSSC received confirmation from the VA and Novartis that our entire order has been shipped and will be received soon (shipped to us this week). For all facilities who pre-ordered the influenza vaccine through the IHS-NSSC, your COMPLETE ORDER of adult multiple dose vials of the vaccine will be shipped to you in the next two weeks. There are no anticipated allocations this year and we believe that all NSSC customers will have their complete order by September 21, 2007.
Vaccine orders placed through the IHS NSSC increased by approximately 10,000 doses this year. Unfortunately, the NSSC does not have extra vaccine on order and will not be able to accommodate new or increased orders from the field.
While no changes are anticipated, it wise to have plan in place in the event one of one or more of these occurrences
For the latest regarding the Influenza vaccine product information, including safety, availability, and approval, please visit: http://www.fda.gov/cber/flu/flu.htm
For the latest on vaccination recommendations, please visit: http://www.cdc.gov/flu/
For questions regarding IHS influenza vaccination recommendations and the IHS Immunization program, please contact:
Amy V. Groom, MPH
IHS Immunization Program Manager/CDC Field Assignee
Phone: (505) 248 - 4374
Fax: (505) 248 - 4393
If you have questions regarding influenza vaccine orders for your facility, please contact the NSSC at 888-948-1415.
Indian Health Services
National Supply Service Center
501 NE 122nd Street , Suite F
Oklahoma City , OK 73114
Phone: (405) 951-6000 (888) 948-1415
Fax: (405) 951-6057
Craig Vanderwagen, Assistant Secretary for Preparedness and Response
Rebuilding Iraq one step at a time: You can be part of the solution
I have become a member of the editorial board for an English language medical journal being published in Iraq through the Ministry of Health called the New Iraqi Journal of Medicine. It is primarily managed by faculty from the Baghdad College of Medicine. It is a listed referreed journal (ISN 1817-5562) that follows the international conventions on referreed journals. They are striving to achieve a high quality product. I am most supportive because the medical community there has been decimated and needs revitalization.
I am wondering if our colleagues in Indian Health would be interested in submitting articles for this publication. As you can imagine primary care in general and the care of women and children are critical needs with infant mortality exceeding 125/1000 and maternal mortality exceeding 200/100,000….we know this in Indian Health better than anyone and I think that our experience would be most informative…over half of deliveries are outside the hospital and our insights would be useful.
The latest version of the Journal is available (my e-mail address is below) with Instructions to Authors. The Journal publishes articles on a wide variety of topics. The Editorial Board have asked me to solicit information from our experience in Indian Country and in other settings. I will also be attempting to encourage folks from Indonesia to offer some articles for instance and some of my Canadian colleagues as well.
Contributions from IHS would be most helpful both for nurturing the science and best practices, but our experience in applying these principles in a low cost and often challenging environment would be instructive.
OB/GYN CCC Editorial comment:
Update on Dr. Vanderwagen
After serving in many helpful roles in the Indian Health system, RADM W.C. Vanderwagen,
M.D.. is currently the Assistant Secretary for Preparedness and Response for
HHS. He has the responsibility for development of medical countermeasures (e.g.
Pan flu vaccines, anthrax anti-toxins, new lower cost ventilators) as well as
the leadership for all federal assets (including VA and DOD) in any medical or
public health emergency (natural or manmade). This role includes leadership in
international preparedness and response activities in partnership with our international
colleagues.
His connection with the Iraqis goes back to 2003 and 2004 when he was working in Iraq with them to try to stand up and strengthen the civilian health system. It has been a very difficult transition for our medical colleagues, just half a world away. Now some of the younger Iraqi physicians are trying to get back in control and create a science oriented culture to health services rather than a purely political entity.in the Ministry of Health. Dr. Vanderwagen is asking for your help in the transition to stability which will help our neighbors.
A copy of the Journal, with Instructions to Authors, is available upon request
Roberta Ward, ANMC
First trimester screening for Down Syndrome
WHAT IS THE COMBINED TEST?
The “combined test” is a combination of an ultrasound measurement of the baby, plus a test for two chemicals that come from the baby and found in your blood. This “combined test” is done at a very specific time--11 to 13 weeks of pregnancy. The test looks for chromosome problems in the baby, especially Down Syndrome. It is done earlier than other testing, is more accurate, and has fewer false positive results.
WHAT IS DOWN SYNDROME?
Down Syndrome is a condition in children caused by an extra chromosome. Chromosomes are found in all the baby’s cells and are like “blue-prints” that direct how the baby’s whole body is formed. Babies with Down Syndrome have an extra chromosome #21. As a result of this “extra message,” the baby may be born with several problems, including learning disabilities, special facial features, heart defects, frequent infections and other special needs.
WHO SHOULD HAVE THIS TEST FOR DOWN SYNDROME?
Women older than age 35 are more likely to have a baby with Down Syndrome, however, women of any age can have such a child. At age 35, a woman has a 1:300 chance of having a baby with Down Syndrome. A 40 year old woman has a 1:100 chance, and a 45 year old woman has about a 1:10 chance. You need to decide if having this test is right for you.
HOW IS THE TEST DONE?
Between 11 and 13 weeks a special ultrasound measurement is made of the back of the baby’s neck. Babies with Down Syndrome will often have a thickened area behind the neck. Blood will also be taken from your finger and checked for the amount of the two chemicals that pass from the baby to you. Babies with Down Syndrome usually have one of these chemicals too high, or the other too low. The laboratory will combine these three measurements to give you your risk of having a baby with Down Syndrome.
IF THE TEST COMES OUT POSITIVE, DOES IT MEAN MY BABY HAS DOWN SYNDROME?
No, this is just a screening test. If your test results are positive, further testing may be needed. Your prenatal care provider will explain this to you if your test shows you may have an increased risk.
Questions: rlward@scf.cc ALASKA NATIVE MEDICAL CENTER
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OB/GYN
Dr. Neil Murphy is the Obstetrics and Gynecology Chief Clinical Consultant (OB/GYN C.C.C.). Dr. Murphy is very interested in establishing a dialogue and/or networking with anyone involved in women's health or maternal child health, especially as it applies to Native or indigenous peoples around the world. Please don't hesitate to contact him by e-mail or phone at 907-729-3154.
