by Dr. Tom Vasileff

In November, 2015, after Dr. Khamtay, Chief of Surgery in Thakhet, Laos submitted a SIGN Application for Khammouane Provincial Hospital, my wife—Christine—and I journeyed to the hospital for a site visit. We were pleased to find a busy, aging hospital—established by the French in 1924—with dedicated healthcare workers.

While Khammouane Provincial Hospital serves 330,000 Laotians, they didn’t have the standard implants necessary to treat common leg fractures—intramedullary implants for fractured femurs and tibias.  After the visit, the application was approved by the committee, and planning began to train Dr. Khamtay in the SIGN Procedure as well as ship both SIGN Instruments and Implants to Khammouane.

Prior to the launch of the program at Khammouane, there were three SIGN Programs running at hospitals throughout Laos.  The Mittiphab Hospital in Vientiane, the capital of Laos, joined SIGN in 2011, and the three programs combined have implanted 577 SIGN Nails since that time.  Mittiphab operates as the tertiary trauma center for Laos with six or more fractured femurs or tibias daily, so training Dr. Khamtay at this location was ideal.  He performed his first surgery using the SIGN Implants at Khammouane in December 2015.

Why launch a 4th SIGN Program in Laos?

Laos has a population of 6.8 million people, and the government possesses the means to provide care for residents.  However, implants—common treatment for leg fractures—are not covered by the governmental treatment programs, and few citizens own insurance or earn enough to cover implant costs.  That’s where SIGN Programs, providing free implants, become an essential element for hospitals to provide equality of care for their patients.

What is the common cause of fracture in Laos?

Motorbikes are the common mode of transportation for middle income families in Laos where it’s customary to see two to five members of one family riding one bike at the same time.  Additionally, motorbikes are routinely used to transport industrial and large food items, and in rural areas, families use rural tractors to transport everything from the family members to produce.

During my last visit to Laos, one family was traveling at night on their rural tractor. It was dark, they had no lights on the tractor, and a truck collided with them.  Sadly, the father was driving and died in the accident. The youngest daughter lost her leg above the knee, and another daughter suffered a closed forearm fracture.  The mother’s tibia fractured, but she was treated at a hospital in Laos with the SIGN Program and received an implant to repair her leg.

What’s next in Laos?

SIGN and I have sponsored surgeons from Vientiane (2), Pakse (1), and now plan two scholarships in 2016 for doctors to attend the annual SIGN trauma meeting and the San Francisco flap course.

We hope you’ll find it in your heart to help as well!  Click here to donate now and ensure the next family receives equality of fracture care!


Dr. Vasileff

Dr. Vasileff caught the vision of SIGN several years ago, and he’s been a staunch advocate for developing surgeons and programs in Laos since that time.  Not only has he attended the SIGN Conference regularly since 2010, but he visits programs in Laos to further training in-country, supports travel for Laos surgeons attending the SIGN Conference and recently joined the SIGN Board of Directors.



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