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Episode 45: Working With Local Champions To Make The World Safer For Babies And Mothers w. Dr. Medge Owen

Apr 20, 2020

This Episode

Interview w/ Dr. Medge Owen

You Will Learn

– The lessons Dr. Owen learned while teaching obstetrics in Turkey.
– Some of the ways that Dr. Owen needed to adjust culturally. 
– How/Why Dr. Owen and her team created the 97 item quality improvement platform.

Resources & Links

In this episode, I sit down with Dr. Medge Owen. Medge is a professor of obstetric anesthesia and the Director of Maternal and Newborn Global Health programs at the Wake Forest School of Medicine in Winston Salem. She’s also the founder of Kybele, an organization committed to creating global access to safe childbirth care for women all over the world.

Justin (00:51)
Hello and welcome to episode 45 of the anesthesia success podcast. I’m very pleased to be joined today by dr Medge. Owen. Medge is a professor of obstetric anesthesia at wake forest school of medicine in Winston Salem, as well as the director of maternal and newborn global health programs at wake forest. She’s also the founder of Kybele, which is an organization committed to creating global access to safe and support the childbirth for women all over the world. And I’m really excited to have her here today. Welcome edge. Thank you very much. It’s my pleasure to be here. To start us off, why don’t you just share a little bit about the current landscape as it relates to you know, maternal access to healthcare as they’re giving birth. And a little bit of the reason why Kybele exists
Dr. Medge Owen (01:34)
Very well. So I’ve been practicing obstetric anesthesia for my entire career. Actually. I started out as an OB GYN resident and then switched to anesthesiology. But I’ve always loved obstetrics. So early in my career I had the opportunity to receive a Fulbright scholarship to go and teach obstetric anesthesia in Turkey. And at that time I was doing a lot of basic science research as well. And so my lab partner was from Turkey and so I was April to go and experience that new culture working in the lab as well as in the clinical realm. And it was during that time that I realized childbirth was so different for women in other parts of the world than what we experienced here in the United States. So for example in Turkey at that time most women would opt to have a C-section because the provision of pain relief during labor wasn’t available. Wow. And women would also go to sleep because they were afraid to have spinal anesthesia performed. And also the obstetricians didn’t like it. So a women then had no a recall of one of the most significant moments of their life, the birth of their child because they were knocked out with general anesthesia. Wow. And so that was the norm. And unfortunately that’s still the norm in many parts of the world today.
Justin (03:09)
Wow. Yeah. This is something that hits close to home for our family. I actually didn’t mention this to you before, but we just had the birth of our first child just a few weeks ago, which was awesome. And we were down the street here at university of Pennsylvania where we were, I would say, shout out to our friends at Penn. We were just ridiculously well cared for. And my wife got an epidural and it went great. And there was a little problem, I guess during the delivery and that there was a code and like 75 people all rushed into the room. And it was, it was amazing. Like the support and the, the sheer like brain power and medical expertise, they’ll crowd it into a very small space. It was, I felt like we were in really, really great hands and everything went really well. And now Calvin is a healthy little guy, which we’re really grateful for as it should be. Yeah. And, and that was just such an amazing experience and I realized, you know, as you’re starting to share your story, how unique of an experience that is on the, on the global stage as it relates to, you know, what, what you saw there in Turkey and elsewhere.
Dr. Medge Owen (04:10)
Well, I remember in Turkey when I was just getting into this, it’s, it’s you’ve got to, you know, you’re completely foreigner in the environment and understand how to build trust with people and how to work through cultural differences and norms and how to be able to make a safety platform that you could build upon. So I remember one day I was in the operating room and I’d finally talked the team and the letting me do a spinal for a lady having a C-section and everything was going great. And she looked up at me and I said, in Turkish, I was, I didn’t even speak Turkish well, but I said [inaudible] I’m a on a CZ Billy Orum, which means I don’t no Turkish, but I know anesthesia. And with that she just, a big smile came on her face. Everybody in the room started laughing and there was just trust and rapport that was built and the patient felt, even though she was awake and having this abdominal surgery performed, she could still enjoy that experience and feel comfortable.
Justin (05:14)
Wow. That’s a, that’s really incredible. Were there any times, I’m sure you know, when you’re as a Fulbright scholar abroad, there was probably some adjustment culturally. Are there any like problems or issues or awkward experiences that you had culturally?
Dr. Medge Owen (05:30)
A few things. Yes. Again, trying to learn and speak a new language sometimes comes out the wrong way. And you may say something you completely donated,
Justin (05:43)
Especially in the medical context, I’m sure. Oh yeah.
Dr. Medge Owen (05:46)
But you know, everybody, I’m just smiles and you go forward.
Justin (05:49)
Yeah. Talk a little bit about how that early experience in Turkey and the time that you spent there grew into, you know, what we see as an established multinational organization that’s marshaling so many people all over the place to pull towards this mission?
Dr. Medge Owen (06:05)
Well, I think one of my revelations while I was there, and it’s actually my husband’s idea to start Kybella actually he, he is, was my lab partner. So the lab partner that took me to Turkey ended up being my husband. So yeah. So even though my Fulbright was in 94, we got married in Turkey in 97.
Justin (06:28)
Oh, awesome. Yeah. Okay. So talk a little bit about how to, how did he kind of broach that topic and what was it like as you were thinking, like, maybe this is, this is bigger than just the work that we’re doing.
Dr. Medge Owen (06:41)
Right. So as in the early days, it was taking shape. It was just [inaudible] kind of a daily frustration about what women were having to endure. And so the idea came about to start the nonprofit, which then we did in 2001. And so I took the first group of people, the first group of professionals to Turkey in 2004. So I realized during my Fulbright experience that even it’s a foreigner that didn’t speak the language, I could still make an impact. So I wanted to experiment a bit with that concept to see if other people given the same opportunity could also generate those same outcomes. And, you know, I didn’t feel like there was anything that’s special about me. I had just had a great opportunity and I wanted to be able to extend that to other people. So at that point in time, I took eight colleagues from four different countries to Turkey and we spread out in academic institutions across the country.
Dr. Medge Owen (07:54)
And I become familiar with many of those during my Fulbright, but we wanted to see what would happen. And it was pretty darn magical and people had a great experience and they post hospitals were so welcoming and wanted to learn and really crazy things happened as a result of that, that I didn’t anticipate. So we ended up on the front page of a major national newspaper that has a circulation of 70 million people. Wow. So it was a little crazy because, you know, as a, it’s a fairly newlywed and being in Turkey and my inlaws were there, you know, they knew I was doing something medical and having two people come over, but when they went to how to ticked up there a morning paper and boom, there we were. It was a little crazy. Wow. That’s amazing. So, and then during that time, same trip we were in the bizarre, which it’s a great experience if anybody goes to Turkey to SDN ball.
Dr. Medge Owen (09:00)
You’ve got to go to the bizarre, but we’re in a bizarre, and I get a call on my cell phone. [inaudible] One of the most famous reporters in Turkey named Ali courage up and they wanted to do a TV show on prime time television in Turkey showing a C-section done under regional anesthesia. Wow. So that became the very first televised birth ever shown in Turkey that again, went across the country. This was an [inaudible] national TV. So that whole thing that just spiraled in a crazy direction made me realize that yes, ordinary doctors can make a huge impact. And to, even though we were dealing with a sub specialty such as obstetric anesthesia, it had relevance in the mainstream society and that childbirth at large was a very important issue that needed, Mmm. Broader recognition and broader discussion. So that experience from that very first trip really submitted in my mind that the impact that we could have.
Justin (10:15)
Wow. That’s excellent. Talk a little bit about, did you get some feedback from some of your colleagues who went on the trip and like what it was like to experience this sort of vicariously through them as potentially first-timers who were, who were doing that abroad?
Dr. Medge Owen (10:27)
Yeah. So most, most everyone’s continued to be involved and and that helps, Oh, helped us on our next tiers or programs to other countries too. So it was just a starting point and it really grew from there. And, and I think as we [inaudible] as we started to dive into this, you know, we realized that you know, childbirth mortality is a real problem worldwide. And, and, and actually Kybella started, you know, really at the time that the millennium development goals were coming out, which have now transitioned to the sustainable development goals. So world digitization, so wh show UNICEF, a world bank and others have really tried to promote the the problem, highlight the problem, and then work together in unity to try to address it. So. Correct. But even now, even currently, if there’s [inaudible] still 300,000 women that die worldwide having a baby.
Dr. Medge Owen (11:28)
So whereas we consider, you know, it’s in your experience, you know, you don’t expect to die having a baby in the United States. Fortunately it does happen sometimes, but not often. And to most people, the childbirth is a, a joyous, the event occasion that you look forward to and there’s a great deal of happiness and excitement. Yeah. And it’s a remarkable, but in some countries, women dread going into the hospital to have a baby because it’s very likely that they may not come out alive or their baby may not come out a lot. And that’s unfortunately the case for 300,000 women every year in the world.
Justin (12:12)
Yeah, that’s very sobering to consider. And as you, you know, you started this work in Turkey, obviously this is a global issue. Talk a little bit about how [inaudible] you guys are doing work all over the place now. Talk about how eventually the footprint expanded from Turkey to all the other places where you currently operate. And maybe talk a little bit about the places where you do currently operate. Well,
Dr. Medge Owen (12:35)
I’ll, I’ll go back and address your first question. So from Turkey we had the opportunity to go and work in Croatia and from there we had the opportunity to work in the Republic of Georgia and Armenia, two former Soviet countries. And so that was all in a right, relatively similar geographic area. And so problems there are a little different than problems in places like Subsaharan Africa. So in Eastern Europe and in [inaudible], the middle East, the healthcare infrastructure is generally pretty good, but they lack sub specialty knowledge in areas such as obstetric anesthesia. So thanks. Maybe practice as they were, you know, in the United States 50 years ago, for example. And so that requires a different skillset then going and working in Subsaharan Africa. So of the 300,000 women that die each year having a baby, a roughly two thirds of them come from Subsaharan Africa. So then in 2003 when I had the opportunity to go and visit Ghana, which is in West Africa, you know, my eyes were, we’re open to even more broadly too. The fact that, you know, healthcare infrastructure is very challenging for a number of different reasons, but the key systems sometimes aren’t even in place such as having medical resources space within hospitals and the necessary staff. So you’ve got to even just come back a step further. So even going into a hospital in West Africa, if you think you’re going to just come in and teach someone how to do spinal anesthesia, you’re not really addressing all the systems level problems that exist. So you’ve got to think about it completely differently.
Justin (14:36)
Makes sense. Okay. So I’m sure that you found in trying to expand you know, Cabela’s, Cabela’s mission that you ran into systems issues. You probably thought you were going to go in and teach people how to do epidurals or spinals and all of a sudden you’re thinking, Oh my gosh. Like there’s no, there’s such administrative problems or systems problems or resource problems that it’s actually more necessary to address those first. Can you talk a little bit about that?
Dr. Medge Owen (15:02)
Yeah, so I think when we started to work in Ghana, I mean, my first experience there was, was horrific. I was in the capital city at a major, major teaching hospital and I saw a woman die from an anesthesia related to error. And that was within my first 20 minutes of going into the hospital. Oh my gosh. It devastated me. And I think I had some PTSD regarding that for a while because, you know, I went in there as a visitor, I saw what was happening before my eyes. I didn’t know what my role should be. They didn’t know me. I didn’t know what I should be able to jump in and do. And it was an unsupervised anesthesiology resident who pulled out the endotracheal tube too soon. Wow. And I said, the your patient isn’t breathing and then she struggled to try to ventilate the patient and then failed to be able to reintubate her. And the lady started having an arrest. Meanwhile the lady’s newborn baby was over in the corner crying. And I thought, Oh my goodness, that it was, it was horrible. And we tried to find another attending and anyway, that the poor woman died again from a completely preventable mistake and that baby will never have a mother.
Justin (16:36)
Oh my gosh. It’s hard to imagine a more devastating 20 minutes.
Dr. Medge Owen (16:39)
Yeah. And it was then that wasn’t the only thing I saw. And at that point I thought, I’m gone. It’s just, or West Africa or, or African general is just off the, off the map. How can any one person come in or an organization come in and, and address some of the, of the issues that exist. I really did not want to go back because it was so horrific and I thought, you know, let’s just continue to focus in the countries where we’d been. And but then the, my key contact there was, was very persistent about having they come back. So I came back with two colleagues about a year later and we had a completely different experience. And from that the project started. So we’ve been working consistently and gone and now since formally with the, with the relationship with the government since 2006 and we’ve made a tremendous impact, but it’s really been in partnership with the local community.
Dr. Medge Owen (17:44)
And so when you ask how do you start in that situation, I had to take a step back and really ponder that, meditate on it, seek the council of some of the other colleagues that went with me in those early days. And we decided that the best thing we could do is just listen. And you know, labor epidurals, we’re not a priority. So we, we gave up our own agenda and we, we listened to the colleagues there and then we jointly came up with strategies that we felt could make improvements in the health care system. And we started with, with one. So our strategies in other countries had been to bring a team in and spread everybody out to go work in a number of different institutions. Well that works fine if you’re, if you’re addressing, you know, a single specialty like anesthesiology or even if you’ve got a few, if you bring a neonatologist along or an obstetrician, but to really understand their root cause, root causes of why women and babies die in these hospitals, you’ve really got to go deep and why you can’t just come in and just glaze the surface.
Dr. Medge Owen (18:57)
It’s not going to do anything. Yeah. So then we had, we decided that we would rather interview different facilities and find the one that we felt like we had the most, a greater sense of partnership with and that we would, we would settle there and go deep and wide and really try to understand what was going on. And then that strategy that it took several years to come together. It’s really impacted care. And it also allowed us to really more deeply understand the situation and the need and develop a model of care, which now through a funding we’re able to scale up to other facilities. So we had to, we had to test in and know what worked before. You know, we wanted to take that out.
Justin (19:45)
Yeah. And it’s what it sounds like one of these things where there was a big, it was, it was difficult to, there was a lot of work required up front to be able to put in a lot of effort and a lot of money and a lot of time probably before you saw any sustainable, tangible result. And it’s not hard to imagine. You could have gone into that hospital that first day and got a 20 minutes in. You see this young mother, this brand new mother die on the table from an utterly preventable error. And imagine like you could’ve just sort of been scared away or intimidated away and, and never have stuck around to do that hard work required. But because of the persistence, not only just in terms of time, but the humility to go in and say like, we have some expertise, but we don’t presume to know exactly what you need. Your input here is more valuable than what we have to bring. So tell us how we can help and then we can collaborate to build some systems to improve things on a scalable level. That’s, I mean, that’s really it’s really amazing and incredible. That’s what’s happened.
Dr. Medge Owen (20:48)
Awesome. So talk a little bit about the process of once you identified that first partner institution w how was the process of, I guess like getting to know them, getting to decide, okay, this is the place we’re going to plant our flag and then starting to do the work of communicating, building systems, training staff, and how did that all come about? Well, we, we found our local champion and that is a person we felt like we could really resonate with who was fairly new to the hospital and obstetrician, but with a think outside the box. And I want to make improvements mentality. So in any cultural context, and we’ve learned this over and over through the projects that we’ve conducted, that having a local champion on the ground is extremely important and you can’t not have that key collaborator that’s a change agent and that in that setting.
Dr. Medge Owen (21:50)
So we identified that person and then we invited that person to come to the U S so they came to visit us in North Carolina. Yeah. And my other key collaborator on this at the time was dr Yemi Olafur lobby, who’s a OB anesthesia faculty member at Duke. So he joined me on that early trip. So there was a nucleus of us that wanted to expose our, are a, an obstetrician to the settings that we worked in. Because when you go in and start to describe things to people that have no concept of even what it is, it’s like you’re talking about something in outer space, you know, so he was able to come in and really quickly comprehend sort of a systems level mentality. Okay. And understand what some of the key differences are. And, and then together as we both understood each other’s settings, we then created what we felt out of the combination of that.
Dr. Medge Owen (22:54)
What’s the best set of, of ideas for what could potentially work in Ghana. So what we did is, is as a result of those visits, we created a 97 item quality improvement platform. Wow. So we divided those into three different pots of activities. So there were personnel, Mmm. There were systems management issues and then there were also quality and communications issues. So we had these 97 items spread out in these three areas and we followed those items, the implementation of those items prospectively for five years. We did three visits a year and we wanted to see if [inaudible] if we completed those activities or tried to complete them, would that correlate with reductions of maternal newborn death?
Dr. Medge Owen (23:47)
So that’s what we did. And so we forged ahead. And so Kybella, we came three times a year to work in that facility and we, we brought new people along, but we also had a core group of people that we’re very intimately involved with this over the time and made multiple trips. And at that time we didn’t have any funding so everybody was paying for their own airfares. And the Ghana health service was also providing our accommodation. So it was really a cost efficient partnership that actually bore tremendous results. Now at the end of those five years, we implemented 68% of those items that were fully implemented. Wow. And that correlated with a significant decrease in maternal death. And we we’re able to estimate that we were, that we saved potentially 245 mothers. Wow. And 129 stillbirths were prevented. Wow. And then because of the the model and, and part of the way we grew as we went along, we looked at the cost effectiveness of our work. [inaudible] It’s important and you do anything, you have to be able to measure it. And is this making an impact and is it cost effective? And we found that we were able to save those mothers for the cost of 158 U S dollars per life year saved.
Justin (25:16)
Wow.
Dr. Medge Owen (25:18)
And now five years later, we looked at the same set of indicators as same 97 items. And we found that actually 80% have been, had then been implemented. So, even when we stepped away and we weren’t doing anything in that, in that second five year period, the activities not only were sustained but more of the things on the list got accomplished.
Justin (25:42)
Wow. What a Testament to the amazing infrastructure that you helped to create. It would be easy to go in and do some things and then leave and have everything kind of fall apart. But the fact that you created momentum locally with those partnerships and, and then the local Ghanian physicians took it and ran with it is phenomenal.
Dr. Medge Owen (26:02)
Well, just one of that 97 things alone was quite ambitious. So as we were getting into this, we realized that women that needed an emergency C-section, it was taken four hours. Hmm. Wow. For that to happen. And you know, here in the U S if it’s a extreme, like level one emergency C-section, you should have the baby out within 15 minutes. Yeah. Wow. And then there’s also an international guideline that’s called the 30 minute rule that your goal is to have the baby delivered within 30 minutes. Well, the fact that it was taking four hours with problematic, so we needed to understand why is it taking four hours. And so two of the things that happened as a result of revelation. Yeah. We’re there weren’t enough anesthesia providers and that was a huge, huge problem. So we actually started or helped we, we co started with our good and the third nurse anesthesia training program in Ghana. Wow. And that helps solve one of those problems. And that program has been sustained and it’s now just celebrated his 10th year. And not only has it expanded in terms of the number of providers being trained, but also providers are coming in from other countries such as the doctors without borders program in West Africa are sending providers from other countries to our school in our hospital to train. So it’s, that’s just been so rewarding. And yeah. And so that was one of the 97 things.
Dr. Medge Owen (27:42)
So they weren’t just little things that we accomplished. Some of those things were big, big things just in and of themselves. They were like projects within the project.
Justin (27:50)
Wow. So I’m curious, you know, if those 97 things in the beginning you probably thought were going to go in and we’re going to do a OB anesthesia, and when you made this 97 item list, probably the vast majority of them weren’t even anesthesia specific, I would imagine.
Dr. Medge Owen (28:04)
No. So you know, a little of what I do and gone is, is anesthesia focus. So now I’m really thinking about systems and about, you know, and you need to be able to deal with problems that start when the mother reaches the door pregnant and what happens to her over the course of hospitalization. Not only just at birth, but you know, how long it takes to get the treatment that she needs, what happens at birth, what happens to the baby. And so it’s the continuum of care that needs to happen across disciplines and across areas of the hospital that should be addressed. And I don’t stop until the mother and the baby leave the hospital. So, and now we’re, I’m even thinking about it even in a, in a more higher level and that we’re now looking at referrals that come into those facilities.
Dr. Medge Owen (28:57)
And we’ve, we’ve just done a study that showed that when a woman is referred from a district hospital to the, to the regional hospital, even in labor, it can take her hours to get there. And how would you like to be driving around town with the pregnancy? Okay. Complication of pregnancy in labor in a taxi. So women, 80% of the women that arrived come by taxi because the ambulance service is it. Mmm. Is inadequate for the needs. So those are the issues that I’m, that I’m, that I stay up at night [inaudible] wake up in the middle of the night thinking about, and they’re, they’re big systems level problems and there problems that just aren’t specific to gone. Are there problems that exist all over Africa and in many low and middle income countries?
Justin (29:50)
Was there ever a time that you experienced either a unique setback in a certain place or maybe organizationally with Kybella where you thought this is, this is a big, a big issue, a big problem and either I’m not sure we can get through it or I’m not sure how we’re going to make it through and take me to that moment and kind of how, how you work through those types of questions.
Dr. Medge Owen (30:09)
Well, there’ve been a few of them to be honest. One of them was early on in our work in Ghana when I realized this wasn’t going to be an easy fix and I myself had just recently had a child. So my, my daughter was born in 2002 just in the middle of all of this stuff going on. So I had, I was lucky at GE were to have one of those great childbirth experiences and I was well supported and it was, I would say hands down the best day of my life is the day that my daughter was born. Yeah. And anyway, so I had a baby and I was 40 when I had her. So, and then three months into her life she was diagnosed with a heart defect. So then we needed to big considering open heart surgery. So that was all happening in the background of the early days of Kabbalah.
Dr. Medge Owen (31:06)
Wow. Yeah. And then Mmm, we successfully got through the, the surgery when she was three and that’s when things were really heating up in Ghana. And I thought, you know, I’ve coming here three times a year, I’m, my mind is constantly spiraling around, you know, what’s going on in Africa. Mmm. And I remember one day I was in Ghana and I was talking to her on the phone and she was just tiny, just, you know, four or five years old. And I was feeling guilty for not being there with her. And I thought, man, I don’t want to be an absentee mom. And my little girl, just as in the sweetest little voice, said, mommy, I am so proud of you for being there and helping all those mommies and babies. And I realized that I thought, you know, she gets it and she’s tiny and she gets it. She’s not thinking about herself, her own satisfaction. And then through our work in Ghana, we’ve had an amazing opportunity when she got a little older, but I took her to go on to for the first time when she was 10 years old and now she spent eight times and we’ve also been helping schools and orphanages and I have developed a side project that helps inspire our youth to think outside of their box that did make a huge difference. And they’re able to do that.
Dr. Medge Owen (32:37)
So, yeah, just having a, you know, I think like I could have said, no, no, I’ve got a child. She’s my priority and I can’t come back anymore. But because my daughter was so giving and so loving I was able to continue it on.
Justin (32:59)
Wow. I that’s, that’s incredible. What an amazing what an amazing story. What an amazing daughter, even as a four year old, what immense character and others centerdness she was able to display. Yeah. So it’s clear that you’ve, you’ve had amazing support in your family as you described with the physician from Duke, whom you partnered with early on. I’m curious, were there others along the way who have kind of been instrumental in helping Kybella to you know, continue to take shape and ultimately take flight
Dr. Medge Owen (33:34)
Good about that? And yes, there are a few people that have been really helpful to me and it’s, it’s been hard because I never did have a mentor as some people would sort of think about that, but there were people that were in my life that helped me make key decisions at key times. So one of those people was a dr Jim Eisenach, who’s a world famous pain researcher, was editor of anesthesiology for 10 years and he’s here at wake forest. And early on in my career I loved the basic science work that I was doing. And then I started the global health work and I realized that, you know, I came to this crossroads of I can’t do both. So he was really helpful in, in helping me determine what I should do. And at that time, there were a lot of people that are, you know, much smarter than me doing excellent basic science work.
Dr. Medge Owen (34:30)
So I thought, you know, that field doesn’t really need me. Whereas that at that time there were not a lot of people that were doing the global health work. And I thought I had a much greater opportunity to impact many more lives by doing that. So he was instrumental. Then I was really fortunate to meet a woman named Linda Combs. And so when Kybella was just getting, she was one of my initial founding board members. She’s a woman that’s okay. Extremely powerful smart woman who was a controller at the white house at the peak of her career. And she’s just got a lot of great connections, a lot of wisdom on how you’d just go from being a local citizen to being able to inspire change within yourself and within others. And then another key person was Dr. Frank James, who it’s another giant in the field of anesthesiology who was the chair of the department at the NSC shit wake forest when I came on faculty. He was also of my original board members, but he and his family foundation have supported Kybella financially through their foundation, ah, for a number of years as we were just getting off the ground. And he’s been there as a friend and as a mentor throughout all of this. So I’ve been really lucky to have those people that have the wind beneath my wings, so to speak.
Justin (36:01)
Oh, that’s great. Wow. This is, this is has been a really excellent discussion. I appreciate your time today. Manage. I want to wrap it up here in just a couple minutes. I’m sure there’s people listening right now that think this sounds amazing. I love the work that’s happening. I love how impactful it is. I love the, even the being able to quantify in like a dollars per unit of impact how diligently you guys have documented that. I’m sure people want to get involved or want to learn more. So where should they go? What and how can they help?
Dr. Medge Owen (36:32)
Well, they can help in a few ways. There’s a website, www, Kybella worldwide.org and you could go on the website and learn about the projects that were conducting worldwide, some of our publications, a little bit more about the organization and also how to donate if you feel so inclined to want to be a part of this. So hopefully as I’ve demonstrated the work we do, it’s extremely cost effective and impactful and that’s helpful. And we always bring new people on board. And, and again, I think hopefully I’ve, I’ve shown that ordinary people can make a tremendous impact. So there’s, there are ways that people can participate as well.
Justin (37:16)
Awesome. So we’ll link to this in the show notes. So anesthesia, success.com/ 45 we’ll have links to the Kybella website as well as any other details that Medge wants to pass along after this interview. So I’ll make sure to check that out. So in closing I want to just close with a personal story from you. Manage about, I mean, you, this has been, I think, I feel like every time I have one of these conversations, it’s utterly humbling. And again, I’m like, this is the best one of these that I’ve done. This is definitely in that category where there’s, there’s such impact, such intimate impact in people’s lives. I mean, I just think that story in the hospital, your first moment in Ghana, that’s just, I mean, as a new dad, that’s just utterly devastating and I can’t imagine how many, there’s been so many stories like that that you have prevented and created systems and like a rubber stamping all over the place to be able to replicate that impact. So tell me about a moment when, you know, you were, you’ve been putting in the time and putting in all the effort in marshaling all these resources elsewhere to be able to make an impact and whether it’s a patient story or an interaction with a local medical faculty where you thought, you know what, in this moment this has been something that I’m able to finally see some of the fruit of all of the effort that we’ve put in.
Dr. Medge Owen (38:32)
I would say that happened just fairly recently. We w we’ve been taking our work and we’ve been applying for grants. So there’s a granting entity called saving lives at birth. It’s extremely competitive and I’m, it’s, it was started by the bill Gates foundation and other other partners such as grand challenges Canada. There’s a, an organization called Diffit in England the South Korean government. So they all, all these national entities got together and, and, Mmm. It started the saving lives at birth program. So we applied two years ago to that [inaudible] and I learned that there were 500 applications and they only gave three awards. Kybella was one of them. Wow. And Kybella is a tiny organization and we were up against huge institutions, huge global health, Mmm. Entities within major academic medical centers. And here we were. And I just remember being up on the stage as one of the 10 finalists. And even I said, even if it doesn’t go further than this, we’ve arrived. Wow. And then we’ve we’re in the middle of that project now in Ghana. But that was when I realized that the work that we’ve done is able to really turn some heads.
Justin (40:07)
Awesome. Well, congratulations on that awesome achievement and all of the work that you’re doing. I mean, it’s just really a Testament to your, your persistence, your perseverance in the face of hardship, your I mean it’s, and your heart, like you just care about people and you want to impact them in such a deep, insignificant way and give so much of yourself in the process. So it’s been a pleasure and a privilege speaking with you. And thank you for joining us today.

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