We started our trip to Asia with our first stop in Myanmar. Professor Thit Lwin was the first SIGN surgeon in Myanmar. Since 2002 he has taught surgeons in two hospitals near Yangon and surgeons in Mandalay. He has pioneered the use of SIGN nail for both retrograde and antegrade fusions of ankle and subtalar joint. We operated with him in Yangon, and then proceeded to the new capital Naypyidaw to sign a memorandum of understanding with the government. SIGN does not interfere with any matters in countries where we are located because our goal is to treat all poor patients. The bones are the same all over the world and the fractures heal similarly.

After signing the agreement in the new capital of Naypyidaw we traveled overland to Mandalay, where we operated with the surgeons there. They are very good surgeons, and we enjoyed operating with them very much. We serve as repositories of SIGN and fracture treatment information and can pass it on. The SIGN surgeons teach us a great deal because they have such great experience.

We then travelled to Vietnam for a conference in Ho Chi Minh City. We visited many old friends and operated in several hospitals in Ho Chi Minh City.

Next stop was Cambodia. Here we also saw old friends and made new friends. Dr. Duong Bunn has been SIGN program manager since 2003. He has taught the SIGN technique to surgeons in 3 other hospitals in Phnom Penh and surgeons in three province hospitals. He arranged a national SIGN conference attended by the Minister of Health. Many papers were presented and a good discussion followed. We operated in 3 hospitals in Phnom Penh which often progressed into the evening.

Tim Keenan M.D., an orthopaedic surgeon from Australia, has worked with the Australian Orthopaedic Association for many years. He has served as consultant to other hospitals in the area and serves as a valuable resource for host surgeons. Intermittently he travels to other countries to assist their orthopedic programs. Two surgeons from Papua New Guinea came to learn SIGN technique. They proved to be good surgeons and affable friends. The Australian Orthopedic Association will sponsor a program in Port Moresby. We had a chance to visit with other Australian and English orthopedic surgeons while in Phnom Penh. It was like the United Nations in the operating room.

We met Sophoan at Kossamak hospital. She had a great impact upon us, as they did not expect her to live when she arrived with many injuries. Her story is in the October 2007 newsletter which is available on the website.