Cincinnati Children’s Deepens Ties with Tuzla Hospital
 A delegation from a hospital in Bosnia recently visited Cincinnati Children's to extend a 10-year relationship for another five years. From left to right: Dr. Elmir Cickusic, CEO of the University Clinical Center Tuzla; Dr. Richard Azizkhan, Surgeon-in-Chief, Cincinnati Children's; and Michael Fisher, President and CEO, Cincinnati Children's.
About Tuzla:
Located in northeast Bosnia, on the southeast slopes of the Majevica mountains, Tuzla is the third-largest city in the country. The city's population is about 150,000, with about 600,000 people living in the greater municipal area. Early settlements of the area began many centuries ago and have long been closely tied to its salt resources. In fact, the city's present-day name is derived from the Turkish word tuz, meaning salt.
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When the war that broke apart Yugoslavia finally ended in 1995, survivors in the new nation of Bosnia-Herzegovina discovered that a once-proud hospital in the city of Tuzla had been “bombed back into the 1930s.”
Even as thousands of sick and injured people sought care, the University Clinical Center Tuzla found itself patching damage from artillery shells, scrambling to find morphine and re-using “disposable” medical supplies dozens, even hundreds of times.
Doctors and nurses from many parts of the world streamed into Bosnia’s third-largest city to help treat patients during the post-war crisis. Soon, however, many of those relief agencies left the region, taking their expertise and equipment with them.
But some people stayed involved. One of those was Richard Azizkhan, MD, then a pediatric surgeon in Buffalo, NY, and now surgeon-in-chief at Cincinnati Children’s Hospital Medical Center. In fact, Dr. Azizkhan is widely viewed in Bosnia as a hero for playing a leading, long-term role in helping rebuild the nation’s medical system.
When Dr. Azizkhan came to Cincinnati Children’s in 1998, the medical center helped him continue the mission. In 2000, then-CEO James Anderson traveled to Bosnia with Dr. Azizkhan and others to sign a formal medical education exchange agreement with UCC Tuzla.
Now, 10 years after that first agreement, the two institutions have agreed to continue building a wider, deeper relationship.
A delegation from Bosnia – including the deputy ambassador of Bosnia-Herzegovina and three top executives from UCC Tuzla – visited Cincinnati May 23-27 to sign a new five-year memorandum of understanding.
The visit included tours of the radiology and oncology departments, a demonstration of the new EPIC electronic medical records system, and numerous meetings with senior leaders at Cincinnati Children’s.
Briefings from the visitors revealed how far UCC Tuzla has come since the war.
The hospital that once needed to perform operations in the basement and bunch newborns on a table near a radiator to keep them warm has become a regional center of care with more than 1,200 beds and 475 physicians. The hospital that once relied on foreign assistance now offers a growing list of high-tech services including kidney, liver and bone marrow transplants and two Linac units for cancer radiotherapy, says Elmir Cickusic, MD, and chief executive at UCC Tuzla.
“We have more than 20 diagnostic and therapy procedures that were not performed before the war,” Dr. Cickusic says.
Dr. Azizkhan, who has visited Bosnia dozens of times and performed hundreds of surgeries there, says UCC Tuzla has become a far more sophisticated hospital than it was before the war.
“This is a truly unique example of the benefits of long-term collaboration,” Dr. Azizkhan says. “Tuzla has become a completely modern health care system that serves a large portion of Bosnia and beyond.”
 Visitors from the University Clinical Center Tuzla toured several parts of Cincinnati Children's during their visit in May, including radiology, oncology and a demonstration of the new EPIC electronic medical records system. From Left to right: Dr. John Perentesis, director of the oncology program at Cincinnati Children's; Dr. Nesad Hotic, medical director, University Clinical Center Tuzla and Dr. Elmir Cickusic, CEO of the University Clinical Center Tuzla.
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In fact, UCC Tuzla has recovered so completely that it is capable of “paying it forward.” In 2005, when a severe earthquake killed 79,000 people in Pakistan-administered Kashmir, the Tuzla hospital sent teams of surgeons, orthopedists, anesthesiologists, gynecologists and pediatricians to help the survivors. The hospital ultimately built an infirmary in one of the damaged villages.
Looking forward to the next five years, plans call for expanding the relationship between UCC Tuzla and Cincinnati Children’s. Educational exchanges will grow beyond surgical specialties into other fields, Dr. Azizkhan says. New emphasis will be placed on research collaboration as well as sharing information about patient safety and quality improvement. The hospitals also will co-sponsor an international medical conference to be held in Tuzla in 2011.
“So much has been done in the past 10 years,” Dr. Cickusic says. “But there is much more to do. We want to continue working together.”
