The following post has been written by: Marc Cassone, PCOM DO Class of 2016, [email protected] (feel free to reach out with questions!) Medical Student Missions – Haiti Spend 7 days working at a rural health clinic in Verrettes, Haiti. You will work closely with a team of other medical students providing medical care to rural villages. As part of a small team you will have plenty of opportunity to work closely with the physicians running the trip, practicing your skills, and gaining experience. The students are given as much responsibility as they can handle and are interested in taking. During my trip each medical student was assigned their own interpreter and patients and were in charge of running the patient history, exam, diagnosis, and prescriptions on their own with an attending physician present to check-in with. We were also in charge of preparing supplies, running the pharmacy, and coordinating with local staff. In five days of clinic as a team of five we saw over 700 patients which allowed us to see lots of different pathologies not commonly seen in the US including TB, ringworm, malaria, malnourishment, and a host of other infectious diseases. The attending on our trip was the extremely knowledgeable Dr. William Forgey- one of the premier experts in wilderness and travel medicine. The clinics are run both in villages and in the mountains (accessed by epic 4×4 rides) and I truly felt like we were helping out the local communities. We also had the opportunity to visit the most well-known clinics in the country (and beacons of practicing medicine in the developing world): Hôpital Albert Schweitzer and Paul Farmer’s/PIH’s Hôpital Zanmi Lasante as well as a completely self-sufficient USAID clinic on top of a mountain and a cholera clinic. Three meals a day are provided and the accommodations were excellent for Haitian standards. (Gorgeous views of Haiti’s Artibonite Mountain right from your breakfast table!) You have most late afternoons off and some of the activities we partook in include going to a local soccer match, classes on Haitian culture & language, mountain and waterfall hikes, beach trip, and even an evening at a voodoo ceremony with a local medicine man! Caveat: This trip is only a week but extremely affordable and you get tons of experience! This is also a smaller organization and will not provide a lot of the pretrip or in-country support some of the larger nonprofits will. It is probably not ideal if this is your first experience in a developing country. However- because of its small nature it really gives you the freedom to shape your own experience and gain from it as much as you are willing to put in! If you enjoy the trip there are also opportunities to return on future trips as part of clinics or vaccination campaigns. Vine Trust: Amazon Hope 2 – Iquitos, Peru This Scottish NGO offers to medical mission trips, both based on former British Naval ships turned into floating clinics. One is on Lake Tanganiyka, Tanzania and the other is on the headwaters of the Amazon in Peru. The Amazon Hope is a 2-week trip in which a variety of medical staff (most are Docs from the UK) that live aboard the boat and work with local staff including physicians, midwifes, lab techs, and nurses. Pending on water levels/rainy season the boat will travel up the Maranon or Tigre Rivers- both major tributaries to the Amazon. The trip departs from Iquitos- the largest city in the world accessible only by plane or boat and known at the “Capital of the Amazon”. While on the ship, you will spend most the morning/early afternoons seeing patients from various local communities along the river- some being some of the most remote villages in South America having access to “floating” healthcare only once every three months. Medical students will work closely with translators, local staff, and expat volunteers to see patients and are given as much responsibility as they can handle (with oversight of course). Pathologies are mostly primary care issues with many tropical diseases seen as well (malaria, parasites, anemia, rash, infectious diarrhea, etc). You will be seeing many, many children- so review your pediatrics! Occasionally, if smaller villages are inaccessible by the major boat and small Explo Team will go on a smaller auxiliary boat with limited supplies to see those communities. Afternoons are spent exploring local communities, playing soccer/volleyball with staff/locals, hanging out and on-board karaoke on Saturdays! The boat travels to villages during the early evenings/early mornings. Meals are on board and eaten family-style with staff and surprisingly fresh! Accommodations are small rooms/bunks but A/C and cold showers are available (if everything is working!). If you’re lucky often you’ll see a variety of parrots and the famous pink dolphins of the amazon from right off the ship. Incredible experience! I recommend to any medical student willing to live aboard for a few weeks!
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This post is a long-time coming. I know I told many of you to stay tuned for this blog. I have finally gotten around to doing it. I’m already over halfway through my trip, which is 4 weeks long. In this post, I’ll focus on what I am doing here in Uganda.
I will begin with some important background information. The organization I am working with is called OmniMed (http://omnimed.org/). They are a non-profit organization based out of a small town called “Kisoga”, which is about 2 hours outside the capital city of Kampala. OmniMed was founded in 1998 by Dr. Edward O’Neil. The organization has worked in 5 different countries worldwide and is currently focused on Uganda. As an organization, OmniMed works alongside the Minister of Public Health in Uganda to help provide many community oriented interventions. The primary mode of the work OmniMed does is through Village Health Teams (VHTs). These VHTs volunteer as the public health leader in their village. Their responsibilities include educating their local community in areas such as sanitation, pediatric illnesses and malaria prevention. They advocate preventing diseases and seeking care early, when appropriate. Many of the villages these VHTs come from are very poor, with low levels of education. Over one third of the Uganda population lives on less than one dollar per day. The VHTs become the first line of defense in preventing many communicable diseases, such as malaria, pneumonia and diarrheal illnesses. OmniMed’s role is to train and maintain the VHTs. So far, there have been over 1,200 VHTs trained, serving many thousands of Ugandans in their local communities. In addition, OmniMed facilitates the construction of home cookstoves with materials easily found the local area for free. These cookstoves help prevent pediatric pneumonia as it drastically reduces the amount of smoke produced while cooking. Omnimed also helps communities construct water sources. The majority of rural Uganda lacks running water. Therefore, they rely on such water sources for drinking, bathing and washing clothes. Water source construction enables access to clean water, which helps prevent the number of diarrheal diseases in the community. These water sources are constructed in such a way to require minimal cost and maintenance. Each of these outreaches is overseen by OmniMed, but their role is advisory only. It is up to local communities and VHTs to put them into practice. The idea is to have a sustainable impact with community investment. All of this is well and good, but these ideas and practices need measurable impact to determine the effectiveness and improve as needed. One of the biggest flaws in global health is the lack of evidence based studies of interventions. Many ideas sound good and look great on paper. When they are examined closely, do they actually benefit the communities they try and help? OmniMed seeks to ask the difficult questions and is working on conducting randomized control trials to determine the effectiveness of the practices put into place. Specific areas of research currently being conducted are: 1) Cookstoves for the prevention of pediatric pneumonia 2) Insecticide Treated Nets in prevention of Malaria and 3) Protected Water Source construction in the prevention of diarrheal illnesses. All three areas are points of emphasis with the VHTs, making them the glue that holds these interventions together and imploring their villages to put them into practice. After this detailed overview, where do I fit into all of this? My primary purpose for being in Uganda is personal education. I’ve read many books on global development and health and this trip enables me to better grasp many of the problems faced in developing nations. Secondarily, I am collecting data from VHTs and writing a report that will be used in the research, helping to answer questions of efficacy. This includes talking with the VHTs to understand what specific issues they face in their respective villages. I am also involved in teaching classes to VHTs regarding the basics of several infectious diseases that are most prevalent in their communities. In my next post I will reflect on what I have learned and seen so far. Hopefully, that post will be out within the next week. |
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