Host Perspectives of Visiting Medical Trainees: a Qualitative Analysis of Global Health Electives

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Medical trainees from Northern, developed regions of the world increasingly travel to Southern or less developed regions of the world for a clinical experience or ‘global health elective’. There is little research regarding these types of activities. This qualitative project aimed to generate the perceptions that medical students from Uganda hold regarding their Northern counterparts who visit on a global health elective. The purpose was to gain insight into the benefits and challenges of these increasingly popular activities. Thirty-two medical students from Makerere University in Uganda took part in tape-recorded semi-structured interviews. Questions revolved around perceived benefits, challenges, and impressions of visiting Northern medical students. Interviews were analyzed qualitatively. Study participants perceived that visitors come to learn tropical medicine and to practice on patients. Students also felt that there was a lack of interaction and engagement with the visitors. They were, however, eager to benefit from the teaching that could potentially be provided by visitors. This project identified perceptions that medical students in Uganda possess towards students who visit from the North. These ideas provide insight into how global health electives can become more mutually beneficial and with a more accurate definition of their intent.

When Culture Meets Medicine: Reflections on a Medical Mission to Cameroon

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The West-African nation of Cameroon is one with limited access to health care, with a ratio of only 1.9 physicians per 10,000 people. Such statistics demonstrate the health care needs of this country; however, personal experience provides a much more striking perspective of such health care disparities. Because of a five-week medical missions trip to Cameroon, I have come to better appreciate the need for health care providers around the globe. During my visit, our team of health care providers, in collaboration with the Cameroonian organization ASCOVIME (Association des Compétences pour une vie meilleure), was able to provide free medical care to over 1,500 Cameroonians from the rural villages of Minkang II, Lomie, Doukoula, and Nditam. These villages warmly welcomed our team, enabling us to provide care through general consultations, ophthalmology screenings, and surgical interventions while being immersed into Cameroonian culture.

Does Pre-Medical ‘Voluntourism’ Improve the Health of Communities Abroad?

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Medical voluntourism involves medically untrained individuals travelling to a community abroad to set up health education workshops, complete observational work or even basic clinical tasks. Often, these volunteers are students who are applying to medical school and are seeking an international clinical experience. Although the ethics of global-short-term medical outreach by medical school students and health professionals has been examined, the ethical implications of international pre-medical volunteer experiences have not been well described. This article is primarily concerned with medically-untrained individuals’ increased scope of practice in international healthcare settings. Specifically, this brief investigation asks: is the use of medically unskilled volunteers for clinical tasks in the developing world ethical? Ultimately, this analysis does not suggest that pre-medical students should avoid engaging with health disparities abroad, but rather that it is necessary to actively question how healthcare-related volunteering abroad is carried out.

Short Term International Medical Volunteerism in Higuey, Dominican Republic: A Student’s Perspective

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Short-term medical missions provide students with the opportunity to aid healthcare professionals in the treatment of patients with severely limited access to care. They also provide ample opportunities for students to learn about differences between healthcare in the United States and global healthcare. In the Dominican Republic, there is disparity with respect to wealth and limited access to healthcare. I participated in a medical mission to Higuey with the nonprofit medical group Guardians of Healing and saw the value of medical missions firsthand. The Guardians of Healing ran a clinic and performed surgical procedures in cooperation with a regional hospital. Community members were invited to receive free medical care at the clinic through word-of-mouth and the distribution of flyers throughout the town. Management of immediate medical concerns was a critical aspect of the mission. The majority of surgical cases seen were cholecystectomies and hernia repairs. Other cases included adult circumcision and removal of a trichilemmal cyst. Common clinical complaints included fever, lethargy, and hypertension. In treating these patients, cultural sensitivity was essential, as was the full sharing of care objectives. Coordination and cooperation with the regional and national governments were crucial to the successes of these endeavors. Everyone involved appeared to benefit from this medical mission, whether through the receipt of direct medical care or through the ability to help others while learning about different cultures and healthcare environments. This experience allowed me to compare medical care, customs, and cultural trends between the United States and the Dominican Republic.

International Aid with a Long-term Perspective: Proposed Guidelines for Effective Development through Community Partnerships Based on the Haitian Experience

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The attainment of adept international partnership outcomes in the global world — particularly in exacerbated settings such as Haiti — is hampered by a lack of sustainability principles and limited capacity building opportunities, such as institutional development. This is further compounded by the unintended consequences of volunteerism in service provision and inadequate empowerment of local communities. Although volunteerism may provide lower income countries with benefits, there are impending pitfalls. Since this form of assistance is compartmentalized, rather than institutionalized, the capacity building of the society remains isolated. This risks fragmentation when greater cohesion is necessary. The conditions in Haiti call for more strategic partnerships to harness and realize latent development potential. Institutional partnership is an effective methodology for developing pertinent interventions with socially marginalized communities; although implementation is challenging, it is necessary for long-term change. To effectively attenuate social disparities in poverty stricken, chronically underserved populations, and interventions must act collaboratively. In order to diminish social disparities one must address issues of access, information, and knowledge to reduce barriers to innovation and social change. This paper presents a bilateral partnership between the Université d’État d’Haïti (UEH) and the University of California (UC) and describes the principles used to stimulate effective development that sets the stage for an institutional partnership and innovation in global sustainable development.

Funds for Felix: A Global Collaborative Effort to Restore One Patient’s Vision

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Undergraduate students volunteer with Global Medical Training (GMT) to provide free clinical services to underserved individuals in Central America. Some patients are unable to physically travel to GMT makeshift clinics because they are excessively impaired by their medical conditions. In these circumstances, physicians and volunteers make home visits to assess how to effectively help such patients. During one visit, GMT volunteers and physicians were so moved by a patient’s crippling vision loss that they refused to be passive observers of his condition. Two undergraduate students spearheaded an international collaboration, called Funds for Felix, to raise money for a surgery to salvage what was left of this patient’s vision. However, several months after the initiation of Funds for Felix, volunteers learned that the patient had dramatized the circumstances leading to his visual impairment. After thorough review of the patient’s predicament, Funds for Felix decided to continue supporting the patient and his family. Though it was ultimately discovered that ophthalmological intervention for this patient would be futile, Funds for Felix helped him enroll in a Braille school in the Matagalpa region of Nicaragua so he could learn how to read. These efforts significantly improved this patient’s self-esteem and instilled in him hope for a more fulfilling life.

The Ethical Dimensions of Focusing Global Health Efforts on a Single Patient: an Examination of “Funds for Felix”

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This article analyzes the ethical considerations involved in focusing a global health effort on a single patient. The specific case considered is “Funds for Felix”, in which money was raised by students for a patient encountered by the UCLA Global Medical Training trip to Nicaragua in December of 2010. As the leader of the UCLA campus branch of Global Medical Training, I approach this case from a broader, organizational perspective. Although the Global Medical Training at UCLA leadership body was enthusiastic about the Funds for Felix project, we wondered about the potential ethical concerns that arise from devoting so many resources to an individual. Ultimately, the approach taken for the Funds for Felix project was extremely successful. This was due to several factors, including the transparency with which the project was conducted, the involvement of Nicaraguan mentors, and the students’ altruistic motivations. Given the rising awareness of global health issues, the relevant ethical questions of the Funds for Felix project are salient for any student or physician in the field of global health.

The Sustainability and Impact of Medical Camps in the Slums of Bengaluru, India

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A medical camp was conducted at the Whitefield slum in Bengaluru, India with the assistance of volunteers from: the Keshava Seva Samithi (local NGO), Youth for Seva (local NGO), Qcare (Qualcomm IT company-Bengaluru branch),Vydehi Institute of Dental Sciences, and Nethradhama and Lions’ Airport City Hospital. At this event the local patients directly consulted with a general physician and/or specialists in a converted school house. This type practice has been the most common form of providing access to healthcare for vulnerable populations. Over a 6 hour camp operation, 324 patients of varying ages were registered to consult with an ophthalmologist, dentist, and general physician. As in most camps, the physicians here did not have a patient history, and as such, the efficiency of this and similar efforts are suboptimal. The public-private partnership efforts of corporate volunteers through corporate social responsibility initiatives was a unique feature of this camp. This report outlines the process of the health camp, the appropriate resources utilized, the methods available for follow-up, and areas of improvement for future camps. The efficiency of the camp through the use of volunteers and the direct and indirect short- and long-term effects of such efforts were evaluated.

International Aid with a Long-term Perspective: Proposed Guidelines for Effective Development through Community Partnerships Based on the Haitian Experience

·

The attainment of adept international partnership outcomes in the global world – particularly in exacerbated settings such as Haiti – are hampered by a lack of sustainability principles and limited capacity building opportunities, such as institutional development. This is further compounded by the unintended consequences of volunteerism and inadequate empowerment of local communities. Although volunteerism may provide lower income countries with benefits, there are impending pitfalls. Since this form of assistance is compartmentalized, rather than institutionalized, the capacity building of the society remains isolated. This risks fragmentation when greater cohesion is required. The conditions in Haiti call for more strategic partnerships to harness and realize latent development potential. Institutional partnering is an effective methodology for developing pertinent interventions with socially marginalized communities; although implementation is challenging, it is necessary for long-term change. To effectively attenuate social disparities in poverty stricken, chronically underserved populations, interventions must act collaboratively through unyielding institutional partnerships. In order to diminish social disparities one must address information and access issues to reduce innovation barriers. This paper presents a bilateral partnership between the Universite d’Etat d’Haïti (UEH) and the University of California (UC) and describes the principles used to stimulate effective development and sets the stage for an institutional partnership.

When Culture Meets Medicine: Reflections on a Medical Mission to Cameroon

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The West-African nation of Cameroon is one with limited access to health care, with a ratio of only 1.9 physicians per 10,000 people. Such statistics demonstrate the health care needs of this country; however, personal experience provides a much more striking perspective of such health care disparities. Because of a five-week medical mission trip to Cameroon, I have come to better appreciate the need for health care providers around the globe. During my visit, our team of health care providers, in collaboration with the Cameroonian organization ASCOVIME (Association des Compétences pour une vie meilleure), was able to provide free medical care to over 1,500 Cameroonians from the rural villages of Minkang II, Lomie, Doukoula, and Nditam. These villages warmly welcomed our team, enabling us to provide care through general consultations, ophthalmology screenings, and surgical interventions while being immersed into Cameroonian culture.

Can It Be Any Hotter?

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Rwanda

In this short piece, Samuel Enumah of the Johns Hopkins School of Medicine details a specific and personal experience from a visit to a local hospital in Rwanda.

Does Pre-Medical “Voluntourism” Improve the Health of Communities Abroad?

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Medical voluntourism involves medically untrained individuals travelling to a community abroad to set up health education workshops, complete observational work or even perform basic clinical tasks. Often, these volunteers are students who are applying to medical school and are seeking out an international clinical experience. Although the ethics of global short-term medical outreach by medical school students and health professionals has been examined, the ethical implications of international pre-medical volunteer experiences have not been well described. This paper critically examines the costs and benefits of pre-medical voluntourism for the health of communities abroad. It is primarily concerned with medically-untrained individuals’ increased scope of practice in international healthcare settings. Specifically, this investigation asks: Is the use of medically unskilled volunteers for clinical tasks in the developing world ethical? Whose interests do medical voluntourism projects serve? Ultimately, this analysis does not suggest that pre-medical students should avoid engaging with health disparities abroad, but rather that it is necessary to actively question how healthcare-related volunteering abroad is carried out.

Funds for Felix: A Global Collaborative Effort to Restore One Patient’s Vision

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Undergraduate students volunteer with Global Medical Training (GMT) to provide free clinical services to underserved individuals in Central America. Some patients are unable to physically travel to GMT makeshift clinics because they are excessively impaired by their medical conditions. In these circumstances, physicians and volunteers make home visits to assess how to effectively help such patients. During one visit, GMT volunteers and physicians were so moved by a patient’s crippling vision loss that they refused to be passive observers of his condition. Two undergraduate students spearheaded an international collaboration, called Funds for Felix, to raise money for a surgery to salvage what was left of this patient’s vision. However, several months after the initiation of Funds for Felix, volunteers learned the patient dramatized the circumstances leading to his vision loss. After thorough review of the patient’s predicament, Funds for Felix decided to continue supporting the patient and his family. Though it was ultimately discovered that ophthalmological intervention for this patient would be futile, Funds for Felix helped him enroll at a Braille school in the Matagalpa region of Nicaragua so he could learn how to read. Through constructing a collaborative team spanning national borders, this multidisciplinary group significantly improved this patient’s self-esteem and instilled in him hope for a more fulfilling life.

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