Global Health Fellows Blog
Share in the adventures of Medical Missionaries' Global Health Fellows
by keeping up-to-date with their work via our blog! The people of Thomassique, Haiti, are greatly benefitting from
the work of our fellows!
February 20, 2010
12:47 am est
Last week, a team of seventeen surgeons and nurses arrived at St. Joseph’s Clinic for the annual surgical visit. After
months of planning, the team came prepared with the supplies and know-how to work through an intense week of operations. Before
their arrival, we rearranged the clinic, organized supplies, cleaned the floors and walls, and prepared the operating rooms
and inpatient rooms. Over the past year, the doctors at St. Joseph’s had been collecting the names of patients in need
of surgeries, and those patients were tracked down and told to come into the clinic upon the surgeons’ arrival.
The team – consisting of two orthopedic surgeons, an OB/GYN, two general surgeons, a urologist, an anesthesiologist,
six nurses, three scrub nurses, and a nurse anesthetist – got straight to work…and didn’t stop until the
end of the week. In just four and a half days, the team completed 85 surgeries and over 100 surgical consultations! The surgeries
performed included prostatectomies
repairs, exploratory laparotomies
, circumcisions, clubfoot repairs
, a leg amputation, and numerous minor operations (see chart below for a breakdown of the surgeries performed). While some
patients were victims of last month's earthquake, many were residents of Thomassique with persisting health problems.
The surgical visit was an incredible experience for both of us, in part because we played a very active role in the goings
on of the week. For example, we devised a patient identification and record keeping system for the surgical cases, by which
patients were tracked following their operations. Post-surgery, they can now receive appropriate follow-up care here at the
clinic because we can easily find their records.
Each day during the week of the surgical visit, one of us worked in triage (where we translated for surgical consultations
and managed the record keeping system), and the other scrubbed into surgeries. Scrubbing in was unimaginably exciting –
not only did we observe the surgeries, but we were able to participate by holding retractors, using the Bovie to cut and cauterize
tissue, putting in sutures, and assisting the surgeons in any other way possible (see photo). We also learned about spinal
anesthesia, how to put in an IV, and how to insert a foley catheter. The week left us with a renewed enthusiasm for clinical
medicine. The clinical skill set, dedication, and compassion that the team brought to their work was inspirational, and we
hope to emulate their approach in our own careers.
Since the team’s departure on Friday, we have been reflecting
on the impact that this year’s surgical visit has had. In just a few days, 85 lives were dramatically improved. It was
refreshing to experience the immediate and tangible changes that result from a medical trip such as this. In many of our other
projects, we find ourselves working on larger systemic problems at a community level. While these endeavors are essential
for addressing chronic problems, it is often difficult to gauge what kind of an impact we are having, or how much time it
will take to make a difference. This week gave us a chance to experience another approach to global health, where impact is
as immediate and palpable as the lengthening of a tendon or the excision of an infected scar. In all, though, both of these
efforts are two sides of the same coin. It is by integrating these individualized and community-based approaches – by
addressing both the immediate needs and the systemic roots of disease – that we can begin to make real and lasting improvements
to health in Thomassique.
January 24, 2010
12:46 am est
After carefully reviewing over 130 applications, we are pleased to introduce the
2010-2011 Global Health Fellows!
Emily Dansereau is originally from Seattle, WA and is currently a senior at Stanford. While there, Emily has excelled academically
and was elected to Phi Beta Kappa as a junior. She studied Human Biology and has been involved in a number of extra-curricular
activities that have exposed her to the underlying issues that affect health. She did significant hands-on work with under-served
communities in East Palo Alto through East Palo Alto Tennis and Tutoring
as well as Stanford's Patient Advocacy Program
at a local clinic.
In the summer of 2008, Emily was awarded a competitive grant from Stanford to travel to Cochabamba,
Bolivia. While there, she worked in a rural health clinic doing a variety of activities. During that time she also implemented
a program designed to teach children about dental hygiene and secured funding to provide tooth brushing kits to children in
local schools as well as those that come to the clinic.
Fidel Desir was born in the Dominican Republic, but was raised in Puerto Rico. He is a senior at Washington University in
St. Louis. As an Annika Rodriguez Scholar
, Fidel has demonstrated academic excellence, dedication to medicine, and a commitment to working with under-served populations.
During the summer of 2008, Fidel and another scholar received the highly-selective Davis Projects for Peace
grant to conduct an eight-week HIV prevention project at a maternity center in the Dominican Republic. For this project,
Fidel led seminars about HIV/AIDS, targeted towards women.
In addition to international work, Fidel has made it
a priority to work with under-served populations in the US. He is the co-Director of College Connections, a service program
that prepares low-income students from St. Louis high schools to get into and succeed in college.
June, Emily and Fidel will be taking our places here in Thomassique. Both of these individuals have great enthusiasm for the
program, for global health and for addressing health disparities worldwide. We look forward to seeing how they grow and what
they accomplish in the next year!
January 21, 2010
12:45 am est
Everyone here in Thomassique has been working furiously over the last week in response
to the devastating earthquake of Jan. 12th
. The brunt of the 7.0 earthquake was felt in Port-au-Prince, where many of our staff have family and friends. Luckily, though
we felt the earthquake in Thomassique, no one was hurt and nothing was damaged at the clinic. We have been very fortunate
all around as our staff members' families were also largely spared from death or injury.
Many of our community
health projects are now on hold as we make plans to mount an effective response and offer relief to those who need it most
in the wake of this catastrophe. While we expect that the effects of this earthquake will reverberate within our community
for years to come, the immediate need is monumental. Tomorrow, a team of 16 people (including 6 doctors and 2 orthopedic surgeons)
from the US will be coming into Thomassique to perform operations and emergency procedures for victims of the quake both here
at the clinic and at facilities in nearby Hinche. After they leave, another team of surgeons and nurses will be arriving on
their heels to continue in the relief effort.
December 24, 2009
12:44 am est
Last Tuesday morning, we awoke as usual, ready for a busy day of work. We were surprised to find, however, that this
particular morning was far from typical: there would be no face washing, no showering, and (much to our dismay) no breakfast.
As it turned out, a pipe n
ear the water source (at the river about fifteen miles away) had broken, and thus all of Thomassique was without water. As
the day wore on, we realized how dependent we are on having water – there was no way to do our laundry, no flushing
toilets, and (much to our dismay again!) no lunch. Luckily, we had a container of drinking water to get by on, so we avoided
dehydration. Eventually our amazing cook, Mme. Gilbert, thought of innovative ways to prepare food without water so that we
wouldn’t go hungry. Still, we were struck by how drastically our lives were changed in the absence of water.
Water seems to have been a theme in our lives as of late: our waterless day was the culmination of a month when we had a
broken UV water filter and two broken water pumps. While water crises have just recently descended upon our personal lives,
Thomassique’s serious water crisis – a lack of access to potable water
- has been a major focus of our community health projects for quite some time (check out previous posts on Boutey Soley
, the Water Study
, and the Water Crisis
Recently, we have been
discussing how best to direct the future of the Water Project. One of our main goals – both with the Water Project,
as well as with our salt
projects – is to integrate the education program into the daily clinic routine. While outreach and community education
remain crucial components of this project, it is important that all of our patients, too, are well acquainted with methods
of water treatment. Therefore, we are encouraging the health care professionals at the clinic to give brief education sessions
that focus on point-of-use water treatment methods (namely solar disinfection), especially targeting expectant mothers and
patients with diarrheal diseases.
A major appeal of the Boutey Soley system is its suitability for a resource-poor
setting; it only requires clear plastic bottles and sunlight. There is no shortage of sunlight in Thomassique, but we’ve
found that procuring the plastic bottles presents a barrier to many families in the community. To address this, we have partnered
with Jasmine Carver, a Peace Corps volunteer who is working on environmental issues in Pedro Santana, a border town in the
Dominican Republic. Jasmine has been working to start a recycling program in Pedro Santana, and she’s agreed to help
us collect clear plastic bottles. We got our first batch of bottles a few weeks ago, and we’re hoping that as Jasmine’s
recycling program continues to expand, we’ll get enough bottles to meet the need in Thomassique.
interventions are effective immediate strategies for decontamination of water, they do not guarantee access to water in the
first place. Currently, almost all water sources in this region are contaminated. Mack Leazer, a Virginia-based well driller
and friend of Medical Missionaries
, is exploring the possibility of increasing access to drinking water by drilling wells in this area to provide people with
improved access to safe drinking water. During a visit to Thomassique in November, Mack learned of wells that have been drilled
in the area by World Vision, with limited success. Those wells have been drilled in conjunction with a US-based NGO, Haiti Outreach
. Mack has been in contact with Haiti Outreach in order to explore ways in which Medical Missionaries can collaborate with
their organization to improve access to potable water for the people of Thomassique and its outlying villages.
there is anything that we’ve learned about water in the past week, it’s that its effects are pervasive. We have
long known that inadequate infrastructure in Thomassique results in an increased incidence of dehydration and diarrheal diseases.
We have witnessed the effects of this serious problem in hindering access to food and drinking water for the people in this
region. Though normally, St. Joseph’s Clinic is equipped to maintain a steady supply of water, we too are affected by
this reality from time to time. Our experiences over the last month have brought home for us the significance of this particular
community health project as well as our own dependency on having a supply of clean water—and just how harsh it can be
when all of a sudden the fragile system in Thomassique breaks down.
Missionaries' partners in improving health
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