How did you become involved with the WOH medical missions?
As a third-year medical student, I knew I wanted to do emergency medicine. I wanted to do a little bit of everything and wanted to be hands-on. Dr. Boni goes beyond teaching the science of medicine by teaching his students about the everyday challenges of medicine: the reality of being a doctor. Some of those challenges include limited access to resources. He had a point. From there, Dr. Boni encouraged me to join Waves of Health and I have been an active member of their medical mission trips ever since.
Tell me about your experience.
This experience arguably taught me more about practicing medicine in one week than any amount of studying could have. It opens your eyes to the issues of health care, not just domestically but on a global scale. This experience has made me the doctor I am today. From taking vital signs to registration, and even packaging medication for distribution, there is much more to being a doctor than just examining the patient. The common goal is to help patients get medical care. Each mission trip, I am part of a team based in Dajabon, Dominican Republic. Clinic is set up daily, some days in the city of Dajabon, and other days in rural sites a drive away. As a medical student my role was to examine patients. I would then present my assessment and plan to an attending physician. After graduating medical school, my role expanded to both treating patients and working with medical students.
What are some moments that stood out for you?
One mission, a gentleman in his 50s came in with chest pain. EKG confirmed STEMI and we were at a rural community site. We had aspirin at the clinic, but, even as a medical student, one knows the patient needs cardiac intervention. We managed to get an ambulance for the patient, and I was allowed to come along. The ambulance had no medications on board, no oxygen, and the stretcher wasn’t even able to be secured. The local ambulance needed a push start for the engine to work. We finally made it to the hospital. We got the diaphoretic, pale gentleman onto a stretcher and explained the situation to the emergency room doctor. She then told us there was nothing they could do for him. They couldn’t see him because he needed to find a cardiologist. The emergency room was not able to facilitate getting him help. Specialists, like cardiologists, are located in the capital, a few hours away by car. I couldn’t believe it. We got the patient to a city with an emergency room and they couldn’t do anything for the patient. Our medical system has its faults, but patients with active STEMIs get treated and transferred as needed.
What were some of your big takeaways from the experience?
“Think, don’t regurgitate.” Don’t have great resources for managing chronic wounds? Consider honey. Guidelines say to give diuretics for blood pressure management, but these people work outside in the hot sun all day and have limited access to water. First line medications may require close follow up, which we can’t provide in this situation, so what are the alternatives? Pregnancy tests are not as readily available, so consider a second line agent that is safe in pregnancy. Working in this resource-limited environment has taught me to consider the many factors that go into caring for a patient, not just memorizing facts.
Why do you think medical missions are important? How would you recommend the experience to other alumni?
Medical missions are important, if being done for the right reasons. Big picture, how much good are you doing by bringing medical care to an area of the world once? One of the things that drew me to participating in Waves of Health is their commitment to continuity. These people become our patients and we return every six months for follow up. From an educational standpoint, I can think of no single greater contributor. Medical missions have taught me to apply what I know within a given context. They have allowed me hands on clinical experience and teaching, and later to pay that forward. Most importantly though, these missions restore my faith in medicine. Between medical school and residency, it’s easy to get worn down by the hours, the demands, the paperwork. Our medical system is broken, and this creates barriers to treatment for our patients and burns out our providers. Going on these mission trips, where I do as much as I can for the patients with the resources I have, where I get to spend more time treating patients than charting or making phone calls, where I get to see a direct impact on my patients’ lives, has kept the spark that started my career in medicine from burning out.