In school, most students going into a medical profession will learn some "cardinal rules of medicine". These “rules” are there to help you when things get tough and also to make sure you can help patients as best you can. This week, one of these rules, Rule #2, was tested out as I helped deliver a set of twins to a sweet first time mother.
New adventures have always been one of my favorite things, especially when it involves traveling to a new country. Since starting PA school at MUSC 2 years ago, traveling and volunteering haven’t exactly been the easiest things to do. So when I found out that I could combine my love of traveling and volunteering with school, I jumped at the unique opportunity to go to Uganda.
Rosa picked out questions from a bag and everyone went around to answer them. The questions were along the lines of "what is your dream" "where were you 10 years ago" "if you could have anything what could it be". Once again, I was reminded by the similarities we all share and the inherent connection we have with people all around the world.
Half an hour into it, we did an activity where we wrote on pieces of paper our fears and worries. That was where I noticed a change in the mood. As the papers were put into a box and pulled out anonymously by Katie to be written down on the white board, you could feel that each fear was resonating with the other women in the room. Fears of raising children correctly, having enough healthy food for everyone, having time to do everything and other worries of mothers I know reminded me of how connected we all are.
As I reflect on the past two weeks, I see personal growth. I see knowledge gained. I have only traveled internationally alone once before, and it was to China with a connection in Germany with a close friend waiting for me at the airport. The traveling adventures, to and from Peru, have forced me to act as an adult, fully responsible for myself. Nobody else was watching out for me.
Much of the material in the medicine class was interesting to me. Most notably, Dr. Neira reported that 34% of the children in the community the clinic serves have anemia. Contrary to popular belief, the problem in Peruvian families is not necessarily a lack of income, but a lack of wisdom on where to allocate their resources. Dr. Neira explained the difference between symptoms (described about a patient by a third party of by him or herself) and signs (a measurable result of illness). He then went through the process of a general examination with us, and taught us the main Spanish words to know when performing these. We then practiced general examinations on one another, and on one young girl from the community that had spent time with us during the class.
12:00 am: It was time for dinner: hot chocolate milk, turkey, applesauce, and fruitcake. After dinner, we opened presents. Mommy got us each a purse and earrings. The whole family, including myself, found great joy in watching Mary’s, our host sister, son open his Christmas presents. I was amazed by the thoughtful gifts exchanged between our family members.
This is where health education comes into play; it must start at the top of the ladder and trickle down. Government officials need to realize the flaw in this policy. Peruvian doctors need to understand the danger in over prescribing drugs to patients. Without understanding that bacterial strands can develop resistance to antibiotics, it seems like there would be no repercussions for giving out pills as if they were candy. Doctors also need to advocate for more restrictions on pharmaceutical distribution. Individuals need to be taught to take antibiotics seriously.
The last patient of the day was a 15-month-old boy with a 42-year-old mother. The young boy could not walk, was unresponsive to verbal cues, and had a fever of 38.6 degrees Celsius (101.5 Fahrenheit). According to medical records, he has congenital heart failure, Down syndrome, and growth stagnation.
It took coercing and candies to get many of the kids to hand over their arms, but this is important. They need to know early if they have anemia. It is worth the temporary pain of a finger prick. Peruvian medicine (and all other medicine) has to remember that preventing disease is far better than finding solutions to disease. This seems intuitive, but it is not always the applied practice.
I am so thankful that I had the opportunity to observe the obstetricians. They were great about explaining each part of the process to me as they went. They drew pictures, and answered the one million questions I asked. I am also thankful for Timothy who also answered a million questions for me and double-checked me on my initial blood pressure readings. Taking blood pressure non-electronically is harder than it seems (or at least it was for me, haha.)