Contributing Writer
Mayo Clinic School of Medicine
Jeremie is a first-year Mayo Clinic medical student, originally from the North Shore of O'ahu, Hawai'i. Having lived in Brazil for over two years prior to beginning medical school, he has gained a great interest in incorporating substantial humanitarian work in his future surgical practice. He plans to pursue either Otorhinolaryngology-Head and Neck Surgery, Neurologic Surgery or Plastic Reconstructive Surgery. His favorite extracurricular activities include sky-diving, long-distance running, and swimming in the Pacific Ocean.
One such opportunity was presented to me the same week of my acceptance phone call earlier this spring: a fully-funded trip to a previously unattended region of Nicaragua with a volunteer medical brigade. It was led by physicians from my institution looking to recruit our entering first-year medical school class to help lead the trip.
Ana and I sat at that table for a few hours, enjoying each other’s company and stories told in choppy combinations of Spanish and English, some laughs of word-finding frustration spattered throughout. We talked about her daughter and grandson who lived with her, the colorful birds that were caged in her open-air courtyard, and the fact that I had come to Antigua from North Dakota to work with the God’s Child Project. As fond as I am of this memory, now that eight years have passed, I look back on my time in Guatemala with some degree of uncertainty about my intentions. I was what many would call a ‘voluntourist.’
I was on a plane heading towards Santiago, the capital of the Dominican Republic. From there, I would take a two-hour bus ride to Mao Vallerde, where we would be working at for most of the week. I was going on a global health trip through Jose’s Hands, an organization that sponsors medical students interested in going on mission trips. For this particular trip, they had partnered with One to the Other Ministries, a Tulsa-based ministry that has been doing mission trips, both medical and non-medical, since 1986. This being my first global health trip, I had no idea what to expect other than the usual warnings of tropical diseases endemic to the area.
Four years ago I was sitting in the living room of my basement apartment in Ann Arbor, Michigan watching the opening ceremonies of the Olympic Games. Now I am a week away from starting my second year of medical school, and the opening ceremonies for the 2016 Rio Olympics are upon us as well.
Among my professor’s stories from Lima, the chicken dinner story haunts me most. It features two students from his time as a middle school teacher in one of Lima’s most dangerous outskirt neighborhoods. A young teacher working at a Fe y Alegria school in North Lima, my professor, Kyle, had promised to take them anywhere they desired for dinner in exchange for exam success. The students requested chicken, standard Peruvian celebratory fare.
In El Salvador, 17 women imprisoned after experiencing miscarriages or stillbirths began a campaign against reproductive injustice. “The 17” were sentenced for up to 40 years in prison for miscarriages or complications during delivery, after being convicted of attempted or aggravated homicide. This was the outcome of a total ban on abortion: young, often unmarried, women of lower socioeconomic status are suspected of inducing illegal abortion when experiencing emergent obstetric complications. Stigma and misogyny play into the result, in which a woman’s health during pregnancy is viewed with distrust.
I recently finished reading Tracy Kidder’s Strength in What Remains, which highlights one man’s journey from the genocide in Burundi and Rwanda to becoming a refugee in New York City. Some chapters are quite graphic in their descriptions of the slaughtering of Hutus and Tutsis — the pain, suffering and atrocities he witnessed. These deaths seemed nothing like being on a morphine drip in an ICU bed or falling into a final deep sleep as your family surrounds you with tears and prayers. Instead they seemed gruesome and inhumane.
Shortly before returning to the United States for the holidays from Malawi, a truck full of police and military men pulled up next to my car as I was driving and demanded my driver’s license. They claimed I was “dangerously parked” while stopped in a long queue of traffic to let my friends hop out across from a bus station and would, therefore, be fined K10,000 (approximately $18).
Across the street from the Public Health Research Institute of India (PHRII) is a laundry, where laundrymen, women and children undertake their quotidian task of hanging white linen sheets before daybreak. They cover the long ropes that run by the dusty, red road with countless numbers of alabaster white sheets. The sheets spread to cover the walls, wrought-iron fences and wooden posts transforming the city street into effervescent maze that billows under the hot mid-day sun.
The counting of compressions permeated the air as we anxiously stood by hoping to see any sign of life. We were trying to save Adam, a young Israeli-Arab who was on our inpatient service due to complications after his hemicraniotomy. He was hospitalized for nearly four months and his vital signs never stabilized, despite our rigorous and numerous treatments.
If you’ve had the chance to look away from your class notes and at the news over the past few weeks, you’ve undoubtedly heard about the Zika virus. You may have even had family members ask about the virus and if you, as a future health care provider, are concerned about the recent outbreaks. Consider this your SparkNotes for the Zika virus.
Before my year abroad, I decided to pursue a masters of public health at the Brown School of Social Work at Washington University. During the weeklong MPH orientation last fall, we had an eight-hour mandatory session on cultural awareness, which included drawing our cultures with crayons on blank sheets of paper and sharing them with the group. Throughout the day, one of the students kept emphasizing how much she has been grappling with her white privilege lately. At the time, I had trouble appreciating what she was referring to, but after almost four months in Africa, my “whiteness” is part of my daily thoughts.
Columnist
Washington University in St. Louis
Austin is an MD/MPH candidate at Washington University in St. Louis (WashU) who is taking a year off of medical school to complete a Doris Duke research fellowship in Malawi through UNC - Chapel Hill. After spending the last eight years in St. Louis as a WashU undergrad (chemistry, music) and graduate student, Austin is loving the opportunity to experience a new culture and explore his interests in global health. His column seeks to illustrate a raw, human, vulnerable lens on the joys and struggles of working abroad.
Lessons in Lilongwe
Global health work can seem glamorous, exotic, and noble. Lessons in Lilongwe presents introspection and critical observations to illustrate what global health research and living in Africa are really like. Come join Austin on his year off of medical school for a research fellowship in Lilongwe, Malawi.
