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.
One of my housemates and I decided early on in my time in Malawi that we needed a code word that would mean, “Austin, stop worrying about money and schedules. Just enjoy the experience and let go.” We decided that “chocolate chips” would be our secret phrase for capturing this sentiment. That way, regardless of the social situation, my housemate could remind me to let go of control and just be.
In undergrad chemistry lab, you likely were introduced to the terms accuracy and precision, often represented visually by the spread of darts on a dartboard. You were told to keep track of significant figures based on how well the various graduated cylinders and titration pipettes could measure volumes. The goal was to express the answer with as much certainty as possible, given the tools at your disposal.
Over the past few months, a recurring topic in news conversation has been the plight of refugees from Syria. Recently, European nations such as Germany have contemplated whether to extend asylum to many of the estimated 6.5 million individuals displaced within Syria, and the 3.5 million who have fled to neighboring nations. The Syrian Civil War began in 2011, and with growing instability in the region due to the growth of groups such as ISIS, much of the previous infrastructure has eroded, including the country’s health care and public health systems. There are a number of concerns for the health of refugees trapped in Syria, and for those who have found asylum in countries across the globe.
In the Gospel of Matthew, a man walks up to Jesus and asks him, “What good thing must I do to get eternal life?” Jesus replied by saying to uphold the commandments. The young man assured Jesus that he has kept all of the commandments and asked what else is required from him. In turn, Jesus replied, “If you want to be perfect, go, sell your possessions and give to the poor, and you will have treasure in heaven. Then come, follow me.”
As medical students across the country enter their fourth year, many will travel thousands of miles to acquire global health experiences from the far reaches of the globe. While much can be learned by exposure to the stark differences among health systems in other countries, there is no doubt that such health disparities also affect the lives of vulnerable populations in our own communities. As a fourth-year medical student, I spent four weeks conducting a community health needs assessment of Burmese refugees in my hometown of Waterloo, Iowa, where I began to learn the meaning of global health at home.
The call for a more global medical curriculum — one that not only recognizes, but prioritizes health issues that transcend national, political and cultural demarcations — is coming from all sides. American medical student interest and participation in international electives is considerable, and surveys indicate that its growth has accelerated in recent years.
There is little doubt that many in the world lack access to adequate public health systems, and we know that good global health work can help these individuals. Fortunately, institutions and individuals are becoming increasingly interested in contributing to the field of global health. In fact, global health has become increasingly integrated into medical schools, so even tertiary care centers with little-to-no public health offerings afford their students opportunities to go abroad.
“Puedo tomar su presión? Puedo tomar su pulso?” I butchered in Spanish, over and over again. Sometimes I received a smile and laugh in return, sometimes a look of confusion, sometimes a placid unfolding of the patient’s arm. I pumped the cuff up repeatedly and listened intently over the screams of playing children and the chatting of a long line of patients.
Sitting across the table from me was a woman with four children, whose hesitancy towards their foreign doctor mirrored my own. I still wonder sometimes how I ended up in that tiny cinderblock-and-corrugated-metal church in Bolivia, not even finished with my first year of medical school. At the time, I felt frantic.
A poem from our writer-in-training Brent Schnipke about his experience abroad.
The gray pickup truck rattled along the rocky path, careening back and forth on a steep incline that reached for the snow-capped peak masked by clouds. While tires slid and kicked up trails of dust that diffused into the mist surrounding us, I was still able to catch a glimpse of Chimborazo, a volcanic pyramid of Ecuador, through pockets of clarity in that atmosphere. Soaring at breathtaking elevations of over 20 thousand feet, Chimborazo is a point near the equator where one can be closest to the sun while standing on Earth.
You are likely aware that several countries in West Africa are battling an Ebola outbreak. To make matters more serious, there have been four confirmed cases of Ebola in the United States and one of these patients has died. Due to the lethality of this virus and its presence on US soil, we find ourselves asking a number of questions: Are we safe? How contagious is it? Is there any chance that I have the …
Contributing Writer
Medical College of Wisconsin
Ghady Rahhal graduated from SUNY with a bachelors in Molecular Biology and minors in chemistry and philosophy. Shorty thereafter, Ghady moved to Boston and worked as a Network & Clinical Analyst for a healthcare company that focused on community-based care. Prior to attending college, Ghady lived in Lebanon which has given him an appreciation for Global Health - a field which he continues to be active in today. Currently, Ghady is a medical student at the Medical College of Wisconsin.
