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University Teaching Hospital – Hongyu Zhao, MD & Qing Meng Zhang, MD

Written by Hongyu Zhao, MD, PGY-2 and Qing Meng Zhang, MD, PGY-2 at Kaiser Permanente Santa Clara Internal Medicine Residency Program while on Global Health rotation at University Teaching Hospital in Lusaka, Zambia in January 2019

This was our first trip to Africa, and our first time doing global health. Needlessness to say, we were excited and looking forward to an enriching experience. After more than 20 hours of travel, we arrived at Lusaka International Airport at 3 a.m. on a Saturday. Instantly, greeted with a wave of tropical humidity and welcomed by a short wave of thunderstorm with an awe-strucking lightning show.

We both grew up in China and I spent a good amount of time in rural villages in China as children, but life in Lusaka was…

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Good Samaritan Hospital – Emily Fisher, MD

Written by Emily Fisher, MD, Fellow at the Kaiser Permanente Napa-Solano Community Medicine & Global Health Fellowship Program while on Global Health rotation with Good Samaritan Hospital in Chichicastanango, Guatemala in December 2018

“Surprising Helpers”

In December of this year, I had the privilege of joining a group from Georgia on their yearly trip to the Guatemalan town of Chichicastenango. What used to be an annual medical mission trip had been on hiatus for years since they had no physician to attend the trip. Since I was introduced to the group, we set out to spend a week setting up pop-up clinics in the rural villages outsides of the already small, but famous, town of Chichicastenango.

Having had ‘relative’ success bringing my daughter along on international trips, I brought by husband and my 2-year-old with me. There’s something about travelling with a child to give you a different perspective on things. She’s a built in ice-breaker and friend-maker, and helped my husband and I look at the culture through the lens of what it must be like for parents living in this place. At times, like when we could barely breathe in the town center due to the black poison that….

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International Organization for Women & Development – Caitlyn Painter, DO

Written by Caitlyn Painter, DO, Fellow at the Kaiser Permanente Northern California Female Pelvic Medicine & Reconstructive Surgery Fellowship Program while on Global Health rotation with the International Organization for Women & Development at Kabagabaga Hospital in Kigali, Rwanda in October-November 2018

Obstetric fistula is a complex and vexing problem, with the majority of women affected residing in sub-saharan African.  Given the medical infrastructure in these resource limited countries, it is difficult to estimate the true incident of fistula, however the WHO estimates around 33,000 new obstetric fistulas per year in sub-saharan Africa.  Our two week mission was structured around providing surgical care for Rwandan women suffering from fistula.  The IOWD, the International Organization for Women’s Development, is a 501(c)(3), that has an ongoing partnership with the Rwandan ministry of health, as well as Kibagabaga hospital in Kigali, Rwanda.  Surgical mission teams travel here, three times a year, since 2010.

The mission starts out with clinical evaluation of women complaining of fistula symptoms, which may include constant leakage or urine or feces from the vagina, usually since the birth of a child.  These women travel from…

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ENLACE Foundation – Gealina Dun-Melli, MD

Written by Gealina Dun-Melli, MD, PGY-3 at the Kaiser Permanente Napa-Solano Family Medicine Residency Program while on Global Health rotation with ENLACE Foundation in Taulabe, Honduras in July 2018

Today was our first day of clinic in El Diviso! Kaiser Permanente has been coming to this area for the past few years with the help of Don Israel and Dr. Javier Sevilla. We were joined by multiple community physicians, la Doctora Ester and Doctor Fabricio and Dentista Gabby. We are very lucky to have these community relationships as they have helped us maintain connections with the community so we can hopefully make some lasting changes outside of our single week.

Things I’ve learned so far (among other things):

  • Finding vegetables in Honduras is hard. We attempted to talk to patients about healthy eating (comer saludable) which we found to be more difficult than we thought in this community. They often have rice (arroz), tortillas, frijoles (beans), occasionally chicken (pollo) and potatoes (papas) for meals. When asked about vegetables (verduras), they reported it was difficult to get vegetables. They do have access to sodas (frescos) and chips (churros) and it seems that they often prefer…
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Rad Impact/ECUREI – Christina Kinnevey, MD

Written by Christina Kinnevey, MD, Fellow at Kaiser Permanente Napa-Solano Community Medicine & Global Health Fellowship Program while on Global Health rotation with Rad Impact in partnership with ECUREI in Kampala, Uganda in June 2018

“A Lesson in Flexibility”

If there is one thing I learned in leading this trip to Uganda for the past two years, it that no matter how much we plan ahead, we still need to plan for plans to change.  Last year, two of us on the team arrived at the airport on the morning of our travels to discover the tickets to Uganda we had purchased had not actually gone through and been ticketed and we did not have a seat on the plane.  This year, while our journey started out smoother, during our route to…

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Queen Elizabeth Central Hospital – Robert Day, MD

Written by Robert Day, MD, PGY-4 at Kaiser Permanente Santa Clara Ob/Gyn Residency Program while on Global Health rotation at Queen Elizabeth Central Hospital in Blantyre, Malawi in February-March 2018

Queen Elizabeth Hospital (QEH) is a government hospital in Blantyre Malawi. It is the largest hospital in Malawi and severs the center of the country. It is also the only hospital in Malawi that is dedicated to medical education. I had the wonderful opportunity to spend my elective time as a resident at QEH where I worked alongside residents from Malawi.

A typical day begins at 0730 where morning rounds take place. Medical students, interns, residents and attendings are present. The obstetric, gynecologic and oncology cases from the previous day were discussed. The hospital is largely run by the resident service and the morning report serves as a place for the attendings to teach the residents how they might have managed the cases differently. Typically this lasts for a few hours and is followed by medical student presentations that they have been assigned for the week. It was very impressive that…

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University Teaching Hospital – Payvand Milani, MD

Written by Payvand Milani, MD, PGY-3 at Kaiser Permanente Santa Clara Internal Medicine Residency Program while on Global Health rotation at University Teaching Hospital in Lusaka, Zambia in February-March 2018

I feel so lucky to have had the opportunity to travel to “UTH”, or the University Teaching Hospital, in Lusaka, the capital of Zambia, for a few weeks. It was my first time in Zambia, and Africa, for that matter. Exciting! UTH is a public hospital and is the largest in the country. It is considered the referral center for all other hospitals in the country and many of the country’s specialists work there. My goal for the trip was to develop a sense of what healthcare is like in Zambia, to learn how physicians operate in a resources-limited setting, and to explore the country/culture.

   

From SFO, I took a 16-hour flight to Dubai and another 7-hour flight to Lusaka. It was quite the journey, so I was relieved to arrive in the relatively small airport of Lusaka. I battled with jetlag the day I arrived and made it out to UTH the next day.

Just by walking around, it quickly becomes clear that…

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Bay Area Surgical Mission – Ijeoma Okwandu, MD

Written by Ijeoma Okwandu, MD, PGY-3 at Kaiser Permanente San Francisco Ob/Gyn Residency Program while on Global Health rotation with Bay Area Surgical Mission in Daet, Philippines in February 2018.

There have been experiences along my academic and training career that have been pivotal to forming the type of physician and surgeon I envision of becoming. The surgical mission to Daet, Philippines with Bay Area Surgical Mission is one of those moments.

At first sight, the group was clearly a force with a mission. The check in line at the San Francisco Airport international terminal was lined and stacked with about five dozen large boxes–each filled with medicine, supplies, surgical and anesthetic equipment. Looking back, the boxes seemed almost metaphorical for the group of people that came together for this very mission. Like the boxes, each person carried a specific need or role: From the premedical students, translators, anesthetist, surgeons, nurses, physician assistants, and volunteers. Each with a specific role, but we came together with…

 

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Da Nang Hospital for Women & Children – Sai-Wing Chan, MD

Written by Sai-Wing Chan, MD, PGY-4 at Kaiser Permanente Santa Clara Ob/Gyn Residency Program while on Global Health rotation at Da Nang Hospital for Women & Children in Da Nang, Vietnam in October 2017.

On 3rd Floor Labor & Delivery at the Da Nang Hospital for Women and Children, at exactly five minutes to nine o’clock in the morning, a procession of gravid women in turquoise gowns assemble outside a small linoleum-tiled room filled with three well-worn examination beds. The dozen women take their seats on a row of blue plastic stools. A few of them have the tell-tale signs- wincing faces and heavy, rhythmic breathing – that reveal the fact they are clearly in active labor. One by one, they hop onto an exam table, each face disappearing behind a swollen belly as they…

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Cacha Medical Spanish Institute – Arielle Randolph, MD

Written by Arielle Randolph, MD, PGY-3 at Kaiser Permanente Oakland Pediatrics Residency Program while on Global Health rotation at Cacha Medical Spanish Institute (Cachamsi) in Riobamba, Ecuador in August 2017.

My experience in Ecuador was a memorable one to say the least. I remember flying into the country ,after a brief layover in Bogota, Columbia, and being taken aback by the breathtaking landscape. Most striking were the clouds. At 10,000 ft elevation, it literally looked as if you could touch the sky. The clouds hovered barely above the ground. Interestingly enough, the weather was surprisingly similar to my home in California. Not too hot, but not quite cold either. There was a cool breeze as well. I immediately observed the warmness of the Ecuadorian people as I was welcomed into the hotel I stayed for a few nights prior to going to Riobamba. This warmness that I…

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