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Obras Sociales del Hermano Pedro – Madeline Hellendag, MD

Written by Madeline Hellendag, MD, PGY-2 at Kaiser Permanente San Francisco Obstetrics & Gynecology Program while on Global Health rotation at Obras Sociales del Hermano Pedro in Antigua, Guatemala in October 2016.

As the only Spanish-speaking physician on the gynecology team, I had the incredibly special job of talking to each patient’s family member(s) after the surgery was finished. At the end of each case, I would peek my head outside of the operating room hallway and call out “Familia de [patient’s first name]”. If it was one of the first cases of the day, I would be calling out to a large crowd of people made up of all of that day’s patients and their families. If it was the last case of the day, there would be just a couple of people left who had been waiting all day for their turn. I was able to give these family members the wonderful news that their loved one’s surgery had gone very well and that the surgery would likely make her feel much better. Without exception, the family members would praise me, pray for me, and thank me profusely. I felt undeserving of their gratitude, but also

madeline

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Hospital de la Familia – Alexander Rivero, MD

Written by Alexander Rivero, MD, PGY-4 at Kaiser Permanente Oakland Otolaryngology Program while on Global Health rotation at Hospital de la Familia in Nuevo Progreso, Guatemala in November 2016.

A known entity – this time, I was less nervous and more confident as we took our 12 plus hour journey from San Francisco to Nuevo Progreso, Guatemala. I felt empowered, sharing with my co-resident, Dr. Jonathan Lin, the ins-and-outs of the trip like when we would have a rest stop along the long way or to make sure and wear pants because they blast the air conditioning on the bus. We were greeted by the staff and locals with a small fireworks display as per custom and unloaded our bags quickly as we dawned our scrubs to start a planned clinic that same day. We immediately began signing several patients up for surgery the following day. As a senior resident on the trip, I was able to have first pick at the complex cases as well as provide guidance on OR planning and scheduling. The transition from spectator on my first trip to Hospital de la Familia (HDLF) to active learner and organizer this time was perhaps the most notable change for me. I quickly realized that

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Un toque de Honduras – Geoff Winder, MD

Written by Geoff Winder, MD, PGY3 at Kaiser Permanente Napa-Solano Family Medicine Program while on Global Health rotation with ENLACE Foundation in Las Lajas, Taulabé, Honduras in July 2016.

While climbing the road to El Diviso yesterday morning, our little silver bullet of a rented van sputtered its wheels against the rocky ruts worn deep into the ruddy soil. Fifteen eager volunteers from across Honduras and the States (and one from Switzerland) had packed in shoulder to sweaty DEET-soaked shoulder. Violeta dug her fingers into Eric’s arm as the momentum around a now familiar curve weighed heavily across our back (the fifth) row. Moments later Lago Yojoa made its brief appearance below, framed amid sloping hillsides and, at the northern horizon, the hazy peaks of one of two transcontinental mountain ranges.

Geoff Winder_Honduras_photo 01At some point along this daily trek, I’ve no doubt that each of us contemplated in some manner the beauty of the countryside around us…I suppose Violeta may have spent more time contemplating her mortality, but clearly there’s value in that too ;).

Un toque more than five days in, we’ve collected more

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Cacha Medical Spanish Institute – Brittany Kausen, MD

Written by Brittany Kausen, MD, PGY2 at Kaiser Permanente San Francisco OB/GYN Residency Program while on Global Health rotation with Cacha Medical Spanish Institute (CACHAMSI) in Riobamba, Ecuador from April-May 2016.

My first two days were spent in the Ob unit that carries all postpartum (12 cs beds, 12 vag delivery beds), antepartum (alto riesgo 6 beds), and early laboring patients. There are also separate rooms for pre-eclamptic patients that have big black curtains to make them dark with little stimulation – so as not to piss off the pre-eclampsia. Days start with table rounds at 7am followed by walking around seeing patients with the whole team which is a small army. There are approximately 6 interns, 2 resident doctors, one junior attending and Dr. Lino who is the chief. Dr. Lino quizzes everyone — on everything. From pre-eclampsia to doses of antibiotics to units on lab values. The level of training is very different here; interns are more like medical students on their first year of clinical rotations and the residents are more like interns. As a second year resident from the US, my depth of knowledge is probably greater than theirs especially on topics like pre-eclampsia, but having to answer questions in Spanish is a whole new challenge. My first day he quizzed me all about pre-eclampsia – questions I actually knew – but translating it into Spanish was difficult. I somehow got through

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Vivekananda Memorial Hospital – Morgan Gilani, MD

Written by Morgan Gilani, MD PGY2 at San Francisco Internal Medicine on a Global Health rotation in Sargur, India with the Swami Vivekananda Youth Movement.

Gratitude.  My time working with the Swami Vivekananada Youth Movement (SVYM) this spring has been an integral part of my residency training. I joined a group from Kaiser Woodland Hills which included mostly family practice doctors, some in training, a rheumatologist, a pre-PA student, and an attorney. We were greeted at the airport in Bangalore and quickly whisked off to Mysore, currently ranked the cleanest city in India on a very hot and humid Sunday morning at 4 AM. Our visit in Mysore was brief and only a layover on our journey farther south to Sargur.  However, during our brief day and a half, we were very graciously introduced to SVYM, its main campus, and had the honor of meeting with two of the doctors who had founded the NGO about 30 years ago including Dr. Balasurbramaniam, or as he shortens- Dr. Balu. What started as a 9 bed hospital on the forest’s edge outside of Sargur has grown into a 90 bed hospital with subspecialty care. The populations served includes rural and 5 different tribal communities which have been displaced from the forest, now two National Reserves. In their longitudinal involvement and growth over the past 30 years in working with these communities it was interesting to

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Daet, Philippines – Bay Area Surgical Mission – Stephanie Cizek, MD

Written by Stephanie Cizek, MD, PGY3 at Kaiser Permanente San Francisco OB/GYN Residency Program on a Global Health rotation with Bay Area Surgical Mission in Daet, Philippines.

Mary has fibroids.  Common, benign tumors on the uterus, which for her have grown disproportionately large, causing abdominal pain and heavy bleeding with her periods.  She has lost so much blood that she is chronically anemic, and her fibroids have grown so large on her tiny frame that she appears 20 weeks pregnant.  She has had surgery for this problem before — 15 years ago, a group of surgeons on a surgical mission trip landed near Mary’s hometown in the Philippines for a week to provide free surgery.  She has a large 15cm scar across her abdomen, but the surgery

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Bay Area Surgical Mission – Brian Song, MD

Written by Brian Song, MD, PGY4 at Kaiser Permanente Oakland Otolaryngology Residency Program on a Global Health rotation with Bay Area Surgical Mission in Daet, Philippines.

I was anxious and excited leading up to our medical mission trip. We had a diverse team from across the United States and the two other otolaryngologists I was scheduled to work with were from New Mexico and mere acquaintances. Coordination was challenging requiring lots of emailing and phone calls. Yet, we had experienced leadership within a well-established organization who ensured the logistics proceeded without issue.

The flight to the Philippines was 14 hours spanning 7000 miles. In this modern age, flights anywhere are ubiquitous with standard amenities and service. The moment we stepped on that plane, we could have been traveling anywhere. Therefore, the reality of our upcoming adventure did not come to fruition until we arrived. The Philippines is

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Global Health Reflection – Aldene Zeno, MD

Written by Aldene Zeno, MD, PGY4 at Kaiser Permanente Santa Clara, Obstetrics and Gynecology Residency Program on a Global Health rotation with Bay Area Surgical Mission in Daet, Philippines.

The Bay Area Surgical Mission (BASM) has provided surgical services to patients in the Philippines for over 16 years. It is based at the Camarines Norte Provincial Hospital in Daet, Philippines. The BASM team members were skillful yet humble and loads of fun. We stayed in this amazing hotel owned by the mother of one of the trip leaders. The hotel certainly lived up to its name, “Zenaida’s Palace;” the daily breakfasts, refreshing swimming pool, proximity to the ocean, and evening karaoke were just a few of the things that made me feel like global health team-royalty.

In our first full clinic day and in the times that we saw patients in between cases, our gynecology team acquired a busy service. Most patients were referred to our clinic, and some travelled as far

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My Rotation to Project Angkor

Written by Chuong Dang, MD PGY3 at Kaiser Permanente Oakland Pediatrics Residency Program on a Global Health rotation with Project Angkor in Cambodia.

We departed from San Francisco Airport on 12/29 early morning, transit flight in Taipei and arrived in Phnom Penh, the capital of Cambodia on 12/30. We picked up our supply boxes (about 30-40), applied for expedite visa at the custom then were on our way to the hotel via buses. It was free time the first evening in Phnom Penh; we went to the Russian Market to buy some personal goods in preparation for the trip. It was a surprise to me that the U.S. dollar is accepted almost everywhere we traveled to in Cambodia.

The second day, the program organized a field trip to the infamous Killing Field, where the old Khmer Rouge regime executed and massacred  tens of thousands of people during 1976-1979 coup. This place taught us to

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Name, Insurance, and Neighborhood – Tessa Stecker, MD

Written by Tessa Stecker, MD Fellow with Kaiser Permanente Napa-Solano Community Medicine and Global Health while on rotation with Cachamsi in Riobamba, Ecuador in October 2015.

What is your name? Do you have insurance? What is your neighborhood? These three questions begin every clinical encounter in Riobamba.

The Ecuadorean health system has undergone an immense and impressive transformation over the last 15 years. Ecuador has become one of the leading countries in the region (and in the world) regarding healthcare efficiency spending (surpassing the U.S. by at least 30 spots on the world rank list). One of the reasons for this success is the strict adherence to patient centered medical homes. Each Ecuadorean is assigned a doctor/clinic based on his/her address and is expected to visit this clinic first except for in an emergency.

The clinic I’m assigned to this week reminds me of

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