Latin America

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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Hospital de la Familia – Tuong Van Nguyen, MD

Written by Tuong Van Nguyen, MD, PGY-3 at Kaiser Permanente Santa Clara Obstetrics & Gynecology Program while on Global Health rotation at Hospital de la Familia in Nuevo Progreso, Guatemala in April-May 2017.

It began with a 6-hour red-eye flight to Guatemala City and then a 5-hour bus ride to the small town of Nuevo Progreso. You would see small shacks lined up along the road that were homes for families of five or more, amongst the luscious jungle spotted with mounds of litter. I thought that traveling abroad a few times, including medical mission trips to similar areas such as Nicaragua would make me acquainted to the setting, yet it ceases to give me a new perspective each time; a new experience, a new family, a new community and never ending knowledge. It revives the awareness and appreciation for life. But it also forces

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Cacha Medical Spanish Institute – Afton Chavez, MD

Written by Afton Chavez, MD, PGY-1 at Kaiser Permanente Oakland Internal Medicine Program while on Global Health rotation at Cacha Medical Spanish Institute in Riobamba, Ecuador in March 2017.

I highly recommend this global health elective.  In just a two-week period (8 days of Spanish classes), my medical Spanish improved significantly.  The teachers at the institute are very professional and are excellent at teaching Spanish.  My professor had a degree in Linguistics and was incredibly

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Labor and Delivery, Traditional Birth Attendant Training, and Women’s Health – Sarah Simmons, MD

Written by Sarah Simmons, MD, PGY-2 at Kaiser Permanente San Francisco Obstetrics & Gynecology Program while on Global Health rotation at Funbichoco/Hospital San Francisco de Asis, E.S.E., in Quibdo, Choco, Colombia in January-February 2017.

I had been to Colombia before, but under much different circumstances as a tourist visiting the country’s largest tourist attractions of Bogota and Cartagena. This time I flew into Quibdo, a small city of 100,000 inhabitants that many Colombians have never been to, let alone foreigners.

Quibdo is humid, densely packed, surrounded by thick rainforests, and located near the Pacific Coast. It is separated from more major cities by muddy, unpaved roads and a network of rivers. Quibdo is located in the poorest state of Colombia (Choco) and is inhabited largely by Afro-Caribbeans, although there is a minority indigenous population who live on the city’s outskirts and neighboring villages reachable by boat.

Our first week was spent working shifts on Labor and Delivery at San Francisco Hospital working side by side with local Family Medicine and OB/GYN physicians delivering babies, triaging consults, and rounding on antepartum patients. Particularly unique cases included

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Hospital de la Familia – Maria Martin, MD

Written by Maria Martin, MD, PGY-4 at Kaiser Permanente San Francisco Obstetrics & Gynecology Program while on Global Health rotation at Hospital de la Familia in Nuevo Progreso, Guatemala in March-April 2017.

My trip to Nuevo Progreso in Guatemala with Hospital de la Familia was amazing! I could not have asked for a more inspirational and fulfilling global health experience. The team of doctors, nurses, translators and staff was exemplary. Everyone worked cohesively to evaluate numerous patients in clinic and perform >200 surgeries during our 6 day surgical mission. The surgical mission included Ophthlamalogy, General Surgery, Plastic Surgery, ENT and Gynecology.

Each day started with over 200

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Hospital de la Familia – Steven Micucci, MD

Written by Steven Micucci, MD, PGY-2 at Kaiser Permanente Oakland Otolaryngology Program while on Global Health rotation at Hospital de la Familia in Nuevo Progreso, Guatemala in March-April 2017.

The moment we stepped off the bus at Hospital de la Familia, I knew that I would have an experience that I would treasure forever. The hospital was in a small town, tucked within the mountains of Guatemala, and was seemingly as remote a place you could find in Central America. As the bus approached, the townspeople set off fireworks and

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Cacha Medical Spanish Institute – Eric Bautista, MD

Written by Eric Bautista, MD, PGY-3 at Kaiser Permanente San Francisco Internal Medicine Program while on Global Health rotation at Cachamsi in Riobamba, Ecuador in March 2017.

Global Health Background and Departing for Ecuador

I took off for Ecuador after my last night shift in residency. I left one of the most resource-rich and connected systems in the world and was off to experience medicine with much more limited resources. Being in a “developing country” is not new to me; my parents emigrated from the Philippines a year before I was born and I had spent some time back in the Philippines. I had also spent a summer visiting HIV organizations in India during college to investigate the impact of discriminatory laws against sexual minorities on the HIV epidemic there. Just this past year, I took a trip to visit my relatives in the northern tip of the Philippines. About a full day drive from Manila, it is a poor region of the Philippines that is not on the typical tropical tourist circuit. Having been to the Philippines multiple times in the past, I never recalled obesity as something I commonly encountered in trips in the past. This time was different. My family had asked many medical questions knowing that I was doctor: not about exotic tropical diseases, but about hypertension, hyperlipidemia, and arthritis. To me, “global health” for my family in the Philippines looked a lot like my practice in Kaiser. I was heading to Ecuador reflecting on this.

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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 – Jonathan Lin, MD

Written by Jonathan Lin, MD, PGY-3 at Kaiser Permanente Oakland Otolaryngology Program while on Global Health rotation at Hospital de la Familia in Nuevo Progreso, Guatemala in November 2016.

As a third year resident physician in Otolaryngology-Head and Neck Surgery,
I had the amazing opportunity to be part of a surgical mission trip to Nuevo
Progreso, Guatemala. As a resident in a busy surgical residency, I cherish any
opportunity I have to get away from the usual “grind.” In this case, it meant going
somewhere new to try and improve the health of people living in a community.
Having gone on mission trips as an undergraduate, I learned early on that as
foreigners visiting a country, the residents of that community often

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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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