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I think most have *some* involvement. One of our attendings Ken Iserson is all into it as are some of the residents.

you know the location!
 
Yale is big into International. Check out their website.
 
crewmaster1 said:
Yale is big into International. Check out their website.
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Yeah, but DKM wouldn't touch an underdeveloped country with mile-long pole, so I guess Yale's out.

Sorry DKM - but you left yourself WIDE open by posting this. 😛
 
leviathan said:
Is this irony or thick sarcasm? Levi can't decide. 🙁
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It's more honest truth.....SoCute and I had a rather heated discussion of my opinion of the AIDS pandemic in sub-Saharan Africa. I effectively said I would NEVER go to Africa to render medical care. Nepal and other countries are a totally different story and hence why I am asking because of my impending trip to Nepal of which you are aware Leviathan.


Oh, and yes, change your avatar back.
 
DropkickMurphy said:
It's more honest truth.....SoCute and I had a rather heated discussion of my opinion of the AIDS pandemic in sub-Saharan Africa. I effectively said I would NEVER go to Africa to render medical care. Nepal and other countries are a totally different story and hence why I am asking because of my impending trip to Nepal of which you are aware Leviathan.


Oh, and yes, change your avatar back.
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Why would you never go to Africa to render medical care? BTW.. when are you applying to medical school?
 
Flopotomist said:
Why would you never go to Africa to render medical care? BTW.. when are you applying to medical school?
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I don't believe in putting myself at high risk for little benefit. I look at taking care of a mass of terminal AIDS patients as being a rather inappropriate utilization of limited resources when there are far more managable issues to be handled. Think of it as triage.

It will be a couple of years still Floppy.
 
DropkickMurphy said:
I don't believe in putting myself at high risk for little benefit. I look at taking care of a mass of terminal AIDS patients as being a rather inappropriate utilization of limited resources when there are far more managable issues to be handled. Think of it as triage.

It will be a couple of years still Floppy.
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To cure sometimes, to relieve often, to comfort always.

Hippocrates

(My guy came first)
 
Do the greatest good for the greatest number.

-First rule of mass casualty incident management.

You don't work on the guy with exposed grey matter who you know is going to die when there are people who are likely to survive bleeding out around you.
 
Since you're bringing up Hippocratic quotes:
"To do nothing is sometimes a good remedy."
"What cannot be cured by medicaments is cured by the knife, what the knife cannot cure is cured with the searing iron, and whatever this cannot cure must be considered incurable."
 
An even better quote (from a slide during an ACLS class a while back)

"Prevent when possible, treat effectively when challenged, and when all else fails admit when you are powerless to prevent the inevitable."
 
DropkickMurphy said:
Since you're bringing up Hippocratic quotes:
"To do nothing is sometimes a good remedy."
"What cannot be cured by medicaments is cured by the knife, what the knife cannot cure is cured with the searing iron, and whatever this cannot cure must be considered incurable."
Click to expand...



Incurable maybe, but did you read his quote about where "cure" fits in our profession?


DropkickMurphy said:
"Prevent when possible, treat effectively when challenged, and when all else fails admit when you are powerless to prevent the inevitable."
Click to expand...

Again my point seems to elude you. "The inevitable" is not the end of the role for a healthcare provider (maybe for a paramedic/EMT, but not for a doctor). The attitude that the end of treatment is the end of care is what keeps families hanging on far beyond when they want to when their loved ones are ill - they are afraid that their loved one will be left alone to die if they agree to take away the full court press.

I'm just pointing out that there is a role beyond "curing" in Africa (although there is TONS of curing to do - far more malaria than HIV).
 
You all have fun with Africa then, because I won't stop you from going if that's your ideal place to expend your efforts...there's malaria elsewhere too (Nepal for one).
 
DropkickMurphy said:
You all have fun with Africa then, because I won't stop you from going if that's your ideal place to expend your efforts...there's malaria elsewhere too (Nepal for one).
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One last thought: The most desperate, needy countries are the ones that benefit the MOST from the smallest efforts. At 21 without so much as a college degree I was able to do things that touched people's lives permanently while in Africa (and after).

And yes, I'm perfectly aware that there is malaria elsewhere 🙄

(But from my Micro notes: Death occurs mainly in children and pregnant women in Sub-Saharan Africa.)
 
DropkickMurphy said:
I don't believe in putting myself at high risk for little benefit. I look at taking care of a mass of terminal AIDS patients as being a rather inappropriate utilization of limited resources when there are far more managable issues to be handled. Think of it as triage.

It will be a couple of years still Floppy.
Click to expand...

I guess I disagree. Before good therapy, when people went down in a year or two, sure. But, a recent trial of routine managment in Haiti (doesn't get much worse as a location) showed that people put weight back on, felt well and perhaps will have years added (during which time they can raise their kids). Results of routine combination therapy may be almost as good in the third world as the first.
 
this aids thing could definitely be its own thread...or even forum. that being said...i'll throw my hat into the african ring. i'd rather be working towards the alleviating the pain brought on by the most extreme plague ever faced by humanity than handing out malaria meds in nepal. just an opinion. b/t education, increased economic support, and increased shipments of protease inhibitors we will see death rates in treated areas of africa drop by greater than 70% in the next few years.

tm
 
BKN said:
I guess I disagree. Before good therapy, when people went down in a year or two, sure. But, a recent trial of routine managment in Haiti (doesn't get much worse as a location) showed that people put weight back on, felt well and perhaps will have years added (during which time they can raise their kids). Results of routine combination therapy may be almost as good in the third world as the first.
Click to expand...

The group I used to work with is currently working towards a preliminary answer to this question! :clap:
 
socuteMD said:
Yeah, but DKM wouldn't touch an underdeveloped country with mile-long pole, so I guess Yale's out.

Sorry DKM - but you left yourself WIDE open by posting this. 😛
Click to expand...

We've had residents do disaster medicine in Israel before. Heck we even had one resident do research on sailors while sailing in the World Cup and another who did research on vascular endothelial growth factor while climbing some bigname mountain (I can't remember which one). I'm still amazed they arranged the rotations. I'm sure they worked very, very hard!
 
southerndoc said:
We've had residents do disaster medicine in Israel before. Heck we even had one resident do research on sailors while sailing in the World Cup and another who did research on vascular endothelial growth factor while climbing some bigname mountain (I can't remember which one). I'm still amazed they arranged the rotations. I'm sure they worked very, very hard!
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Had a jock who wanted to do a "montaineering medicine" rotation on Denali years ago. I told her to show me a curriculum. I'm still waiting.
 
southerndoc said:
We've had residents do disaster medicine in Israel before. Heck we even had one resident do research on sailors while sailing in the World Cup and another who did research on vascular endothelial growth factor while climbing some bigname mountain (I can't remember which one). I'm still amazed they arranged the rotations. I'm sure they worked very, very hard!
Click to expand...

You would know far better than I, and I only skimmed it quickly but the Yale Johnson & Johnson scholars link that you have posted in the past really seemed to emphasize underdeveloped countries. That's where I drew my (apparently erroneous) impression from.
 
DropkickMurphy said:
I don't believe in putting myself at high risk for little benefit.
Click to expand...

I am surprised that nobody has called you on the first part of this statement, Caring for people with HIV is not high-risk at all. Basic precautions (eg gloves, being careful with sharps etc) reduces the risk to a level so low that you can count the number of providers that seroconvert in a year on one hand (fascinating reading if you medline some of the research).
 
Let's drop the Africa topic.....I honestly don't care one way or the others think about that topic; quite frankly my opinions are my own and there is no way to instill some desire to spend my time helping AIDS victims in Africa.

I started this thread to try to find possible sources of assistance in getting ready for my trip to Nepal (possible sources of funding, supply donations, etc). If no one else has anything constructive towards that end (rather than just berating me for being a hardnosed SOB), I will ask a mod to lock this thread. Please PM me if you would like to continue this further.
 
Flopotomist said:
I am surprised that nobody has called you on the first part of this statement, Caring for people with HIV is not high-risk at all. Basic precautions (eg gloves, being careful with sharps etc) reduces the risk to a level so low that you can count the number of providers that seroconvert in a year on one hand (fascinating reading if you medline some of the research).
Click to expand...

Except in Africa you can't be sure that you'll have gloves, that some poorly trained staff won't stick you with an infected sharp, that you won't come down with some tropical disease that requires your stay as a patient in one of the 'hospitals' where they can't afford new clean needles so they reuse them, etc....

At least thats how it's been in 4 or 5 of the African clinics I've volunteered in over the years.

As far as the number who seroconvert, thats great in the abstract...unless you're the one.
 
socuteMD said:
You would know far better than I, and I only skimmed it quickly but the Yale Johnson & Johnson scholars link that you have posted in the past really seemed to emphasize underdeveloped countries. That's where I drew my (apparently erroneous) impression from.
Click to expand...
The Yale/J&J program does emphasize underdeveloped countries and Indian reservations. The residents who went to Israel, sailed in the World Cup, and climbed mountains testing fellow mountaineers' blood didn't receive Yale/J&J scholarships. They paid for it out of their own pockets.

Although you can arrange for a Yale/J&J elective anywhere, it is highly unlikely you will receive a scholarship if you do not go to an underdeveloped country or do something significant to better the less fortunate.
 
DKM,

I know you would like to trop the whole Africa thing, and I don't think you should be berated for not wanting to work there, we all have our preferences. But, after recently completing a PICU rotation, I started to evaluate the whole "triage" concept on a more global scale. In the US, keeping 24 week old preemies alive for many months on an oscillator at a cost of $2-5k per day, knowing they will never lead anything close to a normal life, is the very definition of futility and a waste of resources (I know, some of you baby lovers will think I'm a bastard...really, I'm not..I like kids). While at the same time there are masses in Africa that would benefit from simple, cheap medications, food, and clean water. Many kids there could survive into adulthood and lead productive lives for a fraction of the cost of one of these "miracle babies." AIDS is not the only killer in Africa...dirty water probably kills more people than anything else. If you ever visited there you very well may be as surprised as I was to find that our preconcieved notions don't always reflect the reality.

Either way, Nepal is a pretty cool place with lots of need as well. I wish you the best of luck...
 
a_ditchdoc said:
DKM,

I know you would like to trop the whole Africa thing, and I don't think you should be berated for not wanting to work there, we all have our preferences. But, after recently completing a PICU rotation, I started to evaluate the whole "triage" concept on a more global scale. In the US, keeping 24 week old preemies alive for many months on an oscillator at a cost of $2-5k per day, knowing they will never lead anything close to a normal life, is the very definition of futility and a waste of resources (I know, some of you baby lovers will think I'm a bastard...really, I'm not..I like kids). While at the same time there are masses in Africa that would benefit from simple, cheap medications, food, and clean water. Many kids there could survive into adulthood and lead productive lives for a fraction of the cost of one of these "miracle babies." AIDS is not the only killer in Africa...dirty water probably kills more people than anything else. If you ever visited there you very well may be as surprised as I was to find that our preconcieved notions don't always reflect the reality.

Either way, Nepal is a pretty cool place with lots of need as well. I wish you the best of luck...
Click to expand...
Even as a parent, I don't think badly of you for what you think about the 24-weekers. I agree....most of them will not survive and most that do come out gorked all to hell. You're right, it's the very definition of futility.
 
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