International pediatric education and care

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oldbearprofessor

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There has been some interest here lately on this topic and I’ve received several very nice PM’s from people about this, so I thought, in honor of nearing my 100th post (but not my 100th birthday), I’d actually start a thread and put in some of my thoughts about this. I am limiting my description here to pediatric clinical care, not surgical care or research and focusing on Americans going to developing countries.

There are several ways to go about doing international work in pediatrics. I think the most common way is to do primary care in indigent communities. Often, people go with a group of 5-20 doctors, nurses, etc and will spend 1-3 weeks caring for children in isolated community settings. The doctors can come from any specialty or general pedi. Often these groups have a religious group connection, or a medical school connection and often include non-medical components to the mission. Often they will return annually to the say area. This is a great way for people who are primarily US based with limited time to travel to do a wonderful job of helping some of the world’s poorest kids. The doctors usually pay their way from personal expenses and don’t always need to speak the language of where they go. Usually these groups will bring medical supplies, especially basic medicines with them.

A similar, more academic version of this is to go on a specialty lecture tour to other countries. International pediatric symposiums are common in most countries and they usually welcome academic lecturers, especially if they pay their own way! This type of thing often includes visiting hospitals as well and sometimes some direct bedside teaching, although usually this is limited.

Both of these modes are open to anyone who is interested and require relatively little time commitment. They make a tremendous contribution both in terms of exchange of ideas and providing medical care and medicines. There are no data of course, but I would guess than >95% of international pediatric visits by Americans to developing countries are of these two types.

For those who have more time, more resources and more desire to spend more than 1-2 weeks/yr abroad, there are also several opportunities, but each has its own challenges.

There are a few Americans who operate medical clinics in developing countries. In my experience nearly all of these are people who themselves or their family came from the country in which they are operating the clinic. There are however some amazing examples of doctors who have moved from the US to work in other countries virtually without salary. Most doctors however, will maintain their practice in the US. They may staff the clinics with local doctors, with guests doctors form other countries (including the US), or go themselves for several months each year. Such clinics usually require a substantial level of financial commitment and support either by the US doctor or by a foundation.

The academic version of this is the one that is closest to what I do. Based on support related to nutrition research I do, I will take a team of doctors, nurses and dietitians to other countries and put on a lecture and bedside teaching session for several days. This has varied from country to country but has focused on clinical neonatology. This means everything from teaching how to resuscitate babies without anything in terms of modern neonatology in villages in Africa, to teaching the use of modern ventilator methods in Latin America. I think the team approach is critical as one of the major issues in many countries is nursing care of premature and sick babies, not basic medical knowledge in neonatology.

Finally, I note that we really like to go back to the same place as often as we can. We have found that one visit to a hospital can give some ideas to them, but not really change things the way we would like in terms especially of enhancing nursing care. At each visit we see more improvement and that has been gratifying. We have worked in one hospital for about 5 yrs now in South America and developed a close relationship with them.

I hope this information is helpful to my friends on this community.

Regards

OBP

PS. Anyone here an undergrad or early med student at Emory? – my son and I are visiting there soon to look at it for undergrad (liberal arts major, not a premed) and I don’t have any contacts or experience there at all! If so, PM me.

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I've always been interested in international medicine, though I'm not sure how to go about doing it long term. Most of the residency programs I ranked offer international rotations in many developing nations. I'd like to, later in my career, volunteer for a few weeks every year in an underserved area (be it US or not). I tried to do so as a med student, but the only ones I knew of were missionary trips. And since I'm not a Christian, I didn't feel comfortable going. If I'd found a non-religious organization, I'd have gone...
 
I am doing a rotation with Child Family Health International. I have a friend who went and loved it. They have lots of different opportunities, Their website:

www.cfhi.org
 
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I'll just piggyback onto this thread - although I think it'll be more suitable elsewhere.

Does anybody know of similar non-Christian organisation operating in Nepal? I'm trying to set up an elective, I'm Catholic but not very religious.

Thanks
 
For Nepal I know of this group, non-religious. I met the owner at a talk he had at my school. Seems like a great program, interesting exposure in Nepal and a great adventure!! Might be somewhat expensive.

http://www.helpinghandsusa.org/
 
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