Which MD speciality would be the most "useful" in the Third World?

Which MD specialty would be the most "useful" in the Third World?

  • Anesthesiology

    Votes: 3 0.4%
  • Dermatology

    Votes: 8 0.9%
  • Emergency Medicine

    Votes: 126 14.9%
  • Family Medicine

    Votes: 223 26.3%
  • Internal Medicine and IM Subspecialties

    Votes: 234 27.6%
  • Neurology and Neurosurgery

    Votes: 2 0.2%
  • Obstetrics and Gynecology

    Votes: 37 4.4%
  • Ophthalmology: Eye Physicians & Surgeons

    Votes: 20 2.4%
  • Orthopaedic Surgery

    Votes: 5 0.6%
  • Pathology

    Votes: 15 1.8%
  • Pediatrics

    Votes: 45 5.3%
  • PM&R

    Votes: 1 0.1%
  • Psychiatry

    Votes: 7 0.8%
  • Radiation Oncology

    Votes: 5 0.6%
  • Radiology

    Votes: 1 0.1%
  • Surgery and Surgical Subspecialties

    Votes: 91 10.7%
  • Urology

    Votes: 3 0.4%
  • Other: Elaborate and Explain below...

    Votes: 20 2.4%

  • Total voters
    847

burton117

The Big Kahuna
10+ Year Member
15+ Year Member
Jan 7, 2004
1,087
7
Which MD speciality do you think would be the most "useful" in the poorest countries in the world and why?

Obviously, the need is great for any kind of medical professional, but which ones do you think could make the greatest impact?

Feel free to let me know if I have missed any specialties here..

Definition of: "The Third World":
The third world is kind of a dated term now, I guess. The more politically correct way of describing these countries would be to refer to these countries (those with a disproportiately high number of poor people) as "developing countries".

I believe that the origins of the term are from during the Cold War. The first world was the United States and other capitalistic countries. The second world was the former soviet union and all the communist countries. The third world was everybody else.


Note: This is not about which speciality is most important!! This poll is about which specialties could make a huge impact in the poorest countries in the world. i.e. to give direction to future doctors who would love to focus on the needs of the poor.

:cool:

Also see Poll: What do you think would be the most "useful" dental speciality in the third world?
 

huduvudu

Member
10+ Year Member
5+ Year Member
Jan 25, 2005
38
0
Status
I'm going to venture a guess that all primary care along with general surgery and/or plastic surgery (cleft palattes, not boob jobs) would be the most useful.
 

eralza

Senior Member
10+ Year Member
5+ Year Member
Jun 2, 2004
355
3
51
Virginia
Status
Medical Student
Emergency medicine with a keen ability to improvise like "McGuyver"
Check out the fellowship that Stanford started up a few years ago
http://emed.stanford.edu/education/wilderness.html
They offer up one or two slots per year. Looks like an absolutely awesome program that I would love to pursue!
 

YzIa

Senior Member
10+ Year Member
5+ Year Member
Jul 16, 2004
812
1
Status
I agree with primary care. Such a need for general medicine in underdeveloped countries.
 

AF_PedsBoy

Stuffed Animal Overlord
10+ Year Member
5+ Year Member
Jun 22, 2004
714
3
Japan
Status
Attending Physician
If you're going there with a charity group like Mercyship, then surgery or dentist is best. Primary care is almost useless because you stop in for a couple of days or so and then disappear, so there's no follow up with nutrition, meds, development, etc. It's all quick fixes.

If you are going to stay or live there for at least 6 months or more, then primary care specialties are more important
 

Blake

10+ Year Member
7+ Year Member
Jun 21, 2004
1,801
1
34
Status
Resident [Any Field]
Plastic surgery... I'm pretty sure it's primary care though.
 

U4iA

εὐφορία
10+ Year Member
15+ Year Member
Oct 12, 2003
382
0
19
a state of well-being
Status
i've spoken to a number of people about this and i think as an ophthalmologist you could greatly benefit the "third world." i have heard that family and internal medicine are not as useful in those regions because they have plenty of people who address those problems (non-procedural), and the health problems you will see abroad are quite different from what you will be trained in at home (whereas surgical procedures will be the same). in many parts of the world they have very few people who can perform ophthalmic procedures and there are huge amounts of people going blind or losing vision that could easily maintain their vision with intervention. childhood blindness is a growing but preventable problem... something to think about..

read this article on preventing blindness worldwide.. http://bmj.bmjjournals.com/cgi/content/full/309/6956/682
 

Megalofyia

425 lbs and growing
15+ Year Member
Oct 13, 2001
6,976
11
105
Missery
Status
Attending Physician
U4iA said:
i've spoken to a number of people about this and i think as an ophthalmologist you could greatly benefit the "third world." i have heard that family and internal medicine are not as useful in those regions because they have plenty of people who address those problems (non-procedural), and the health problems you will see abroad are quite different from what you will be trained in at home (whereas surgical procedures will be the same). in many parts of the world they have very few people who can perform ophthalmic procedures and there are huge amounts of people going blind or losing vision that could easily maintain their vision with intervention. childhood blindness is a growing but preventable problem... something to think about..

read this article on preventing blindness worldwide.. http://bmj.bmjjournals.com/cgi/content/full/309/6956/682
Depends on where you are... where I go in Mexico there are VERY few general practice docs .. a actually very few docs regardless. I go with a group that do volunteer work there and it's always the pediatrician and general practice docs that are the busiest with things like diabetes, STDs, vitamin deficiencies, etc.. granted the eye docs do get their share of patients and are important to the team they aren't more so than other docs.
 

U4iA

εὐφορία
10+ Year Member
15+ Year Member
Oct 12, 2003
382
0
19
a state of well-being
Status
Megalofyia said:
granted the eye docs do get their share of patients and are important to the team they aren't more so than other docs.
i'm not saying any medical specialty is more important, i am just saying that in certain parts of the world ophthalmologists are in critical demand..
 

dopaminophile

nerd extraordinaire
10+ Year Member
5+ Year Member
Nov 29, 2004
833
2
37
Status
Generalists with the ability to leave their comfort zone are the most useful. I worked for a while in East Timor, the poorest nation in Asia, and those guys did everything. The GPs and general surgeons could do peds, infectious disease, ob/gyn, EM, rads, derm, and some amount of cardio. There were very few things that they were unwilling to take on. The specialists were almost paralyzed because they were largely unwilling to do anything on which they weren't experts. Only one psychiatrist who was willing to basically be a GP was useful and the exception. General surgeons are usually desperately needed because cutting that requires anatomical intuition tends to be where GPs draw the line.

E. Timor is, however, only bested by some of Africa as far as lack of health care goes. If there is any reasonable infrastructure (transportation and otherwise) then the needs change and specialists become more important. However, where there is absolutely no access to any health care, a visiting generalist is the most useful.

All the best. Read some of Paul Farmer's books if your interested in health care in absolute poverty--very smart reads.

-dope-
 

dopaminophile

nerd extraordinaire
10+ Year Member
5+ Year Member
Nov 29, 2004
833
2
37
Status
I'm actually really surprised to see EM so high in the poll. In my experience, very little of what you'll see in the third world is emergent medicine. If you're in an area that is in active conflict (Darfur of Sudan, Rawanda, Chechnya) then surgeons will deal best with those sorts of injuries. Even then, however, most of the medicine that is seen will be disease consequences of a poor (or missing) public health infrastructure--and those are best approached by GPs and GSs if you don't have a large team.
 

evines

peek-a-boo
10+ Year Member
15+ Year Member
Sep 23, 2003
980
1
39
sinking sand
Visit site
Status
What about military medicine? Not really a normal "specialty" I guess, but the emphasis is on infectious disease, tropical medicine, doing a lot with limited resources, taking care of whatever comes your way, etc. This is all applicable to the 3rd world, and many times milmed is practiced in the 3rd world anyway.
 

pratik7

Senior Member
15+ Year Member
Jul 10, 2003
853
6
Atlanta, Ga
Visit site
Status
Attending Physician
dopaminophile said:
I'm actually really surprised to see EM so high in the poll. In my experience, very little of what you'll see in the third world is emergent medicine. If you're in an area that is in active conflict (Darfur of Sudan, Rawanda, Chechnya) then surgeons will deal best with those sorts of injuries. Even then, however, most of the medicine that is seen will be disease consequences of a poor (or missing) public health infrastructure--and those are best approached by GPs and GSs if you don't have a large team.

Ironically, emergency medicine docs see more chronic patients than emergent cases. However, with their ability to do certain procedures, i think they are a good combination of IM and surgery.
 

Firebird

1K Member
10+ Year Member
15+ Year Member
Mar 15, 2001
1,190
3
Visit site
Status
eralza said:
Emergency medicine with a keen ability to improvise like "McGuyver"
Check out the fellowship that Stanford started up a few years ago
http://emed.stanford.edu/education/wilderness.html
They offer up one or two slots per year. Looks like an absolutely awesome program that I would love to pursue!
Also check out Marshall University's wildnerness medicine program. It's fairly active, and if I'm not mistaken, we created the concept of wildnerness medicine...although we were not the first to offer official programs in it.

Last year, our wilderness med group climbed Mt. Kilamanjaro (spelling?) and they plan to do similar things every two years.
 

arierty

Senior Member
10+ Year Member
5+ Year Member
Jul 9, 2004
118
0
Status
From what I have heard basic primary care can be handled by nurses, PAs and the like, it is useless to have an MD in the third world if they aren't doing surgery at least that is what people tell me when I say I want to do international medicine.
 

45408

aw buddy
10+ Year Member
7+ Year Member
Jun 14, 2004
16,976
47
Status
Resident [Any Field]
Lots of things, though. An orthopedic surgeon could correct someone's club feet and allow them to walk. A plastic surgeon could correct a cleft palate and allow them to eat and smile normally. A dentist would obviously be nice, as would an internist to stay with these people on a long-term basis.

Btw, these types of countries are usually referred to as the undeveloped countries. China would be more along the lines of a developing country, with the US being a developed country.
 

Scubadoc

poriomanic
10+ Year Member
15+ Year Member
Apr 4, 2004
13,463
289
bidster said:
Off the top of my head--Infections and Inequalities and Mountains Beyond Mountains. The first is ethnographic/analytical, the second is biographical, but both leave you pretty much in awe for everything he's done.

I second this. Mountains Beyond Mountains is great. It will only take you about 2 days to read it. Makes you want to go open your own clinic somewhere.
 

mercaptovizadeh

ἀλώπηξ
15+ Year Member
Oct 16, 2004
6,888
1,018
Status
Farmer is kind of annoying. I saw him speak, and he was a boring (talked all evening about statistics), and arrogant ("when I was at Harvard...when I was at Harvard"). I was not in the least impressed, and I certainly do not find him to be the model of international medicine. In fact, I think he is so famous only because he's at Harvard. There are many people out there in the third world who dedicate their lives to people there full time, but we don't even know about them and there aren't any webpages or books about them - again probably cuz they're not a haavaad.

As far as the survey goes, I shadowed a surgeon in a third world country. It was clear that surgery was the most useful specialty. He did obstetrics, emergencies, orthopedics and amputations, thoracic and abdominal surgeries. Not only that, but his enormous breadth in surgery insured that he knew TONS of IM as well, so he was kind of a back up in IM, when things were a bit slow in surgery (which was practically never).

So, definitely surgery, and definitely general surgery at that. If you specialize in pediatric neurosurgery, that's not very useful in the third world (although it's great for those poor kids who do need a pediatric neurosurgeon). In terms of sheer volume, surgery will help them most, as it addresses many diseases, accidents, war injuries, even birth defects.

Other than surgery, probably IM is most useful...vaccinations, antibiotics, anti-parasitic drugs, etc.
 
OP
burton117

burton117

The Big Kahuna
10+ Year Member
15+ Year Member
Jan 7, 2004
1,087
7
mercaptovizadeh said:
As far as the survey goes, I shadowed a surgeon in a third world country. It was clear that surgery was the most useful specialty. He did obstetrics, emergencies, orthopedics and amputations, thoracic and abdominal surgeries. Not only that, but his enormous breadth in surgery insured that he knew TONS of IM as well, so he was kind of a back up in IM, when things were a bit slow in surgery (which was practically never).

So, definitely surgery, and definitely general surgery at that. If you specialize in pediatric neurosurgery, that's not very useful in the third world (although it's great for those poor kids who do need a pediatric neurosurgeon). In terms of sheer volume, surgery will help them most, as it addresses many diseases, accidents, war injuries, even birth defects.

Other than surgery, probably IM is most useful...vaccinations, antibiotics, anti-parasitic drugs, etc.
I agree that surgery could make a huge impact. Especially when you consider that getting adequate drug supplies in the Third World is pretty difficult. Much less getting the drugs that you are familiar with. This probably makes treating non-surgical problems challenging, especially if the problem can only be treated with a prescription. :(

As for me, I am looking at dentistry for some of the above reasons and have posted a similar poll on the Dental thread on SDN:

Poll: Which Dental Specialty would be the most useful in the Third World?

I am pretty excited about the possibility of someday working with multi-specialty teams of Physicians and Dentists in undeveloped countries. :thumbup:

We'll see what happens, as only time will tell!! :D :D
 

BigRedPingpong

Senior Member
7+ Year Member
15+ Year Member
Oct 18, 2003
543
1
38
NY
Visit site
Status
i'm surprised that im the only one, so far, who has voted for anesthesiology. According to MSF, MDA's and surgeons are the only ones who will be given special consideration for shorter terms of service due to the shortages of their respective specialties.
 

PookieGirl

Senior Member
10+ Year Member
5+ Year Member
May 4, 2004
344
0
Boston, MA
Status
The Global Health Forum for Health Research has shown that only 10% of the world health expenditure on health R&D in spent on health conditions that represent 90% of the global burden of ill-health. aka "10/90 gap". Much of the poor health in developing countries is due to water-borne illness and infectious diseases. As infectious disease is a subspecialty of internal medicine, I think that would be the best route to go, coupled with a degree or work in public health.
 

dopaminophile

nerd extraordinaire
10+ Year Member
5+ Year Member
Nov 29, 2004
833
2
37
Status
mercaptovizadeh said:
Farmer is kind of annoying. I saw him speak, and he was a boring (talked all evening about statistics), and arrogant ("when I was at Harvard...when I was at Harvard"). I was not in the least impressed, and I certainly do not find him to be the model of international medicine. In fact, I think he is so famous only because he's at Harvard. There are many people out there in the third world who dedicate their lives to people there full time, but we don't even know about them and there aren't any webpages or books about them - again probably cuz they're not a haavaad.

As far as the survey goes, I shadowed a surgeon in a third world country. It was clear that surgery was the most useful specialty. He did obstetrics, emergencies, orthopedics and amputations, thoracic and abdominal surgeries. Not only that, but his enormous breadth in surgery insured that he knew TONS of IM as well, so he was kind of a back up in IM, when things were a bit slow in surgery (which was practically never).

So, definitely surgery, and definitely general surgery at that. If you specialize in pediatric neurosurgery, that's not very useful in the third world (although it's great for those poor kids who do need a pediatric neurosurgeon). In terms of sheer volume, surgery will help them most, as it addresses many diseases, accidents, war injuries, even birth defects.

Other than surgery, probably IM is most useful...vaccinations, antibiotics, anti-parasitic drugs, etc.
Farmer may be arrogant, but you can't knock his philosophy or what he's done in the world. The guy is absolutely a "no excuses" humanitarian and he takes what he talks about in his books and at Haavaard and applies them to his practice in the real world. He makes a fortune from his books and speaking tours and he applies the vast majority of it to his work in Haiti, Chechnya, and somewhereelsethatIcan'tremember.

When I was overseas a woman that I was working with told me that only "the mad, the bad, and the sad" do the type of work we were doing and that to which Farmer dedicates his life. The doc who ran the clinic in which I worked was one of the least personable physicians I've ever met and I probably wouldn't have spent any time around him if I met him in the US. But I just couldn't argue with the good that he was able to do and his "no excuses" mentality. With most of these people it's important to judge them by their actions rather than your initial impressions.

Just a thought on MSF too. They are a very well oiled machine and bring with them the public health infrastructure, money, and political might that comes with it. With that kind of organization, it's very useful to have physicians of different specialties operating much as they would in the west. If you're with a smaller organization or you are the only physician (or only person) in your team, then I maintain that generalists are best, be they general surgeons or GPs. I voted surgeon because in my experience, they were fewer and further between.
 

erin682

Senior Member
10+ Year Member
Oct 21, 2004
622
6
Hogwarts
Status
Attending Physician
Firebird said:
Also check out Marshall University's wildnerness medicine program. It's fairly active, and if I'm not mistaken, we created the concept of wildnerness medicine...although we were not the first to offer official programs in it.

Last year, our wilderness med group climbed Mt. Kilamanjaro (spelling?) and they plan to do similar things every two years.

Do you have a website for this program? Its sounds fantastic. I'm pretty sure I'm going into EM and maybe then a fellowship in Wilderness med. if I can get into one.
 

Firebird

1K Member
10+ Year Member
15+ Year Member
Mar 15, 2001
1,190
3
Visit site
Status
erin682 said:
Do you have a website for this program? Its sounds fantastic. I'm pretty sure I'm going into EM and maybe then a fellowship in Wilderness med. if I can get into one.
Our WM program is within the FP residency, and I don't think they offer a fellowship in it. I believe you have to do our FP residency, but during it you get to take electives that qualify you as a WM trained physician. I could be wrong...the website is :MUSOM Family Practice You'll. then have to click on "Wilderness Medicine."

Don't get too excited though...Marshall has YET to create an impressive website for anything.

Here's a cool photo...they're on the peak of Mt. Kilimanjaro.



Every month, the Wilderness Medicine group, along with other residents, attendings, medical students and undergraduate premeds get together at a physician's house and someone gives an informal talk on something related to WM. I heard all about the trip to Kilimanjaro and like I said, they're planning similar trips every two years. I've also heard about their trips to South America and I was there for a talk on cave rescue. It's pretty fun, and everyone is really easy to get along with.
 

TripleDegree

Joker Doctor
10+ Year Member
15+ Year Member
Nov 6, 2003
687
0
Visit site
Status
I'm just back from a trip to Southeast Asia, and I can guarantee you that the biggest hole that these countries have in their medical systems is the TOTAL lack of emergency medical services. God knows how many people with acute MIs die, because it takes 3 hours to get to the nearest hospital. The traffic is horrendous, the hospitals are overcrowded, and the system is WAY WAY too commercial. We in the US are much more philanthropic that what I've seen over there.

A huge amount of ER's and EM physicians is what is needed here, they would save a TON more lives than any fancy-schmancy specialist.


Trust me, I'm very serious here. This is absolutely on the level.
 

TripleDegree

Joker Doctor
10+ Year Member
15+ Year Member
Nov 6, 2003
687
0
Visit site
Status
dopaminophile said:
I'm actually really surprised to see EM so high in the poll. In my experience, very little of what you'll see in the third world is emergent medicine. If you're in an area that is in active conflict (Darfur of Sudan, Rawanda, Chechnya) then surgeons will deal best with those sorts of injuries. Even then, however, most of the medicine that is seen will be disease consequences of a poor (or missing) public health infrastructure--and those are best approached by GPs and GSs if you don't have a large team.
Sorry dope, but you're wrong here, imho. Most of the third world is NOT in active conflict with anything other than sheer abject POVERTY. People die of stuff that is ridiculously preventable. You don't even need EM phyisicans just a frikkin ambulance and some paramedics would have a huge impact.
 

dopaminophile

nerd extraordinaire
10+ Year Member
5+ Year Member
Nov 29, 2004
833
2
37
Status
TripleDegree said:
I'm just back from a trip to Southeast Asia, and I can guarantee you that the biggest hole that these countries have in their medical systems is the TOTAL lack of emergency medical services. God knows how many people with acute MIs die, because it takes 3 hours to get to the nearest hospital. The traffic is horrendous, the hospitals are overcrowded, and the system is WAY WAY too commercial. We in the US are much more philanthropic that what I've seen over there.

A huge amount of ER's and EM physicians is what is needed here, they would save a TON more lives than any fancy-schmancy specialist.


Trust me, I'm very serious here. This is absolutely on the level.
Where in SE Asia did you go? In areas with abject poverty, which is much of SE Asia, acute MIs aren't anywhere near the major health problems. There is a lot of congestive heart failure, TB, and malaria, but those develope relatively slowly and in my experience generalists deal best with them. When I was in Timor (the worst of the worst of SE Asia), there was only very rarely a need for the ambulance that we had outside of transport. The EMTs and medics that came only did long-term wound care and occassionally stitching cuts. An actual ambulance system requires quite a bit of infrastructure and money that many of these places don't have.

Furthermore, in areas of absolute poverty the hospital systems aren't commercial at all because nobody can pay for it. There just simply aren't enough sick people with enough money to pay, so all of it has to be free.

There's no doubt that EM would be useful, but in my experience everybody becomes a generalist when there's no infrastructure for referral.

Perhaps we're bound to disagree, but I stick with what I said before: the wider the range of things you can do, the better. GPs and GSs can diversify the best.
 

gujuDoc

10+ Year Member
15+ Year Member
Feb 21, 2004
13,874
36
Status
Medical Student, Resident [Any Field]
Well here's my 2 cents on this subject:

I think the following are most needed:

ER docs
general IM docs
OB/GYN's
trauma surgeons whom know how to improvise
And the primary care fields beyond gen. IM and OB/GYN.

This is slightly off topic to the original question, but an amazing story that I thought I would share with you all. But first, here's a little background info:


A very good friend of mine, whom will begin med school at USF next year, aspires to be an international doctor, with an MD/PhD. Her dreams are to build clinics around the world and do research in tropical health and medicine.

anyhow, this friend that I am talking about goes to Haiti. She is part of a nonprofit organization called the Rome Foundation. While on one of her many trips there was a woman whom was 8 months pregnant as one of the patients. My friend was asked if she wanted to see this lady deliver her baby because she had never seen anything of that nature. After going into the operating room she was told that the lady had severe gashing and bleeding and was induced into labor early. No one really knew what happened to cause this lady to be induced into labor early, but the thing was this lady looked as if things may not have been good. In other words, there was a possibility she wouldn't have survived because she had severe bleeding and gashes etc. Since it was a developing country there was a lack of proper anaesthetics to lower the pain so obviously she was in severe pain and discomfort and screeming etc.

However, my friend took this lady's hand, feeling helpless, and started singing Amazing grace. This patient then started to sing along but in creole. The next day my friend had to leave to come back to America and was very worried about whether this lady would have her baby or not and whether either of them or both would survive.

So here's the clincher of why I thought I would share this story with you. When I heard the first part of it, I wanted to cry because I thought that the ending would be horrible. Instead I was happy to hear that both the woman and her baby survived and all was well. When the lady had her baby, which by the way turned out to be a girl, she went back and told the villagers that she made it through because of the white angel who helped her get through it. I thought that was the most beautiful thing I have ever heard.

When you here of the conditions in these poorer countries it makes you thankful for all that we have here in America and in Europe.
 
OP
burton117

burton117

The Big Kahuna
10+ Year Member
15+ Year Member
Jan 7, 2004
1,087
7
dopaminophile said:
With that kind of organization, it's very useful to have physicians of different specialties operating much as they would in the west. If you're with a smaller organization or you are the only physician (or only person) in your team, then I maintain that generalists are best, be they general surgeons or GPs. I voted surgeon because in my experience, they were fewer and further between.
This seems to make a lot of sense with some practical experience to back it up. :thumbup: :thumbup:
 
OP
burton117

burton117

The Big Kahuna
10+ Year Member
15+ Year Member
Jan 7, 2004
1,087
7
bidster said:
Off the top of my head--Infections and Inequalities and Mountains Beyond Mountains. The first is ethnographic/analytical, the second is biographical, but both leave you pretty much in awe for everything he's done.

Does anybody have any suggestions for any more good books about medicine and poverty? Inspirational, biography, whatever, I'm up for anything...

Let me know.. :D
 

umsak

Junior Member
10+ Year Member
5+ Year Member
Aug 20, 2004
18
0
Status
gujuDoc said:
Well here's my 2 cents on this subject:

I think the following are most needed:

ER docs
general IM docs
OB/GYN's
trauma surgeons whom know how to improvise
And the primary care fields beyond gen. IM and OB/GYN.

This is slightly off topic to the original question, but an amazing story that I thought I would share with you all. But first, here's a little background info:


A very good friend of mine, whom will begin med school at USF next year, aspires to be an international doctor, with an MD/PhD. Her dreams are to build clinics around the world and do research in tropical health and medicine.

anyhow, this friend that I am talking about goes to Haiti. She is part of a nonprofit organization called the Rome Foundation. While on one of her many trips there was a woman whom was 8 months pregnant as one of the patients. My friend was asked if she wanted to see this lady deliver her baby because she had never seen anything of that nature. After going into the operating room she was told that the lady had severe gashing and bleeding and was induced into labor early. No one really knew what happened to cause this lady to be induced into labor early, but the thing was this lady looked as if things may not have been good. In other words, there was a possibility she wouldn't have survived because she had severe bleeding and gashes etc. Since it was a developing country there was a lack of proper anaesthetics to lower the pain so obviously she was in severe pain and discomfort and screeming etc.

However, my friend took this lady's hand, feeling helpless, and started singing Amazing grace. This patient then started to sing along but in creole. The next day my friend had to leave to come back to America and was very worried about whether this lady would have her baby or not and whether either of them or both would survive.

So here's the clincher of why I thought I would share this story with you. When I heard the first part of it, I wanted to cry because I thought that the ending would be horrible. Instead I was happy to hear that both the woman and her baby survived and all was well. When the lady had her baby, which by the way turned out to be a girl, she went back and told the villagers that she made it through because of the white angel who helped her get through it. I thought that was the most beautiful thing I have ever heard.

When you here of the conditions in these poorer countries it makes you thankful for all that we have here in America and in Europe.

Hi, just wanted to say thanks for the story -- gave me chills. I am also interested in dedicating part of my career to underdeveloped/developing/3rd world countries (whatever the politically correct term is nowadays), and it's nice to be reminded of how even the little things make such a difference!

I agree that IM, general/family practice physicians, and general surgeons would be most versatile in such an environment.
 

dopaminophile

nerd extraordinaire
10+ Year Member
5+ Year Member
Nov 29, 2004
833
2
37
Status
burton117 said:
Does anybody have any suggestions for any more good books about medicine and poverty? Inspirational, biography, whatever, I'm up for anything...

Let me know.. :D
I just read Farmer's "Pathologies of Power." I liked it. His books are intensely intellectual so be prepared for serious discussion about what creates these ultra-poverty conditions. Many classes use his books as texts.
 

dopaminophile

nerd extraordinaire
10+ Year Member
5+ Year Member
Nov 29, 2004
833
2
37
Status
Here's a site that I set up for my friends and family when I went overseas. I wrote home while I was in East Timor pretty regularly and my Dad posted the stories. It might be of interest to those wondering what a lowely pre-med could contribute. Good to kill some time!

http://mysite.verizon.net/vze8u0ft/index.html
 
OP
burton117

burton117

The Big Kahuna
10+ Year Member
15+ Year Member
Jan 7, 2004
1,087
7
The Republic of Sierra Leone, West Africa

Poverty in Sierra Leone is endemic and pervasive. In fact, the country is ranked at the bottom of the UNDP Human Development Index as the poorest in the world. The ten-year civil war has further exacerbated the depth and severity of poverty.

The human development and social indicators, including illiteracy, primary school enrollments, life expectancy, maternal deaths, malnutrition, and child mortality rates, are about the worst in the world. The infant mortality rate (IMR) is about 182/1000, while life expectancy at birth is about 38 years compared to 45 years for Sub-Saharan Africa. The adult literacy rate is estimated at 30% while the population with access to safe drinking water is about 34%. Endemic diseases, especially Malaria and HIV/AIDS, loom as a menace. About four-fifths of the population lives in absolute poverty, with expenditures below $US1 a day.

In this place, with the largest United Nations force (over 15,000 peacekeeping troops) in the world, it might seem that all the solutions are within capable hands. There are no easy answers here, and pain and death lurk around every corner. Countless stories of horrific trauma inflicted during the war mark the landscape of every citizen’s memory.

Whether an individual lost 23 members of his family in one day, or had a child eaten by rebel soldiers, as food was scarce – the scars of these experiences refuse to go away or be forgotten.

There were so many questions. Why? Who would do such things? Why doesn’t anybody else outside this country know? Or even care? I found no answers.

Struggling to make sense of the overwhelming reality, I realized that all I could do was to listen to the few stories of people that God showed to me. God has shown me these faces and stories for a reason, and asked me simply to listen…
 

Dr_Amr

Member
10+ Year Member
5+ Year Member
Feb 21, 2005
29
0
Status
I think that " training doctors there would be the most benefical "speciality" for the 3rd world
 

dopaminophile

nerd extraordinaire
10+ Year Member
5+ Year Member
Nov 29, 2004
833
2
37
Status
Dr_Amr said:
I think that " training doctors there would be the most benefical "speciality" for the 3rd world
There are a number of clinics that are permanently based in some of these places that are trying to do just that. The problem, as always, is a lack of money and professors. Many of these clinics are run by just one or two full-time, permanent physicians. They can't possibly teach everything (especially not the pre-clinical sciences) by themselves. If they were to try to teach classroom material, then that would be less time for them to see patients. Local medical schools can realistically only arise from Universities, which even then few people can afford and the governments can't supplement. It's a slow process but most of what the medical world does right now in those areas is to try to train proficient nurses and assistants with only hands-on experience.

You're right though, training locals would be the best way to go.
 

gujuDoc

10+ Year Member
15+ Year Member
Feb 21, 2004
13,874
36
Status
Medical Student, Resident [Any Field]
Dr_Amr said:
I think that " training doctors there would be the most benefical "speciality" for the 3rd world
How do you propose a country such as Haiti do that, when there is sooooo much political turmoil tha the only medical school in the nation is shut down????

There are situations where people have no choice but to go outside to study medicine so that they can return to their own country to do such a thing. I think its great that there are outsiders willing to go to countries such as my own country of India, or such as Haiti, to help these people.
 

Dr_Amr

Member
10+ Year Member
5+ Year Member
Feb 21, 2005
29
0
Status
well , I was talking about my country ( egypt ) at least,

anyhow , any efforts aiming at raising physicians' scientific level is appreciable , I even think sending text books is a good thing to do :)
 

Llenroc

Bandidos Motorcycle Club
10+ Year Member
5+ Year Member
Dec 25, 2004
1,514
5
Status
What a stupid poll. They need all kinds of doctors in 3rd world countries, just like they need all kinds of doctors here.

I'm from a 3rd world country. :p
 

dopaminophile

nerd extraordinaire
10+ Year Member
5+ Year Member
Nov 29, 2004
833
2
37
Status
Llenroc said:
What a stupid poll. They need all kinds of doctors in 3rd world countries, just like they need all kinds of doctors here.

I'm from a 3rd world country. :p
The question is: which are MOST useful? I've done medical work in the "3rd world" and it's a reasonable question to ask. If someone is trying to figure out how they can do that kind of work permanently, it's important to consider how they can be most useful. Certainly all specialties would be useful to some degree, but only some would be more useful or most useful. It's not a stupid poll.
 

lulubean

Senior Member
10+ Year Member
7+ Year Member
Nov 8, 2004
410
0
Status
Resident [Any Field]
infectious disease (malaria, tb, and aids)

obstetrics and gynecology (maternal mortality is still a huge problem)