Trouble Abroad - Recap and Commentary

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Trouble Abroad - Recap and Commentary

The responses provided so far have been phenomenal, both insightful and provocative.  I am truly impressed.  As mentioned by several of my colleagues, many of these cases are deeply personal, not only because they involve highly vulnerable populations, but also because they may put clinical providers in harm’s way.  When we begin to discuss ethics, especially global health ethics, there is often no single correct answer to a given scenario.   We often deal with hard science and hard facts but sometimes you just have to go with your gut and do what you think is right.  If you missed the first case and initial discussion, check it out here.

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Global Health Case Files

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Global Health Case Files

Imagine:  you are the single provider manning a rural clinic in Northern Tanzania along the shore of Lake Victoria.  You are one of only a handful of physicians in the entire region and you have minimal access to diagnostics or therapeutics.  Your clinic does not have any power.   Your diagnostics include:  urinalysis, urine pregnancy, CBC and rapid tests for HIV, syphilis, and malaria.  You have 2 nurses, one of whom acts as a translator (from Swahili to English).  You are armed primarily with your intellect, knowledge of local disease processes, and your keen sense of intuition.  

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Disaster and Emergency Medicine: An Overview

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Disaster and Emergency Medicine: An Overview

Disaster. It’s trending right now. In the last few years we have seen epidemic outbreaks of hemorrhagic fever, earthquake induced nuclear meltdowns, and large-scale civil war. It is no secret: both the scale and frequency of disasters are increasing. This appears to be due to a complex interplay of interconnected, global factors that show no signs of slowing. More people means harvesting more food, tapping more clean water, clearing more land, crowding more cities, and releasing more harmful products into the environment. The consequences to this include rising water levels, widening temperature extremes, increasing erosion, and a growing number of vulnerable people. With inevitably more disaster on the horizon, preparedness and experienced leadership are critical for the world’s future.

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Prehospital Care, An International Perspective

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Prehospital Care, An International Perspective

The State of Affairs

     The morbidity and mortality of trauma on a global perspective is humbling.  Aside from HIV/AIDS and TB, trauma is the chief cause of mortality for 15 to 45 years of age (based on 2002 WHO data).  5.8 million deaths annually.  5.2 million of those deaths, or 90%, occur in low-and-middle-income countries (LMIC’s).  Prehospital care in LMIC’s varies immensely.  Total prehospital time, the training level of prehospital providers, transportation method, and access to emergency medical systems (EMS) are some of the better described aspects of prehospital care in LMIC’s.  The attributes of the prehospital health care delivery system differ significantly on a country by country basis.

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Ebola

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Ebola

Ebola.  Synonymous with Terror, Class A Bioterrorism Agent Extraordinaire.  The Republic of Guinea and surrounding countries are in the midst of the deadliest, most widespread outbreak ever.  Death totals are rising every day, and each new death is a new record that with any luck will never be eclipsed.  

To quote the man that discovered and named Ebola after a river in the Congolese jungle,

“Soap, gloves, isolating patients, not reusing needles and quarantining the contacts of the ill - in theory it should be very easy to contain Ebola”

        - Peter Piot

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What is Global Health?

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What is Global Health?

Welcome to Taming the SRU’s Global Health section, where our goals are to increase awareness of global health issues, discuss clinical and ethical cases, and develop opportunities for residents to participate in global health electives.  We believe global health education is critical to well-rounded medical education.  Global health electives (GHEs) often have a profound effect on participants at any level.  One study found that 70% of students participating in GHEs subsequently entered primary care residencies or intended to work in resource-limited settings. (1)  These experiences lead to enhanced clinical and communication skills, humanism, cultural competency, and understanding of alternative concepts of health and disease.  GHEs help trainees foster a deeper understanding of the global collective and how one’s own health is uniquely connected to the rest of the world. (2)

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