Frameworks for the Future

Written by Tendai Machingaidze, Associate Site Director for University of Zimbabwe

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The world is becoming smaller and smaller every day. A clichéd saying perhaps, but acutely true when it comes to healthcare. Countries, cultures, and communities are increasingly intertwined via travel and migration. The burden of disease in one country can, in a matter of hours, become the burden of disease in a country on the opposite side of the world. As such, developing sustainable local medical practices around the world is ever more critical as we seek to promote healthy lives for all people.

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Graduation: Part II

Written by Dr. Judith Lewis, Director of the Psychiatry Residency Training Program at the University of Vermont Larner College of Medicine

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Visually, to punctuate the red earth, tropical green, and drab concrete of the city, there are the bright colors of traditional Ugandan garb: bright and beautiful heavy cotton fabrics forming head wraps and traditional long dresses called gomezi, which are adorned with high shoulder puffs. Dressed in these bright colors, women walk along the roadside with goods expertly balanced on their heads. When it comes to more modern clothing, the main style is best described as tropical island meets Gucci.

Ethical Dilemmas in Global Health: Reader Response

Written by Dr. Lauris C. Kaldjian, Director of the Program in Bioethics and Humanities at the University of Iowa Carver College of Medicine

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I recently spent two weeks at a mission hospital in rural Kenya, where detailed cost considerations are part of the daily experience of every patient. It is humbling to learn that a peasant farming family would have to sell two cows, worth about $150 each, to pay for an EGD plus stent to palliate dysphagia and prolong life in the setting of an inoperable esophageal cancer. But it is also highly encouraging to be at a hospital that demonstrates compassion and respect for life, one patient at a time, even in the midst of needs that regularly outpace resources- and where physicians, surgeons, and administrators provide any available emergency care whenever it is needed, even if payment cannot yet be provided (and, perhaps, will not be provided).

Graduation: Part I

Written by Dr. Judith Lewis, Director of the Psychiatry Residency Training Program at the University of Vermont Larner College of Medicine

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As my daughter and I sat in the , once again sweating through our clean clothes and beginning to take stock of our time in Uganda, we were glad to be returning home. Simultaneously, however, we were very glad to have come. We felt privileged to visit the beautiful country of Uganda and to meet its kind, welcoming citizens. Although I had heard a lot about the rotation from prior residents, I realize now that there is nothing that truly prepares you for the experience. I think that is what one of our residents, Megan Gething, meant when she said that our global mental health rotation offers a “visceral” kind of knowing. In psychiatry, we know that there is a cognitive knowing and an emotional knowing, and their conjoining is what we call “insight.”

Plant a Tree, Plant Your Roots

Written by Reverend Professor Samuel and Christine Luboga, creators of the first global health homestay model in Uganda

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Collaboration in home activities promotes bonding among family members. This idea is reflected in the Swahili saying, Suku mbili mugeni. Suku ya tatu mupa jembe. “For two days a guest is regarded as a visitor and is waited upon, however on the third day he is given a hoe to participate in the work (digging) the family does for a living.” Essentially, this means that s/he has become a member of the family.

The World of Global Health

Written by Dr. Majid Sadigh, Trefz Family Endowed Chair in Global Health at Western Connecticut Health Network and Director of Global Health at the University of Vermont Larner College of Medicine

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Imagine this scenario: A tertiary city hospital with 1500 beds and over 3000 patients and annual admission of 180,000. One-third of these patients die during their hospitalization, and 30% within two months after returning home. That equates to 100,000 people who die each year - the equivalent of a New England town that is annually erased from the surface of the earth.

Ethical Dilemmas in Global Health: Reader Response

Written by Dr. Cyrus Kapadia, MD, FACP, AGAF, Professor Emeritus of Internal Medicine at Yale University

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I was deeply moved by the post “Reading “Ethical Dilemmas in Global Health: Financial Barriers and Interventions” and disagreed with the points of view expressed until I read Dr. Mahsheed Khajavi’s perspective, which is exactly my own. As physicians, we definitely do need to be engaged in discussions that eventually lead to decisions made at a societal level. If we do not, then others will. However, faced with an individual situation involving the sacrosanct trust inherent to the doctor-patient relationship, every physician MUST make a decision that is best for the patient.

Being One With the Matoke

Written by Dr. Amanda Lindo, Internal Medicine Resident at Norwalk Hospital

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My second week in Uganda marked the beginning of another huge shift. In a flash, my week in Kiruddu Hospital’s Emergency Department was over and I was off to start work in Mulago Hospital’s Intensive Care Unit (ICU).  The only tertiary hospital in the country, and affiliated with Makerere University, Mulago is the most advanced intensive care facility available. The New Mulago Hospital ICU, currently under construction across the street to advance from a seven-bed to twenty-eight-bed unit, will be functional as of September 2018. Despite its small size, the ICU does not disappoint.

The Sun is Particularly Harsh Today

Written by Christina Dawson '21

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The sun is particularly harsh today. The intermittent gush of wind usually provides temporary relief despite the swell of red clay that stains my white coat, but today I feel it making a paste on the back of my neck. The day begins with our routine: waiting for Dr. Cathy to greet us as she promptly does every morning around 9. She is late today. I decide to make a quick dash for the restroom, and head towards the only clean one I know in the maternity ward.

Growing Into Comfort

Written by Katherine Callahan '21

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This is the first week during which I have noticed a significant change in myself: I am comfortable. That is, during Monday morning rounds, I found myself as less of a bystander and more of an active participant. Over the past two weeks, I have become accustomed to the language, lab tests, patient population, and attending style so much so that I automatically begin to create a differential diagnosis and have an idea of where to start on physical exams. This is the first time I have found myself effectively doing this.