At Long Last

It is crazy to think that I have already been home from the first Haiti trip for almost a month.  Med school has felt sort of like living in a time-warp; life is just so busy, every moment, that before you know it, you look at the calendar and you have to change it already.

Anyway, after much delay, I finally got my act together to put some photos up.  And by "got my act together", I mean I am unwisely resorting to my most creative procrastination methods to put off studying for a big exam on Monday.  (Today I was also talked into joining Twitter... and that was pretty much the end of my day.)  Social media is just so much more fun than learning about diarrhea.

However, speaking of diarrhea, (which, after four weeks of the GI module, I can finally spell), it is a very important and pertinent class of disease processes, especially with regards to global health and medical mission trips like this one.  Diarrheal diseases remain the second leading cause of infant mortality worldwide, and a leading cause of overall mortality.  Cholera, in particular, is currently circling the globe in its seventh major pandemic in modern history, and as recently as October, was causing deaths in Haiti.  Fortunately, there are no current cases in the area of Haiti where we were, but there were plenty of other sources of misery. 


With that, I leave you with pictures from trip #1.  Disclaimer: these are not my pictures- they were taken by someone with much more talent and a much nicer camera.  If I get time later, I will try to go back through and add some captions/explanations, but I think that a lot of them speak for themselves.

This trip left me with a lot of ambivalence about short-term medical missions.  For me, it was really fun, it was an adventure, it was gratifying to feel like we could maybe help a few individuals, and wonderful to get to know some Haitians and a little bit of the country of my sister's birth.  Is it worth it, for the community, for the resources spent, for the maybe less-than-ideal care that any patient will inevitably receive at the hands of a provider who can't speak his language and doesn't fully understand his culture?  Honestly, I don't know if I have a good answer to that.  I am really glad to be able to go back in another month or so, although I am not sure that another similar trip will get me much closer to clarity on this issue.  Something to keep thinking about, I guess...

Simple and Cheap

Infant Deaths Drop After Midwives Undergo Inexpensive Training

By DONALD G. McNEIL Jr.

Published: May 9, 2011

Giving midwives simple training has already been shown to save newborns’ lives, and a new study in Zambia has found that it can be remarkably cost-effective as well.

Even a small pilot project costing only $20,244 saved the lives of 97 infants, the authors estimated, meaning that it cost just $208 per life saved.

The study, published online in April in the journal Pediatrics, was paid for by the National Institutes of Health and the Bill and Melinda Gates Foundation, and conducted by American and Zambian university and government doctors.

Midwives from 18 Zambian clinics were taught a basic course in newborn care and encouraged to teach their colleagues as well. The course covers simple interventions like cleaning and warming a newborn, resuscitation, breast-feeding and diagnosing common illnesses. (Above, a birth attendant listened for a baby’s heartbeat with a clay stethoscope.)

The midwives normally handled births that were expected to be uncomplicated, with women typically going home with their babies after one night in the clinic.

The researchers compared survival rates among 20,000 babies born before the teaching and 20,000 afterward. The first-week death rate among babies had dropped by almost half, they found, to 6.8 deaths per 1,000 live births from 11.5 deaths.

Past studies have suggested that the single most important aspect of training, in terms of saving lives, is to teach midwives that an infant who is not breathing at birth can be revived with quick action — by massaging to prompt it to inhale, or using a simple resuscitator.

Real Life

Studying hard for the GI exam next Friday and the following Monday.  I feel so behind that there can't possibly be any way to get all caught up.  Fighting a bit of a cold.  Bleh.  And the weather outside is just perfect.

I miss this one:

And also this one, who turned 19 two days ago:

And this one, whose college graduation I can't go to because of this stupid test:

 But, something to look forward to-- I get to see her:

Plus them:

And this guy:

And also this guy:

... in just about 3 or 4 weeks.  Can't wait. 

Happy May!