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INMED News, January 2005

Where will the next generation of medical missionaries come from? How will young health professionals catch the vision for missions unless they actually experience them? On this theme, my thoughts frequently turn to the new, 80 bed Lubango Evangelical Medical Center. Conceived by Steve Foster, MD, and funded through Samaritan's Purse, the EMC will be a beacon of hope for the impoverished city when it opens in the near future. However, the heart of any ministry is not in its buildings and grounds, but it's people. The EMC has but one full-time physician who is committed to serve the thousands who will seek assistance. People will come suffering from malaria, malnutrition, liver failure, fractures, and labor complications. They will require emergency care, surgery, anesthesia, and prevention efforts aimed at curbing these diseases. Yet these worthy efforts require devoted professionals. Foster described the shortage succinctly: Dr. Steve Foster "In November we did 32 surgical cases in 3 days. One 16 year old gal from Chicuma went in to labor 5 days before coming to the hospital. When she arrived the baby was dead, squashed into a vaginal canal. I managed to get the baby out, but the gal promptly went into septic shock. Only massive doses of IV fluids and antibiotics brought her round. By the second day she was hungry and wondering what happened to her. Without a doctor present she wouldn't have made it. Even a well-trained Angolan nurse doesn't understand septic shock well enough to manage these cases. So keep telling the message. We need another doctor or two!" INMED graduates will be among those who respond to such a challenge. We must do our part to assist them; to help share the vision and provide the means for young professionals to experience the privilege assisting those people who are most in need.

INMED News, February 2005

International health should remain the goal, regardless of training Well-meaning people continually inquire about the terminology associated with global health. Their inquiry is not just hair-splitting. Terminology may be subtlety different, and yet the meanings conveyed be profoundly divergent. And so consider these terms: global health, international health, international public health, and international medicine. In common usage, global health and international health best refer to the overall health status of the people being considered. These people may be wealthy or advantages, or impoverished. Leaders in this field usually focus on the needs of people who are most disadvantaged, for enormous wealth and knowledge benefit the world's affluent people, while some three billion persons subsist on less than US $2.50 per day. Global health and international health tend to focus on the factors of economics, literacy, education and public policy, in addition to more traditional 'health' factors. International public health and international medicine, by contrast, are fields that focus more on the roles of the disciplines of public health and medicine, and on how these disciplines interface for the benefit of disadvantaged people. The caution I constantly urge for people in the fields of international public health and international medicine is that they do not allow their disciple itself to limited the actions or innovations that may be necessary to succeed in the overall goal of health improvement. Hence, global health or international health should remain the goal of us all, regardless of training or discipline.

INMED News, March 2005

John Testrake in Beirut, 1985 In 1989 I arrived in Luanda, the capital city of Angola, to begin making good on my commitment to assist the churches in interior city of Huambo as they launched a healthcare project. Those were wild days of civil war: roads littered with landmines, random military attacks on nationals and foreigners alike, wide-spread hunger, and epidemics of cholera and typhoid. Travel to the interior was especially risky. Mission Aviation Fellowship had just stationed a plane in Angola, upon whom so much of our initiative depended. The pilot, an older man, was very warm, competent, and engaging in character. Over several days I discovered that this was John Testrake - the hero of TWA Flight 847, hijacked in 1985 from Athens to Beirut and Algiers. I was reminded of John when I discovered that his grandson is one of the students in my public health class at the University of Missouri-Kansas City School of Medicine. What is so very striking to me about John Testrake is that he was a man of faith, fulfilling his 'routine' duties, when suddenly called upon to lead with wisdom and valor. Whether negotiating with terrorists, traversing the African outback, or confronting any of a myriad of challenges, may you and I do so with wisdom and valor.

INMED News, April 2005

Chrissy VanDillen Chrissy VanDillen recently served at the Baptist Medical Center in Nalerigu, northern Ghana, and earned the INMED International Medicine & Public Health Diploma." "I am a medical student at the University of Missouri in Kansas City, and have been interested in international medicine and learning about all the opportunities available for physicians to help people outside of the United States. When I say opportunity, I am trying to impress upon others what a trip like the one I took to Ghana can do for an individual. This trip changed my life. This adventure forced me to think of every aspect of life and my plans for the future." "I was given enormous responsibility, and this made me realize what I need to learn and what my future holds. I saw Dr. Faile treating patients the best he could, even if that meant being on call every night, not eating for an entire day, and not seeing his family. The only compensation was the fact that patients were living more comfortably who otherwise might have died. His example helped strengthen my own faith in God. I would like to follow his example by working a developing nation." Several INMED medical students and residents come to Baptist Medical Center each year. Clinical responsibilities will normally include outpatient clinic, inpatient care, obstetrics, pediatrics, and surgery. Students will normally take night call and be responsible for select inpatients. Students are constantly under the guidance of a staff physician or visiting consultants.

INMED News, May 2005

New INMED Office In May 2005 HCA, Hospital Corporation of America, donated office space to INMED in the doctor's building at Baptist-Lutheran Medical Center at 6700 Troost Avenue, Suite 224, in Kansas City, Missouri, 64131-4401. These 200 square feet of comfortable space now allow INMED's full-time staff of two to more effectively equip health professional for international service. Micah Flint also joined INMED as C.E.O. Micah is a native of Kansas City, and graduated from the University of Missouri-Columbia with Bachelors degrees in biology and political science, and from Park University with a Masters of Health Administration degree in non-profit management and disaster relief. "I've always dreamed that my career would also be my personal ministry," says Micah. "When I became acquainted with INMED, I was excited to realize this dream would become a reality." At this juncture in INMED's development critical support is also being provided by INMED Board members: Don Philgreen of the Research Family Medicine Residency Program, Roy Moran of Shoal Creek Community Church, Thad May of George Butler Associates Engineers, and Dan Hickey of Transformational Journeys.

INMED News, June 2005

2004-05 INMED Grads Six medical students from the Universities of Missouri and Kansas Schools of Medicine completed the INMED International Medicine & Public Health Diploma during the 2004-05 academic year. Erika Kloepfel served for a month at Hospital Evangelico in Honduras. Jennifer Rathburn, Chrissy VanDillen, Diana Atashroo and Lisa Roark studied at Nilerigu Baptist Medical Center in Ghana. To date INMED has enrolled 25 medical students and resident physicians for the Diploma in International Medicine for the 2005-06 academic year. They will complete a core didactic study of international health issues, diseases of poverty, cross-cultural skills and health leadership, and serve for 1-2 months at an INMED training site in Asia, Africa or Central America. To date, INMED's most popular training site is the Baptist Medical Center in Ghana. Baptist Medical Center has capacity for 120 inpatients, is usually full, and occasionally runs as high as 150 percent capacity. At the height of malaria season there may be up to 60-70 kids in the 18-bed pediatric ward. The Center also provides a public health service that sponsors rural clinics where villagers receive immunizations, health teaching, prenatal clinics and under five clinics. The hospital was started in 1958 by Dr. Georg Faile Jr. with support of the International Mission Board, SBC.

INMED News, July 2005

Albert Schweitzer The face of medical missions has changed dramatically since Albert Schweitzer left for Gabon in 1910. He served isolated people with very limited medical resources. Over the last 100 years we have witnessed enormous increases in international relations and medical capabilities. We have also seen the capitalization of medicine into an industry, the rise of HIV, natural disasters, and terrorism. What does all this mean for the future of medical missions? Without a doubt there will continue to be a multitude of people in severe need of medical care. Some physicians and other health care professionals will also continue to be highly motivated out of compassion to assist those in need. Yet our approaches to such care must flex with the realities of today's world. The following trends will mark the future of medical missions: Emphasis on basic care. In a world of limited medical resources expediency is a key concept. Dollar for dollar, more health can be "purchased" by emphasizing clean water, nutrition, vaccinations, contraception, and well child care than can be attained through hospital services. Yet hospital care also fills needs that are both painful and real, and will continue to play a role. Emphasis on training. Health workers with very basic training can make an impact on their communities. Courses of 3-6 months duration will be an essential health strategy in developing countries. On a higher level, training national leadership in schools of public health will continue to facilitate ownership and national self-sufficiency. Emergency response. SARS and the recent tsunami are striking reminders that lives may fall into peril at any moment. Preparation for such crises will remain both a high priority and an excellent opportunity to show compassion. Volunteer service. Medical missions bring out the very best in doctors and other health professionals. Besides meet genuine human needs, it reignites many of the virtues that propelled us into medicine in the beginning. Service in developing nations will doubtlessly remain a timeless medical career hallmark, and INMED will continue to provide the training essential to success in this field.

INMED News, September 2005

Paul Cartwright Paul Cartwright has long dreamed of serving in Africa. Now, as a medical student at the University of Missouri-Kansas City School of Medicine, Paul's dream is becoming reality. He is scheduled to study at Banso Baptist Hospital in Cameroon, West Africa, in January and February, 2006. "At the beginning of med school I had the opportunity to do ophthalmology work with at team in Haiti. We took out cataracts and prescribed glasses for hundreds of people who were basically blind before we came. The experience totally transformed me. Medicine is a great way to serve people, and almost no needy country will turn doctors away. I'm excited to go study in Cameroon now that I have more skills to share. After finishing my medical training I can see myself integrating medical missions throughout my career." Banso Baptist Hospital is a full-service facility with a daily census of 300 patients. Outpatient services include the entire range of family medicine, including prenatal care and well-child care. Banso Baptist Hospital is part of a network that includes 23 health centers, a nursing school, and a village health worker training program. Banso Baptist Hospital is also part of the Pan-African Association of Christian Surgeon's residency program.

INMED News, October 2005

David Lachman David Lachman is a medical student at the Medical College of Georgia. Inspired through his earlier experience in China, David is preparing to study in Shenyang, China, for the INMED International Medicine & Public Health Diploma. "While I was studying Chinese in Shanghai, my professor wanted me to see the contrast between the modern cities of China and the rural poor. As I witnessed the miserable life of rural China, I realized how much a few medications, vaccinations, and simple public health measures could ease the people's pains. I wanted to be able to help them in substantial ways. That experience motivated me to go to medical school and sparked my interest in studying international medicine. After repaying my medical school debts, I plan to permanently work in a developing country." The mission of LIGHT, the medical facility in Shenyang, is both to provide care for marginalized people and to train Chinese resident physicians in family medicine. Multiple medical care settings are employed. The Deji Hospital Global Doctor Clinic mainly serves international persons working in China. Image International Clinic provides care to local Chinese people of humble means. LIGHT mobile clinics also serve the medical needs of a large orphanage, a retirement community, several rural town sites, and an HIV care clinic.

INMED News, November 2005

Nicholas Comninellis Images of hurricane destruction along the Gulf Coast are rapidly being supplanted by ones of hungry, hurting victims of the disaster - many of whom are physically ill. Hospitals as far away as Denver and New York are filling with transferred patients suffering from dysentery, dehydration, and respiratory diseases. What does this crisis teach us about international health? First, it is a solemn reminder that emergency preparation is critical. Comparison between the tsunami of December 2004, and Hurricane Katrina is inevitable. In both cases, grave inadequacies surfaced in early warning and in relief response. Katrina is also a reminder of how intimately health depends upon clean water, food, and shelter. Remove these essentials, and note how rapidly disease appears. Yet not so far from our own borders reside many millions of people who live a post-Katrina lifestyle every day of their lives! As we rush to assist the victims of the hurricane, we will do well to think of those in South America, Africa and Asia who subsist with so little. Finally, Katrina is a heart-warming reminder of the good will and giving nature that characterizes people. From mobilized Army Engineers to grade school children making care packages, we are experiencing first hand that it is not only those who receive assistance who benefit. Giving also brings out the very best in the ones who give. To increase your own skills to respond to global health challenges, please take advantage of the INMED Self-Paced Courses.

INMED News, December 2005

INMED STUDENTS IN HONDURAS

Nicholas Comninellis, MD, MPH

Erica Heitmann, center Erica Heitmann fulfilled a life-long dream by serving at the Hospital Evangelico in Honduras qualifying for the INMED International Medicine & Public Health Diploma. Erica is a senior medical student at the University of Missouri-Kansas City School of Medicine, and President of their student chapter of the CMDA. "I had seen photos and heard stories about health problems in the developing world," says Erica, "but no education was nearly as valuable as actually making the trip and trying to help out for myself. I felt pretty inadequate in the beginning, but the thoughtful staff physicians there guided me through my first cases of malaria and dysentery. They also gave me a roll model to follow. Working with way too many patients and far too little in the way of supplies would strain anyone. But these docs were consistently patient and compassionate. Amazing!" "I'm about to start residency, but I'm already looking for my next opportunity to go back to Honduras and serve again. This time, I will be much better prepared, both with knowledge and skills. But perhaps more importantly, studying in Honduras fueled my personal desire to serve God and other people through my career in medicine." Located in the city of Siguatepeque, Hospital Evangelico cares for some seventy inpatients and one hundred outpatients daily. People coming to Hospital Evangelico represent a broad spectrum of society, with many suffering from chronic diseases. The medical staff consists of sixteen Honduran physicians of various specialties. Many American medical students and residents have worked at Hospital Evangelico over the years. Students are constantly under the guidance of a staff physician.

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