INMED News, January 2006

A GIFT OF HOPE TO ZAMBIA

By Anthony Warren

INMED Training Site: Mushili Health Center Africa is being ravishing by disease; a fact compounded by the frequent lack of even most basic health care. Countries like Zambia, southern Africa, are witnessing dramatic increases in HIV/AIDS, malaria, and malnutrition. According to the UNICEF, for example, one child dies of malaria each 29 seconds, from TB each 18 seconds, and one person is infected with HIV each 6 seconds. The statistics are staggering. In the face of this challenge, INMED has partnered with a health clinic in Zambia to build a teaching hospital in the city of Luanshya. The hospital - better known as Mushili Health Center - will provide health care services to the native peoples of northern Zambia, as well as war refugees from neighboring Congo. The hospital will have capabilities to care for patients suffering TB and other preventable diseases, as well as provide surgical care. Mushili Health Center will also offer treatment to prevent newborns from becoming infected with HIV. Beyond caring for the sick, Mushili Health Center will also be a training center for Zambians to gain the skills and knowledge needed to care for their own people. Contributing to this effect are two INMED students, Angela Bymaster and Mary Sievers, both from the University of Iowa College of Medicine. Throughout the month of February, Angela and Mary will be serving at Mushili Health Center. Says Mary, "The disparities between the healthcare resources available to US citizens compared to the majority in other nations is huge. I feel it would be immoral to ignore this problem and not personally take steps to improve the situation." Angela resonates with Mary's convictions, "My husband and I don't know if we will do future missions at this point but we are sure we will be serving the poor in some way with our lives."

INMED News, April 2006

COULD YOU DIAGNOSE BIRD FLU?

Nicholas Comninellis, MD, MPH

Avian influenza, or bird flu, was first recognized as a potential world health threat in 1997 through an outbreak in Hong Kong. This illness is caused by several subtypes of influenza A virus. Normally affecting chickens, turkeys and ducks, the virus can be transmitted to humans who inhale aerosolized bird feces or respiratory secretions. Bird handlers are especially at risk for infection from direct contact. Avian flu, especially the subtype H5N1, has caused serious illness and death in humans in Asia. To date human-to-human transmission appears to be quite rare. However growing concern exists that avian and human influenza viruses may be capable of recombining to form more virulent subtypes that could potentially spreading from person to person. The organism's new pathogenicity could indeed cause a global pandemic. Would you recognize someone suffering from avian flu? The initial presentation of symptoms is typically two to five days after exposure. Symptoms are very similar to other influenza illnesses, and include fever, myalgias, sore throat, cough, conjunctivitis, and watery diarrhea. Leukopenia or lymphopenia is typically present. Chest X-ray frequently detects infiltrates resulting from viral pneumonia. Patients may progress to respiratory distress and multi-organ failure. Distinguishing avian flu from other forms of influenza or pneumonia is aided by a history of direct or indirect contact the birds. Definitive diagnosis is made by viral isolation or identification of the H5-specific RNA from nasal or pharyngeal swabs. While the chances may seem remote that avian influenza would appear in the US, it is just this line of reasoning that will cause us to misdiagnose the first cases. International travel makes it possible that an outbreak in the Far East could indeed affect us within hours. A basic understanding of the disease coupled with clinical vigilance could prepare you to nail the diagnosis. To gain more expertise in threats to global health, please take advantage of the INMED International Medicine Course.

INMED News, May 2006

FIRST EXPLORING MEDICAL MISSIONS CONFERENCE

First Exploring Medical Missions Conference The INMED Exploring Medical Missions Conference was held May 12-13, 2006 at Research Medical Center, Brookside Campus, formerly Baptist Medical Center. The very first of its kind in Kansas City, this conference provided health professionals with the unique knowledge needed to successfully serve in medical missions. The conference was hosted by INMED, the University of Missouri-Kansas City School of Medicine and Research Medical Center. RMC also granted continuing education credits for attendees. Generous financial support was also provided by College Park Family Care Center. 200 people attended the event, including 85 practicing physicians, 20 nurses, 14 resident physicians and 20 medical students from Kansas University, University of Missouri-Kansas City and Kansas City University of Medicine and Biosciences. Attendees came from as far away as Angola, Africa! Conference presentations focused on international health issues, diseases of poverty, cross-cultural skills and health leadership. Presenters included Gary Morsch of Heart To Heart International, Stan Shaffer of Maison de Naissance in Haiti, Kansas City's own Tim Myrick of the Annoor Sanatorium in Jordan, and KU's Director of Infectious Diseases, Daniel Hinthorn, and others. When commenting on the presentations, conference attendees commented, "Every general aspect of medical missions was touched on. The enthusiasm and expertise of the speakers was wonderful" and "The networking was awesome!" 12 exhibitors provided an excellent chance for conference attendees to quickly connect with international service opportunities. Some exhibitors included the Baptist Medical Dental Fellowship, Medical Centers of West Africa, Mushili Hospital of Zambia, and the Greater Kansas City Christian Medical Dental Association. Click here for information about the next Exploring Medical Missions Conference.

INMED News, June 2006

TWO BABIES IN ANGOLA

Drs. Foster & Comninellis in Angola INMED is devoted to developing the next generation of medical missionaries. To this end, we work to maintain a close connection between ourselves and our international training sites, and to assure that our teaching stays on course with the reality of international medicine practice. To this end, INMED President Nicholas Comninellis worked alongside Steven Foster in Angola, Africa throughout the month of June, 2006. Dr. Foster is a Canadian surgeon with SIM who has been serving in Angola since 1975. Over the last five years he has also been the point man for creating the Lubango Evangelical Medical Center, a state-of-the-art facility due to open in the near future. Foster is an INMED faculty who mentors INMED students that come to study international medicine with him. Comninellis is no stranger to Angola either. He worked along side Foster and started a mobile clinic ministry in 1989-1991 amidst the Angolan civil war. During June, 2006, he cared for patients at Kalukembe Hospital, and polished a protocol that nurses use in caring for outpatients. Comninellis observed, "Almost daily I talk with INMED students about international health issues; the hunger, the poverty, the preventable diseases that can be cured, and the appalling deficiency of medical personnel. But how easily I forget the emotional gravity of these hurting people." The INMED President when on to describe two mothers who arrived one evening at the hospital seeking help for their six-month old babies, "Both babies were suffering from pneumonia and dehydration. We had a very difficult time getting IVs started, but eventually both babies were receiving intravenous fluids and antibiotics. By morning, one baby had died, while the other was recovering on her mother's lap. The tragedy of this death once again engaged my heart in the mission which is ours: to raise awareness, motivate and equip health professionals, and to ultimately show the compassion of the Great Physician toward these people who are most in need."

INMED News, July 2006

COMING TO LOVE ZAMBIA

Emily Schwartz In Zambia Emily Schwartz is a wonderful example of the enthusiasm that characterizes students pursuing the INMED International Medicine Diploma Program. When applying she commented, "I believe that God put me on this earth for a purpose, and gave me a desire to study medicine for a reason. I believe that He wants me to share not only His truth and His life, but also the healing that comes from medical care. I believe He has given me great compassion for those who are suffering, as well as a vision for caring for His children in the future." It is this sort of compassion and commitment that motivates health professionals to breakaway from the security and comforts of home and move out to where the suffering is greatest. Emily is a physician's assistant student at Philadelphia University. She studied through INMED at the Mushili Health Center in the Copper Belt of northern Zambia, Africa. In this remote region malnutrition, malaria, TB, HIV, polio, anemia, and burns are common, and infant mortality approaches a startling 70 percent. Emily's primary mentor was Dr. Andy Mtambo, who guided her through the paces of caring for clinic patients, well child visits, vaccinations and prenatal care. When reflecting on her month in Zambia, Emily concluded: "This experience has impacted my life greatly - being with the others at the mission, as well as experiencing healthcare in another country. I've come to love Zambia, and I hope God will bring me back. I think the most valuable aspect of the experience was seeing the challenges that healthcare providers in Zambia face, with the lack of resources, language barriers, lack of health education on the part of the nationals. My goal was to learn how healthcare systems operate in a third-world country and begin to learn what needs to be done to make the operations better. I believe that I did begin this process, thanks to INMED."

INMED News, August 2006

INMED & THE ISLAMIC MEDICAL ASSOCIATION

Drs. Sufi, Comninellis & Mir In a gesture of extraordinary kindness, the Islamic Medical Association of North America (IMANA) invited INMED President Nicholas Comninellis to address their third annual continuing medical education conference as the keynote speaker. INMANA has a particular interest in medical relief, especially in light of the devastating earthquake that shook Pakistan in 2005, killing 73,000 and leaving 3 million homeless. In responding to such crises IMANA has provided medical supplies and sent medical personnel where they are most urgently required. IMANA's medical relief missions have provided timely and effective aid in Bosnia, Kosovo, Turkey, Venezuela, the Carolinas and Chechnya in recent years. Abdul Rauf Mir, a nephrologist and President-Elect of IMANA, introduced Dr. Comninellis with the statement, "We are together here because we want to help those who are suffering. Now Dr. Comninellis, he is a Christian, and we are Moslems. But we are all people of 'The Book' (i.e. the Tora, the first five books of the Old Testament). Jews, Christians & Moslems. We are all people of the Book. So he is really one of our own, and one heart with us in this work!" Dr. Comninellis describe principles of international medical relief, including the importance of training nationals, collaboration with national governments, and appropriate response to disasters. He also explained the cost-effectiveness of primary health care over hospital services, and INMED's role in preparing health professionals for such ministry. As an illustration of principles in action, Dr. Comninellis told the story of Oasis Hospital, opened in 1960 as the first medical facility in Abu Dhabi Emirate - an impoverished, neglected area of the Persian Gulf where maternal mortality was a staggering 35 percent, and 50 percent of infants died in the first year of life. Oasis led the way toward a marked improvement in the survival of women and babies. Ashraf Sufi, gastroenterologist at Kansas University Medical Center and President of IMANA, commented, "Such self-sacrificing work brings out the very best in people. We are committed to continuing medical relief and look forward to a lasting relationship with INMED."

INMED News, September 2006

INMED ADDS NEW TRAINING SITES IN PAPUA NEW GUINEA

HIV Prevention In Papua New Guinea Students, residents and attending physicians who apply for the INMED International Medicine Certificate frequently seek out opportunities to study in the most underserved locations on earth. In light of this fact, INMED is pleased to announce two new training sites in Papua New Guinea. Kapuna Hospital and Kikori Hospital are both in remote areas on the southwest peninsula of Papua New Guinea (PNG) - the island nation just north of Australia. This is an area marked by dense jungle and river deltas, and yet it is also home to tens of thousands of native people who have little or no access to medical care. Kapuna and Kikori Hospitals are administrated by Gulf Christian Services, a charitable organization. Today they have 50 and 70 beds respectively, and are normally filled to capacity with those suffering from typhoid fever, malaria, TB, HIV and obstetrical complications. Injuries from crocodile attacks, snakebites and machete wounds are also commonly treated. About 300 deliveries are performed each year. The outpatient clinics are busy providing antenatal checkups, immunizations, well childcare and TB treatment. Community health activities include malaria prevention through mosquito net distribution, and a comprehensive AIDS/HIV awareness program. Both hospitals provide ideal training opportunities for health professionals who are interested in exploring medical missions, for education is an integral part of both health ministries. Medical students from the Port Moresby Medical School regularly serve at these sites, as do students in the Community Health Worker (CHW) training school. Medical students and physicians will get as much hands on experience, as they are comfortable with, and often are first on call with the doctor on standby. Opportunities for other health professionals are also available. Individuals who are interested in training in Papua New Guinea are invited to apply for the INMED International Medicine Certificate Program.

INMED News, October 2006

SAVING CHILDREN IN GHANA

Erica Horton with a newborn in Ghana Erica Horton is a medical student at the Kansas City University of Medicine and Biosciences (KCUMB) who attended INMED's Exploring Medical Missions Conference in May 2006. "God had already laid on my heart ideas about going into medical missions. During the INMED conference I listened to the presentation by a UMKC student who served in Cameroon. I've always been interested in going to Africa because of the vast need they have in all areas of medicine, especially preventative. I felt a strong urge to go there - to serve people who do not have the means to help themselves. I believe that's why we are here on this Earth... to respect the value of human life, and to give whatever we can to serve God." Erica's altruistic vision came into focus when she enrolled in the INMED International Medicine Diploma Program. INMED arranged for her to study with American physicians during August and September 2006 at the Nilerigu Baptist Medical Center in northern Ghana. The Baptist Medical Centre (BMC) ministry was founded by an American physician, George Faile II, half a century ago, and today the Faile Foundation provides many valuable services and funding for the Baptist Medical Center. The Nilerigu BMC is a full-scale hospital and clinic whose services include surgery, dental care, TB treatment, HIV care and management of obstetrical emergencies. Erica passionately describes her experience: "I saw so many children die from malaria, pneumonia and dehydration...often 5 or 6 a day. We worked extremely hard to try and save them, giving IV fluids and medications. We prayed for them, too. We prayed with their families, we prayed before surgeries. I saw American surgeons bow their heads and grasp the hands of their patients before anesthesia. How often would I ever see that in the United States? I came to realize the importance of prayer - how it brings peace of mind. When we had provided all we could to save a child and asked God to intervene, then we knew we'd done everything possible."

INMED News, November 2006

INMED PUBLISHES ITS INTERNATIONAL MEDICINE COURSE

Giardia lamblia The practice of international medicine relies upon a core of knowledge that is essential for success in the field. Some courses already offer medical professionals a review of the diagnosis and treatment of "tropical" diseases, but rarely address the broader issues surrounding international health. Other courses touch of such issues, but are too lengthy in duration for students or practicing professionals to take advantage of. This month INMED released the International Medicine Course, tailored to be a comprehensive and convenient preparation tool for international service. The course addresses four bodies of knowledge: International Health - Exploring the large-scale health issues and determinates of health for people in developing nations Diseases of Poverty - Focusing on those unique medical conditions that are most frequently associated with low income and encountered in developing nations Cross-Cultural Skills - Addressing how to adapt to living and working effectively in unfamiliar cultures Health Leadership - Detailing how health professionals can work in cooperation with communities to design and lead effective health systems. Joe LeMaster, MD, MPH (London), was one of the course reviewers. Dr. LeMaster served in Nepal from 1990-2000, and today is an assistant professor of community & family medicine at the University of Missouri-Columbia. "INMED's on-line international medicine course reviews content such as one would encounter in a Diploma of Tropical Medicine & Hygiene course. It also provides an excellent guide to cultural adaptation and developing local leadership. I have rarely encountered an educational tool that undertook such a broad agenda and did it so well. Those who give this course serious attention will be much better mentally prepared for their overseas medical experience. This is a 'must see' for the serious student of international medicine and faculty member, and I highly recommend it." Health professionals can receive Continuing Medical Education (CME, 15 hours) and Continuing Education Units (CEU) for taking the Course. Several medical mission sending agencies are requesting their personnel to take the Course as an orientation prior to embarking on medical missions service. All INMED International Medicine Certificate students will take the Course as a preparation for their international medicine elective. Dr. David Tillema, the Baptist - Trinity Lutheran Legacy Foundation, and the Jack Hill Continuing Medical Education Foundation, provided generous funding for development of the Course. Please visit the INMED International Medicine Course.

INMED News, December 2006

INMED TRAINS HEALTH PROFESSIONALS TO COMBAT HIV/AIDS

HIV Distribution Global attention is riveted on the HIV/AIDS crisis, and rightly so. The most threatening epidemic of modern times claimed 3.1 million lives in 2005 alone, and some 4.9 million people were newly infected. Most tragic of all is that HIV infects the most innocent of innocent: 15-30 percent of all HIV-infected pregnant women will transmit the virus to their newborn babies at or soon after delivery. The last decade has witnessed significant progress in drug treatment against HIV in developed nations. But the truth remains that 95 percent of all people with HIV live in the developing world. This proportion is anticipated to grow even greater as infection rates continue to rise where poverty, meager health care and limited resources for prevention and care fuel the spread of the virus. Managing HIV in resource-deficient nations presents special challenges, including cultural barriers and limited drug supplies. In light of this fact, INMED is now developing a focused International HIV Medicine Certificate. This new training program builds upon the current INMED International Medicine Certificate in International Medicine, and will be available to health professionals and students. The International HIV Medicine Certificate will consist of two main components: an on-line course and 1-2 months of clinical instruction in a developing nation. The course will provide the essential didactic information for HIV prevention and management, with an emphasis on prevention of transmission. Clinical instruction will be provided by American physicians and nurses at several INMED training sites in Africa and Asia. HIV Intervention will be the theme of next year's INMED Exploring Medical Missions Conference, being held May 11-12, 2007 on the main campus of the University of Missouri-Kansas City (UMKC). On Friday night, May 11, INMED will host a Fight HIV Benefit Night to support this new Diploma program.