INMED News, January 2009
Nicholas Comninellis, MD, MPH
| NEW OPPORTUNITY IN JUNE 2009: INTERNATIONAL MEDICINE INTENSIVE COURSE
In the Disney/Pixar movie Wall-E, a tiny robot is left on Earth to clean up the trash remaining after humans have long departed. Wall-E's existence consists of a mundane routine of sifting through lifeless rust, garbage and refuse. That is, until one day when he encounters for the first time a living plant, one whom he must guard and protect. Suddenly, his life is filled with adventure and purpose.
Meanwhile, Earth's citizens are living luxuriously on a cruise ship style spacecraft. They've grown shamelessly fat and deconditioned from the computerized comforts and have all but forgotten that their voyage was never intended to be permanent. When the captain learns of Wall-E's plant discovery, he concludes it's time to return home. Suddenly, creature comforts have little value. What matters most is fulfilling his mission and safely landing the passengers.
Many health care professionals today are like both Wall-E and the captain. We find that a world of lifelessness and personal comforts is not satisfying. We want a challenge, a life that matters; one that makes a difference.
This month INMED is introducing a new learning opportunity for those who seriously want to care for the poorest of the poor. The International Medicine Intensive Course is a two-week event designed to give health care professionals the academic fundamentals of the field. It builds upon the information provided in INMED's current International Medicine Online Course, but will go into much greater depth. The course will address:
A highly qualified 20-member faculty is assembling on June 1-12, 2009, on the main campus of the University of Missouri-Kansas City. The concentrated lectures, case studies, and formation groups will take place from 8AM-5PM Monday through Friday. Housing and meal plans are available on the University campus to accommodate those from outside the region. For complete details please visit the International Medicine Intensive Course.
- Determinants of health for developing nations
- Diseases of poverty
- Cross-cultural competence in health care
- Health leadership
- Personal skills for international living
In addition to the knowledge and skills attained, this course will provide participants with the opportunity to become personally acquainted with leaders in medical missions and international medicine - like Joe LeMaster MD, MPH, a graduate of the London School of Tropical Medicine who served ten years in Nepal, and Nancy Crigger, RN, PhD, an authority in medical ethics and veteran healthcare provider in Latin America.
Those who successfully complete the course of study and who pass the final examination will receive the INMED International Medicine Academic Certificate. More importantly, they will be on their way toward a life that matters in defense of those who are living.
INMED News, February 2009
Nicholas Comninellis, MD, MPH
| ETHICS AND MEDICAL MISSIONS
Unprecedented numbers of health care professionals are volunteering their services in poorer nations. But their altruistic motives are often quickly tempered by the reality of novel and daunting questions connected with very limited resources, and further complicated by unfamiliar cultural context. For example:
- Is it acceptable to diagnose a person's hypertension, but be able to only supply 30 days of therapeutic medication and provide no follow up care?
- Is it ethical to prevent malaria among children by providing bed nets, but not to provide them adequate nutrition?
- Is it justifiable to treat an HIV positive mother to prevent transmission of HIV to her newborn child, but then not provide continued HIV treatment to the mother, realizing that she will likely die and leave that newborn orphaned?
- Is it ethical to allow medical or nursing students to care for people in poor countries without the benefit of supervision they would receive when caring for patients in their home nations?
Such questions have plagued mission-minded health care leaders for decades. But only recently have these ethical issues begun to receive broader attention. Leading the way in this field is Nancy Crigger, PhD, ARNP. Dr. Crigger is an associate professor of nursing at William Jewell College. She is also presenting the topic Ethical Issues in International Medicine at this year's International Medicine Intensive Course. The topic will also be addressed at the Exploring Medical Missions Conference.
Dr. Crigger implores volunteer medical professionals to carefully examine their actions. "We must assure that we're not just providing care that makes us feel good, yet is not really helping the nation or its people in the long run. Sustainable change and safety are two most important considerations. For example, our healthcare team recently saw a Honduran lady who was treated for her chronic neuropathic pain with a newly marketed and expensive medication by an American physician. After the physician left, the lady developed severe adverse effects. While well intended, the physician's care was neither sustainable nor safe. Even if the drug had been effective, she would never be able to obtain this medication in Honduras. Using prudence in prescribing, limiting prescriptions to medications that are on the World Health Organization Essential Drug List, and making sure that a local community-based followup was in place may have helped the physician avoid this precarious situation."
Nancy Crigger, PhD
Learn more of Dr. Crigger's insights in her publication in the Journal of Transcultural Nursing. Better yet, come to hear her insights in person at the International Medicine Intensive Course and Exploring Medical Missions Conference.
INMED News, March 2009
Nicholas Comninellis, MD, MPH
| FIGHTING THE DISEASES OF POVERTY
David Livingston, one of the 1800's most beloved personalities, is best remembered as an explorer. He was the first white man to traverse southern Africa, to see Victoria Falls, and to walk the length of the Nile River. But Livingston's autobiography documents a different identity. He saw himself primarily as a physician and as a messenger of Jesus. During the first eleven years of his career, Livingston lived in South Africa, devoting the majority of his life to caring for the sick and starting churches.
In his autobiography, Livingston described the diseases he most often encountered in Africa: pneumonia, malaria, TB, dysentery and birth complications. He himself died in Zambia in 1873 of malaria and dysentery.
Today, the startling fact is that these same diseases remain the leading causes of death in poorer nations. Wealthier nations on our planet enjoy life expectancies into the 80's and child mortality is significantly less than 1 percent. By stark contrast, life expectancy for Africa as a whole is only 51. In some nations the average person only lives to the youthful age of 41, with 25 percent of children dying before age five. This should not be so!
This year's Exploring Medical Missions Conference will emphasize the strategies proven most effective in fighting the diseases of poverty. While some of these strategies are outside the traditional realm of medicine, health leaders must nevertheless be advocates for:
Health care professionals like you and I are rightly concerned about the appalling and preventable suffering in poorer communities. Many want to get personally involved. This year's Exploring Medical Missions Conference is an opportunity for you to investigate the crisis, to network with like-hearted individuals, and join the fight against the diseases of poverty. Livingston would be sickened to know that people are still succumbing to the same diseases of poverty. He would be proud to learn that you joined him in caring for the poorest of the poor.
- Economic Development. Health status is intimately connected with economic status. Today's nations of poverty host the highest prevalence of TB, malaria, HIV and malnutrition. As national economies develop, these diseases become less frequent and life expectancies prolong. A prime example of this phenomenon is the remarkable economic and health advances that have occurred in China since the 1980s. One particular organization making a significant improvement in local economies is Heifer International. By providing families with animals and training, Heifer helps to alleviate hunger, generate income and foster community health.
- Ending Military Conflicts. "Currently, nations with the most devastated health conditions are also nations that are, or recently were, at war. These include Angola, Afghanistan, Liberia, and Sierra Leone. The British Medical Journal, 2002, declares, "In many war zones, violent deaths are often only a tiny proportion of overall deaths." The article further notes a survey from eastern Congo that illustrates the precarious health issues that many poverty-stricken countries endure..."Of 2.5 million, only 350,000 were because of direct violence; most died from malnutrition and disease." Despite these disturbing circumstances, esteemed organizations such as Samaritan's Purse are valiantly working to negotiate settlements and ceasefires and to provide relief in the most troubled lands.
- Effective Disease Interventions. Some of the most successful actions against the leading diseases of poverty include supplying of safe drinking water, providing mosquito nets to prevent malaria, educating to curb HIV transmission, and giving of basic prenatal care. Some low-resource nations effectively utilize community health workers to rapidly recognize and treat TB, pneumonia, and hypertension.
INMED News, April 2009
Nicholas Comninellis, MD, MPH
| PLIGHT OF THE DISABLED POOR
Most Americans today are curbing their excesses, avoiding risks, and grumbling about falling victim to this recession. Now consider the contrast revealed through Richard (Dick) Bransford, a featured speaker at the Exploring Medical Missions Conference on May 29-30: "The Democratic Republic of the Congo (DRC) has been in civil war for years. I knew there would be a lot of neglected little kids. Some would have club feet, burn contractures, hydrocephalus, hip dysplasia, spinal deformities, cerebral palsy, and polio. Honestly, I wanted to see how I could help and if my skills could be of use to the people."
The risks were startling. Some 5 million have died in the DRC's civil war, no one would pay him to serve there, and he would practice medicine under appalling conditions. Dr. Bransford reflected while waiting at the airport, "I know that I am not too good at passing a kid by. That is one of my weaknesses."
Selfless compassion is not only his "weakness", it's his lifestyle, too. In 1975, fresh out of surgery training and Air Force service, Dr. Bransford joined African Inland Mission (AIM). He and his wife Millie lived and labored together in the DRC, Comoro Islands, and at Kenya's Kijabe Hospital. In 1998, Dr. Bransford's love for kids developed into his vision as he became leader of Bethany Crippled Children's Centre in Kenya.
In Kenya and the DRC, like most low-income nations, physical disabilities are an enormous challenge. Birth defects, such as spina bifida and cerebral palsy, occur more commonly than in wealthy nations. Acquired disabilities, like those resulting from burns and head trauma, occur much more frequently. As many as 80 percent of all disabled persons in the world live in isolated rural areas of developing nations. In some of these nations, the disabled population is estimated to be as high as 20 percent (UN document A/37/51).
Yet appropriate care for these precious individuals is extremely slim or only available for those who can pay. So, some 97 percent of disabled children in low-income nations receive no form of rehabilitation and 98 percent go without any education. Families and communities often compound their children's plight by rejecting them during the critical years when they are physically and emotionally most vulnerable.
Answering the plight of the disabled poor begins with a spirit of noble compassion. Dr. Bransford concludes, "At 68 I have found that God has given me the desires of my heart. I am a surgeon working with disabled children and utilizing these gifts to heal, to open spiritual doors, and to protect disabled children throughout Africa." Don't miss your opportunity to meet Dr. Bransford and other inspirational international medicine colleagues at the Exploring Medical Missions Conference. They are proof that compassion need not be victim to recession.
INMED News, May 2009
Nicholas Comninellis, MD, MPH
| UNLEASH YOUR POWER TO SERVE
"Would serving people in serious need help fulfill my life?" It's a frequent, even if subconscious, question we ask ourselves. Gary Morsch observes, "People really do want to help one another and make the world better, but they often don't know how to do it. People are looking for significance in their lives, but they don't know how to find it. Often they've tried accumulating wealth, increasing excitement, exercising authority, but those attempts left them empty. The fortunate ones discover that the true source of power in our lives, the power to change the world, is available when we serve others."
Dr Morsch, keynote speaker at the Exploring Medical Missions Conference on May 29-30, speaks from heartfelt experience. He organized the first ever medical airlift to Russia, carried out trash for Mother Teresa's hospices in India, cared for injured Iraqis in Baghdad, and provided clothes to earthquake victims in China's Sichuan Province. In 1992, his vision to serve took on exemplary proportions when he founded Heart to Heart International, a globally recognized relief organization that has provided some $300 million in humanitarian supplies to people in more than 100 countries. More significantly, Heart to Heart has linked thousands of volunteers who desire to serve others with people who most desperately need assistance.
"As a relief worker and a physician, in some of the worst conditions imaginable, I see people helping others who are in need," continues Dr. Morsch. "Usually they are strangers to one another; often they are from different tribes, races, economic or social classes. What draws them together is that someone is in need and someone else is able to provide help. With that experience in mind, I have come to the following conclusions:
"For me, I decided in medical school that I would devote time out of each year to practice medicine where people didn't have adequate medical care. Each year I would pack duffel bags with medicine samples and head to a Third World country." (excerpts from The Power of Serving Others: You Can Start Where You Are by Gary Morsch and Dean Nelson, Berrett-Koehler Publishers, 2007)
- Everyone has something to give
- Most people are willing to give when they see the need and have the opportunity
- Everyone can do something for someone right now"
Most healthcare professionals, like Gary Morsch, would like to somehow serve the world's very vulnerable citizens. At the Exploring Medical Missions Conference Dr. Morsch's insights will add to our theme this year: Fighting The Diseases Of Poverty. With such experience as a guide, you may discover not only how to save a life, but also how to satisfy a longing within your own heart.
INMED News, June 2009
Nicholas Comninellis, MD, MPH
| FEELING INSPIRED? NOW TAKE THE NEXT STEPS!
Many healthcare professionals are enamored over the possibility of serving the poorest of the poor. But what steps follow this vision? First: equip yourself with the essential professional, cross-cultural and personal skills. Your transition from functioning in a community of affluence to one of poverty demands unique, new abilities. Second: join forces with other like-hearted individuals. Superb service organizations are already at work, they would benefit from your participation and would likely make your own efforts more effective.
INMED exists to assist individuals like yourself take these next steps. On May 29-30 a capacity crowd of 393 attended the Exploring Medical Missions Conference held at the University of Missouri-Kansas City, where this year's theme was Fighting The Diseases Of Poverty. Enthusiastic attendees included 86 physicians, 89 nurses, 2 dentists, 5 pharmacists, 8 therapists, 3 PAs, 11 NPs, 110 students, and 77 others. 30 states were represented, and some 8 nationalities. 28 sending organizations were represented at the conference, giving attendees the chance to connect with service opportunities.
Please save the date for INMED's next event, the Cross-Cultural Competency in Healthcare Symposium. Strengthen your skills at caring for culturally diverse people here in the Midwest or continents far away. This one-day opportunity will be offered on October 2, 2009 at the Research Medical Center-Brookside Campus in Kansas City.
At this moment, 33 healthcare professionals are also equipping themselves thru the INMED International Medicine Intensive Course. This two-week curriculum is designed to prepare these students representing six nationalities with the academic fundamentals of global health. As an additional benefit, they also are meeting some of the most influential teachers and leaders in the field today. Take advantage of the next INMED International Medicine Intensive Course June 7-18, 2010, being held at the University of Missouri-Kansas City.
2009 International Medicine Intensive Course Participants
A supervised clinical experience in international medicine is a priceless complement to academic study in the field. INMED offers such experiences through the International Medicine Certificate program. What about those of you who already have significant supervised experience outside of INMED? You are welcome to enroll in the INMED International Medicine Intensive Course and qualify for the INMED International Medicine Diploma. And for those seeking the highest level of training, INMED now offers the International Medicine Fellowship.
Precious are those individuals who can transform a vision into action - especially a vision from which they can expect no financial gain. And priceless are the rewards of a life well lived on behalf of those people in greatest deprivation.
INMED News, July 2009
Nicholas Comninellis, MD, MPH
| SERVING THE SOMALI PEOPLE!
Pirates, Somalia, Mogadishu, battling warlords, Black Hawk Down. These words provoke images of immense anguish and adversity. Most people flee at the thought of providing any sort of assistance under these conditions. But one particular physician from the American Midwest is serving Somalia intentionally, and his identity must remain anonymous due to security concerns. He and his family have lived in the Middle East for sixteen years, and I recently visited with him in East Africa:
What are the conditions today in Somalia?
"Worse than at any other time since the war broke out in 1991, with relentless clashes between militant factions, clan militia, and African Union troops. Millions of people are clinging to survival in tent cities and refugee camps, amid endemic hunger, water-born diseases, and hopelessness. The number one health problem in the nation is neglect. People come to us with far advanced cancers, disabling deformities from burns, complicated gun shot wounds."
Why are you especially passionate about Somalis?
"These are endearing people living under extremely challenging conditions, and very few outsiders are assisting them. Medicine is an extremely effective way to meet their real physical needs, to build trust, and to equip Somali medical personnel to care for their own."
Most all Somalis are Moslem and yours is a notable Christian ministry. Yet Somalis unapologetically seek you out for medical attention. Why is this?
"Christian healthcare professionals have a good reputation in the Middle East, thanks to the tireless service of hundreds who have gone before me. Jesus is also known in Moslem circles as the 'healing prophet,' and they perceive a connection between Him and healthcare. All-in-all, we offer superb, compassionate attention, so that Somalis who are able, frequently come directly to us from Mogadishu."
What would you say to healthcare professionals in North America who feel moved to relieve the plight of Somalis?
"First, realize that Somalis frequently feel misunderstood. Invest some effort in getting to know them, their beliefs, and their remarkable culture. Events like the INMED Cross-Cultural Competency in Healthcare Symposium are ideal for learning how to bridge these gaps. Large contingents of Somalis also live in the Cleveland and Minneapolis areas. Link up with those organizations that are already serving Somalis in your community. And consider volunteering your skills here in Africa and the Middle East. INMED's International Medicine Certificate program is designed to both prepare you and ease the enormous transition to serving here on the front lines."
You and I will likely continue receiving disturbing news from the eastern horn of Africa. But lets be heartened that Somalia is not only a story of rebels and renegade gunboats. Theirs is also a story of courage and compassion - one which we ourselves can help shape.
INMED News, August 2009
Nicholas Comninellis, MD, MPH
| WHAT'S THE ALLURE OF INTERNATIONAL MEDICINE?
"I've lost three more patients today," writes Ben Cavilla, MD, from the Lubango Evangelical Medical Center in Angola, southern Africa. "One had terminal AIDS. Another had a liter of puss in her belly. And the third was a young child with typhoid fever." Dr. Cavilla gave up the comforts of British Columbia, paid his own expenses, entered into a foreign culture, and learned a new language - all for the privilege of volunteering his time and talent.
Consider also Rick Donlon, founder of Christ Community Health Services in South Memphis. "We took a dramatic pay cut to help the poor," says Dr. Donlon with all humility. "Some of us mortgaged our houses to pay bills and salaries so we could impact the most largely underserved part of the city."
Why did these individuals make such sacrifices? What is the genesis of this allure; the allure of international medicine?
Let's begin by defining just what we mean by the words international medicine. While various interpretations are in use, most fundamentally international medicine means healthcare for all people - especially those on the margins.
And here begins the first allure of international medicine: We want to care for those who are most marginalized. As I read applications for the INMED International Medicine Certificate, I encounter professionals inspired over the prospect of investing their time, talent and treasure for which their only likely recompense will be a "Thank you" and a sense of satisfaction. In an age of economic crisis, why is this so attractive? Because, first of all, it is consistent with the ethics we most admire; also, because it resonates with the faith possessed by many; and because we realize that somehow this kind of self-sacrifice is intensely good for our souls.
But caring for those most poor presents daunting obstacles. And here originates the second allure of international medicine: We like a challenge, something difficult; something that demands innovation and often brings out the very best in us. Those who are truly poor, whether in the United States or in other nations, are often separated by divergent culture and low-resources. Providing effective health intervention requires mature skills in crossing cultural divides - skills in language, worldview, and health beliefs that are infrequently addressed in formal education. For this reason, INMED is offering the upcoming Cross-Cultural Competency in Healthcare Symposium. Successful health intervention with limited resources also demands unique abilities in community health assessment, managing diseases of poverty, and health leadership. The INMED International Medicine Intensive Course is an invaluable opportunity to gain these skills. So equipped, we are better prepared to be fueled by the challenge.
The third allure of international medicine touches on a deeply personal note: We want a healthy legacy. I am struck by the frequency with which healthcare professionals reflect on their experience in medical missions or free health clinics or community health centers, even years removed. Though their service was often difficult and marked by failures, it also created intense personal meaning and deep significance. And while pride did not prompt the service, they are intensely gratified that it became part of their personal history.
So how shall we respond to the allure of international medicine? For those new to the field, I would first recommend volunteering in your current community. Displaced people, minorities, and neglected citizens are almost ubiquitous. Also, seek out like-hearted individuals for collaboration and encouragement. The meld of similar conviction produces success unthinkable by those working alone. Strengthen your understanding and skills in the field. It is for this very reason that INMED exists: to so equip healthcare professionals. Finally, realize that the allure is not simply intellectual, but one that originates in our souls, and happy are those who permit themselves to be lured on behalf of those who are least served.
INMED News, September 2009
Nicholas Comninellis, MD, MPH
| CROSSING CULTURES WITHOUT BECOMING CROSS
People seeking healthcare in North America are increasingly global in their make up. Some 50 million are culturally diverse and operate with understandings of health and medicine that are unfamiliar to most healthcare professionals. Nevertheless, we must effectively understand and communicate with these individuals and families to be successful in assisting them. For this very reason, INMED is offering the Cross-Cultural Competency in Healthcare Symposium on October 2, 2009. Consider the following scenario:
In a busy emergency department at an urban hospital, a Hispanic mother sits crying in an exam room while a resident physician examines her month-old baby. The infant is severely dehydrated, and immediately is given IV fluid. Throughout the encounter, the mother is very detached, sitting across the room, and continuing to weep uncontrollably. The resident senses there must be important dynamics at play, but feels frustrated and at a loss to understand what's really happening.
This young healthcare professional is not alone. A recent survey of physicians in the Healthy Families program reveals that 71 percent believe that culture and language are important in delivering patient care. Over half also believe that their patients do not adhere to medical treatments as a result of cultural or linguistic barriers. Yet, over half of these physicians also report never receiving any form of cultural competency training.
In any number of culturally confounding situations, a most helpful question to ask is simply, "Help me to understand why..." In the case of this health care professional assisting the weeping mother, "Help me understand why you are crying," "Help me understand why your baby is ill," and "Help me understand how I can assist you." Asking questions of this sort with an air of genuine warmth and interest often reveals the concepts or behaviors that lead to ill health. This sort of tactful inquiry also preserves self-respect and may prompt patients to discover for themselves important insights or corrective actions. Lets see how our resident physician deals with this situation...
Through an interpreter, the young physician takes his time asking the mother about what is wrong. A few minutes of conversation makes it obvious that she is suffering from post-partum depression. The astute resident asks, "Help me understand why you are not nursing your baby," and discovers that the mother believes she must not nurse when she has sad feelings or thoughts, for these are caused by evil spirits that will then be passed on to the baby via her breast milk.
This resident physician was successful in bridging significant barriers between himself and this mother, calling upon essential skills like those being taught at the upcoming Cross-Cultural Competency in Healthcare Symposium. Most healthcare professionals would do very well to strengthen their abilities in this field, and when cultures conflict, remember to ask, "Help me understand why..."
INMED News, October 2009
Nicholas Comninellis, MD, MPH
Just twelve days ago our planet was rocked by a duo of disasters. A 7.6-magnitude quake struck the island of Sumatra in Indonesia, followed by shocks of similar magnitude hours later. Within moments, these geologic convulsions reduced buildings to rubble in the city of Padang, where U.N. officials estimate as many as 4,000 people could be buried. For days local citizens used hammers, chisels, and bare hands to dig through debris for survivors, hampered by heavy rain and power outages, while the hope of success was strangled with each passing hour.
Almost simultaneously, two thousand miles to the east, a deadly tsunami slammed into the Samoan Islands, burying communities under an avalanche of mud. Witnessing waves as high as thirty feet, rushing as far inland as twenty miles, inhabitants exclaimed, "We could hear the wave coming and the noise was deafening. And we could hear buildings crashing."
These calamities occupied a small segment in the North American national news, somewhere between the release of this fall's influenza vaccine and GM's failed bid to sell off Saturn. Most of us thought to ourselves, What a tragedy! And then we turned our attention to the messages in our inbox. Very quickly, these became forgotten disasters. Twelve days ago easily seems like twelve weeks ago. How quickly our attention is diverted!
I should be different at heart. My own experience of living in pre-prosperity Shanghai and war-consumed Angola should have galvanized my character into one that is more sensitive and aware of catastrophes like those that just erupted. The truth is, however, that I am just as vulnerable as anyone else to neglect the distress of humans in crisis.
But it's not only disasters that you and I tend to easily forget. Our world continues to be plagued by forgotten diseases - ones like Chagas disease and dengue fever that plague millions of persons but don't have the media draw of HIV nor the funding streams of malaria intervention.
Ultimately, however, it is not only disasters and diseases that are forgotten. It is people who are forgotten. Who are these forgotten ones? Often they are those on the margins of our societies; the poor, the sick, the prisoner, the lame, the brokenhearted; the very ones of whom Jesus spoke in Matthew 25:34-40.
This year, our theme at INMED is Serving The Forgotten. I would like to appeal to you to intentionally look beyond yourself and join with us to engage our time, our talents, and our treasures together on behalf of those who are most neglected - like those today searching for shelter in the South Pacific. With all our potential to meaningfully intervene, the greatest disaster of all would be to simply forget!
INMED News, November 2009
Nicholas Comninellis, MD, MPH
Find yourself reluctant to let go a sneeze in public? Understandable, given the nation-wide anxiety surrounding Swine Flu. Feel good when you pin on a pink ribbon? Quite appropriate, given the ubiquitous concern for fighting breast cancer. And isn't it comforting to know that today's treatments for heart disease call for stents far more often that for scalpels? These diseases are well recognized and their management well funded.
But what about the Forgotten Diseases? Now I don't mean those obscure, rare maladies that get only a fleeting mention in pathology textbooks. No, I am referring to those illnesses that today cause immense human suffering, but receive comparatively little attention or resources - those plagues that paralyze the lives of people, so very similar to you and I, but are all but unnoticed. For a moment, consider...
There exist a plethora of other forgotten diseases: orthopedic injuries, burns, hydrocephalus, river blindness (onchocerciasis), to name just a few. Thankfully, some individuals are taking action on behalf of people suffering from forgotten diseases. Marcy Lynn Coonce, a physical therapy student at Ohio State University, returned this fall from Vellore Christian Medical College & Hospital in Tamilnadu, India. Marcy writes,
- Forgotten diseases like vitamin A deficiency. Some 250,000 to 500,000 children in low-resource communities throughout Africa and the Indian subcontinent go blind each year from dietary deficiency of vitamin A. Startlingly, about half of these children die within a year of becoming blind - often due to associated malnutrition and increased susceptibility to respiratory and diarrheal infections.
- Forgotten diseases like obstructed labor (dystocia). About twenty percent of women in the process of childbirth experience dystocia - failure to progress with the natural birth process. In the setting of modern medical care, dystocia is relatively easy to diagnose and to manage. But in communities without such care, dystocia results in a plethora of complications, including hemorrhage, uterine infection, brachial nerve damage, hypoxic brain injury, vaginal fistula, and death of both mother and baby. In fact, in low-resource nations some 600,000 women and untold numbers of infants die each year from dystocia.
- Forgotten diseases like Chagas disease. This parasitic infection is caused by the protozoan Trypanosoma cruzi, and results in some 21,000 deaths each year in poorer communities of Latin America. Infection typically occurs when blood-sucking assassin bugs bite sleeping humans in their humble dwellings, transmitting the protozoa. Symptoms are deceptively insidious, yet over time individuals develop disabling cardiomyopathy, dysphagia and dementia. Unfortunately, today's medical treatments are highly toxic and often ineffective, but the disease is entirely preventable.
"I assisted with treatment for a young boy that had an old femur fracture and had not walked for at least one year. His father carried him places. His family was very poor, but we provided treatment for free. We practiced walking him and taught him exercises to strengthen his hip, lower back, and legs. By the end of just one week he was making some progress. Three weeks later he was walking independently, all after just providing the simplest of therapy interventions!"
You too can take action against the forgotten diseases, and INMED would like to assist. This month INMED is introducing the International Public Health Certificate program. This training, in conjunction with the INMED International Public Health Intensive Course, is designed to equip healthcare professionals and healthcare profession students with skills and experience to protect vulnerable communities from the recognized causes of human suffering - and from those that have been largely forgotten.
INMED News, December 2009
Nicholas Comninellis, MD, MPH
Typhoid fever. At this moment I'm caring for a youth with this disease in the highlands of Angola, Africa. The typhoid ruptured six holes in his intestine, and has nearly taken his life. He is of the Ovimbundu people, for whom life has not changed in hundreds of years. The women and children tend corn and bean crops, while men and boys do the hunting and raise sheep and cows. Endemic among them is tuberculosis, intestinal parasites, malaria, and a quarter of their children die before school age. As the Ovimbundu way of life remains obscure, so also does their plight remain unknown.
Epidemic diseases and catastrophic disasters draw our attention to people in need. It's a heartwarming testimony to the altruistic nature of humankind. But prior to such calamities, multitudes of forgotten people continue to silently struggle for existence. In the Internet age, some two billion persevere without basic housing, education, nutrition, safe water and healthcare.
Some of these forgotten people do not live far away. Nor do they mainly suffer from infectious diseases. Every metropolitan area contains pockets of those living on the margins. The Kansas City area, headquarters of INMED, hosts a great concentration of H'Mong. Originally from Laos, Burma, and Thailand, this distinct people possess deep convictions regarding health and healthcare that frequently marginalizes them.
In the Internet age, some two billion persevere without basic housing, education, nutrition, safe water and healthcare.
What can we do to assist forgotten people? First, become informed. The Spirit Catches You And You Fall Down is a provocative book enunciating the cultural barriers between divergent societies. Understanding Global Health moves beyond medical care and articulates the multiple behavioral, economic and policy factors that impact physical wellbeing. And plan to attend the Exploring Medical Missions Conference in May. It's an ideal opportunity to walk with and become inspired by leaders in this humanitarian field.
Next, make an investment. This Christmas season, invest in INMED's ongoing efforts to serve the forgotten. Become a monthly contributor , donate a vehicle or make a one-time gift.
And don't miss your chance to become personally active. INMED provides service-learning opportunities for the entire range of healthcare students and practicing professionals through our certificate programs in International Medicine, International Public Health, and International Pharmacy.
People should not remain unknown simply until disaster or epidemic strike. Please join the growing number of INMED associates in their efforts to serve forgotten people.