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  • in reply to: Graduate Certificate Week 7 Discussion Forum #62631
    Haley Nelson
    Participant

    I love and agree wholeheartedly with your response to question 2. Speaking as a medical student, I feel like students really dismiss the importance of a good physical exam and good bedside manner. We are so focused on knowing all the facts and how quickly that we can come up with a differential that we forget about the patients behind the lab results. Clinicians that demonstrate these skills to their learners are my favorite kinds of clinicians to learn from.

    in reply to: Graduate Certificate Week 7 Discussion Forum #62630
    Haley Nelson
    Participant

    Question #1: What barriers exist to expansion of faculty development programming in LMIC (low and middle income) settings?
    Other than the obvious lack of resources and personnel, I think a really important barrier to highlight is lack of educators that educate not only about medical knowledge but also cultural knowledge. You can take several cultural competency courses but until you’ve actually lived in an area it’s hard to get a solid idea of the culture. So I think it would be important to have someone who has “been there, done that” guiding students so that they can provide care to the best of their ability without having to worry about accidentally offending a patient. The FAIMER program seems to be a step in the right direction but it would still be a barrier in the countries without the program.

    Question #2: Which habit of exemplary clinical teaching is translatable to education in LMIC (low and middle income) settings? Can you provide an example of effective implementation from your own experience?

    After reading the article, I believe that all of the aspects of clinical teaching that were mentioned could be translated to education in LMIC. But the three that stuck out to me the most were Think Out Loud, Adapt Enthusiastically, and Link Learning to Caring. All of these are applicable in any setting of clinical education, but especially so when undergoing education in LMIC especially if you are not native to that area. Medical/healthcare students in general are terrified of making mistakes or being unsure of their diagnosis so it would be helpful to watch a provider walk through their history, physical exam, and the following differential. I feel this is especially helpful in LMIC where students may be encountering certain diseases for the first time. Being adaptable is also very translatable to learning and practicing in LMIC as you will have limited resources and personnel so learning how to adapt early on is a must. Linking learning to care seems like a given to me but I think it’s always important to emphasize whole-person healthcare in LMIC because you never know when you may see that patient again so it’s important to care for their mind, body, and spirit if you’re able to.

    in reply to: Graduate Certificate Week 6 Discussion Forum #62558
    Haley Nelson
    Participant

    Question 1: What additional elements would be necessary for universal health coverage to be effective?
    Universal Healthcare tends to be a controversial topic and thus there are several obstacles preventing it from being effective. In the article it discuss how many countries, political parties, etc. all have different definitions of what UHC is and thus common ground is never met. So I think the most appropriate first step would be to come to a common definition of what UHC is. Once those in power have been educated on what UHC actually entails, then ideally governing bodies could/would move from there to strategize how to provide healthcare for everyone. Furthermore, we need to make sure that we have enough healthcare providers to provide adequate care. In my mind this means doing away with applications fee’s that are a significant barrier to lower-income people wanting to enter a healthcare profession and advocating for more residencies, clinical training programs, etc. so that the students produced by these programs have somewhere to be trained after graduation.

    Question 2: What actions could improve community health workers career prospects?
    A common theme in the article was Community Health Workers expressing feelings of being undervalued and experiencing burnout. I think in order to combat this, we need to educate other healthcare providers about what exactly CHW’s are and how much benefit they provide, especially in LMIC. I personally never knew what exactly a community health worker was until this class so I can imagine that many western physicians, nurses, etc. traveling to LMIC to help don’t either and thus don’t really appreciate the monumental role that CHWs play in the wellbeing of these communities after these short-term providers leave. In the same vein, as providers, we need to be advocating for the adequate compensation of CHWs. One can become a CHW because of an immense love for their community but the position still has to be sustainable employment in order for CHWs to want to stay long-term.

    in reply to: Graduate Certificate Week 6 Discussion Forum #62557
    Haley Nelson
    Participant

    I really like your approach to question 1. I think people fail to realize that we can have limitless amounts of policy change and financial backing but if you don’t have an adequate number of physicians then Universal Healthcare can never be realized. So maybe an appropriate first step towards UHC would be making medical school, nursing school, etc. more affordable and providing more training programs so we can grow the healthcare profession so that we can actually provide care for patients.

    in reply to: Graduate Certificate Week 5 Discussion Forum #62486
    Haley Nelson
    Participant

    I agree with your answer for question 1. There is no better way to learn about a culture than by being taught by a person from that culture. In addition to this, the educator could bring in people from the local culture to further educate the students about the community that they reside in.

    in reply to: Graduate Certificate Week 5 Discussion Forum #62345
    Haley Nelson
    Participant

    Question 1: What actions can healthcare educators take to help their learners to reduce cross-cultural barriers?
    First and foremost, I think healthcare educators needs to encourage their learners to be actively open-minded, which sounds like a given but it’s very easy to slip into a way of thinking that you’re comfortable with. So I think being aware of your own biases is an important first step. Educators can also provide a brief history of how the medical field and various patient populations in an area have interacted, so learners can have a better idea of the dominant and then also the less prominent cultures in that area. It would also be beneficial to provide a brief overview of the cultural norms of the relevant minority cultures in that area, not only to provide cultural education but also to teach the learners how to educate themselves on any new cultures they come across.

    Question 2: What prevention/interventions could best help reduce consequences of complex humanitarian emergencies resulting from wars?
    The second article focused on several ways that countries can prepare for and react to humanitarian emergencies. In my opinion, the two options that would have the biggest impact would be to one, prepare a generic plan for humanitarian emergencies and two, to train health staff/increase education programs. Planning ahead of an emergency allows the reaction to it to be much simpler when it is put into play as all of the complexities of reacting to an emergency have been thought out beforehand. This then allows the government, rescue groups, etc. to focus on the people that have been hurt/displaced/etc. when an emergency does occur. Furthermore, increasing education programs allows people in the community to participate in the plan before the emergency occurs, increasing the likelihood that the emergency plan will be followed. An education program would also help to decrease the panic that ensues after an emergency which could then decrease the breakdown of communication and institutions that commonly occurs when communities are unsure how to proceed after an emergency.

    in reply to: Graduate Certificate Week 4 Discussion Forum #62284
    Haley Nelson
    Participant

    I agree with your reasoning for question 2. I think healthcare globally focuses heavily on reactive interventions of disease and doesn’t focus enough on preventative medicine when in reality that is what could solve/prevent many health issues.

    in reply to: Graduate Certificate Week 4 Discussion Forum #62283
    Haley Nelson
    Participant

    Question 1: What actions are most important to improve global nutrition?
    This article addresses the potential for advancing the prevention of malnutrition based on increasing certain micronutrients in the diet, such as choline, but it acknowledges that there is not yet enough information to make any standard recommendations on any one micronutrient. After reading this article I think that one of the most beneficial ways we could improve global nutrition would be to advocate for international policies that encourage growing crops in a sustainable manner both industrially and individually. Providing families with the seeds to grow crops would be sustainable way to provide food for their families. However, international agriculture is often super focused on churning out crops for export that deplete the soil of it nutrients, essentially ruining any chance of further crop growth and providing food for the locals. So I think advocating for policy that promotes sustainable crop growth and providing seeds for families in need would definitely be a step in the right direction regarding global nutrition.

    Question 2: In your opinion, what are today’s greatest obstacles to progress in global health?
    In my opinion, the largest obstacle to progress in global health is greed. Food companies produce nutrition-less food, snacks, etc. that they sell at a cheap price in areas where they know that the average family income would not allow these customers to travel to other stores to find better quality food. These families buy these food items because they need to feed their families and they have limited food options and in the end, they end up ruining their health because of it but they most often do not have any other option. Additionally companies that import food from other countries often indirectly promote non-sustainable crop growth in order to meet the demand for the crop. Overall I think we need to shift the focus back towards sustainability and providing resources for communities that would allow them to create their own source of nutrition rather than having to rely on the food options that don’t have any nutrients in them. Ensuring proper nutrition all over the world would help with all of the issues of communicable, non-communicable, and chronic disease as proper nutrition sets up a foundation for the human body to take care of itself when given the proper nutrients.

    in reply to: Graduate Certificate Week 3 Discussion Forum #62202
    Haley Nelson
    Participant

    Question 1: Which, in your opinion, are the two most powerful pathways to improving infant growth in lower income communities?
    I believe that the most powerful to improve infant growth in LMIC is to start at the root cause, ensuring the health of the mother. This includes not only making sure the mother is eating properly and is educated about breastfeeding, but also screening her for conditions that are known to cause issues with the baby such as hypertension, diabetes, HIV/AIDS, or other diseases that can be vertically transmitted. I think if mothers and communities are educated on the harm that can come to their children due to their lack of care for themselves, they will be much more willing to get their conditions treated. Another way to improve infant growth in LMIC would be to increase the education about what malnutrition in infants looks like and the long-lasting impacts of it. Many mothers may not be aware of how much or what kind of food their baby needs to eat.

    Question 2: In the context of India, what are potentially the most powerful interventions to broadly improve maternal health?
    In the context of India, I think the most powerful intervention would be the promotion of general education of women. An education would allow these women to increase their chances of employment, giving them fiscal power and autonomy to make decisions for themselves rather than blindly following what their family/partner says because they have no other choice.

    in reply to: Graduate Certificate Week 3 Discussion Forum #62201
    Haley Nelson
    Participant

    Marion, I really like your question 1 rationale. I agree that if we educate and encourage pregnant women to nourish themselves in the context of nourishing their baby, they and their families are much more likely to pay more attention to maternal health. Women in developing countries often put their health last in order to care for their families and I think if we educate them that nourishing themselves is nourishing their family they will be much more willing to listen.

    in reply to: Graduate Certificate Week 2 Discussion Forum #62144
    Haley Nelson
    Participant

    I really like your focus on the education about the symptoms and treatment TB. Educating communities is one of the more simple and cost effective ways that we can combat TB in patients that live in impoverished communities. The education can also either be done by healthcare providers on a global health mission or by community members already living in that area, making it one of the more accessible options.

    in reply to: Graduate Certificate Week 2 Discussion Forum #62105
    Haley Nelson
    Participant

    Question #1: From your perspective, why are people living in poverty most likely to suffer from TB, and how should this fact influence efforts to control the disease?
    In my opinion, people in poverty are more likely to suffer from TB because they often live in multi-family homes and they often do not have access to medical care, either due to lack of finances or lack of transport to receive medical care. Because of this, I believe that the global effort to treat and prevent TB needs to identify these poverty stricken areas within the countries where TB is prevalent and send the most support there. With other disease of poverty, there has been an improvement whenever a community member is trained to recognize symptoms of disease, as well as how to diagnose and treat said disease, so something similar to this could be implemented for TB. Obviously the TB treatment is long-term so it would likely require a local clinic rather than just a single person.

    Question #2: What, in your opinion, are two interventions that would be most effective against neglected tropical diseases?
    This article reviewed the 5 top public health interventions recommended by the WHO. In my opinion, the most important intervention among them is ensuring access to clean water. Water is one of the most essential things in life so if there isn’t any clean water to drink, people will drink whatever is available and this is often how people develop NTDs. Along that same vein, another intervention I believe is extremely important is the presence of sanitary bathrooms where the flow of waste doesn’t affect the potable water supply. Several NTD’s are transmitted via the fecal-oral route and even if there is a water filtration system, there is a chance that these organisms can still end up in the water if people are using the bathroom in the same place that they get their water from.

    in reply to: Graduate Certificate Week 1 Discussion Forum #62063
    Haley Nelson
    Participant

    Question #1: What system-wide changes, in your opinion, would most successfully increase world-wide food security?

    Increasing world-wide food security is a multi-faceted issue that unfortunately cannot be solved with a single solution. However I think a solution that would be extremely impactful is the implementation of better roads/modes of transit in areas of food insecurity. Improving roads would allow more efficient and effective dissemination of seeds, fertilizer, etc. for farmers to use and also for the same farmers to distribute their crops. Better roads would also make it easier for community or international organizations to come in and provide support to these communities. Obviously this is a solution that would work in a perfect world, which we are far from, but it could still be impactful.

    Question 2: What do you believe are the most substantial barriers to global measles elimination, and how can these be overcome?

    I believe the most substantial barrier to global measles elimination is lack of access to culturally competent medical care and vaccine education. We are taught in medical school that the first step and one of the most important steps in a patient interaction is developing rapport with our patients. If strange individuals come to a community of people who look nothing like them and have never interact with them before, it’s highly likely that there will be hesitancy to believe anything that the newcomers say. I believe this can be overcome by providing cultural education to those that participate in global health outreach. Furthermore, healthcare providers could educate a select few locals about vaccines, etc. and then allow this community person to bring that information to their own community rather than an “outsider.”

    in reply to: Graduate Certificate Week 1 Discussion Forum #62060
    Haley Nelson
    Participant

    Megan, I agree with your thought process for question 2. We can create all of these vaccines that help eradicate disease but they are of no use if we aren’t able to get them to the people who need them. I think it’s also important to recognize that we should be providing culturally competent vaccine education in an effort to establish rapport with the communities that we are trying to bring vaccines to.

    in reply to: Introduce Yourself Discussion Forum #62033
    Haley Nelson
    Participant

    Hello! My name is Haley Nelson and I am currently a second year osteopathic medical student. Prior to medical school I was a CNA for four years and I have volunteered in healthcare since I was 14.
    I am taking this course because I have always been interested in global healthcare and providing care for underserved individuals both domestically and internationally. I went to Cuba last summer for a week on a global health trip and I’m hoping that this course will prepare me to possibly complete an international rotation in the future.
    I’m hoping to complete either an internal medicine or psychiatry residency in the future.

Viewing 15 posts - 1 through 15 (of 15 total)