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Nicole, I like how you pointed out that universal healthcare has cons like increasing wait times, shortage of physicians, etc. There are many benefits to increasing healthcare access for all, but I think there are a lot of aspects that need to be taken into account for the system to be effective.
Question 1: What additional elements would be necessary for universal health coverage to be effective?
As the article mentions, adequate healthcare is not only about resources within the hospital and clinic setting or the amount of tests that can be run to make a diagnosis. Access to healthcare coverage must begin with qualified and trained physicians or healthcare professionals who are present, knowledgeable and willing to care for patients within their community. Increasing access to healthcare providers would put less strain on the healthcare system as a larger team is able to care for a greater number of patients. Moreover, increased numbers of providers allow them to spend more time with their patients, whether this be for increased time per visit or more visits in general per patient, which in turn allows for greater discussion of healthcare measures such mental/emotional health and preventative care. I have heard many times throughout my first year and half of medical school that the most important aspect of caring for a patient in hopes of making a diagnosis is by gathering a good and detailed history and physical. Numerous tests can be ordered but nothing is as good as talking with face-to-face with the patient about their concerns. In modern medicine today, this valuable time is cut short due to hospital/clinic protocol on the number of patients scheduled per day and the amount of time given to the provider for each patient. Having more skilled and qualified professionals in primary care would decrease the need to cut each of these visits so short.
Question 2: What is the most appropriate role for community health workers in your particular community of interest?
I am unsure about where I will end up some day but I am very passionate about primary care. Growing up in a rural farming community, I saw the importance of having access to a primary care physician. My doctor served patients from several small surrounding towns, many of whom drove 30-45 minutes to see him as he was the closest physician. Various specialty physicians would visit this rural hospital 1-2 times per month, and this was the only access to specialty care that many patients received as they were not able to drive to the larger town for routine specialty care. Community health workers are essential to provide care to those in areas where medical services are less accessible.Casey, I agree with you on the fact that our current pandemic demonstrates our preparedness for disaster. We currently are in a reactive state in a day-by-day situation. If we had better prevention methods or a disaster team/plan put in place from the beginning, maybe the current state of our country with COVID cases would look a little different.
Question 1: What prevention interventions could best help reduce consequences of complex humanitarian emergencies?
I think the best way to reduce consequences is by decreasing infectious disease outbreaks alongside humanitarian emergencies. Decreasing disease outbreaks begins with looking at ways to decrease illness or infection in the first place. The best possible means for disease prevention is to vaccinate against diseases that typically cause these outbreaks and exacerbate an emergency caused by disaster, unrest, or other means of governmental destruction. As stated in the article, consequences of humanitarian emergencies are typically due to vaccine-preventable illnesses. Providing increased awareness about the importance of vaccines and routine visits to administer them to patients on a large scale would be the first method in prevention.
Question 2: Why, in your opinion, is disaster prevention minimized in comparison with disaster response?
I think disaster prevention is minimal because it is more difficult to carry out that disaster response. When a disaster hits, very tangible items like food, water, clothing, shelter, physical labor can be sent to the specific location to help “clean up the mess”. It is easy for us as humans to respond to a disaster with the desire to care for those who were negatively affected. However, disaster prevention is minimal because it can seem intangible. This involves years of education, planning to make sure that infrastructure can withstand disaster specific to each location, and designing protocols for disaster response teams.Nicole, I think it is great that you are teaching your peers about Hispanic culture and helping them to learn Spanish. Although it may feel like these students never get to use their medical Spanish or that it might be difficult to learn at this time, these students will undoubtedly come into situations in the future where they will be grateful for the knowledge that took away from that course.
Question 1: What actions can healthcare providers take to decrease cross-cultural barriers?
I think the first step to decreasing cross-cultural barriers is asking people if they have any practices, customs, or beliefs that they would like to implement into their healthcare experience. Too often, I think physicians go about their routine without taking a moment to stop and ask the patient what is most important to them. People of different cultures view medical care in many different ways, and asking can be the first step in understanding. Being able to communicate in the patient’s language also puts them more at ease and shows openness about their background or culture. There may be a good chance that you don’t speak the native language, but with such advanced technology in this day and age, virtual interpretation is typically provided by most hospital systems. If in a rural setting, trained interpreters may also be available to help overcome that language barrier.
Question 2: Describe how short-term healthcare trips came become more effective.
Short-term trips allow healthcare providers to go to an underserved area that has a lack of medical care, whether due to poor infrastructure, lack of skilled professionals, lack of resources or education, etc. An impact can be made in an area, no matter the length of time. However, I think that if the trips are short term, like only a week or 2 at a time, follow up trips should be scheduled for consecutive months or years. Continually visiting a certain area establishes trust with the people of that community. It allows the providers to become more accustomed to that culture’s practices, beliefs, or rituals. I also think it develops relationships with providers in the area, and they can come provide care alongside the team who is going in only for a short time. Working with local healthcare providers can indicate respect for the community for which your team is entering into. I went on a medical mission trip near Lima, Peru for a spring break trip in college. Although this was short trip, we worked with Peruvian doctors and medical students seeing patients in the “clinic” within a local village. I was able to learn a lot about the structure of their healthcare system, common medical concerns among the people due to their way of life, and how a physician-patient relationship looks like in their culture. The group that I traveled with has an established relationship with that village outside of Lima, and the people were very excited and grateful for our group to be back once again.Hi Alice,
I do agree with your point that over-nutrition is a major problem here in the US. We are well aware of that fact that there is an obesity crisis in our country, but it doesn’t seem like much is being done to correct that from a food standpoint. For example, fast food restaurants serve food in quantities that are much larger than an actual serving size. Reducing portion sizes at these restaurants could be the first step in addressing the issue of overconsumption.Question 1: What actions are most important to improve global nutrition?
A very important and easy way to improve global nutrition is by educating communities on the necessity of attaining a balanced diet, if possible. One of the videos in the lesson on malnutrition in children stated that resources are present to feed the children, however, mothers were unaware at how much protein the young children need to consume. In this particular instance, malnutrition could be prevented by supplementing the porridge with protein food sources that are currently available in their region. Moreover, education about proper food handling and preparation could provide ways to mitigate disease and infection spread from contaminated food. The article discusses many of the negative affects that contaminated food sources have on a community and among individuals. Being malnourished makes consuming contaminated food even more of a concern as the body’s immune system is weak and doesn’t have the proper defenses that it would if well-nourished. Both of these methods of education would be at low cost since they discuss ways to improve malnutrition and food safety with the resources that are within access to these people already.
Question 2: In your opinion, what are today’s greatest obstacles to progress in global health?
I think a major obstacle to progression in global health efforts is war and conflict in developing countries. Unrest disrupts the local government, health systems, schools, and businesses within a community. This interferes with people receiving preventative healthcare measures like vaccines or screenings against infectious diseases. Pregnant mothers aren’t able to get to their prenatal visits. Infants may be born at home and not be able to be seen by a healthcare provider for initial checkups. When children are taken out of school at an early age due to unrest in their country, they miss out on many years of valuable education, especially from a public health standpoint. I think war and unrest is a major obstacle for global health strategies to be implemented, carried out, and transformed among generations.Hi Nicole,
I agree with the fact that not all locations will be able to provide machines like incubators as these can be very costly. Assessing the needs of each community and then tailoring the improvements to each location by spending less money on equipment or being resourceful is key.Question 1: What actions should be taken, in your view, to increase availability of basic newborn resuscitation in low-resource communities?
Educating providers on warning signs of asphyxiation and the need for resuscitation is the number one step in low-resource communities. This will allow providers to be aware of when intervention is needed most to save a newborn’s life. Education has been accomplished in some ways by providing the Neonatal Resuscitation Program and, further, “Helping Babies Breathe”. Providing this curriculum and educational tools is essential for providers to be aware, receive training, and implement their learned skills to save lives within the most critical time of a newborn’s life. Not only should providers be educated on a one-time basis, but continuing education is important as resuscitation is a skill that can be forgotten how to implement properly if not used frequently. On another note, at-home labor still frequently occurs in low-resource settings; educating mothers on the benefits of having their child in a birthing center or hospital could be the factor that saves the newborn from delivery complications.
Question 2: What is the mechanism, in your opinion, through which WASH and promotion of nutrition complement one another?
I think these two efforts complement themselves in ways that encourage healthy eating and a safe way to do so. Having a well-balanced diet or eating as many fruits and vegetables is key to getting as many vitamins and minerals from the natural source. However, if the food is not properly cleaned or the preparation area is full of contamination, the benefits outweigh the risks. Therefore, teaching about hand washing, sanitation, and water alongside nutrition will benefit in the long run by preventing illness, for example. Moreover, children get excited when they learn a new skill or reach the age where they feel quite independent. Promoting WASH and nutrition will empower children at a young age to learn skills that will profit them throughout their lifetime.Casey, I like what you pointed out about mothers acting as the head of the household in times of conflict. This is something that never really crossed my mind. I agree that it is such an added burden for a mother to care for the rest of the family, including both children and elders, and that her personal care may get set to the side.
Question 1: What do you believe are the most direct impacts of conflict upon the health of pregnant women?
I think that the most direct impact of conflict on the health of pregnant women is the difficulty of receiving the healthcare that they need throughout pregnancy. This could be due to a lack of hospitals or clinics within travel distance of where they live. On the other hand, it could be the fear of leaving their home to walk to the clinic due to the conflict present on the street. This could be a life or death decision. Even if these mothers receive one checkup throughout their pregnancy, many preventable or treatable illnesses could be missed from lack of being able to receive routine care. This could lead to pregnancy complications that end in maternal mortality at the time of birth. Moreover, women in areas of conflict may have to deliver at home and don’t have a skilled medical team to assist with the delivery.
Question 2: In your opinion, how should maternal healthcare be best expanded to protect women throughout their lives?
One way to expand maternal healthcare is by putting an emphasis on annual women well-check visits to assess their current health status. I think these annual visits are important at any stage in one’s life as it provides the patient with opportunity to discuss any health problems they may be experiencing. I think that some women may shy away from going to the doctor because they don’t think their symptoms are “bad enough”. This may especially be the case in areas of poverty or with a lack of a healthcare system. Furthermore, having an annual visit allows the physician to perform a physical exam that may identify disease that the patient may have thought was a normal variant. Routine checks could include blood work, pap smears, breast exams, etc. It is important for women to maintain their health outside of just pregnancy.Autumn, I like how you pointed out that pregnancy can be a dramatic change in a woman’s life and it can be overwhelming. I would agree that negative stigma placed on a woman, especially if a single mother, along with new responsibilities can affect their prenatal and perinatal care with regards to HIV screening and treatment. Having screening protocols in place or at least identifying a need to test for HIV during the pregnancy can overcome this barrier.
Question #1: From your perspective, what are the largest remaining barriers against worldwide HIV control?
I think one of the largest barriers to HIV control worldwide is awareness to those who are infected with this disease. Many people may be living with HIV but not know due to the inability to get tested since there may not be routine HIV screenings or testing sites in their country. The first step to controlling HIV transmission is identification of infected individuals so that they may begin antiretroviral medication as necessary. Factors that contribute to unidentified cases of HIV include no current disease symptoms, poverty, no access to quality healthcare, negative social stigma regarding the disease, multiple sexual partners, and lack of testing if healthcare is available. Increased education and resources would help to overcome this barrier in worldwide HIV control.
Question #2: Why, in your judgment, is pediatric HIV control lagging behind that of adults and what should be undertaken to reverse this status?
I think one major factor that affects pediatric care in regards to HIV is the lack of testing protocols in place for children. Adults are more likely to be screened for HIV or are able to seek out treatment and care when needed. However, children need medical providers to take action to screen at birth or at follow-up visits. Without protocols in place to identify those infected, children in need aren’t able to receive proper medical care. The article also mentioned that individuals may fall through the cracks; I think that this is an unfortunate reality that can happen in medicine as it takes a team of providers to implement control and take action against a disease.