 I traveled to Uganda this past summer and had a chance to both shadow in rural and city clinic settings as well as assist a HIV research project at the Mulago-Mbarara Teaching Hospitals' Joint AIDS Program. The wonderful thing about traveling abroad is that no matter who you are or what your interests are you will come away from the experience with a new appreciation about a different culture, a different system, and a different way of life. Objectively, I had a chance to improve my computer skills by creating and implementing a database to collect patient time flow data at HIV clinics in the capitol city of Kampala. Like much of sub-Saharan Africa, Uganda has an overwhelming burden of HIV illness compounded by issues of prejudice, ignorance, and a lack of resources. 25% of the estimated 1.1. million HIV infected patients are in care. Accordingly, there is an urgent need for rapid scale-up of HIV clinics and I worked on the initial phase of this research project entitled, "Evaluating models of care for clinic efficiency, quality of care, and cost-effetiveness" to track baseline measurements of how much time patients spend at the clinic and how they spend their time. This introduced me firsthand to a variety of key issues surrounding HIV care in Africa including the regulations that PEPFAR places on who it will supply with ART, issues in many of the religiously based clinics on subjects like sexual practices and counseling, and simply the staggering load of patients at these clinics, and the obstacles they face in even getting to clinic. Indeed, medicine is not just biology and the patient in front of you, but an intersection of politics, religion, and societal values and practices. Moreover, beyond the realm of anything even remotely medically related, I think there was such a wealth of lessons to be learned from fellow medical students, patients, doctors, and the people you end up meeting. Although both the similarities and differences I noticed in culture and beliefs are too numerous and sometimes individually insignificant to count, I think that every realization and insightI gained had its role in changing how I view the world, and how I view myself as a part of it. At the risk of sounding overly idealistic (but I'm going to do it anyway), in short I felt that my experiences renewed the overhanging "purpose of it all" and in the spirit of Obama's inauguration speech reminded me that we can choose to be a part of something bigger than ourselves. I learned so many things both medically and non-medically, and I do think that my trip not only reinforced my commitment to pursuing a career in global health, but also gave me insight into how to be a better doctor. | |
