Week 2

Today I met physicians from abroad: one from the UK and one from Canada. They are surgeons, here for two weeks, assessing complicated patients, and scheduling the necessary ones for the operating room.

The issue of sustainability in global health is one that I became familiar with during medical school. NU-AID, a student group I worked with first and second year, sent one-week long mission trips to Jamaica and Nicaragua biannually. An enthusiastic but naive student I have to admit I had not thought much about the issue of sustainability when I first joined NU-AID. I realized that a one week clinic would not solve chronic conditions such as diabetes and hypertension... and cooperation with the local health-care workers is an absolute must. I wondered though, if not sustainable, were these trips at least doing some good? If there is nothing else offered to these communities, could it be doing harm? These are questions I do not have an answer for yet.

I think the doctors I met today represented a model of global health that I believe is sustainable and one I could potentially follow in my future career. They come for a short time, yes: two weeks. (Most physicians in the US do not have the time or resources to do an extended trip unless going abroad is a part of their job). The surgeries they do are finite-- they typically do not require repeat procedures and there are no complicated post-operative requirements. Most importantly, they work with the local residents and physicians while seeing the patients. Mulago residents worked with the physicians, examining the patients together and coming up with an operative plan together. A lot of teaching went on and I have no doubt the residents benefited from the presence of these foreign doctors. One of the physicians had been coming to Mulago for the last 13 years and they were even collecting records from previous surgeries to compile the data for outcomes analysis. This is probably the most "sustainable" model of global health I've seen to date and one in which I have the most confidence in its "good". After almost four years of medical school I'd like to believe I'm still enthusiastic and slightly less naive. I wonder if in 10 years I'll look back on this and agree.