bulletin - Allegheny County Medical Society

More documents

Recommendations

Info

○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○MEDICAL STUDENT MUSINGSProviding a Forum for ExpressionALAN ROSENBAUMThis past summer I found myselfin Tanzania, a nation known forbeing one of the more stable, accessibleand beautiful places on theAfrican continent. Home to thebeaches of exotic Zanzibar, theheights of Mount Kilimanjaro andthe wilds of the Serengeti, it is nosurprise that Tanzania is such apopular destination to those who arewilling to sacrifice some of thecomforts of home.I was drawn to Tanzania by anopportunity to volunteer in a ruralgovernment-run health dispensary inthe small town of Kwala. When Idiscovered that even GoogleEarthcouldn’t pinpoint the location ofKwala, Tanzania, I knew it was timeto purchase the plane ticket. I hadhoped that working in a sub-SaharanAfrican rural setting would be anexciting opportunity to learn adifferent kind of medicine from whatI was accustomed to in westernhospitals, but by the end of thesummer, I had discovered that it wasreally the same.Upon arriving, I toured thevillage to become familiar with mynew surroundings, navigating the dirtpaths that surrounded the only road.I eventually came across the dispensary,a cement and sheet metalbuilding consisting of a large, openwaiting room, a few small closets,one examination room, a basic laband an open-air doctor’s office. Thewindows had horizontal metal barsthat lacked any glass, permitting theoccasional gust of wind to give theworkers a reprieve from the heat,although the bars also allowedinsects, birds or bats to swoop in andout. In fact, a space under the roofwas a favorite haunt of bats; despiteattempts to remove them, theirpresence persisted. The floors werecovered with pervasive dust and dirt,making it appear as though the dull,gray cement was covered by a browncloak. The ceiling was littered withspider-webs, and throughout theday’s work I could turn my eyesupwards and witness the demise ofsome unfortunate creature thanks toa spindly-legged arachnid. It wasevident that the walls were painted atsome point, but over time chunkshad disintegrated away, leaving gapsin the finish. In the sole examinationroom, the walls had been splatteredand stained with various liquids overthe years, as if it were the setting of agory video game. Indeed, the aestheticsof the dispensary were more akinto a haunted house than a health carecenter.Working there certainly met myexpectations and, throughout thecourse of my stay, I saw manyconditions that were relatively aliento me: terrible infections, cripplingtraumatic injuries and debilitatingdevelopmental disorders. While that12 Bulletin : January 2011
MUSINGSarea shares common diseases foundthe world over, those ailmentsseemed all the more intimidatingthere. Often patients lacked access tohealth care, so their illnesses festeredand advanced; they might havedelayed seeking treatment until theirstate was unmanageable, waiting untiltheir condition became incapacitating.To make matters worse, it wasnot uncommon that their ailmentshad been complicated by a prior visitto a tribal healer or witch doctor.Within days, it was clear that alarge proportion of cases seen at thedispensary fell into the category ofsexually transmitted infections (STI).STIs are a familiar foe in Tanzania; anestimated 7 percent of her people areinfected with HIV, and Kwala is noexception, with 0.5 percent of thevillage residents being registered asnew cases of HIV annually. Mostconcerning was that it was often thesecondary school students whosought care at the dispensary for STIsymptoms. As a result, I decided tospend the summer creating andimplementing a sexual educationcourse in order to contribute to theprevention of diseases that werecausing so much suffering in thecommunity.After obtaining the support ofthe school administration and localcommunity, I was ready to begin thelessons. The students were divided bysex and age, and at the differentsessions I was accompanied by aphysician or teacher to serve as atranslator. Their participation wascritical because the material was tooimportant to risk the language barrierbecoming an obstacle. It was imperativeto create a comfortable environmentfor the students, and translatorsgreatly facilitated that goal. I wasentirely satisfied that we had accomplishedthis based upon the amountof questions that our talks produced;every seminar prompted at least 15-20 questions.The inquiries from the studentscovered every topic I had hoped todiscuss and more: Can you get HIVor get pregnant from anal sex? Is itsafer to be abstinent or use condoms?Can you use a plastic bag instead of acondom? Can I play football withsomeone who has HIV? The prevailingtheme was that the students werecurious about the subject and thatthere had never before been a venuein which they could find answers totheir questions.Our discussions displayed whatmakes the doctor-patient relationshipso unique; the patient discusses hiscuriosities, secrets, concerns and fears,no matter how personal or embarrassingthey may be. Despite the vastdifference between the challengesfaced by Tanzanian medicine comparedto our own system, the fundamentalprinciples and essence of theinteraction remained the same. Of allthe roles a physician plays, I’ve foundone to be the most important:providing a forum for patients toexpress issues that they cannotelsewhere.○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○○Mr. Rosenbaum is a second year medical studentat the University of Pittsburgh. He can bereached at rosenbaum.alan@medstudent.pitt.edu.The opinion expressed in this column isthat of the writer and does not necessarilyreflect the opinion of the EditorialBoard, the Bulletin, or the AlleghenyCounty Medical Society.Got Something to Say?If you’re an ACMSmember and would like towrite a student or residentcolumn, call Linda Smithat (412) 321-5030, x105 ore-mail lsmith@acms.org.Tracy L. Prizant, M.D.announces the opening ofPRIZANT DERMATOLOGY Providing complete general dermatology and dermatologicsurgery services including pediatric, adolescent, adultand geriatric care.January 2011 : Bulletin13
Page 6 and 7: ○ ○ ○ ○ ○ ○ ○ ○ ○
Page 8 and 9: What Does ACMS Membership Do For Me
Page 10 and 11: ○ ○ ○ ○ ○ ○ ○ ○ ○
Page 14 and 15: Need an antidotefor high-cost,low v
Page 16 and 17: 16 Bulletin : January 2011
Page 18 and 19: USI AffinityService You Can Count O
Page 20 and 21: 123We will help you withyour diagno
Page 22 and 23: ○ ○ ○ ○ ○ ○ ○ ○ ○
Page 24 and 25: Look for details in the February Bu
Page 26 and 27: ○ ○ ○ ○ ○ ○ ○ ○ ○
Page 28 and 29: Doctors and Patients. Preserve the
Page 30 and 31: ○ ○ ○ ○ ○ ○ ○ ○ ○
Page 32 and 33: FEATURE (from page 31)Ralph Schmelt
Page 34 and 35: FEATURE (from page 33)Drs. Maryann
Page 36 and 37: ○ ○ ○ ○ ○ ○ ○ ○ ○
Page 38 and 39: ○ ○ ○ ○ ○ ○ ○ ○ ○
Page 40 and 41: ACMS BOARD OF DIRECTORSThe Alleghen
Page 42 and 43: CLASSIFIEDSFOR RENTMEDICAL OFFICE,
Page 44: Malachy Whalen & Co., Inc.Visit www

bulletin - Allegheny County Medical Society

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?