BUFFALO, N.Y. -- A diagnosis of acute appendicitis, based solely
on clinical observation. A mother’s reluctance to undergo
Caesarean section based on cultural beliefs about going through
labor. An interest in birth control methods that don’t
require a husband’s approval.
These are a few of the dramatic clinical experiences that
University at Buffalo medical students will discuss on March 13
from 6 to 8 p.m. in Room 125 (Lippschutz Room) of the Biomedical
Education Building on the South Campus.
The event, “Global Health Electives and Medical Relief
Projects,” aims to promote volunteer medical opportunities
available to UB medical students and to educate them about some of
the situations they may encounter overseas.
“Interest in global health is definitely up at UB,”
says David Holmes, MD, director of global health education and
clinical associate professor of family medicine in the UB School of
Medicine and Biomedical Sciences. He says that about a quarter of
all UB medical students participate in an overseas medical program,
up from the teens a few years ago.
At the March 13 event, four UB medical students will show slides
and describe working at clinics in the Democratic Republic of
Congo, Uganda, Lebanon and Peru. Two residents in UB’s family
medicine program who recently staffed clinics in Haiti and Mexico
also will make presentations.
In her first year at UB, Julie Garchow, now a fourth-year
medical student, became co-president of UB’s International
Health Interest Group, working with several like-minded classmates
to help facilitate overseas rotations.
“We wanted to make it as easy as possible for medical
students to do global rotations,” she says. Members also
gather regularly to discuss issues in international health.
The value of these overseas rotations is hard to overstate, she
explains. Last month, she returned from spending four weeks in
Garchow and two UB classmates worked in a hospital’s
maternity, pediatrics and adult internal medicine departments.
Because of the lack of medical practitioners of all kinds, the
medical students are called upon to play a more active role, under
supervision, in an overseas clinic than they can in the U.S.
“In the U.S., a medical student wouldn’t get to do
first assist on a C-section because that’s what the interns
and residents will do,” Garchow says. “So when
you’re a medical student you’re usually delivering the
placenta, not the baby. But in Uganda, we were able to do first
assist on C-sections. We had the opportunity to have more
responsibility, all the time under supervision from a
The students also worked with many HIV patients with
comorbidities, including malaria and typhoid. “You see
diseases that you just don’t see here in the U.S.,”
says Garchow. While working with HIV patients in Uganda, she
developed a color-coded labeling system for HIV medications to
enable patients with minimal literacy to know what to take when,
even if they couldn’t read the instructions.
The experiences drive home how powerfully culture and personal
experience can impact medicine. While working at a remote mountain
clinic in Haiti, sponsored by Heart to Heart International, an
international medical relief organization, UB family medicine
resident Alisha Razack optimized an older woman’s
hypertension medications and recommended some blood tests. The
medications are provided for free by Heart to Heart. The
woman’s adult son was so thankful he broke down and cried,
sharing his story with her, how his father had died of cholera, and
how he was trying to care for his mother.
Sometimes the cultural differences directly influence how
receptive a patient is to medical care. “One woman needed an
emergency caesarean delivery, but she didn’t want it,”
Garchow recalls. “We thought she was just scared, but then we
found out that in her culture, people believe that if you
don’t push the baby out, you’re not a woman. In that
culture, laboring is a badge of honor.” With
encouragement and support, the mother did undergo the procedure and
delivered a healthy baby.
Students are expected to pay for their travel and
accommodations, but student fundraising efforts at UB are helping
to offset these costs. This year, a group of first-year medical
students are raising funds to send a group to a clinic in Haiti;
they were so successful in raising funds that they have money to
spend on medications for the clinic as well. Another UB group of
second-year students is going to Panama this spring to work with
Floating Doctors, which provides free health care to isolated
Holmes began leading overseas rotations with UB medical students
in the late 1990s. Since then, he has led UB medical students on
medical rotations in Haiti and the Dominican Republic; he has also
done medical missionary work in Kenya, India and Costa Rica.
“Dr. Holmes is our biggest cheerleader,” says
Garchow. “When we wanted to start the International Health
Interest Group, he and the Department of Family Medicine said,
‘Tell us what you need. We’ll help you.’ Karen
Devlin, the department’s program coordinator, also has been
extremely helpful and helps coordinate all the details.”
UB medical students interested in volunteering overseas and in
the International Health Interest Group should contact Karen Devlin
in the Department of Family Medicine at 829-2608, firstname.lastname@example.org or
Holmes at 716-697-1884, email@example.com.