Globe Trotters: Coming to an ER Near You

Dr. Luke Husby evaluating a patient in a mobile clinic in rural Uganda.

Dr. Luke Husby evaluating a patient in a mobile clinic in rural Uganda.

Palmetto Health Emergency Medicine Residents are finding that the skills they have learned during their residency in Columbia are making lasting impacts across the globe. The EM department has 13 residents participating in global health trips during the 2015-2016 academic year which are as varied as teaching emergency medicine to physicians in India, treating patients in mobile clinics in Tonga and Nicaragua, training Tanzanian physicians to use bedside ultrasound, and managing emergencies in Haiti’s only critical care hospital. As global health opportunities such as these become increasing available, more of our residents are participating, even if it means they are using their vacation time to do so. Nearly all of the EM residents are participating in some type of global health experience during their residency with increasing movement towards longer term, sustainable activities. The EM department is also forging partnerships with hospitals in rural Uganda and Tanzania to improve patient care and knowledge exchange.

Global health electives provide residents with exposure to disease pathology rarely seen in the US and experience practicing medicine in resource constrained environments. As one of our recent graduates Dr. Jo Innes noted, treating the same condition in Haiti and the US varies greatly, but not necessarily the outcome. “A patient in acute on chronic CHF didn’t get an EKG, chest x-ray, CBC, BMP, BNP, troponin, coags, and cardiology consult. He got an EKG, a bedside ultrasound and lasix. And he got better. And he was grateful.” Residents are working within fragmented healthcare systems with very limited resources and frequently find that basic health education is the most useful skill they have to offer.

Dr. Luke Husby and Dr. Leslie Osborn noted about their time providing care in mobile clinics in Samoa; “All in all we held 6 clinics and saw over 1200 patients, dozens of which ended up hospitalized for various injuries or illnesses and at least one woman was rescued from an abusive situation. A great deal of education through pharmacy, wound care, nurses, the Christian based team, and the practitioners was probably the longest lasting effect we had, although whenever possible the positively screened patients were able to be referred to local physicians.” Although practicing in these environments can be frustrating, such experiences give residents a new perspective and a renewed sense of what it means to be a physician.

Thank you to Palmetto Health for seeing the value global health experiences have in resident education and patient outcomes in some of the poorest regions of the world.