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GLOBAL MEDICAL TRAINING

30 November 2019 Written by  By Christine Douglas
Published in December 2019 Articles

from Brentwood to Lima, Peru

Growing up in her comfortable suburban home, Bella Trezza often dreamed of travel. Her sights were always set on volunteering abroad and she had researched opportunities for such efforts feverishly, for many years. Throughout her years at Heritage High School, Bella excelled in Science classes and was leaning toward furthering her education in courses that would lead to her working in the field of endangered species conservation or genetic counseling. It wasn’t until her freshman year of college that she decided on a path toward practicing medicine. With her eye on expanding her worldview and immersing herself into other cultures, she turned her focus on volunteering toward outreach programs that addressed global health. 

There are many different clubs at the University of California, Davis. At Bella’s particular school, Davis College of Biological Sciences, the one that piqued her interest most was the Global Medical Training club. Many requirements must be met prior to a student being selected to go to a foreign country and work with representative doctors. There was a certain amount of volunteer hours required, dedicated to Sacramento area homeless shelters and food banks. In addition to the numerous socials and meetings to attend, there was a lengthy interview process, and requisite essays to submit. The selection of participants was left up to a board that was comprised of club members that had already traveled to six or seven different countries themselves. Bella received the notice that she was chosen to go to Lima, Peru for a trip scheduled for June 16 through June 22, 2019. Bella had worked hard in the commissary at school, in order to save up enough money to fund her trip. This experience is not paid for by the school, and requires a truly dedicated participant, willing to give of themselves and their resources. Training sessions ensued where students ran mock clinics, learned how to fill out forms, and formulate recommended treatments. She was exuberant and ready to take on world travel for the first time! Most importantly, she was looking forward to learning about the Peruvian culture and their health care practices. 

The group of six students and one parent volunteer left from SFO and were quickly split up at their layover in LAX due to travel delays. The second leg of her trip was with only one other student, and she barely made it to Peru in time to attend orientation. The other students that were part of the group had an extra day inside of Lima, and they had explored the city center. They saw the popular tourist sights and the more upscale shopping district. As Bella was driven into the outskirts of town from her hotel, she experienced a very different view. The scene was very bleak and dark, devoid of any color. There were rolling hills shadowed in fog and the homes were lined up like huts. The ramshackle housing was made simply of four walls and a flat roof. There were random outhouses throughout the small town. Bella likened the landscape to a scene in the movie “Isle of Dogs” because on every street there were random dogs roaming, but not many people outside. There was no indoor plumbing, even the schools simply had a hole and a bucket for flushing it down. Locals had been notified that a traveling clinic would be available to them through postings at the schools and the clinics were set up within them. 

Bella recalls one family of three boys and their parents. The parents appeared to be very old, but Bella learned they were only in their thirties. Bella says, “These are farmers who have worked the land all their lives for their survival. This clinic was their first interaction with a medical team since they had given birth to their three boys. For many, the volunteer clinics are their only form of treatment outside of their neighborhood pharmacy.” Those neighborhood pharmacies’ primary focus is not on fostering health, but financial gain. Bella learned through the translators that the local pharmacist would listen to a complaint and often prescribe unnecessary or expensive treatments. “One lady shared her story of bringing her baby into the pharmacy, it was having trouble breast feeding and had a stuffed nose. The pharmacist prescribed saline solution that was much pricier than it should have been. Our doctors taught her the health benefits of breast milk and how she could ease the baby’s symptoms by applying that to the baby’s nose. We also taught her how to create her own saline solution of saltwater, to avoid the high cost from the pharmacy.” Another standout moment for Bella was an interaction she had with a young boy who had waited patiently for hours while his parents were getting help. Bella shares, “I had brought some Dollar Store trinket toys with me for the children, as rewards for good behavior. The young boy of about five, was wearing a Jurassic Park backpack, so I presented him with a small, plastic dinosaur that I had. He lit up so much, it was as if it was the best present he’d ever received. He stayed by my side for another hour and when his parents were done, they couldn’t pry him away from me for a good ten minutes before he would finally say ‘Ciao’ and after a huge hug, skip away with his parents. To see him so thankful for such a small gift, really affected me.”

“ALTHOUGH WE ARE A GLOBAL OUTREACH PROGRAM, WE CANNOT LOSE SIGHT OF THE NEEDS WITHIN OUR OWN BORDERS AND WITHIN OUR OWN TOWNS. WE CAN START HERE TOWARD MAKING THINGS BETTER, LEARN FROM IT, AND TRANSLATE THOSE METHODS TO THE WORLD.”

Another part of their trip was dedicated to serving immobile residents in their homes. The families had cooked for days in order to provide a humble spread of their Peruvian meats and potatoes for the traveling students and doctors. Their stone and brick homes were adorned with family pictures and partitioned with cloth for room dividers. On one of these visits, they encountered an older woman who had fallen and broken her arm weeks ago, but never received care for it, all the while caring for her adult, wheelchair-bound paraplegic son. The son had extreme cerebral palsy and suffered severe muscle cramping. “We advised her on the aid that was available to her family at the hospital in Lima and prescribed muscle relaxers for her son. These are strong people, they are humble and quick to describe their problems. Getting to a doctor inside of the city is nearly an insurmountable task. That is why the clinics are so important, but sometimes the problems are outside of our scope of treatment.” 

Much of the Peruvian health system is based on nutrition. Much of the teaching methods during these clinics were geared toward eating healthier foods. Being versed on proper nutrition may be something we take for granted in the United States, but daily life appears to be a struggle for most Peruvians from Bella’s perspective. They feel the need to fill up when they eat, as a result, the Peruvian diet is very heavy and greasy. They do not consume many fruits and vegetables like we are taught to. Roughly 60% of the population is obese and therefore suffer from back issues and muscle aches regularly. During this trip, what Bella derived most was the importance of asking the proper questions in order to get a proper diagnosis. The guidance from the local doctors taught her that lifestyle and diet also make up a large part of creating the proper treatment plan. The ability to create a solid diagnosis comes from many interactions with people, learning good communication techniques, and gathering information. Having the opportunity to study in this setting has provided a unique skillset for such a young medical student. It’s these tools that Bella will bring with her on her next round of adventures. She plans to volunteer for future trips to Nicaragua, Dominican Republic, and South Africa working with the Peace Corps. “My focus is now going to be on the fight against AIDS and HIV. Once I become an OB/GYN doctor, I will also participate in Doctors without Borders, wherever the need may be.” The traveling bug hit hard upon her return from Peru. Prior to beginning her junior year of studies, Bella embarked on a tour of Europe, taking in the cultures of Denmark, Austria, Scotland, Belgium, and Germany. She reveled in the sights and sounds as a tourist, enjoying a much-needed break. 

This talented future leader in medicine has come a long way from her quiet Brentwood home. She intends to lead the way for many people who sit in the shadows, on the outskirts of the type of medical care that our nation provides. She is currently in her third year of college and has recently become the secretary of the newly commissioned Doctors without Borders club for UC Davis. Current efforts with the club center on raising funds to help with the homeless problem in Sacramento. “Although we are a global outreach program, we cannot lose sight of the needs within our own borders and within our own towns. We can start here toward making things better, learn from it, and translate those methods to the world.” 

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