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International Student Report

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8 months, 4 nations & 32,000 miles later – A Snapshot of our International Experiences

A little bit about us…
We are two fourth year medical students who were granted an extended year of medical school to pursue international experiences. Our journey began with our wedding a week before we left on our 8 month trip. Its been an amazing first year of marriage and we gained a lifetime of memories. Our calloused, bug bitten, now healing feet have touched four nations (not including numerous layovers), traveling over 32,000 flight miles (plus countless more in auto rickshaws, trains, buses, taxis, trufis, carriages, motorbikes, & on foot).
How we decided on where to go…
Our desire was to see and partner with a variety of hospitals and medical service projects overseas. In the future, we are considering work overseas and wanted to explore this long-term vision by taking an extended year prior to residency. We wanted to see what the needs were and see how we could best use medicine overseas in order to guide what course of further training we would need. We decided to contact hospitals and doctors through IMER and on our own. Through the contacts we are able to create a tailored itinerary that would take us to four countries around the world – Nepal, India, Bolivia & Costa Rica working in missions hospitals, academic institutions, public hospitals, and mobile clinics.

How our journey began…
Our travels began with >2 days of flights, buses, taxis and not having 3 important checked baggage for several days. Being without toiletries or change of clothes etc. for three days was an unforeseen hurdle to say the least. After a few days of multiple phone calls we received them. The following days brought more drama as a 6 hr bus ride to Tansen Missions hospital turned into a 16 hr trek with road blocks (fires in roads, hostile people with sticks, armed guards, basically a human road block). We were thankful to finally arrive safely to our destination in Nepal.

Nothing could have fully prepared us for India – the nation had the unique ability to inspire, frustrate, thrill and confound us all in the same day. There's a constant sensory overload with the noise of autos, lorry trucks, cows mooing, scooters blowing their horns and the many smells that test our cranial nerves (some positive, some negative).
St. John's Hospital…
Located in Bangalore, India (population 6 million) in the state of Karnataka, St. John’s hospital is a large academic hospital affiliated with the University of Minnesota. We rotated in Community Health for a few weeks and made daily 1-3 hr trips in rugged Jeeps to the rural villages, mainly to Mugalur and Lakhur. Clinics were set up, physical exams done, immunization given, hours of health education taught and numerous diseases were treated. Otherwise, we rotated through OB/GYN, Dermatology, Pediatrics, and the Intensive Care Unit gaining much perspective. The disease pathology and the medical system itself were fascinating (and at times also frustrating) for us to experience. We enjoyed seeing wildlife here daily: monkeys, emus, deer, exotic birds, roosters, goats, lambs... Many of these animals are actually on the hospital grounds and used for pet therapy for the patients.
HIV/AIDS Center – This hospice care and children's home was started to help those with this disease. The patients are shunned by their family, as many people in India still think they can contract the disease through touch. We spent our time rounding with the staff, working with a paraplegic patient doing physical therapy, playing with the orphaned children, and updating the nursing staff and doctors with the latest evidenced
based medicine treatment & management of infectious diseases - TB, AIDS.
San Juan de Dios Hospital located in San Jose, Costa Rica is connected with Universidad de Ciencias Medicas (affiliated with the University of Minnesota). Dr. Hernando Gonzalez helped us set up our experience in San Jose and we were assigned to work with Dr. Monge (extremely hospitable and a great instructor). We rotated through Tropical Dermatology and were exposed to many diseases we had only read about. Living with a great host family (organized by UCIMED) we enjoyed practicing our Spanish, learning more about the culture, and eating wonderful dinners. Our weekends were spent travelling around beautiful Costa Rica.

Where next…

From January to April, 2009 we plan to be overseas again, this time to be in Honduras working at a hospital there, mainly on the inpatient services. We plan to return and begin our residencies in June 2009.

Closing remarks…
One of the best ways to gain both medical and educational perspective is to travel. We like to explain it by a mathematical equation: a change of place plus a change of pace equals a change of perspective. We cannot go back to our former perspectives after treating a tiger bite, a 75-year-old woman injured after climbing atop a tree in attempts to collect firewood, or having to wait one month to receive results of "routine" lab tests. We have gained understanding of the density of suffering this past year working in health care facilities with extended exposure to impoverished communities. The immense need of the people, the vibrant chaos of their lives, and the variety of costumes, cuisines, and cultures have left us drained. Certain images keep returning with an absolute force: the leprous distorted fingers thrust into our faces, the impoverished woman with AIDS who was outcast by her family, and a child covered with dirt on the street stretching out his hand to offer us the rest of his bread. In the future, we envision ourselves involved with programs that bring not only supplies, but also dedicated physicians to underserved people groups.

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