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Monday, April 6, 2015

Our Vision

This is a space to express the ideas and global journeys of medical students of UC Davis School of Medicine.

We inaugurate the beginning of this blog with three global trips for Spring 2015:

  • Nepal
  • Nicaragua
  • India
This is an exciting opportunity for students to start their narrative story and help others who are stateside to walk in our shoes. 

We ask for each medical team to write a weekly blog entry during their trip. Some ideas for entries include the following, but are not limited to:
  • Stories
  • Reflections
  • Pictures
  • Student spotlights
  • Day in the Life
  • Clinical Cases
  • Feedback
Blogging is simple. All you need is a gmail account and something you want to tell your audience.

Jacquelyn Yu, Lucy Sung, and Nancy Rodriguez
MS1s in front of their bus in Santa Barbara, Honduras
During Spring Break, a team of 46 health professionals and medical teams, led by Drs. Bob and Kathleen Quadro and the Sacramento chapter of CMDA, went for their 12th trip to Santa Barbara, Honduras. The trip had an unsteady beginning, with an Avianca plane whose engine was leaking, but as with traveling to any place, flexibility and patience is key. The airlines set us up with hotel rooms for the next 2 nights and we were on our way to Honduras -- 2 days later than expected but our spirits were still high.

Each day of clinic consisted of two yellow school buses that once originated in some upper middle class suburban town or a dusty farm road in the US. One bus was filled with people and the other with our clinic supplies: medications, dentist chairs, doctoring tools; you name it, we had it in our yellow bus.

The students rotated through different clinics and on my last day, Dr. Mama Q (as we affectionately grew to call her as), pulled me away from my table to show me a little 9 year old girl. At this school site, the environment was way more tropical than that of the other clinic days. Great leafy trees decorated the school and there was a great number of patients who already came through clinic with a chief complaint of insomnia and stomach pains. Dressed in her school uniform, surrounded by 5 other children (who may or may not have all been related), the little girl look uneasy as stood at the center of attention. Dr. Mama Q asked the little girl's mother if we could see her hair. Su pelo? Esta bien?

Cute hair tie

What can you inspect? 
What is the cause of the hair loss?
What is on the differential diagnosis for this girl?
How to treat this patient, especially if this will be the first and last time you will see her?

This is a case of either tine amiantacea, an eczema-like skin disease. It is also known as pityriasis amiantacea -- it causes scales that are attached to both hair shaft and scalp to occur. But, at the time, we thought this could have been tine versicolor or impetigo. Tinea versicolor is an overgrowth of the naturally found yeast on our skin and scalp. Impetigo is a contagious skin infection of gram-positive S. pyogenes or S. aureus. Without labs to do and only using clinical judgement, we prescribed the little girl fluconozole (the anti-fungal medication we had available) and advised the mother to wash their hair of all her children every day. Washing hair everyday is the most effective treatment we could give to this family.

Some standard questions popped up in my head that is hotly debated in medical missions trips. Should we even give out medications? After all, medications run out and my personal mission has always been to empower communities with knowledge. Giving out pills and vitamins almost feels like you're doing more harm by creating a dependency of foreign aid worker and community member. 

These questions are hard and something to ponder about. How do we as medical students fit in the medical community, let alone in the global medical community? We are not here to treat, we are here to learn -- where does the line get blurred in places where there is no doctor?

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