Trauma Threatens To Overtake Infections

November 3rd, 2017 by Nicholas Comninellis
Posted in International Public Health|

 

One of the most dramatic developments in international public health this decade in the emergence of trauma as a growing cause of life years lost. Some of this trend is due to better control of HIV, one of trauma’s chief competitors, and the growing availability of motor vehicles throughout developing economies.

 

Of all the grotesque causes of trauma, it’s road injuries that lead to the greatest mortality. I witness this firsthand each summer at CEML Hospital, where individuals with motorcycle and vehicular femur, hip and tib-fib fractures present every day, accompanied by a disturbing number of head injuries.

 

What can be done? Clearly, improved emergency medical care is one priority. Risky behaviors must also be addressed, like curbing alcohol consumption and wearing protective helmets. Upgraded highways and bridges not only decrease trauma, but also increase economic output.

 

Naturally, multiple strategies to target a particular injury problem may be more effective than any one strategy alone. Government agencies usually have the greatest power to curb injuries through public education, engineering policy and police enforcement. With the reduction in infectious disease deaths in many developing nations, attention to the task of injury prevention must become a higher priority. All of us involved in international health can champion these redeployments.

 

INMED Grads 3+ Years Serving In Ghana

October 27th, 2017 by Nicholas Comninellis
Posted in INMED Grads In Action|

 

Tim and Lori Cahill were family medicine residents together at my alma mater: John Peter Smith Hospital in Fort Worth TX. They also took part in the first INMED International Medicine & Public Health Hybrid Course hosted by JPSH in 2011. Since May 2014, the Cahills and their children Rebekah and Abigail have served at INMED’s Training Site in far northern Ghana, Baptist Medical Center.

 

Tim describes one especially memorable patient: “She had presented with two weeks of abdominal pain and then began vomiting profusely. Her abdomen was tender, mostly in the upper part, and she had a little bit of blood in her vomit. She then began having difficulty breathing and became less responsive. I found her blood sugar to >600mg/dL and concluded she had diabetic ketoacidosis (DKA). We started treating her with IV fluids, IV insulin, serial urinalysis to check for ketones, and lots of prayer. Her DKA resolved a few days later and she began feeling well.

 

He also gives us a glimpse into his inspiration: “The hospital hosts morning devotions every day at 7AM for the hospital staff and for patients who may want to take part.  I did not know about these devotions until recently, and in spite of utterly exhaustion from the workload I decided to make these devotions a priority in my routine. What an encouraging time to sing some spiritual songs, listen to a sermon, and interact with some hospital co-workers in a slightly different context than usual. Please pray that there would be a revival among us all to represent Christ well in how we live our lives, both inside and outside the hospital.”

 

I speak from personal experience: healthcare in northern Ghana is outrageously challenging. Would you like to share an encouraging word with the Cahills? Please grace Lori and Tim with a reassuring message.

 

Who Are These 2017 China INMED Course Grads?

October 20th, 2017 by Nicholas Comninellis
Posted in INMED Grads In Action|

 

For the second year, INMED offered the International Medicine & Public Health Hybrid Course in Shenyang – a relatively small city of 6 million in far NE China. Among our intriguing graduates are:

 

Grace Liu Xiaoping, back row far left, a family physician in the resort city of Hangzhou, impressed us with her warm social character, near perfect tropical medicine exam performance, and volunteer service in both Cambodia and Egypt. No “foreigner” to self-sacrifice, Grace is intentional about expressing her vibrant personal faith through applying her talents to benefit the poor beyond China’s expansive borders.

 

Melchizedek Gyamfi, back row second from the right, is a Ghanaian medical student studying in China. Like Grace, Melchizedek stood out from among his peers by composing essays expressing remarkable insight onto convoluted international health issues. We have been told that Chicago has more residency-trained Ghanaian physicians than all of Ghana. But Melchizedek won’t be contributing to that statistic. Look for him in Ghana next year, completing his INMED Service-Learning experience while caring for his own countrymen.

 

INMED ‘Serving The Forgotten’ Conferences in China

October 13th, 2017 by Nicholas Comninellis
Posted in Global Health News & Inspiration|

 

Since inception, INMED’s vision has included equipping healthcare personnel within developing nations to provide excellent care for their own people. This week, INMED  & MedForum hosted two Serving the Forgotten events. In the photo above, 200 medical students in Nancheng, southern China, participated in exercises to enhance their skill in managing tropical fever, and acute and chronic malnutrition. These learners are all citizens of China, India, Pakistan, Ghana and Tanzania.

 

The following day, 23 medical students in Shanghai built upon the previous day’s activities by participating in INMED & MedForum workshops on newborn resuscitation and wound care. These individuals hail from Malaysia, Singapore, China, and Vietnam. Observing their enthusiastic desire to learn, I am most impressed with the altruistic intentions they so fluently expressed toward me: to care for the marginalized among their own peoples.

 

INMED China Grad Serving The World

October 6th, 2017 by Nicholas Comninellis
Posted in INMED Grads In Action|

 

Let me introduce you to my colleague, Edgar Wu. The graduate of medical school in Beijing, Edward completed formal family medicine residency training at LIGHT/H’Image Clinic here in Shenyang, China, from where I am writing today. Edgar is a visionary young man with his eyes on serving in the world’s poorest communities. Consistent with this vision, last year he participated in the International Medicine & Public Health Hybrid Course when INMED offered it here in China.

 

Three days ago I arrived in Shenyang to visit my Chinese friends in the healthcare community. Edgar, who has been serving in Cambodia, encouraged me by describing how the INMED course content about malaria, Zika, dengue, and typhoid has proven particularly useful to him while caring for patients in that remarkably tropical locale. Other course subjects on malnutrition and care of injuries, explained Edgar, provided him with useful skill while he served in Lebanon, too.

 

What is next for Dr. Wu? Look for him working back in Cambodia next year, guiding younger resident physicians here in Shenyang, and returning as faculty for the 2018 INMED courses in China. Can you tell how proud we are to be partners this particular gentleman?

 

What Is Today’s Most Urgent Humanitarian Crisis?

September 29th, 2017 by Nicholas Comninellis
Posted in Disaster Management|

 

Sadly, we have a crowded line up of contenders for this moment’s most pressing human catastrophe. They include Syrians fleeing ISIS, Yemen’s cholera epidemic, South Sudanese facing starvation. Yet almost unnoticed, and eclipsing them all, are the more than 400,000 Rohingya Muslims fleeing Myanmar (Burma) since August 25. Some 250,000 of these refugees are children, and in the wake of their flight lie villages ablaze and soldiers shooting at their backs.

 

The United Nations High Commissioner for Human Rights, Zeid Ra’ad al-Hussein, identifies this as a “textbook example of ethnic cleansing.” Like most other chapters of interracial persecution, this one has a long, sorted history of escalation that includes systematic discrimination, unbridled lethal force, and blatant neglect of the most fundamental human rights.

 

But at this very moment what is most urgently needed is live-saving aid for these refugees arriving in Bangladesh by the thousands each day. Follow these developments via your preferred news outlet. Consider an immediate financial gift to Samaritans Purse or to UNHCR. And develop your own crisis response skills via the INMED Disaster Management Self-Paced Course and upcoming Humanitarian Health Conference.

 

 

Why US-Trained Surgeons Often Aren’t Ready For Humanitarian Work Abroad

September 22nd, 2017 by Nicholas Comninellis
Posted in Low-Resource Healthcare Pearls|


 

I am not a surgeon. Yes, I can readily perform some of the most urgent and lifesaving procedures, like colostomy and Cesarean section. But a surgeon, I am not. In this light, allow me to make some observation about North American surgeons in an international, low-resource context.

 

Surgical needs and resources in such settings differ significantly from wealthier contexts. Where I volunteer in Angola, for example, the majority of surgical needs are in orthopedics, OB/GYN, and urology. North American-trained general surgeons, by contrast, rarely have any significant experience or skill in these fields. General surgery as a specialty has all but forfeited any procedural skill outside of the abdomen. This is to a degree understandable. Given the plethora of surgeons and rapid development of surgical knowledge, it is only natural that surgeons begin to concentrate their skills into sub-specialties.

 

But this phenomenon does little to prepare surgeons for the broad skills needed in low-resource, low-personnel settings, as recently pointed out in the NPR discourse, Why U.S.-Trained Surgeons Often Aren’t Ready For Humanitarian Work Abroad.

 

All is not lost, however. General surgeons are an intelligent, highly motivated lot. Their ability to rapidly learn new skills is astounding. With proper drive and mentorship in a high-volume context, many surgeons in a matter of months can acquire the broad skills fitting of the title general surgeon. Should this transformation be your desire, please continue this conversation with me.

 

What Is The Single Most Useful Language?

September 15th, 2017 by Nicholas Comninellis
Posted in Cross-Cultural Healthcare Pearls|

 

Language is powerful. Beyond its direct usefulness for communication, language also conveys one’s culture, social status, and history. Acquiring language as a child is an almost thoughtless, painless process. I continue to marvel over how my father never addressed me in Greek. While Greek is not highly useful outside of that tiny nation homeland, other languages are extremely serviceable. Which one is the single most useful?

 

One might be inclined to simply look at the numbers illustrated in this image, suggesting that Chinese, Hindi, Arabic, or Russian would be favored. A more practical position would be based upon what language is most used in one’s day-to-day life. While Hindi, for example, is one of the most numerically favored languages, its geographic footprint it is rather small. English and Spanish, by contrast, are spoken broad swaths of the planet. Rest assured, you already speak one of the world’s most useful languages!

 

Who Are The 2017 Boston INMED Courses Grads?

September 8th, 2017 by Nicholas Comninellis
Posted in INMED Action Steps For You|

 

Harvard Medical School Teaching Hospital, Massachusetts General, Center for Global Health and Global Disaster Relief again this fall hosted the INMED International Medicine and International Public Health Hybrid Courses. Allow me to introduce our inspiring graduates!

 

From North America come physicians and nurses in the fields of primary care and emergency medicine, and with service experience in Honduras, Ecuador and South Sudan. From Asia come medical and public health students from the nations of Pakistan, India, China, and UAE. And from Africa, representatives of Nigeria and Ghana in dentistry and medicine.

 

Where will these uber talented professionals next invest their skills? Most will advance towards the INMED Diplomas in International Medicine and International Public Health. This provides them will supervised application of their skills on behalf of disadvantages people in their home nation and  throughout the entire world.

 

INMED Board’s Richard Randolph Aiding Houston

September 1st, 2017 by Nicholas Comninellis
Posted in INMED Grads In Action|

 

Today is Richard Randolph’s birthday, and like so many first responders, he’s foregone the lighter side of life to give life-preserving care in these hours since Hurricane Harvey struck Houston. Dr. Randolph, a Director on INMED’s Board, is also Chief Medical Officer for Heart to Heart International, whose mobile Disaster Response unit is providing clinical care to the thousands of Texans who have lost primary medical services.

 

Dr. Randolph is a family physician from the Kansas City area who first distinguished himself as a West Point Military Academy graduate, adding credentials including the INMED Academic Qualification in International Medicine & Public Health, and appointed Medical Officer for Joint Special Operations Command at Fort Bragg. In 2015 Dr. Randolph shipped out to Liberia. On location at the Tappita Ebola Treatment Unit he served Ebola afflicted people for six months – just one of his extended deployments since 1993 providing healthcare in seven different nations.

 

 

This week Dr. Randolph again diligently applies his hard-won insight on behalf of Americans in acute distress. Let’s all of us look for opportunities to share an encouraging word with these goodhearted volunteers!