May 31st, 2023 by INMED
Posted in International Public Health|

“My child, he’s coughing, has fever, and stop eating!” This young mother in Angola, Africa held in her arms a four-year-old. His fast breathing, dry mouth, and somnolent countenance alarmed me. The year was 2020. Was her boy suffering from pneumonia, bronchitis, tuberculosis? Could it be Covid-19? At the beginning of the pandemic, many pressing questions were unclear: testing for the infection, effective prevention, reliable treatment. But one fact was certain: those people most vulnerable – low income, minorities, chronically ill – were also most likely to die.

At the Institute for International Medicine, we make use of the Human Development Index as an objective measure of human well-being. It takes into account just three measurable parameters: education, income, and life expectancy. The pandemic resulted in at least one, often two, lost years in primary and secondary education throughout the world. Most nations saw a drop in their income of 5 to 10%. A sample of 29 nations registered loss in life expectancy as well.

With the COVID-19 pandemic now largely under control, thanks to vaccination and growing natural immunity, what is a strategy towards Post-Covid Global Health? The Human Development Index is not only a useful measure, but also an effective strategy. This is because increases in education, income, and physical health all complement one another.

In the context of Angola, adult education is particularly important to health. Today’s adults that grew up during the Angola Civil War often could not attend school, and are only now learning to read and write thanks to hospital-led initiatives. With growing literacy, adults now have better jobs, better income, and are better able to afford healthy food and medical care.

Provision of drinking water is also critical to income. Look closely at the image above. Is there something better these women could be doing than waiting for water? They could be running businesses and generating money. To address this economic barrier, our hospital arranged the digging of deep wells to provide drinking water throughout the community. As a result, women have become entrepreneurs, purchasing modern homes that protect their families from the ubiquitous mosquitoes and malaria.

Health professions education is pivotal to the physical health of a nation. Angola offers little advanced nursing or medical training. In response, INMED’s Training Site CEML Hospital launched a two-year internship to provide a structured learning environment in which new practitioners can safely advance their skills to help Angolans maintain and restore their health.

What could be your own role in advancing comprehensive health? This is not work to be done in isolation. Rather, inspiration and partnership are crucial. Where can you meet like-hearted people? I recommend the Humanitarian Health Conference, held June 9-10 in-person in Kansas City. Here you can share ideas with healthcare leaders serving vulnerable people and identify your role in Post-Covid Global Health.

May 19th, 2023 by INMED
Posted in International Health News & Inspiration|

“I’m already giving you all I can,” was his reply to a man begging at the house. As a young doctor, I was with SIM in the world’s very poorest nation: Burkina Faso, West Africa. It was Ken Elliot speaking, an Australian physician living and serving in Burkina since 1972. In his austere, desert town of Djibo were many children, like the one I photographed below, so weak and malnourished they could not swallow and required a feeding tube for re-nutrition. Also common in Djibo were adults with kidney stones and renal failure, all connected with blazing temperatures, and short supply of drinking water.

In 2016, after four decades working in isolation, serving Jesus, and the little ones whom He loves, Ken Elliot and his wife Joyce were kidnaped by a group aligned with al-Qaida. Joyce was released just a few weeks later, but “The fact that he is a missionary, as I understand it, is not going to be good. [The kidnappers] will tend to see that as being not so much the good works he’s been doing since the 70s for the local people, but as being a missionary spreading the word of Christianity. So that will not be good for them,” wrote one counterterrorism expert.

Then miraculously, on May 18, after seven years without a word and presumed dead, 88-year-old Ken Elliott was suddenly released from captivity. Australian foreign affairs minister Penny Wong that Elliott was “safe and well.” The Elliott family wrote to thank the government and “all who have been involved over time to secure his release”. They continued, “We wish to express our thanks to God and all who have continued to pray for us,” and “We also continue to pray for those still held and wish them freedom and safe return to their loved ones.”

Become familiar with the Elliott’s vision and ministry in West Africa by partaking of this three-minute interview:

May 5th, 2023 by INMED
Posted in International Health News & Inspiration|

Healthcare for forgotten people is punctuated by professionals who inspire their younger associates to consider similar careers. INMED is honored to recognize such quality professionals by announcing these recipients of the INMED Awards at the 2023 Humanitarian Health Conference, June 9-10 in Kansas City, Missouri.

Introducing David Vanderpool, 2023 International Medicine Award recipient. In 2010, an earthquake devastated Haiti. Dr. Vanderpool was a first responder, caring for horrific injuries and witnessing firsthand the desperate needs in Haiti. He and his wife Laurie sold their Tennessee home and moved to Haiti, where for 10 years they’ve facilitated LiveBeyond school, church, demonstration farm, and medical clinic.

Please meet Dale Agner, winner of the 2023 National Healthcare Service Award. A US Air Force physician with 25 year’s service in Turkey, the Middle East, and Africa, in 2017 Dr. Agner brought his leadership skills to the Open Door medical clinic – an urban, underserved, gospel–rescue ministry in Omaha, Nebraska.

Get to know Julie Rosá, recognized with the 2023 Cross-Cultural Healthcare Service Award. Julie and her husband practiced family medicine for 24 years before joining the medical education team at Kanad Hospital, equipping young healthcare professionals amid the sand dunes of Al Ain in the United Arab Emirates.

Don’t miss Mark Wardle, 2023 International Healthcare Preceptor Award recipient. Dr. Wardle is an osteopathic family physician and Director of both Global Medicine and Medical Spanish on the Rocky Vista University Utah campus. He completed the INMED Master’s Degree in International Health (MIH) and today guides his students through service-learning experiences in Latin America and East Africa.

Explore Blessings International, winner of the 2023 Humanitarian Crisis Response Award. In February, earthquakes struck Turkey and Syria, immediately killing 50,000 people. Emergency response teams – supplied with medications provided through Blessings International – arrived within days facilitated by the Emergency Disaster Relief fund established in advance by Blessings International.

Be inspired by Rick Donlon, recognized with the 2023 Comninellis Award for Compassionate Service to Humanity. A citizen of Memphis, Tennessee, Dr. Donlon’s lifelong calling has been to serve the most vulnerable residents of that urban community. He’s also distinguished himself as an elder in the house church network and spokesperson for Christian physicians throughout North America.

Where can you meet so many inspiring individuals all at once? How could you arrange an opportunity to explore the organizations with whom they themselves are serving? Please register today for the Humanitarian Health Conference and make plans for June 9-10 in Kansas City, Missouri, to get to know the 2023 INMED Award winners!

April 14th, 2023 by INMED
Posted in Low-Resource Healthcare Pearls|

Low-resource, cross-cultural healthcare will test your skills to the extreme. Begin by eliminating the options of comprehensive laboratory testing, advanced imaging, or even specialty consultations. Would you be able to care for these three patients correctly?

1. You are volunteering at a safety net clinic in Oklahoma City and seeing Erasto – a sixteen-year-old refugee newly arrived from Somalia. He has cough, weight loss, poor appetite and vague but increasing abdominal pain. On questioning you learn that in his Somali home safe drinking water is a luxury and sanitation is in disarray. On exam Erasto has an oral temperature of 38.8, respirations of 30, and capillary refill time of 5 seconds. His abdomen is tense and diffusely tender. You are considering the possibility of typhoid fever. Which ONE of the following statements about typhoid fever is TRUE?

A. Salmonella typhi is transmitted by ingestion of contaminated food or water.

B. Typhoid fever almost always causes diarrhea.

C. Typhoid fever commonly presents as an acute illness.

D. Typhoid vaccination is quite effective.

E. Typhoid fever can be readily differentiated on clinical examination from other infectious diseases, such as mononucleosis and infectious hepatitis.

Carefully consider before selecting your answer. The correct response is A. Although typhoid fever does not frequently cause diarrhea, it shares many of the risk factors associated with diarrheal diseases and is usually transmitted by fecal-oral ingestion of contaminated food or water. Typhoid should be considered in persons with non-acute, persistent, unexplained fever and GI symptoms, especially diarrhea and abdominal pain. Diagnosis is often challenging. The differential diagnosis includes malaria, infectious hepatitis, enteric fever syndrome (due to Yersinia enterocolitica, Y. pseudotuberculosis, or Campylobacter), atypical pneumonia, mononucleosis, bacterial endocarditis, tuberculosis, and brucellosis. Common complications include intestinal hemorrhage and perforation, with osteomyelitis and endocarditis occurring less commonly. Typhoid vaccination is available, but it is of marginal effectiveness.

2. You are in the Middle Eastern nation of Jordan caring for Anas, a 2-year-old child whose family just escaped the bloodshed in Syria. Anas is alert, temperature is 38 degrees C, respirations are 30 per minute, pulse is 90 bpm, and blood pressure is unobtainable. He has extreme muscle wasting throughout, reddish hair discoloration, and loss of adipose tissue with no peripheral edema. Your first priority in managing this child with acute protein-energy malnutrition (PEM) is which ONE of the following:

A  Treatment of coexisting medical illnesses

B  Provision of high-concentration protein supplement

C  Administration of micronutrient supplements

D  Immediate refeeding

E  Correction of hydration and acid-base alterations

The appropriate answer to this question may not be the most intuitive. The correct answer is E. The management of acute protein-energy malnutrition (PEM) can be separated into two stages. The first stage is stabilization: to immediately correct hydration and acid-base alterations. The second stage is refeeding. This can begin as soon as medical problems are reasonably stable and rehydration is complete. It may be necessary to begin initial refeeding slowly in persons who have advanced PEM or kwashiorkor because of damage to the intestinal mucosa. During the period of renutrition, micronutrient supplements and attention to any coexisting medical illnesses may also be indicated.

3. You are in Cambodia, South America, seeing Solyna, a twenty-one-year-old lady, who suddenly developed fever, vomiting, severe headache, and pain on moving her eyes. On physical examination you note that Solyna is lethargic, has generalized lymph node enlargement and a slow heart rate relative to her fever of 39 degrees. Your initial differential diagnosis is broad: influenza, dengue, typhoid fever, mononucleosis, malaria.  You Giemsa stain her blood smears but you do not identify any ring-like Plasmodium parasites that would suggest malaria. You initiate intravenous fluids and antipyretics. Over the next hours Solyna develops hypothermia, severe abdominal pain, decreased mental status, and bleeding from her gums and nose. You now suspect dengue – an arbovirus infection. Which ONE of the following is a characteristic of severe dengue fever?

A  Leukocytosis with increased band forms

B  Increased urinary output

C  Abnormal vascular permeability with spontaneous bleeding

D  Predictable improvement in response to gamma globulin infusion

E  Decreasing hematocrit

This case requires careful attention to detail in the history and physical exam. The correct answer is C. Key criteria for diagnosis of severe dengue fever are abnormal vascular permeability with spontaneous bleeding, fever, and low platelet count. Leukopenia (low white blood cell count), increasing hematocrit, and decreased urinary output commonly accompany severe dengue fever. Gamma globulin is of no therapeutic benefit.

Practicing in the absence of comprehensive laboratory testing, advanced imaging, and specialty consultations provokes understandable anxiety in most medical care professionals. But you can learn to provide quality care within such parameters, especially when you develop such skills under the watchful attention of an experience supervisor. INMED International Medicine, Nursing and Public Health Training Sites are designed to assist you in developing such prized, life-saving skills.

April 1st, 2023 by INMED
Posted in INMED Action Steps For You|

Last Sunday, many readers of this blog commemorated the historic entrance of Christ into the city of Jerusalem. During those ensuing days, Christ spoke passionately about eternity’s most compelling truths. He knew that within a few precious days he would be arrested, tortured, executed – and then return once again to physical life. Of what did Christ speak? Matthew 25 records a particularly compelling theme: care we show towards those in need:

“Then the King will say to those on his right, ‘Come, you who are blessed by my Father; take your inheritance, the kingdom prepared for you since the creation of the world. For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.’ “Then the righteous will answer him, ‘Lord, when did we see you hungry and feed you, or thirsty and give you drink, stranger and invite you in, needing clothes and clothe you, sick or in prison and go to visit you?’ “The King will reply, ‘Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.’

How skilled are you at caring for such people; those who are poor, homeless, minorities, refugees, or victims of disaster or war? INMED’s richest skill advancement opportunity begins on June 7-8 with full day courses in Ultrasound, OB Ultrasound, Helping Babies Breathe (HBB), Essential Care for Every Baby, Helping Mothers Survive, and Hands-On Skills for Low-Resource Healthcare. Stay on location on June 9-10 for the 18th annual Humanitarian Health Conference to connect with professionals of the same mind. Use coupon code “equip15″ to enjoy a 15% discount. First-time undergraduate and medical students use coupon code “connect2023″ to register for just $30. (Please register using your school-issued email address)

During these precious days preceding Easter celebration, let’s dwell again upon eternity’s most compelling truths. How we treat those in need indeed has eternal consequences. Let us double our commitment to provide care with kindness and excellence.

March 17th, 2023 by INMED
Posted in International Health News & Inspiration|

Albert Schweitzer is one of international health’s most fascinating personalities. Born in on the border between France and Germany in 1875, by age 30 Schweitzer distinguished himself with advanced accomplishments in theology, philosophy and music. Most notably, Schweitzer transposed Bach’s renowned compositions from orchestra to organ, and traveled throughout Europe with the Paris Bach Society performing to considerable acclaim.

At the age of 30, Schweitzer received an appeal from Paris Missionary Society for a physician to serve in west Africa. One biographer documents what happened next: “Amid a hail of protests from his friends, family and colleagues, Schweitzer resigned his post and re-entered the university as a student in a three-year course towards the degree of Doctorate in Medicine… He planned to spread the Gospel by the example of his Christian labor of healing…”

Over the next 50 years – including a period being interned during World War I – Albert Schweitzer lived in what became of the nation of Gabon, West Africa. His autobiography is filled with accounts of caring for Africans who suffered from dysentery, malaria, sleeping sickness, leprosy, poisonings, and surgical emergencies. Throughout these decades, Dr. Schweitzer continued to compose works of theology and philosophy, most notably The Quest of the Historical Jesus (a rebuttal against growing liberal interpretation of scripture) and  literary works expanding the principle of Reverence for Life – for which he was recognized with the 1952 Nobel peace prize. Visitors to his remote hospital he also regularly entertained through organ recitals well into the nights.

March 3rd, 2023 by INMED
Posted in Disaster Management|

The earth would occasionally rumble under my feet as a child living with my grandmother in Greece. We ran outside of her brick home; fearful it would collapse and kill us. One month ago, just 400 miles away in Turkey and Syria, earthquakes did indeed collapse thousands of homes, instantly killing 50,000 people – the same number of US soldiers who perished in the Vietnam War. The extent of this tragedy is almost unimaginable, and 1 million people are now homeless.

How shall we – people who enjoy relative affluence – respond to this catastrophe? In the coming weeks and months, survivors will be afflicted with hunger, cold exposure, unsafe drinking water, contagious diseases, and marked depression and anxiety. In the short term. your immediate donation of time or treasure to a reputable relief organization is especially strategic. INMED highly recommends Heart-to-Heart International (HHI), headquartered in greater Kansas City. At this moment, HHI is distributing trauma emergency surgery kits, deploying stand-alone portable medical trauma clinics, and sending the most-needed medicines and supplies, including analgesic medications, bandages, and crutches. You can also meet HHI staff in-person at the Humanitarian Health Conference on June 9-10.

In the long-term, how can we support sustainable infrastructures that will both prevent and more effectively respond to upcoming cataclysmic disasters? This broad question requires answers from multiple disciplines, including construction, governance, law-enforcement, and public safety. Within the discipline of healthcare education, professionals must be better equipped with critical disaster response and prevention skills – INMED’s particular forte. Each major INMED education program includes Disaster Management coaching.

Next time the ground rumbles, waters rise, tempest blows, or fires encroach may we all be well equipped for immediate and long-term response.

February 17th, 2023 by INMED
Posted in International Public Health|

Last week, Jimmy Carter – 39th US President 1977-1981 – entered hospice care at age 98. Post-presidency, Carter focused his energies on distinguished humanitarian pursuits: launching Habitat for Humanity, negotiating cessation of international conflicts, instructing biblical truths, and leading the march to eradicate a human infection.

Dracunculiasis, or Guinea worm infection, is a parasitic disease acquired by humans who drink water contaminated with its eggs. Within the human intestine, these eggs develop into adult worms about 1 m (3 feet!) long that penetrate the intestine and begin migrating through the body until they reach the skin. Once the parasite detects water nearby, it begins to emerge through the skin inflicting unrelenting, debilitating pain upon the sufferer.

No successful medication, vaccine, or other treatment has been discovered. Management of this disease remains the same as it has for millennia: raping the emerging worm on a stick and slowly extracted over a period of weeks.

In the 1980s, about 3.5 million new cases were reported in eastern, central, and western Africa – primarily in the countries of Ethiopia, South Sudan, Angola, Mali, Chad, and Cameron. It occurs mainly within very low-income communities where water and sanitation infrastructure are undeveloped.

In 1986, a coalition of international partners, including the World Health Organization and the Carter Center, began a systematic program to both track the occurrences of the disease and educate communities regarding prevention. Effective prevention efforts include provision of safe drinking water, application of approved chemical agents to kill the parasite in contaminated water, and educating Community members to properly dispose of fish guts which breaks transmission of the parasite eggs.

So successful has been these efforts worldwide trust 25 cases were reported in 2016 and only 10 cases in 2021. Successful eradication of Guinea worm would be only the second time in history – following smallpox eradication – that a human infection has been entirely eliminated. A distinguished pursuit indeed!

February 3rd, 2023 by INMED
Posted in INMED Grads In Action|

“Over the last year and one-half I have set foot in four continents, been a part of five conferences, lost a few team mates, welcomed others, and spoken languages I haven’t used in years. Captured below is a summary of the last few months in pictures. May you be blessed to see what the Lord is doing around the world!”  In 2015, Caren Abraham, DDS began studying at INMED, and in 2019 earned the INMED Professional Diploma in International Medicine and Public Health (DIMPH) which included her supervised dental care service-learning experience in East Africa.

Caren continues, “Thank you to each one of you for upholding me in your constant prayers. Behind these highlights have been many challenges, but God has watched over me through them all. I pray that these photos give you a glimpse into the work that is happening on our side of the globe and help you know that your prayers and financial investment are not in vain.”

Caren is preparing to move back to Kenya to continue providing long-term dental care. Contact Caren Abraham at [email protected]

January 20th, 2023 by INMED
Posted in International Public Health|

What great advances in international health have resulted from research? Measles vaccine, HIV drugs, malaria bed nets, tobacco controls, basic newborn resuscitation, to name a few. But profound international health challenges remain that can only be vanquished through continued scientific investigation. Some of these challenges include the quests for more effective tuberculosis vaccines, successful cardiovascular polypill, low-cost cancer treatments, and road trauma prevention.

The Humanitarian Health Conference, June 9-10 in Kansas City, is an opportunity for students and researchers of all experience levels to share their insights to an altruistic audience. We invite Poster Presentation subjects in three categories: global health education, research or innovation, and case study. For examples, please view the 2022 Poster Presentation Participants and Award Recipients. That’s right, awards and cash prizes for the premier poster presentations! More importantly, poster presentations can expand your professional network and advance your career qualifications. Please view the Poster Presentation Information and submit by May 25, 2023.

What great advances in international health are just over the horizon? Participating in the Humanitarian Health Conference is an ideal opportunity to contribute to the science, increase your healthcare skills, connect with volunteer organizations, and ultimately to advance the welfare of all humankind.