“My boy, Tomas, is urinating pure blood!” Her speech was pressured and rapid fire. “He’s been hemorrhaging for days. Is my boy going to die? ” The anxious mother lifted her son, moving the pool of accumulating blood from the floor to her lap. The young, listless, glassy eyes of Tomas met mine, and I realized we hadn’t much time to act.
“His bleeding is likely from a urinary tract infection and he needs an antibiotic – right? “I asked myself. That’s what I’d learned in medical school at the University of Missouri. But this was Africa and the Kalukembe Hospital. I ran in pursuit of my mentor, Dr. Andreas Rohner. On hearing my diagnosis, he shook his head and rolled his eyes ever so slightly. Turning to the marshland, Rohner asked me guiding questions:
Rohner: “Where do the children play?”Comninellis: “In those swamps”
Rohner: “And what creatures live in those shallow waters?”
Comninellis: “Mosquito larvae, a few fish, lots of snails”
Rohner: “And what’s living within those snails?”
A light clicked on in my brain. “Schistosomas! ” I exclaimed. “Tomas suffers from schistosomiasis of his urinary tract!” Rohner glowed. “Exactly, young doctor!”
I trotted back toward the mother and her bleeding son, beating myself, “I’d studied schistosomiasis in tropical medicine school at Walter Reed. But when I first encountered someone with the disease I didn’t even think of the diagnosis! Did I really learn NOTHING about global health?”
Tomas looked forlorn; his mother, fearful. I quickly collected a urine sample and rushed to the lab. Sure enough, under a microscope I found schistosome eggs, confirming the diagnosis of this disease transmitted when the parasites that live in snails penetrate the skin of people in the water.
Back in the clinic, I dosed Tomas with an antiparasitic medication and hastily arranged for a transfusion. Shortly, as the life-saving blood was dripping into the boy’s fragile veins, I reconsidered my global health training experience. “Isn’t the experience of caring for someone with a disease far more valuable than attending a lecture about it? Isn’t supervised learning like I’m enjoying here with Dr. Rohner way better than any classroom exercises?”
The vision for superior global health learning began to grow within me. I observed Tomas. The color in his face was returning and he began smiling at his mother, whose wrinkles were relaxing and voice filling with ease. This approach to education and care would prove to be life giving for Tomas, and later become the foundation of INMED’s Diploma Programs.