July 14th, 2019 by Steven Duncan
Posted in Uncategorized|

Every Monday afternoon I go to a homeless shelter to help with patient consultations. We take blood pressures and reapply bandages to wounds, often listening to complaints of chronic pain and worries about reinfection. We disperse a fair amount of over-the-counter pain medications and eye glasses that have been donated by Agape. A doctor is employed full-time by the facility and we recommend patients to him if they are complex.

I’ve been told things run slower at the facility during the summer because seeking shelter is less urgent in the warmest months. Many residents are amputees because becoming homeless in Russia during the winter is a serious threat to life and limb. Untreated frostbite, on top of undiagnosed diabetes in some cases, is extremely dangerous and the consequences are long lasting.

Problems with limited mobility are also very common in this population because of trauma related to alcohol abuse. I remember on my first day we helped bandage a man’s leg after he hurt it from jumping off a bridge while drunk. I was surprised to hear the opinion that acute injuries resulting from inebriation are a bigger problem for the Russian homeless than chronic cirrhosis and subsequent liver failure. It seems that most individuals who don’t require a wheelchair have gait abnormalities. Treating substance abuse disorder seems to be the highest priority as it remains the root cause of many patients’ troubles.

July 13th, 2019 by Steven Duncan
Posted in Uncategorized|

Here are some pictures of the area surrounding Agape’s guest apartment. The name of the neighborhood is Kotelniki, which is considered Podmoskovye (just outside of Moscow city).

June 28th, 2019 by Steven Duncan
Posted in Uncategorized|

Meet Dr. Zhanna from Kyrgyzstan (I am a solid foot taller than her at least). Every week we take a train outside the city and visit elderly patients living in retirement homes. Many of them are bedbound and require full-time care by nursing staff. Dr. Zhanna helps encourage her patients to move around and stretch so they can retain their strength. We mainly manage chronic conditions like hypertension but each visit includes checking on patients who have fallen acutely ill and are being treated with antibiotics for pneumonia or urinary tract infections.

Some of the patients have conditions that could benefit from medical intervention (like the woman pictured, whose skin lesion should be biopsied and removed in my opinion) but their next of kin don’t want to spend the money. We do all that we can for them, but it can be difficult to navigate. Dr. Zhanna told me that when the family declines to pay for any care, she sometimes buys them medications herself. I’m inspired by her generosity and have been getting good practice listening to lots of senior hearts.

June 27th, 2019 by Steven Duncan
Posted in Uncategorized|

Moscow is a lively city with an estimated population of 12 million people. There is so much amazing history and culture here, and I love being immersed and exploring when there’s time. Even more than the colorful sights and smells, I enjoy interacting with the native people and gaining a better understanding of what life is like here. I was raised in a very Western culture and it’s always a good experience to listen to perspectives that vary from my own.

June 27th, 2019 by Steven Duncan
Posted in Uncategorized|

I live on the outskirts of the city in an area called Kotelniki. Agape provides guest housing so I have a bedroom and access to a kitchen, WiFi, and a washer (laundry is air-dried on a rack here). We are conveniently connected to the main city by a metro station and it takes about 30 minutes to get to the center. Because of that, I spend at least an hour a day on public transport traveling to and from the clinics. The Moscow metro system is really beautiful. Some stations are more richly decorated than others but many have old Soviet art on display, especially in the center of the city. I can’t stop taking pictures of it.

“Moscow…how many strains are fusing
in that one sound, for Russian hearts!
What store of riches it imparts!” – A. Pushkin

June 27th, 2019 by Steven Duncan
Posted in Uncategorized|

I’m working with a Christian outreach organization called Agape Unlimited here in Moscow. They have several clinics around the city that I’ve been assigned to rotate through during my time here: a clinic for African refugees, a rehabilitation center for the homeless, and retirement homes for the elderly.

June 27th, 2019 by Steven Duncan
Posted in Uncategorized|

It’s time to start documenting my INMED journey! After finishing the 10-week online DIMPH course, I attended the in-class session in New York at the Long Island Jewish Medical Center. I really enjoyed my time, even more than expected (and I love global health!). The hands-on activities and group interactions helped me synthesize the material and connect to it in a new way. Other students were friendly and brought a wealth of diverse experiences to share. I came away feeling edified and ready to apply what I’d learned over the past three months to my upcoming rotation in Moscow, Russia!

May 29th, 2019 by INMED
Posted in Uncategorized|

Hello! My name is Steven Duncan. I am a medical student at UT Southwestern, and I’m starting my INMED service-learning experience at Agape Unlimited in Moscow, Russia, beginning in June, 2019.