Blog

Journeys through an African medical school

In a time when so many Americans wonder what our healthcare system will look like in a couple of years, it’s also important to consider what it will feel like. In some instances, it often seems doctors have thrown their bedside manners out the window, acting more like mechanics working on broken machinery than human beings treating patients.

That’s when “illness becomes a mater of biology,” said Claire Wendland, a doctor and an anthropology professor at the University of Wisconsin. Wendland, who has spent several years studying the concept of medical socialization, is trying to understand the shift in mindset that occurs in North American medical students between the time they enter medical school, to when they graduate.

“Students quickly learn to accept death,” she said. Many students enter school as a heterogeneous group with a common idealism, but what happens is what she describes as a “blending process,” often even dressing alike. And, “by the time they finish medical training,” she said, “they have increased cynicism.”

The notion of medical socialization, Wendland explained, had only really been studied in North America and Western Europe, so she set out to Malawi, located in southeast Africa, to see if geographic location, culture and wealth play a role in the development of this mindset.

It is an understatement to say that a hospital in Malawi is different from one in the U.S. According to Wendland, in Malawi, nurses earn $3 a day, and medical interns earn $4. It was not uncommon at Queen Elizabeth Central hospital to “run out of soap, iodine or Tylenol” she said.  Additionally, public hospitals in the U.S. tend to have a 75 percent occupation rate, while Queen’s rate was about 150 percent, with patients often lying on the floor.

Wendland spent a total of about a year and half living and working in Malawi. She noticed that students there often studied the same text books as American medical students, in fact some of the same books she studied while earning her M.D. at Michigan State University, but the difference was that with a frequent shortage of supplies, they could rarely put their education to use. So instead, she said, “they expanded their definition of what they could give to the patients.” Perhaps they could not give them Tylenol, but they could give them love.

Malawi doctors showed less detachment from their patients than American doctors and shared the “we are all humans” perspective, she said.

In Wendland’s first book, “A Heart for the Work:  Journeys Through an African Medical School,” she shares her experiences working both as a doctor in Malawi as well as an anthropologist. And one question that remains unanswered in Wendland’s mind is: “If poverty has an impact on our practice, does wealth?”

Claire Wendland shared her experiences with Northwestern University students on February 23.

Share and Enjoy:
  • email
  • Print
  • Digg
  • StumbleUpon
  • del.icio.us
  • Facebook
  • LinkedIn
  • Twitter
  • Google Bookmarks

Tracy Kidder: Journalist and Advocate

Paul Farmer holds a number of impressive titles – most people would feel fulfilled with just one. It takes five full scrolls to reach the bottom of his biography page on Harvard’s website.

*courtesy of Lyceum Agency

To name a few, he is Chair of the Department of Global Health and Social Medicine at Harvard Medical School and founder of Partners in Health – a non profit, which most recently is best known for its work in Haiti.

He is also the inspiration for, and central character in, Tracy Kidder’s 2003 book “Mountains beyond Mountains: The quest of Dr. Paul Farmer: a man who would cure the world.”

Kidder addressed students, faculty and community members on Thursday at the newly renovated Harris Hall on Northwestern University’s Evanston campus. He discussed – and promoted – his book as well as the work of Partners in Health.

In a graphic – and slow paced – slideshow, Kidder showed static images of the mal-nourished and extremely ill children Partners in Health has been helping over the years.

Kidder met Farmer in 1994, he said

“I like that he has that unique relationship [with Farmer] because most journalists don’t,” said Ryota Terada, a freshman at Northwestern University who read the book this summer as part of his assigned reading.

Kidder’s book was selected as this year’s One Book One Northwestern – a “campus-wide program that brings students, staff and faculty from across campus together around a single book,” according to the university website. “The project builds community at Northwestern by promoting conversation and collaboration across disciplines and schools.”

The university purchased 2000 copies of his book, President Morton Schapiro said.

But this isn’t the first time Kidder writes about Farmer. In 2000, he published a profile of him in the New Yorker. With a biography as long as Farmer’s, he is undoubtedly a busy person who is consistently on the go.

Many of the magazine’s female readers held a similar view of the piece, and they let Kidder know. In their letters, they often first acknowledged that Farmer was indeed an amazing person, followed by, “but I wouldn’t want to be married to him,” Kidder said.

Kidder couldn’t help but finally think: “I didn’t know he had proposed?”

Share and Enjoy:
  • email
  • Print
  • Digg
  • StumbleUpon
  • del.icio.us
  • Facebook
  • LinkedIn
  • Twitter
  • Google Bookmarks

Strength in what remains

Tracy Kidder

Big events are best told through small stories. At least that’s the approach author Tracy Kidder took for his latest book, Strength is What Remains, which details the journey of a genocide survivor from Burundi, Africa to Columbia University medical school.

Kidder has been called a “purposive write,” one who analyzes and exposes larger issues and proposes solutions, but he says his focus is more modest—the individual. “I have a hard time bending my own mind around generalizations. Often all I can think of are the exceptions,” he said to a crowd of nearly 100 at Northwestern University Wednesday as part of the One Book One Northwestern initiative. “Stories can be windows into enormity,” he added.

Kidder met Deogratias by chance and was struck by the Burundian man’s remarkable story of survival and perseverance. Deogratias narrowly escaped death by leaving his door open—his would-be killers assumed he had fled—and through a mix of luck and sheer tenacity he arrived at JFK airport with $200 and a Visa under false pretenses. After eking out an existence delivering groceries and sleeping on benches in Central Park, he encountered an ex-nun who found a home for him. Less than two years after his perilous escape from Africa, Deogratias enrolled at Columbia University. He was later accepted into medical school and eventually returned to Burundi to open a clinic and Village Health Works, a collaborative health organization of Kigutu villagers and Americans.

Kidder said Deogratias’ story stirred a sense of wonder in him about the people he encountered. “I hoped that I could never again look at anonymous faces in quite the same way, particularly the faces of people with foreign accents,” he said. “Who are they really? What memories and dreams do they carry? ”

Although Kidder is hesitant to define what the book is, he’s very clear on what it’s not. It’s not simply another story about Africa, nor does it intend to cast Burundi in an exotic light; instead, he wanted to humanize the country.

The book touches on many topics: civil war and genocide; courage and endurance; the generosity of strangers; and memory. However, the truths about these subjects are widely known and Kidder wanted his readers to explore these elements, not as truisms, but as experiences through Deogratias, he said.

And for Kidder stories are more than words on a page. He believes they have the power to move people to empathy, a necessary first step in spurring people to action to ameliorate suffering.

Although Kidder prefers to keep a temporal separation between his writing and activism, he was moved by what he observed when he accompanied Deogratias to the future clinic site in 2006. While speaking to a crowd of Kigutu villagers, he promised to do everything possible to get the clinic built. He eventually donated some of his own money to help speed the project along.

However, Kidder modestly downplays any suggestion that his writing has inspired others to take action. After a woman in the audience credited his book with determining her daughter’s career path, he replied: “I’m first of all a writer, and I don’t set out to tell these stories to do a good deed. If they do, in fact, do a good deed, then I can’t take credit for it.”

But Kidder is willing to acknowledge that his writing aims for a higher purpose.

“What I aspire to is art,” he said. “And art has the great power to transform the experience of suffering and injustice into something beautiful.”

Share and Enjoy:
  • email
  • Print
  • Digg
  • StumbleUpon
  • del.icio.us
  • Facebook
  • LinkedIn
  • Twitter
  • Google Bookmarks

Cross the border, and your human rights may stay behind

(from left to right): Susan Gzesh, Maureen Lynch, Howard Adelman, Deborah Anker

Scholars and students from around the nation and beyond joined to discuss the issue of migration within the context of human rights. As part of Northwestern University’s Conference on Human Rights, the topic at Friday’s forum was: Defining Forced Migration.

“Refugee law define a refugee as a person with a well founded fear of persecution,” said Deborah Anker, a professor of law at Harvard University and director of the Harvard Immigration and Refugee Clinic.

But the all too common problem is that once refugees cross international borders into a country where they do not hold citizenship, they are not always treated like human beings, a notion Anker argues vehemently against.

“Once refugees are outside their country, they are owed certain rights by the refugee convention,” she said.

Anker was referring to the fact that refugee law is an international law that grants every human fundamental rights – independent of where they are in the world.

“Overwhelmingly, refugees are products of war,” said Howard Adelman, a former professor of philosophy at York University in Toronto and founder of York’s Centre for Refugee Studies.

Adelman gave the example of the thousands of Christians who fled Iraq due to persecution because of their religious beliefs. While many of them may have hopes of returning to their home country, he said, in practical matters though, returning could be very difficult.

Adelman introduced the concept of LIMS (Persons In Limbo): they cannot live in their own country, but other countries won’t take them in either. Or, even worse, the country in which they were born may not recognize them as citizens. So where does such a person call home? Without citizenship anywhere, they are deprived of basic levels of assistance and structure provided by governments.

Adelman said that as a low figure, there are about 14 million stateless people around the world. A stateless person is one that does not hold citizenship within any recognized state.

While the panelists all agreed that something has to be done, no immediate grandiose solution was given. But Adelman touched upon a humanitarian quick fix: “If we just divide up the game, and everyone took some of them, we could solve the problem – but that’s not likely to happen,” he said.

Share and Enjoy:
  • email
  • Print
  • Digg
  • StumbleUpon
  • del.icio.us
  • Facebook
  • LinkedIn
  • Twitter
  • Google Bookmarks

Good manners and common sense: Charity founder addresses Feinberg students at benefit for Pakistani flood victims

Neal Ball, Founder and Honorary Chair, American Refugee Committee and Terry Long, Department of Family and Community Medicine, Feinberg School of Medicine

Neal Ball, founder and honorary chair of the American Refugee Committee, spoke to more than 30 students and faculty at the Feinberg School of Medicine as part of a benefit to raise funds for Pakistani flood victims Friday.

Twenty million Pakistanis were directly affected by the flooding last summer, and large swaths of farmland are still under water, according to event coordinator Paul Battone, a Feinberg medical student.  The 24-year-old president of the Student Senate said lingering floodwater would affect next year’s harvest and exacerbate the disaster.

Ball’s charity emerged from another disaster in the Eastern hemisphere more than thirty years ago.

After sponsoring a Vietnam War refugee from Laos, Ball set about trying to find the boy’s family.  The search took Ball on a tour of refugee camps in Hong Kong, Malaysia and Thailand.

The poor conditions in the camps motivated Ball to address the plight of refugees—an effort that culminated in the present-day American Refugee Committee.

Ball pulled from his experiences with the charity to explain how humanitarian outreach can make a difference and to point out obstacles along the way.

“Good manners and common sense. That’s what I think humanitarianism is,” Ball said when asked to define the term.

But life often complicates simple and sound advice.

Ronak Vashi, a Feinberg medical student, said people are often consumed by their everyday lives at the expense of what’s happening in the world around them. But she’s optimistic that small acts can have an impact.

“People think that you have to do a lot to make a difference, but there’s more to be said for a larger number of people each doing a smaller part to help a bigger cause,” she added.

It was this same lack of attention that prompted Battone to coordinate the benefit with first-year medical students Matthew Hire and Alex Sidlak.

“Truthfully I’d heard of the disaster in Pakistan, but I didn’t know too much about it,” he said.

Battone wasn’t alone. After researching the issue for the Feinberg Student Senate at the request of a professor, he noticed knowledge about the flood was limited.

Pakistani student Hira Bai said she was also surprised at the limited US outreach, especially in light of American support for the country in other areas.

”We should all just be more aware of our international community,” she said.

Battone partnered with Northwestern’s Center for Global Health and the South Asian Medical Student Association to host Friday’s benefit to raise awareness and funds for flood victims.  He also contacted local Pakistani restaurants to contribute food for the occasion.  Through donations the benefit raised $550 for Pakistani flood victims.

While some might argue that a small gathering in Chicago might not make a difference in a region ravaged by flood waters, Ball would disagree.

“No matter how big the problem is or how far away, don’t be shy about it,” Ball said.  “It’s never too big or too distant to give help.”

Not all charities are created equal.  Make your donations count with Neal Ball’s suggestions:

  • Look for transparency and accountability. Find a charity willing to share information about their work.
  • Find the shortest line between need and aid. Middlemen can complicate things.
  • Put your charity to the test with Charity Navigator, an independent, online evaluator.
Share and Enjoy:
  • email
  • Print
  • Digg
  • StumbleUpon
  • del.icio.us
  • Facebook
  • LinkedIn
  • Twitter
  • Google Bookmarks