Medical student Neena Qasba spent most of last summer in Bolivia studying poor women’s use of small loans for essential health services. Cheryl Bilinski, an MD/MPH student, spent the summer in Haiti working on a prevention and treatment program for
pregnant women and newborns with syphilis.
The two students represent the growing number of Health Center students who study abroad during their graduate school careers.
Both say the experience was an invaluable adjunct to their education, giving them an understanding of cultural issues in health care they might not see if they studied only in this country.
Qasba says she came to recognize that there are many cultural barriers to obtaining health care. She worked with women who had successfully used microfinance loans to build small businesses to support themselves and their families.
Because of their success with the business loans, they were eligible for small loans for health care services, but they didn’t use them very often.
“Barriers to obtaining care seemed related more to cultural attitudes, such as the lack of trust in doctors and low health care literacy or general knowledge about health care procedures,” says Qasba who is analyzing the data for a presentation during Medical/Dental Student Research Day in February.
Bilinski says her experience helped her understand the difficulty of implementing health care protocols in low-resource settings. A simple blood test can detect syphilis in newborns, but in a rural country where laboratories and supplies are scarce, a blood test is not such a simple procedure, she says.
Bilinski adds that her experiences in Haiti affirmed her interest in international health studies, and she hopes to return there to do additional public health research during her fourth year of medical school.
Judy Lewis, professor of community medicine and pediatrics and director of global health education, says the Health Center’s program to support foreign study by students has an emphasis on encouraging students to study in “low-resource settings, where they can experience what life is like for 80 percent of the world, as well as gain a sense of how it feels to be ‘the other.’ This type of immersion helps improve communication and other clinical skills for effective patient care in all settings.”
| Cheryl Bilinski, an MD/MPH student, examines a patient at a clinic for pregnant women in Haiti, where she spent the summer. Photo by Cheryl Bilinski
Lewis plans to expand students’ access to global health studies with the help of a recent gift from Dr. Edward Hargus, ’73, and his wife Maria. She also hopes to attract other donors to help support
Lewis says study and research in other countries help students think more about what they need to know about a person in order to take care of them, says Lewis.
“We are a nation of immigrants,” she says.
“Physicians need to understand the culture and background of their patients to provide appropriate health care. They have to know what language their patients are speaking and what their lives are like. They can’t find out if they don’t ask, and we believe global health studies can help them better understand the kinds of questions to ask.”
The medical school curriculum includes a first-year elective seminar, Community Health Research Methods, that prepares students for the development of international health research proposals.
As part of the elective, students conduct research for two months during the summer and then are guided in data analysis by faculty advisors.
Opportunities for clinical work abroad have been available to fourth-year students since 1984, when two medical students went to Lima, Peru, to work in a clinic serving shantytown communities with Stephen Schensul, professor of community medicine and health care, who has developed global health studies with Lewis.
Since 1984, more than 18 faculty members have established relationships with institutions in other countries where students can work; and informal program relationships support students
in many more countries. More than 300 students have taken part in global health studies, traveling to Puerto Rico and 67 other countries.