Blake WH Smith Scholarship Essay: Stephanie Vachirasudlekha, MS4
The Blake W.H. Smith, PhD, Scholarship provides a stipend of at least $1,000.00 for a CHM student, resident, or faculty member (academic/clinical/volunteer) engaged in furthering the goals of primary health care, or community-oriented medical education with an emphasis on international settings or under-served areas and populations in the United States.
As a fourth-year medical student in the College of Human Medicine’s Leadership in Medicine for the Underserved Program, I embarked on a two-month international rotation to Uganda with five fellow Michigan State University medical students. Nestled in the remote mountains of Eastern Uganda is a small village in the District of Bududa, called Kikholo. In this rural village, we worked at a primary care clinic that focused not only on personalized clinical care, but also on community outreach to surrounding villages, and health education and social support programs. Living and working in this community not only facilitated my professional development, but also nurtured my personal growth.
Our clinical duties included seeing and caring for patients of all ages, working in the small laboratory, and assisting in the wound care and pharmacy stations. While most of our cases were common illnesses that we have seen in the United States, we also saw pathologies that were unfamiliar to us. Many times, these were manifestations of diseases that were ignored for far too long. We also learned about different pharmacological options that are available in Uganda versus the United States.
Buried within the multitude of clinical cases were additional lessons concerning psychosocial determinants of health, the importance of family and social support, and how social stigma of certain diseases can affect health outcomes. These lessons were learned not only through discussions with the patients and their families during clinic visits, but also beyond the clinic’s walls. For example, in the middle of the town square one day, a few members of our group came upon an adolescent boy who was lying on the side of the road. Around him, people were going about their business, selling goods and visiting nearby shops. My colleagues approached the boy as others stood around and watched. A passerby told them that the boy was known to have epilepsy and had just suffered a seizure. After helping the boy sit up, ensuring he was alright, and getting him something to eat and drink from a nearby stand, the medical students were told that people in the village believed that epilepsy was contagious. If someone touches an individual who is seizing, that person would also acquire the disease. It became apparent that misunderstandings and the accompanying stigma associated with them can significantly affect an individual’s health trajectory.
We also had the opportunity to contribute to and lead many projects. We participated in clinic programs that were established years ago based on community need, such as a weekly Post Test Club (PTC), which is a support group for adults who are HIV positive, monthly Orphans and Vulnerable Children (OVC) meetings for children with HIV who have lost one or both of their parents, and other various women’s and men’s groups. In addition to seeing patients in the clinic, we accompanied local community health educator volunteers to homes to assess sanitary living conditions of local villagers. We also traversed the lush, green mountains to outlying schools and villages
to hold immunization clinics, provide vitamins and deworming medication to villagers, and deliver health lessons to local schoolchildren. We taught women and girls how to make reusable menstrual pads and kids about basic wound care and healthy eating. We would often hike for hours over treacherous terrain and through downpours to reach our destinations.
This entire experience has reinforced my desire to pursue primary care, community medicine, and also additional global health experiences. Working with schoolchildren, interacting with kids who greeted us each day on our walks to and from the clinic, and the young patients in the clinic reinforced my desire to pursue a career in pediatrics. I have a background in public health and social work, and felt that much of the work accomplished by the volunteers and staff of the clinic embodied many principles upon which these fields are based. Accompanying Community Health Educators as they traversed hills and mountains to reach the farthest homes in the clinic’s catchment area reminded me of what I had only read about for years and strengthened my desire to incorporate community health into my future medical career.Living in Uganda for seven weeks and working with the local clinic staff and volunteers transformed me. Prior to my trip, I had only read about utilizing community health workers to reach remote areas in third-world countries. Here, we not only saw it in action, but were able to participate as well. Our community outreach trips widened my views of access to care issues, showing me how far some of our patients travel to be seen in the clinic. I saw how little some people have, how hard villagers work to provide for their families and how these dynamics play into their health behaviors and outcomes. Electricity is a rarity and so much time and effort are spent collecting water from wells that are often far away. These are two examples of everyday things that I used to take for granted. Through the PTC and OVC meetings, I saw the positive impact of social support on the ability for those with chronic illnesses to thrive. Through my daily interactions with the clinic’s staff and volunteers, I was constantly inspired by their commitment to improving the health status of this community. One such volunteer hikes four hours from his home to pick up vaccines from the clinic and continues for one to two more hours to vaccinate children in neighboring villages before turning around and making the long return trip home.
Completing an international medical rotation was one of the most rewarding experiences of my medical school career. Living within this rural, Ugandan village for two months provided an in-depth look into how the people in our community truly live in a way that cannot be captured by books read by a student half a world away. As I continue my medical training, I will hold my experience in Uganda very close to my heart.
Find more information on the Blake Smith Award.