ENT in DR -- Sustainability

Whenever I come back from a mission trip to a 3rd world country, not that I've gone on a lot, I always wonder about the lasting impact that we made. The reality is, probably not much. I remember when I went to the DR for my ISI trip, we doled out GERD mediation, antibiotics, vitamins, etc. to almost every patient we saw. The got treated for their illness, but the sad part was that they would get sick again. They will get parasitic infections again, UTIs, the consequences of acid reflux, etc. again once the medication runs out. It seemed to me that we were fighting a losing battle.

Surgical trips seemed to make more sense to me. They could fix hernias, remove tumors, repair joints, create fistulas for dialysis, etc. and that wouldn't depend on a long lasting supply of medication. The patient would come in for a one day surgery and possibly be rid of their ailment for the rest of their lives. I think that is one reason that drew me to ENT in the first place. The ability to practice medicine, but also surgery.

In the DR, we saw a lot of patients with GERD. We gave them whatever medications we had and they'll feel better as long as they have the medication, but once they run out, the problems will return, unfortunately. We saw a lot of patients with obstructive sleep apnea secondary to large tonsils and adenoids. We were able to remove those obstructing appendages and the child is "cured" of their apnea. I find that amazing because a 15 minute surgery was able to do that. We also performed about 8 PV cases to create AV fistulas for dialysis for patients with renal failure. Now these patients will be able to get dialysis and improve their quality of life.

However, medicine to me has always been an acute fix. It exists to fix problems when they occur. For these 3rd world places that I visit, their problems are more systemic. Their health problems exist because of their lack of infrastructure and no amount of medicine/surgery can fix that. The amazing part of this trip was in meeting the Peace Corp volunteers and hearing about what they are doing for the communities -- things that are sustainable.

One person is helping her village develop a clean water supply system. Clean, running water will go a long ways in terms of public health and cutting down on infectious diseases. Another person is helping to develop a computer curriculum for his area. That will help bring the people there up to speed with the rest of the world in terms of technical know-how and put them in position to compete for better jobs in the future. Technology is so interwoven into our daily lives these days that knowing how to use computers is a necessity.

The projects that the Peace Corp volunteers are undertaking are the type of projects that can make lasting changes. Something that our 1 week long medical mission trips can't do.

David Chan, MS4