It usually comes to me in a super market, sometimes Wal-Mart. This time, it was in a Chili’s restaurant in Miami International Airport. I was returning from 6 weeks in Guyana and the bustling airport led me to seek refuge in a restaurant. The burger I ordered, with a thick slab of bacon, nearly overcame me with emotion. It wasn’t that it was such an incredible burger. It was my reflection, the contrast, of the place I often take for granted and the place I was returning from. The excess we have become accustomed to. Something so simple as a good burger is not obtainable everywhere. Many things aren’t.
I am sorry it has taken me this long to post again; the work here in Guyana is so great, and keeps me busy and exhausted. I’ll try to do better this week.

Today, I’ll share a bit about my hospital. Georgetown Public Hospital Corporation (GPHC) is the primary referral center for the country of Guyana. The “Accident and Emergency” Department treats roughly 75,000 patients a year. In a country with a total of only about 750,000 people, that’s roughly 10% of the nation’s population. To get an idea of what that’s like, imagine if one emergency room in the United States saw 30 million patients a year!
She was only six years old. She had somehow fallen from a height, landing on her head…unfortunately on concrete. It’s always concrete here. Her father told me she had been knocked unconscious immediately and she had not spoken since she fell. She had not vomited, but she also had not moved since the fall.

My residents and I performed a physical exam on the girl based on the “ABCDE” pneumonic I had been reinforcing: Airway, Breathing, Circulation, Disability, and Exposure. It is designed to simplify the assessment of trauma victims and to ensure that examinations are performed that same, every time, by every person. The theory is that if you do something the same way every time, there is less of a chance that you will miss something important.
This is my first post. I want this journal to be exciting, insightful, and encouraging. Most of all, I want to share the resilient spirit of these families, and encourage you to help better the lives of children around the block and around the world.

Located on the north coast of South America, Guyana is the only anglophone ("primarily English-speaking") nation on the continent. 83,000 square miles large, only 750,000 people call it home, making Guyana one of the most sparsely populated countries in the western hemisphere. It also has some of the largest, undisturbed tropical rain forests anywhere on earth! The infrastructure is very underdeveloped: power outages are not uncommon, many roads are in disrepair, telecommunications are unreliable, and tapwater is not always safe to drink. The people, however, are some of the most welcoming and kindhearted folks I've ever met; I've been treated well and respected everywhere I go.
Physiologically, people are essentially the same no matter where you go. Yet, when I first arrived in Guyana, I was surprised at how quickly death came for many. Infections, head injuries, road accidents, malaria…they all take their toll. There is no fanfare, drama, or ceremony. The body is covered and taken away and another patient placed in the bed. Relatives grieve, but they don't seem surprised. It is as if the boundaries between life and death are much narrower. Life seems much more fragile.
As my brief time at Kijabe hospital has come to an end, I'm amazed at all that I have been able to experience over the past 4 weeks. I wasn't sure what to expect when I arrived, but I found a resourceful medical center in a beautiful rural town, full of hardworking, enthusiastic and selfless individuals, with the primary goal of providing the best possible health care to the people of East Africa. The hospital is short on funding, resources and supplies when compared to American standards, but the incredible work they are able to accomplish with the little that they have is truly remarkable.

by Senator Bill Frist, M.D.

If you are a health professional, what can you do to influence global health? How can you get involved in health care around the world? What does health diplomacy mean?

This short video serves as an introduction to a lecture on health diplomacy and global health for those who currently serve in medicine in the United States. We invite you to watch and let us know what you think.

I have learned a lot from my time in Guyana. It is amazing to see how long patients will wait patiently to be seen. Crowded onto benches for hours just waiting their turn.

The "asthma room" as it is termed is one of my favorite areas of A&E. Patients magically appear there from the waiting room and are started on breathing treatments. All doctors have heard the term "all that wheezes is not asthma." So daily I would make my way through the group placed in the asthma room searching for the one who didn't have asthma but some other process. I found one elderly lady in heart failure and another baby who had a murmur and heart issue as well. Largely though the asthma room works as it gets those who need breathing treatments quickly the medicine they need. Teaching the residents at GPHC to be cautious about those other kind of wheezers was enjoyable and they will be on the lookout in the future as well.
These last two weeks at Kijabe I've been working on the pediatric service. I've worked on a fabulous team in pediatrics. My main "partner in crime" is a Kenyan clinical officer who loves kids and has a tremendous fund of knowledge and experience. Between the two of us, we see all the patients every morning in preparation for team rounds, write their daily notes and orders, and see outpatient pediatric consultations and admit patients in the afternoon. Everyday we go on rounds with a short-term family practice volunteer doctor from the US with years of experience, and a brilliant Kenyan pediatrician who trained at the top national hospital in Kenya.

Senator Bill Frist, M.D. is board member of the Kaiser Family Foundation.

The Kaiser Family Foundation has released a collection of new resources examining global health and HIV/AIDS funding in the Obama Administration’s budget plan for fiscal year 2012.

On global health, a new fact sheet breaks down the $9.8 billion in the budget request for the Administration’s Global Health Initiative (GHI), a proposed six-year, $63 billion effort to develop a comprehensive U.S. government strategy for global health. The fact sheet reviews proposed funding for the initiative, including breakouts by program area (HIV/AIDS, malaria, etc.) and by agency, including trend data where available.  It also examines support for the President’s Emergency Plan for AIDS Relief (PEPFAR).  The Foundation also has updated its Global Health Budget Tracker to reflect the President’s proposed fiscal year 2012 budget; the tracker will be updated to reflect changes as Congress considers and acts on global health appropriations.

A second fact sheet examines the $28.3 billion in proposed funding for HIV/AIDS programs both within the U.S. and overseas.   On the domestic side, the fact sheet breaks out support for programs that provide health care, drugs and other services to people with HIV or AIDS, as well as prevention and research funding.  The global budget examines spending for HIV/AIDS through bi-lateral and multi-lateral efforts.

In addition, the Foundation has updated the relevant Kaiser Slides charts to reflect the President’s budget proposal.  The charts can be downloaded for use in presentations or slide decks.

The Kaiser Family Foundation is a non-profit private operating foundation, based in Menlo Park, California, dedicated to producing and communicating the best possible information and analysis on health issues.

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