In the US, general surgery residents do not get exposed to a lot of urologic surgery since this consists of a separate residency training program. However, in Africa, most general surgeons still perform a lot of urologic surgery. I enjoyed learning a new subset of skills and operations. Overall it was a productive week of learning and delivery of medical care.
While many would view healthcare as a personal “right” or entitlement in the west, in much of the rest of the world, it is still very much a privilege and is treated as such. I feel like it is becoming a more infrequent occurrence for most physicians to encounter patients on a daily basis who are genuinely appreciative of their services and care, even when things do not go as either the physician or the patient wanted. However, this is still encountered in Kenya. Patients are usually thankful, appreciative and respectful.
No matter how much you’ve planned, nothing ever seems to come together to meet your original vision. But, if you remain flexible and open to new ideas, there is always a time and place to make an appreciable difference in the community.
The Port-au-Prince metropolitan area is about the same size as Chicago, with a population of 2.6 million and no sewer system. Today, GHESKIO is flanked by The City of God and The Eternal City—massive slums that an estimated 200,000 Haitians call home.
Nothing brings a trip to Cambodia to an eventful end better than a national soccer game between Cambodia and Timor Leste. Not only was this game the biggest event of the week here in Cambodia, it was the perfect representation of this country, their camaraderie, and their never-ending joy. This futball game was more than two teams playing against each other for a win. It was a representation of the ability of this country to join together, to fight for joy and for the well-being of one another. Hearing thousands of Cambodians pridefully sing out their national anthem is unforgettable.
An education is a valued resource for these students, and it is an opportunity that many Cambodians do not get because of poverty. It was an honor to take a small part in this life changing opportunity for these people.

(The Hill, October 2016)

In 2010, the world watched in horror as more than 200,000 people lost their lives to a devastating earthquake in Haiti. And we shuddered again earlier this month when Hurricane Matthew – the most powerful storm to hit Haiti in more than 60 years – killed hundreds of people and impacted more than 2.1 million.

As the country continues to respond and rebuild, and as the world mobilizes much needed relief and assistance, it’s instructive to understand how Haitians are making themselves more resilient to natural disasters. And it is important to believe that there are strategies for long-term answers for Haiti.

One way might surprise you: better family planning.

That might seem like a lower priority amid disasters such as Hurricane Matthew. But it is exactly in these situations that women and girls are often subjected to an increased risk of sexual violence, unwanted pregnancies due to a lack of access to contraceptives and an overall lack of control over their situation.

And the time for women and couples to really strengthen their family planning strategies is between disasters, something that was clear just a week prior to Hurricane Matthew’s landfall, when CARE and Hope Through Healing Hands hosted a Learning Tour to Haiti. During the visit, the group visited successful U.S. foreign assistance programs focused on supporting healthier mothers and families.

There, the group met a woman named Ermicile Joseph, a 49-year-old mother of twelve. Ermicile welcomed the group into her home and shared her life story. She explained how hard it was to feed and provide for her large family and her wish that she had been able to time and space her pregnancies.

Ermicile lives in rural Haiti in the Central Plateau region where access to quality health care and family planning services is practically non-existent. Haitian women are often marginalized and have unequal access to everything from education and land to health care. They often experience health challenges due to serious obstacles in accessing pre- and post-natal care and family planning services.

However, this all changed for Ermicile when a community health agent made a visit to her home as part of a new effort to give mothers the services they desperately need to live healthier lives. Until recently, her options were limited. But now, Ermicile has taken control over her life and has used this newfound knowledge to educate her 31-year-old daughter Raphael about her options to choose when to have a family. Given the struggles Raphael witnessed growing up, she has decided to delay her first pregnancy until she is more financially prepared.

The benefits of this decision will have a long-term ripple effect for Raphael, her family and her community. Family planning is a powerful tool to combat poverty, particularly for those women who are able to avoid adolescent pregnancy, finish their education and enter the labor force.

When another disaster strikes the poorest country in our hemisphere, Raphael and her husband will have more capacity to provide for themselves. She will be more resilient in the face of danger. And if she does become a mother, she will know how to space a future pregnancy to avoid falling further into poverty.

We know that if women had the means to time and space the births of their children, it could prevent one in three maternal and child deaths in the developing world. Family planning is literally a life-saving intervention.

Thanks to U.S. foreign assistance, maternal and child mortality rates have dropped drastically in the past decade, as more mothers time and space their pregnancies. At a time of budget constraints, we must ensure that all of our federal programs are effective and this is an investment that pays off in the short and long-term. We must continue to ensure mothers and their families have access to the tools they so desperately need and deserve. This is particularly important during times of crisis and disaster.

We applaud the Senate for passing international family planning at the level of $622.5 million in FY17, and we call on leaders in Congress to protect these funding levels when they finalize their appropriations work after the upcoming November election. We also urge the incoming presidential Administration and the next Congress to prioritize international family planning programs within their FY18 budget requests and appropriations bills next year.

The foreign assistance budget supports families around the globe through low-cost interventions – such as family planning – that generate high-impact results. Through investments in women and girls, these programs will help women fulfill their potential and build a more sustainable future for their families and communities. And in the face of danger, they will be able to better control their family’s destiny and face the future with strength and resiliency. As Haiti currently responds to Hurricane Matthew – including CARE’s efforts to provide clean meals, water and supplies to those in immediate need throughout the country – we must stand behind mothers like Ermicile and Josephine who are the promise of a more hopeful future for Haiti.

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