As women, sometimes we can be consumed with the needs of all the people right before us in our homes and communities. Yet, there is a longing in each of us to be part of something bigger than ourselves. We experience empathy and concern for others, our neighbors, both near and far.

Jamie Cirbus MD, giving a lecture on trauma care at weekly Emergency Medicine Conference at Georgetown Public Hospital, August 2017.

The past month taking care of patients, teaching, and learning from my colleagues in the A&E at GPHC has been a wonderful experience as always. I have learned a great deal and I have also had the opportunity to teach in a variety of settings, which has been very gratifying. I never leave here not in awe at the great work these physicians do with the limited resources they have available. I also rarely leave without a memory of some patient that we were not able to help as much as I would have liked due to these limitations. This month in particular it was a lack of streptokinase (the medicine they usually give here to break up the blood clots that cause heart attacks as they do not have a Cardiac Catheterization option available at GPHC). Over the month we unfortunately saw many patients with heart attacks and there was little we could do for them. Still, the physicians here push on and do the best they can with what they have.  I am looking forward to my next trip back in a few weeks so I can continue to work alongside these excellent physicians providing the best care possible to the people of Guyana.

Hi Ryan Van Nostrand here in Georgetown, Guyana. This is the end of my second week and it has been an educational and enjoyable experience working in the GPHC. Over the last two weeks I have been able to gain an insight to the difficulties and similarities between medicine in the US and Guyana. It has been a pleasure to work with the doctors and staff in the Emergency Department and I have really enjoyed being able to teach and learn from the residents here.
I am sitting on the terrace of my hotel in Kathmandu, sipping spicy masala tea and looking out at the cityscape for the last time. Below me, the pudgy, fresh-faced toddlers of affluent Nepalis learn to swim in the crystal-clear swimming pool, a far cry from the muddy, leech-infested floodwaters of the nation’s rivers and lakes. The all-seeing eyes of the Boudhanath stupa, the holiest Tibetan Buddhist temple outside of those in Tibet, gaze placidly down at me from their towering perch above Kathmandu, watching over the nation. In the distance, somewhat obscured by the dust and smog of the capital city, I can see the Himalayan foothills, their dark, untamed beauty seductive in its wildness. I think of my ten SBA students, scattered now throughout isolated villages in those very mountains, providing contraception services and prenatal care and delivering babies in remote clinics. I offer up a silent prayer for them, and for the women, children, and families they are serving.
This is now my third trip to Guyana to work at Georgetown Public hospital, fondly referred to as GPHC, in the Accident and Emergency Department (A&E). Each trip has been eye-opening, motivating, inspirational, at times frustrating and heart wrenching, and always immensely rewarding. I am fortunate to be the current Global Health Emergency Medicine Fellow at Vanderbilt, meaning I will spend much of my time this year working in Guyana.
There is no period more critical in a child’s development than its first few months of life, which is why so much attention is paid to what the mother, and the child, eats during that time. Nutritionists like to call it the “golden window” — the slim period of time where a child, if he gets the right nutrients, can set out on a healthy path, or, if he doesn’t, risks irreversible stunting and developmental delays. “Eighty percent of the brain development happens in the first 1,000 days of a child’s life, starting from conception,” says nutritionist Sanjay Kumar Das.
Over 13 million adolescent girls between 10 and 19 years–equivalent to the population of South Sudan–were married in India in 2011, according to census data, but fewer literate women were married as children or had children early compared to those who were illiterate, according to an analysis by Child Rights and You (CRY), a Mumbai-based child rights nonprofit.
The Senate confirmation last week of our colleague Ambassador Mark Green to be USAID Administrator comes amid the struggle between the president and Congress over the administration’s proposed 30 percent cuts to foreign assistance. In this convergence of events, we see a real opportunity for Congress and the administration to do much more than debate where the burden of potential cuts might fall, and instead make lasting reforms to make our foreign assistance better able to enjoy long-term success and provide savings far beyond next year’s budget. Success will not be easy and will require significant changes to our approach to development.

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