We arrived on the pediatrics ward this Monday, a little less naive and much less shell-shocked. I had grown accustomed to hearing only the whirring of ceiling fans, barking dogs, and the quiet chatter of Sinhalese in place of the traditional mind-numbing beeps and alarms of our medical equipment. I was pleased to see protective screening over the open air hallways, to keep the children from tumbling two stories, and to keep out the birds. It was surprising to see the number of children waiting to be evaluated for possible admission. Nearly all the beds were full, and it seemed as though they were in the habit of converting previous storage closets, consultant lounges, and any available space into treatment areas. The need for even more space remains evident.
We arrived safely in Nairobi and stayed at the Mennonite Guest House. The next morning we ate breakfast with missionaries from all over the world in different stages of their calling around Africa. Kijabe’s reputation is well known and they wished as well as we were picked up and driven to Kijabe via a road that had terrible slums juxtaposed with sweeping views of the Rift Valley.
I had plenty of time to contemplate all that I had seen during 12 hours of travel back home from a medical mission trip to Georgetown, Guyana. I had just spent three weeks working in the Accident & Emergency (A&E) department at Georgetown Public Hospital and using my training as an Emergency Medicine resident in the United States to help teach new ER doctors core material such as EKG reading, airway management, and the approach to shortness of breath and chest pain. I had not realized when I arrived how much of my time would be dedicated to sitting in the metaphorical trenches and caring directly for patients coming to the A&E. I was prepared for a foreign experience in a distant land, but instead I found myself right in my element.
We arrived on the pediatrics ward this Monday, a little less naive and much less shell-shocked. I had grown accustomed to hearing only the whirring of ceiling fans, barking dogs, and the quiet chatter of Sinhalese in place of the traditional mind-numbing beeps and alarms of our medical equipment. I was pleased to see protective screening over the open air hallways, to keep the children from tumbling two stories, and to keep out the birds. It was surprising to see the number of children waiting to be evaluated for possible admission. Nearly all the beds were full, and it seemed as though they were in the habit of converting previous storage closets, consultant lounges, and any available space into treatment areas. The need for even more space remains evident.
After a long journey to the other side of the globe, I was finally in Sri Lanka. It was 1:00 am when I landed then I arrived at my lodging at 4:00am. I had 4 hours to sleep and be ready to work! When I woke up to monkeys howling and playing in the trees 20 feet away, I knew I would like this place.
We arrived safely in Nairobi and stayed at the Mennonite Guest House. The next morning we ate breakfast with missionaries from all over the world in different stages of their calling around Africa. Kijabe’s reputation is well known and they wished as well as we were picked up and driven to Kijabe via a road that had terrible slums juxtaposed with sweeping views of the Rift Valley.
As I was packing for my first international medical trip to Guyana, South America, my wandering mind conjured image after image of third-world medicine based on popular notions and dramatic stories I have heard over the years. I imagined a row of soiled cots where emaciated children without IV access spent their final hours. I pictured a sweltering tent full of tuberculosis patients collectively coughing up blood; or a bathroom-sized emergency department packed with fever-stricken, jaundiced, indigenous peoples dying of AIDS, malaria, and other ailments while overwhelmed healthcare workers looked the other way out of emotional self-preservation because they had nothing to offer. As described to me by some physicians who had been there in recent years, some of these were features specific to the hospital I was heading to in the capital city of Georgetown.
I've probably done more than 30 appendectomies so far during my general surgical residency. For all the times I've taken care of someone with appendicitis, rarely, if ever, has the thought that they might die from the illness crossed my mind. Indeed, some of these patients were quite sick; but once they presented to medical attention, we could get them through their illness. Many of these patients were young which help in their recovery.
As I was packing for my first international medical trip to Guyana, South America, my wandering mind conjured image after image of third-world medicine based on popular notions and dramatic stories I have heard over the years. I imagined a row of soiled cots where emaciated children without IV access spent their final hours. I pictured a sweltering tent full of tuberculosis patients collectively coughing up blood; or a bathroom-sized emergency department packed with fever-stricken, jaundiced, indigenous peoples dying of AIDS, malaria, and other ailments while overwhelmed healthcare workers looked the other way out of emotional self-preservation because they had nothing to offer. As described to me by some physicians who had been there in recent years, some of these were features specific to the hospital I was heading to in the capital city of Georgetown.

I am delighted to tell you how antiquated and cynical my preconceived notions had been.


By: Bill Frist

Politico
December 15, 2011 12:03 AM EST

While Congress remains deadlocked in fiscal debates, American families are holding their own budget negotiations. How much can we spend this year on gifts for the children, home projects or even food for the holidays? Congress and families alike are tightening their belts, cutting costs and planning ahead.

This week, Congress is to vote on a drastic reduction of foreign assistance. While most Americans shy away from the language of foreign aid, polls show that despite continuing economic problems, more than half all Americans support funding for health, including education and emergency relief, in developing nations.

On World AIDS Day, President Barack Obama, joined by former Presidents George W. Bush and Bill Clinton, spoke about the global commitment to end HIV/AIDS by 2015 and recommitted the U.S. effort to do so. He announced new targets to combat the pandemic — including providing anti-retroviral drugs to more than 1.5 million pregnant women with HIV over the next two years.

Obama received a sustained standing ovation when he announced his administration has set a goal to get six million people with HIV on anti-retroviral treatment by the end of 2013.

These are worthy targets to celebrate. But to achieve it, we must have the support of Congress. Continued investment in the fight to end global AIDS is more than an investment in the lives of families and communities in developing nations — it is an investment in security, diplomacy and our moral image worldwide. It uses health as a currency for peace.

Millions of lives are at stake — literally. Under the current budget cuts, more than.4 million people will likely lack mosquito nets, a cheap way to prevent malaria. More than 900,000 children will lack access to vaccinations for measles, tetanus and pertussis. These numbers are staggering, but real.

Yet, as with any good investment, there is need for accountability, transparency and results. The Millennium Challenge Corporation is a good example of promoting aid effectiveness from “input to impact.” There is mutual responsibility for both donor and recipient to achieve the goals agreed on — an expectation that the recipient take ownership, as a partner, of both the aid and its implementation. Washington should and does require seeing results in practice.

For example, one of the best investments is providing access to clean, safe water. Every $1 invested in safe drinking water and sanitation, according to the U.N. Development Program, produces an $8 return in costs averted and productivity gained. Children are healthier, girls can go back to school and women can begin to work again.

A Millennium Challenge Account compact funding package for El Salvador now invests nearly $24 million to provide access to potable water systems and sanitation services to benefit 90,000 people in the country’s poorest region. This money creates healthier and more economically sound communities with something as basic as clean water.

More than 68 percent of Americans in a recent holiday poll said that because of the economy, we should be committed to charity this year more than ever before. With Americans reaching deep into their pockets to fill the coffers of red-hatted Santas on street corners or offering plates at houses of worship, Congress should follow their constituents’ leadership as they consider foreign assistance this week.

This holiday season, let’s recommit to investing in global health and development in the parts of the world that need our assistance the most. Foreign aid is less than 1 percent of our national budget, so cutting it would have a miniscule effect on our deficit reduction.

But it means the world to a mother whose child’s life we will save.

For the hope of greater peace on earth, investments in health and security could be the best bargain in town.

Former Sen. Bill Frist, a doctor, served as Senate majority leader. He is the chairman of Hope Through Healing Hands, a nonprofit charity that promotes using health as a currency for peace.

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