Siloam Health stands in a unique place in the landscape of the American health system as a primary care clinic for the uninsured. Shouldn’t our healthcare system be emphasizing quality care for these, the ones who need it most?
UNFPA has seen thousands of examples of smart, courageous, effective and positive change, from girls saving their peers from child marriage to young people dreaming up wildly new solutions to age-old problems. Here are 10 New Year’s resolutions inspired by real people who are working every day to change the world.
Yesterday Americans woke up to news of a new president-elect: Donald J. Trump. The immediate question for those whose lives focus around lifting the health of individual Americans is, “What does this mean for health care in America?”

At the heart of the answer is uncertainty. Trump is an “unknown unknown” when it comes to deep, thoughtful health policy. He has excelled in many fields, but at best he personally has only dabbled in the field of health care, which accounts for a fifth of our overall economy and affects literally every American. So, to begin to answer the question, we can only start with what he has said on the campaign trail and the bare-boned, seven-point “plan” on his website and conjecture from there.
The A&E. I have enormous appreciation for the staff, nurses, residents, and attendings I met during my time in Guyana. In a short time, they have welcomed me into their emergency department, helped sharpen my clinical skills, and become a second family far from home. What’s more, there are actually some elements of Guyanese health care that I wish for after returning home, such as universal health care and access to primary care. There were many times I could send a patient from the A&E directly to a specialty clinic the same day. I prescribed medications knowing that patients could fill them for free from the hospital pharmacy. Time and again, I was shown ways in which low resource did not equate to low quality care.
Personally, working in the A&E has challenged me in surprising ways. There are not nearly enough nurses and staff available to start IVs, draw blood, hang IV fluids, administer medications, or reassess patients. Much of that responsibility is left to the physician, and it’s awkward to admit I’ve placed more IVs in 2 weeks than I have in all of residency. Lab results can take half a day to return and a CT scan is often out of the question. While it is actually refreshing to rely on my physical exam, technical skills, and clinical intuition to take care of patients, I feel the weight of each decision I make much more.

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