Future Doctors Hone Skills on Medical Missions Around the World
by Candi Helseth
VCOM students Becky Striker (left) and Patrick Hickey examine a young girl at "Peace Messengers," a home for HIV positive children in San Salvador. VCOM student also went to surrounding rural villages in El Salvador during the November 2009 trip.How do you encourage medical students to consider a career as a physician serving rural and underserved areas? By plunging them into the depths of people’s needs and giving them tools to make a difference in people’s lives. At least, that’s the philosophy of Edward Via Virginia College of Osteopathic Medicine (VCOM), a four-year osteopathic medical school at Virginia Tech in Blacksburg, Va., which sponsors nine student medical mission trips every year and staffs and maintains year-round clinics in El Salvador, Honduras and the Dominican Republic. Students also volunteer at clinics and do medical rotations in the Appalachians.
“These experiences instill compassion and that helps students understand the true meaning of medicine and service," said Dean Sutphin, VCOM Vice President of International Outreach. “These students will make better medical doctors regardless of where they practice.”
VCOM graduate and emergency medicine resident Jeremy White has been a member of several international VCOM emergency and disaster missions, most recently in February when VCOM responded to the Haitian earthquake. Team members set up on the Dominican Republic’s border with Haiti where they provided assistance and treatment for more than 3,000 earthquake victims.
“Basically, I was hooked on medical missions after we went to India to help the Tsunami victims a few years ago,” White said. “You step so far out of your comfort level. You’re exposed to a completely different view of life and you have the privilege of helping and caring for people who are in the most need.”
Dr. Jim Powers, Chairman of the VCOM Department of Emergency Medicine, says teams learn humanitarianism, which is difficult to teach or simulate in the classroom.
“In addition to providing medical care and medications, disaster response missions teach students the importance of providing patients with reassurance, hope, empathy, and simple comforts we take for granted — food, clean water, clothing or a warm blanket,” Powers said. “Even here in the United States, our experiences show that after a large disaster, most medical care requirements will continue to be for those with chronic or common medical problems rather than directly due to the disaster itself. And students learn that disaster response is not one-dimensional. Nutrition, good hygiene practices, preventative care and health maintenance, psychological support and counseling must all be taken into consideration in the medical response.”
In isolated, mountainous towns where families may earn less than $1 per day and there is no water treatment or sanitation services, VCOM students practice primary care, treating malnourishment, parasitic diseases, malaria, Dengue fever, intestinal worms and environmental concerns most American medical students would never encounter. In the Dominican Republic, White treated more than 1,000 people with scabies caused by a parasite. With an educational program designed to modify lifestyles and medications to treat the disease, White recorded significant progress over a 10-month period. The project was part of his doctoral dissertation in international health. He returns periodically to the village where residents continue to follow his protocol and keep the disease at bay.
During the Dominican Republic/Haiti Relief trip in December, VCOM students Max Bursey (left) and Austin Nabet help transport an injured woman to a care facility.VCOM’s outreach also supports desperately poor populations close to home. In rural and underserved sites of the Appalachians in southwest Virginia, VCOM students spend three to five month rotations providing medical care in clinics and hospitals. They also work with churches, schools and community centers doing health and lifestyle education.
Organizing and implementing medical mission trips requires a comprehensive commitment from many levels, Sutphin said. During the Haiti trip, the group encountered barriers getting into Haiti. Because there was already an established relationship with the Dominican Republic, they were able to treat Haitian patients that crossed the border for help. The team operated under adverse conditions with scarce resources and heavy patient loads. Sutphin said working in a foreign culture also forces students to gain diplomatic skills and overcome language barriers.
“In each country we go to, the logistics and management coordination varies depending on the country,” he said. “The students offer assistance within the legal framework of that country. Where we have year-round clinics, they work under the physicians there.”
Participation in medical missions isn’t a requirement, but Sutphin said most students choose to go. Team members pay their own travel expenses and often bring large suitcases filled with medical supplies and donations. Recently, 40,000 pairs of shoes were donated to VCOM for distribution to needy families throughout the international sites. Sutphin said the donation is equivalent to nine Mayflower tractor-trailers filled with shoes.
“We want to develop sustainable healthy communities,” Sutphin explained. “We’re always doing medical care but we also emphasize public health and prevention. The shoe project addresses parasite control and prevention of foot infections and injuries that are accompanied by wearing shoes. Another trip we might be working on getting clean water. Our real hope is that our involvement will lower the incidences of health issues and the number of patients we actually need to see.”
VCOM opened in 2003 following a Virginia Tech study that indicated the nationwide physician shortage is expected to reach almost 100,000 physicians by 2020, with rural and medically underserved communities such as those in Virginia’s Appalachian region most negatively impacted. VCOM has begun collecting data to measure how medical mission trips impact career choices and influence students’ decisions in whether or not they will practice in rural and underserved areas.
White, who graduated in 2007 with a doctor of osteopath degree from VCOM and earned a PhD in international health from Virginia Tech in 2008, continues to volunteer for medical mission trips whenever possible.
“Every one of the trips I’ve gone on and whatever help I’ve been able to provide on them, I always leave with so much more for myself,” White said. “I’ve learned so much about this world, about myself and about the goodness of humankind.”
For more information, contact:
Dean Sutphin
Edward Via Virginia College of Osteopathic Medicine
2265 Kraft Drive
Blacksburg, VA 24060
Phone: 540-231-6862
Email: dsutphin@vcom.vt.edu
AROUND THE COUNTRY
Nonprofit Networks Supply Travel Nurses to Rural Montana
by Candi Helseth
Carla McCune, who works as a travel nurse at three different rural hospitals for Monida Healthcare Network in western Montana, says she enjoys the challenge and variety of her work.Two nonprofit ventures in Montana are proving that bigger isn’t necessarily better, especially when it comes to rural nursing staff needs. The Montana Health Network (MHN), serving eastern Montana, began offering a travel nurse staffing program in 2006 and Monida Healthcare Network in western Montana followed suit a year later.
Travel nurse companies and recruiters place nurses in temporary positions, often in large city hospitals. While rural Montana facilities can fill temporary nursing slots using large travel nurse organizations, local travel nurses are more likely to understand the rural environment and are often available for shorter time frames than those centered in urban environments.
Jill Domek, Vice President of Aging Services for two nursing homes in Glendive, Mont., says that MHN nurses provide a greater consistency of care. Having the same nurses return reduces staff’s time spent orientating temporary staff.
For Carla McCune, a registered nurse who is also certified in public health nursing, being a travel nurse with Monida offers challenges and rewards she was no longer finding in her 20 years working as a nurse in large, full-service hospitals. McCune, who lives in Missoula, Mont., travels up to 160 miles round trip to assignments at three critical access hospitals (CAHs) in western Montana.
“The beauty of being a travel nurse is that I can care for patients and not become embroiled in any hospital politics,” she said. “It’s given me a chance to experience a different aspect of nursing, that of rural nursing in a CAH environment. I always look forward to my next shift.”
Many nurses working for national travel agencies refuse rural assignments, said Amber Rogers, Monida director of clinical services. Additionally, national agencies generally ask hospitals for a 13-week commitment. That can be a financial drain for a rural hospital that only needs a nurse to fill a spot for a much shorter period.
“Basically every nurse in a small town already works for the hospital so when nurses leave for vacation or educational workshops, it’s tough to find staff to cover their absence,” Rogers said. “That’s where we come into play. We try to be a matchmaker essentially. We look at the skills of the nurses we have and what the hospital needs from that travel assignment.”
Six clinics and CAHs with an average daily census of one to 10 patients in seven western Montana counties are members of the Monida network. Montana Health Network serves 17 hospitals in eastern Montana; three are frontier hospitals and all are CAHs, with the exception of one at Billings. The two networks provide a variety of services, including travel nurses, which improve efficiencies and reduce costs for member facilities.
Under the temporary staffing program, the networks each employ 20 to 30 nurses. The travel nurses live in Montana and North Dakota. The networks are responsible for background checks, nurse education, assignment coordination and paying nurses’ salaries. Temporary staffing services are offered to member and non-member hospitals, nursing homes, assisted living facilities and physician offices.
“We’ve also implemented a mobile educational unit so we can teach nurses on-site rather than their having to leave their facility to travel for education,” said Chris Hopkins, MHN vice president of strategy and business development. “That helps reduce staffing issues too.”
Members in the networks can still use national agencies when they choose. They receive a discount or rebate using the MHN staffing programs. MHN used in-house funding to start their program; Monida funded their program through a HRSA Network Development grant that ended April 30th. Both programs are self-sustaining now.
For more information, contact:
Chris Hopkins
VP Strategy and Business Development
Montana Health Network
11 South 7th St. Suite 241
Miles City, MT 59301
406-234-1420
Chopkins@montanahealthnetwork.com
Amber Rogers
Director of Clinical Services
Monida Healthcare Network
3700 S. Russell, Suite 108
Missoula, MT 59801
406-829-2385
arogers@monida.com
