It's finally arrived. It's kind of crazy how fast time has flow by since I planned this trip, and it almost doesn't feel real....though I'm sure when we land in Ethiopia it'll hit me that I'm actually, finally IN AFRICA! I've really dreamed about this moment since I was a kid and we sent those shoeboxes to the boys in Malawi and Sierra Leone. It's a surreal experience knowing that I'm finally getting to go and work with the people of such a tremendous place. To update you on some general things, I just matched into Emergency Medicine at Henry Ford Hospital in Detroit. To know that when I get back, I graduate from medical school and can begin my training as an ER doc....pretty cool. I'm going to learn a lot and be able to make that much more of a difference in my future. This trip is going to really lay some foundations I think for both becoming an ER physician and a global health adventurer. I don't know about you, but I love being in a new environment, unfamiliar culture, surrounded by people of different colors, who speak languages that are not my own (and that I do not understand). For one, it helps me to understand my patients a little bit better -- doctors consistently speak in a language that is unfamiliar to their patients. "Your WBC is 14,000," or "Your MRI shows an infarct in the left MCA region".....some are better at interpreting that for patients, and some are not. Anyway, this is kind of a tangent, but that's one of the reasons I love it. The other is that the world is such a vast, amazing place filled with variety and unknown -- and most people never experience it! Right before I left I was talking with a friend and I brought up an experience in the Dominican Republic where I was working with an otolaryngologist, and she said something about wishing she had cool stories about her world travels to tell people. I'm fortunate that I've been provided with the experiences via the support that all of you who are reading have given us. And, more importantly, we can extend those experiences to other health care professionals now and really start to make a difference in the world. This spring alone MACI is supporting 10 other medical students on trips to India, Dominican Republic, Congo, Philippines, Korea, and Peru -- that's insane to me. The quote that I've based my organization around is by Mother Teresa, "I alone cannot change the world, but I can cast a stone across the waters to create many ripples." Well my friends, thank you so so much for the support because we've dropped a boulder into the global health pond this spring. Now, many of you may argue that we are wasting our time....you know, because we are only going for "short term mission trips," and we are getting more out of it than the people we are helping. Two responses for you in utter disagreement, and maybe I can help change your mind.
1) We are laying a foundation with the health care workers that we are sponsoring and giving them a knowledge and experience base from which they can continue their global health work in the future. Every single one of the people I have worked with overseas has come back changed, and most importantly, wanting to go back and find a way to make it part of their future practice. Maybe they don't want to go back....but they'll support it because they see the value in it. So, maybe that first trip they don't change the entire country, but ripples my friends, ripples.
2) Have you ever done the smallest of deeds and seen an impact beyond your wildest dreams? You know, like when you bring someone coffee in the morning and it somehow changes everything for their day? If not, try it. If you have, then you're on the same page and keep following me. I'll be in the Congo for a month, some people will be on their trips for a week, two weeks, or longer -- either way, yes you can argue these are all short term trips. However, I have no idea how many lives I might impact during this short one month. Maybe it's only one....maybe I do something for one person and it alters their life.....WORTH IT. I hope you think so too. I've seen that on prior trips, or with the patient that I still e-mail from 2 years ago. Ultimately why this matters is because I believe in sustainability. It's what separates MACI from other organizations in general I think. We want sustainable health care in countries that don't have it. I want to develop a model of how to do that and start implementing it around the world. Well, to do that I have to experience what's lacking. Maybe it's the public health side of my mind more than the medical, but I don't walk into a country expecting to change things in a moment, I see a big picture....maybe years down the road. I do believe that the experiences, connections, and partnerships that come from these trips are....yep, you guessed it, ripples :)
Okkkk, I'll get off the soapbox and back to my current trip! So Jason and I left this morning at 3:30am for O'hare (thanks to my dad for driving us...he's taken me to every trip and most of them are at the crack of dawn, so he rocks) and we took our flight to Washington. Of course it wasn't quite that smooth.....they did revoke Jason's ticket because they said they didn't get the fax confirming his credit card, and they couldn't find my reservation....but we eventually got it straightened out-ish and flew to Washington. We had to exit and grab his bags because they couldn't check them straight through. By the time we got finally checked in by the no-rush Ethiopian airlines, we were well past our boarding time.....luckily, they don't board on time either. I will say that once boarding the airline, I'm extremely impressed with Ethiopian airlines. Super nice actually. Jason and I got put in the same row, with no one sitting between us, and they served us 3 meals during the course of our 11 hours. Pretty good too - some chicken/mashed potato meal, chicken sandwich, and an omelet. Airline is quite spacious and open feeling, so it was an overall pretty comfortable flight. The pillow, blanket, toothbrush and.....socks that they gave us were perks too. Don't really get the socks thing....they're bright yellow, and....socks. I was hoping not everyone was changing their socks on the plane, though maybe the ventilation is good.
We arrived in Ethiopia and had about an hour and a half to chill as we waited for our flight to the DRC. You depart the plane on the tarmac in Ethiopia, and then they drive you to the airport. We all boarded the bus....and they drove about 20 feet and let us off. Everyone had a good chuckle as it took longer to load and load everyone than to drive. You had to leave security to go look at any of the airport shops, so I left Jason with the bags and went perusing. My nephew, Isaac, is adopted from Ethiopia, so even though I would only be there for an hour and a half, I wanted to snag him a gift....and something for my living room too. Good thing I left the bags with Jason because they were a bit more strict coming back through security and prolly wouldn't have let me take what I had with me as far as a carry on and a small bag (some of these airline restrictions are strangely annoying). The flight to the DRC was about 4ish hours, and after the 12-13 hour flight from Washington to Ethiopia, I was starting to feel the blood clots form in my legs (sarcasm) so the walk around the airport felt good for the ol' circulation. We were in Kinshasha in the DRC for about an hour sitting on the plane and then took the 7 minute flight to the Republic of Congo, Maya Maya International airport in Brazzaville. I didn't hear them announce it was 7 minutes so when we took off and then started to land I thought maybe the plane broke....but everyone applauded as usual when we landed (at least they do that overseas from my experience) so I figured we must have been somewhat ok.
The first stop was the EBOLA screen. A nurse just scans your forehead to see if you have a fever. Now, right as we began our journey I started to come down with something, and by this point I had a deep burning sensation in my chest and was hacking up nasty green phlegm and had a headache....so I was mildly worried I'd have a fever and they would detain me, but I made it through. Then you fill out your documentation and proceed to the other medical check where they make sure you have a yellow fever vaccination card. The next stop was with the police dudes, and I was really expecting this to take a loooooonnnnnngggggg time.....but actually ended up being a few minutes and they passed us on our way. The letter that Dr. Harvey sent us, which invited us to work at L'Hospital Evangelique a Impfondo definitely helped.....it looked super professional and I'm guessing they've seen it before because they took the letter and didn't ask us a single question.
At this point, Adolphe was waiting for us right outside the police stop, and he directed us to the baggage claim and helped us gather the luggage.....and score! We got everything. We had 4 bags in addition to carryons filled with supplies for the hospital, and considering we had to check them in at different hospitals due to the ticket revoking, I was pretty surprised. The next step though was the most terrifying.....running the luggage through the customs scanner. One of the things we were bringing down was a coagulation testing kit, which was a bunch of boxes of lab equipment in a giant styrofoam container with an ice pack on it....looked sketchy if you ask me. And a transformer (not the like Optimus sadly), and some other big scary lab stuff. I really expected them to detain us and ask us questions and see what we had, etc. But nope, walked right through. Maybe they knew Adolphe or something.....
There was a van waiting for us and we headed out to Hotel Bravo, which was a couple kilometers away. Dr. Harvey called us as soon as we arrived and let us know that he was setting up some opportunities for us the following day to see the university hospital, as well as a patient who was being transferred out for open heart surgery. Should be great. As I've harped on how much I want to impact the sustainability of health care in these countries, I need to see what the health care options are to start. Nastacia is a med/peds resident from OSF/St. Francis in Peoria who was at Hotel Bravo when we arrived -- and she spoke English, yay! Pretty much the whole afternoon she just gave us loads of information about the Congo, DRC, Rwanda, and the cultures/people within. Awesome to hear about these people and start to get an understanding for what we will be dealing with over the next month. Sounds like a couple of the doctors had to leave for personal medical reasons, so there might actually be more of a need for us to be here now. From what I can tell, the typical things we are dealing with is really malnourished children (kwashiorkor vs. marasmus), worms, cholera (or other nasty things from lack of clean water), malaria that is realllly bad (like kids seizing bad), leprosy in the pygmy population (one of the nurses does home leprosy visits, so that should be cool to see), and your typical other tropical type diseases....but sounds like everything is pretty far progressed. One really interesting thing for a public health minded brain, and maybe otherwise, is that the government reported HIV rate in Congo is 2%. However, with the number of pre-testing they do for blood transfusions (if the malaria is so bad that the hemoglobin is 2-3, they transfuse, and then 2-3 family members have to come and replenish the supply) they have identified that the number is more 5-7%. I feel a paper coming on.....maybe if I had more time/had more know-how into writing a paper, but I think this is interesting for several reasons. First, is this actually known and it's underreported for some political reason, or is it not known except by those identifying it. Second, it drastically affects sooooo many different aspects of their care and the real question is how do we stop it before it happens (birth control/condoms isn't really much of a thing in the country). Thirdly, this points to the fact I think that there are opportunities for scholarly work in third world countries that might influence even our health care....again, I'm pretty terrible at this point when it comes to scholarly work, but sounds like there are possibilities here to me....maybe in the future I'll learn more on how to contribute in that way.
I felt pretty terrible after we ate dinner (which was amazing by the way....some Senegal style food that Reol cooked for us), and I went to lay down. This cough and migraine now is getting annoying, so I'm popping pills and hoping for the best. Jason headed off to find a phone card and check in with his wife, so I'll hear about that tomorrow. They are supposed to cook breakfast for us and then I'll see what the plan for the day is. I really want to explore Brazzaville a bit....taxi ride is $2 only, so no excuses. We have a couple days as our flight to Impfondo isn't till Friday, based on scheduling, and we are meeting with 2 PA students from Indiana as well, so the following days should be fun. As always, thanks for reading, I hope you enjoyed :)
Aaron Tabor, MPH
Founder and President
Make A Change International, Inc
708.580.MACI (6224)
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