Q: You trained at the CDC prior to your trip. How did that training prepare you?
A: During those three days at the CDC, we were taught how to put on and take off personal protective equipment every day, and so we understood how difficult it was, especially in searing heat. It is very challenging, and we were able to teach those skills in Liberia.
Q: In a paper recently published in the Journal of Hospital Medicine, you call on hospitalists to join the ranks of global health hospitalists. Can you explain?
A: Whether it’s Navajo Nation in Arizona or rural Haiti, the healthcare needs of the poor are very similar. Global health hospitalists play an important role in capacity building, running a health system, improving quality while reducing costs, working in teams to provide holistic care for the inpatient, and improving transitions to the outpatient setting.
Q: How do the skills learned in resource-poor settings apply back home?
A: Let’s say you have a patient with tuberculosis, which is very common in places like Liberia, and you suspect fluid in the lungs. [In Liberia], you would insert a needle and remove the fluid. In the U.S., a lot of providers would not be able to remove the fluid without getting an ultrasound and multiple other studies. Those costs add up. Global health hospitalists are very well versed in the skills of ultrasonography because there are no ultrasonographers in the field working with us.
Q: You said it was in Haiti where you began to notice volunteers arriving with good intentions but without needed skills. What exactly did you learn?
A: I spent a lot of time there, responding to the earthquake and also the cholera epidemic in 2010. I came across dozens of healthcare volunteers who had passion and commitment but really came ill prepared, not through any fault of their own, but because they never had an opportunity to learn the skills needed to be effective in the field. For example, take a nurse from an ivory tower hospital and suddenly put her where she doesn’t have IVs to work with or the right type of fluids or tubing. Well, suddenly she feels like her efficacy has gone way down. That could easily lead to a lot of frustration and potential burnout.
Stephanie Mackiewicz is a freelance writer in Los Angeles.