Service abroad brings rewards, challenges

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Holly Hawkins left all of her textbooks behind, slept under a bug net and helped deliver a baby a week after arriving in Kenya.

Some of Pacific’s health professions programs offer students the opportunity to complete one of their clinical rotations at an international site.

According to Pacific physician professor Anya Hill, approximately 50 percent of her students travel abroad each year.

Pacific’s Physician Assistant program partners with the Ray of Hope Foundation, a non-profit organization founded in 2003 by Dr. Teresa Gipson. Gipson is a family medical practitioner at the Oregon Health Sciences University who has dedicated the last 10 years working with underserved populations both locally and abroad.

Hawkins, a student of Pacific’s School of Physician Assistant Studies, is one of three students who traveled to Kenya in the fall of 2010. While abroad, the students stay with a host family, and learn and work at two different clinical sites: St. Joseph’s Hospital, a private facility and the district hospital, which is open to the public.

The students see a variety of extreme medical cases while working in the hospitals.

According to Hawkins, HIV is a serious and on going problem in Africa. “That got to be hard,” she said, as it was not unusual for her to diagnose 20 people with HIV in one day.

The students commonly treat malaria and typhoid fever and frequently assist delivering babies.

In addition, they visit the local village schools to treat children for parasites. Many of the children and their families live in poverty and due to the lack of basic sanitation practices; village streets are covered with trash and sewage. The students try to educate patients in order to create an awareness of basic self-care skills and health care options.

The PA students also have the option of traveling to Costa Rica, Ecuador, Honduras or China.

Silvia Ochoa graduated from Pacific’s PA program in Aug. 2010. Ochoa traveled to China for her six week Community Medicine clinical course requirement. While abroad, she observed and practiced acupuncture and traditional Chinese medicine, worked in the local clinic and attended evening lectures.

According to Ochoa, patients often wait in line for healthcare all day, but may still not receive treatment. There is no air conditioning in the hospitals, the patients and the doctors are almost always overheated and exhausted and the facilities are lacking compared to those in the United States. Toilets are rare outside of tourist areas and many basic sanitation practices differ widely from U.S. settings. Ochoa distinctly recalls that healthcare providers don’t usually wash their hands between patients.

Ochoa said it is not uncommon to be in a room where one woman is having a baby, one woman is being treated for a miscarriage and one woman is getting an abortion.

Due to the Chinese government policy that only allows couples to have one child, there is a great need for pediatric services.

Ochoa recalls treating a woman who came in six-months pregnant after taking some over the counter medication that could have potentially negative side-effects for her child. Because there was a chance her child could be deformed, she decided to have an abortion and try again. Ochoa said the woman didn’t want to take a chance that the only child she could have would be disabled.

Cases like this are not unusual in China.

“Nobody could have prepared me for the cultural shock,” Ochoa said. “It was very interesting every day; we never knew what to expect.”

Sandra Pelham-Foster and Sandra Rogers of the Occupational Therapy Department, Nancy Cicirello of the Physical Therapy Department and Kathlene Postma of the English department travel to China to establish a program designed to provide services to children with physical, mental and developmental disabilities residing in orphanages. They are working together to implement a program designed to educate the pediatric health care staff to better provide health care for children with special needs.

In June, two OT students will travel to China as part of their senior projects. The faculty members have already been there twice and it was a “phenomenal experience,” according to Pelham-Foster.

The program focuses on how to better address the needs of the individual child. Many of the children in the orphanages were never adopted because of their disabilities. The ultimate goal of the program is to show health care providers and the community that “kids with disabilities are able to grow, develop, learn and participate in society,” said Pelham-Foster. “They can do things just like other people.”

OT students also have the opportunity to travel to a variety of international sites to complete part of their clinical rotation requirements.

Senior OT student Tara Haug traveled to South Africa for 10 weeks where she worked in a government-run rehabilitation center. She worked primarily with patients who suffered from spinal cord injuries, traumatic brain injuries and other neurological issues.

Haug’s clinical site was one of three rehabilitation centers in the entire nation of South Africa. The site was understaffed.

“I think they appreciated the help,” said Haug.

Her patients were mainly of low socioeconomic status and the victims of violence. Many people came to the clinic to relearn basic life skills after suffering from stab or gunshot wounds.

Many of the people Haug treated traveled to the center from Townships, the impoverished neighborhoods on the outskirts of Capetown. “People there literally have nothing,” said Haug. “But everyone took really good care of each other. Their good spirits rub off on you.”

Haug said she would recommend international experience to other students, but she said, “It’s not easy. You’ve got to be ready to be pushed to your limits.”

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