Traveling to remote locations around the world poses interesting challenges. Some of them are programmatic and administrative. Some require close attention to one’s own health and security, depending on the region. What travelers often experience upon arrival to a new place is mostly perceptual: new scents, bizarre cuisine, kaleidoscopic hues of color, tropical fauna and sites only seen on television or in Lonely Planet literature. It takes time to adjust, no matter how short-term the trip, to the newness of being in a foreign setting. Alex Vandergrift, MD remembers fondly how his trips abroad brought strange delight and comfort to his senses.
“There’s some initial shock that takes a little getting used to,” explained Vandergrift.
Vandergrift, a neurosurgeon and associate professor at the Medical University of South Carolina (MUSC), finds the change refreshing compared to commonplace amenities in the western world. His trips to Morocco and Cameroon were in no way respite, however. Vandergrift traveled to rural regions in Morocco to perform surgical procedures on ailing patients through Medical Campus Outreach (MCO), an organization that sends medical professionals abroad to treat the underserved in low and middle income countries and strengthen the clinical skills of the local students through a train forward model.
“What I really hope to do is give insights, tips and techniques to the trainees in Africa so they can take care of patients with trauma,” Vandergrift said. He worked in Cameroon on his own accord with colleagues who forewent the American way of life to dedicate their talents and knowledge to treating marginalized communities in rural sub-Saharan Africa—they now reside in the region.
Vandergrift’s objective on his most recent trip to Morocco was to teach Moroccan students and trainees through procedures he performed with colleagues from the west. He was accompanied by a team of roughly 50 healthcare professionals comprised of medical students, pharmacists, dentists and allied health workers who helped treat illnesses like diarrhea and ear infections.
Despite the healthcare disparities that exist in these regions, Vandergrift was particularly struck by the amount of people impacted by the gap in those who actively seek care and those who don’t given the life expectancy in Cameroon is 53 years. What’s more, treatable illnesses like diarrhea and pneumonia kill 34 percent of children five years and younger every year. These troubling statistics aren’t unique on the continent. Morocco lacks a public health system capable of taking care of its marginalized populations even though the country spends more than five billion dollars every year on healthcare.
The causes for health system degradation and instability are many. Doctor retention, for instance, can be attributed to poor health in both Cameroon and Morocco: data from 2000-2009 show that there are two physicians for every 10,000 Cameroonians and 3.3 physicians for every 10,000 Moroccans. In the U.S., the physician to patient population ratio is 24.2 per 10,000 Americans. Vandergrift emphasized the need for trainees to practice in their countries, where the need is greatest.
“Our goal when we go abroad is to create sustainable programs,” said Vandergrift. “In Africa, we train the general surgery residents giving them the necessary surgical prowess so they are able to work autonomously without the assistance of a western physician.”
When treating the underserved Vandergrift said that it is very important to key in on listening skills and physical examinations. He invokes a lesson from his mentor, Sunil Patel, MD, Chair of the Department of Neurosciences and professor of medicine at MUSC: “the art of patient care is caring for the patient.” Getting back to basics is what’s most important when caring for patients in remote, tropical settings as well as rural South Carolina. “We’re simply using what we were taught in medical school,” remarked Vandergrift.
He found that these endeavors abroad make more empathetic and cost-conscious practitioners, avoiding costly tests through thorough physical examinations and having command of one’s own scrutinizing senses. In a time when payment systems are being reformed and a shift from volume-based care to quality-based care is becoming the standard, resourcefulness and empathy are valuable commodities among healthcare practitioners—both of which are, by anecdote, best learned abroad.
At the end of a trip, Vandergrift is contemplative about his experiences and how there are still unmet needs around the globe, especially in South Carolina. Whether he is eating Moroccan msemen flatbread with friends, sipping soups enriched with cassava in Cameroon or inhaling the comforting scent of post-rainstorm petrichor in Charleston, Vandergrift is immediately taken back to the pleasures of practicing his craft and the impact he strives to have on communities across the world.