I will be joining Dr. Checkley's project involving obtaining pulmonary function tests throughout Peru and seeing if different cook stoves will affect these people’s lungs differently. I will also be working in a team who will be performing the pulmonary function tests which will allow me to understand the logistics and challenges in obtaining population wide data. Finally, I will help with analysis and writing up portions of the manuscript which will give me experience in data analysis and communicating my findings through publication. I believe that being able to spend 2 months in Peru will allow me to become a better physician by teaching me to use research to further medical knowledge.
I lived in Puno, Peru for 7 weeks to assist with the CHAP (Cardiovascular Outcomes and Household Air Pollution) trial led by Dr. William Checkley. I am a second year internal medicine resident at the Johns Hopkins Hospital and I chose to pursue Global Health research as I hope to include global health in my future career.
Transitioning to a research environment from a clinical setting was challenging in that I was forced to use a new skillset. First off, I was not treating any patients while in Puno. I am a clinician at heart and we would oftentimes find farmers during our fieldwork who were in need of medical care however because I did not have any equipment or medical staff – I could only simply give them advice. Additionally, my primary role was to assist data gathering and not to treat patients, because the study only enrolled mainly healthy patients. As a physician, it is easy to convince someone you will help him or her, as there will be a tangible result – that is not the case in research. In fact, I learned from the enrollment team on how to inform and enroll the participants (who are all farmers) that while they may not see the benefits of the study, it will become important to their children in the future. These results would not be published for several years, and even longer to have a tangible impact on their lives.
Left: EndoPAT training. Right: Field Equipment
My favorite part of my global health project was spending time with the local research team and exploring Puno. The city is located in the Andes Mountains and is nearly 2.5 miles above sea level. My research team wanted me to have a good research experience but they also prioritized that I could go and explore the city and surrounding landmarks. My Spanish dramatically improved because it was a matter of survival for me as there were no English speakers around! As I came to know Puno better, I also felt that I could relate to the participants better. I felt that I could ask more probing questions in order to form connections with them.
The most important facet of my career I learned from this is that I want to make global health a part of my future. There are so many good reasons to share the expertise and knowledge with other countries who are developing their healthcare resources and services. While I still plan to pursue my dream of becoming a physician in critical care medicine – I hope to continue working abroad in global health. I believe I can do this in two ways. First, I can continue to keep my research going with my research site in Puno. This will ensure that if another opportunity arises where I can go back down – I will be informed. Secondly, and what I think is more important is that I will be willing to make small sacrifices and compromises in order to take global health opportunities.
For students and residents interested in performing global health research my main advice is really to prepare as much as you can prior to leaving because when you arrive, you will be inundated with work. However just as important is the ability to flexible as often times, things will not turn out the way you expected. It can be very unpredictable sometimes problems that would take days to solve in the USA take weeks abroad (i.e. a broken ultrasound machine). Most importantly is that global health is worth the extra time, energy and emotion invested – without any doubt.
Finger Stick Training