School of Medicine
During my rotation, I will be working with a team of Physicians, Nurses and Pharmacists affiliated with the African Primary Healthcare Foundation (APHF). We will be working in Ovim, a small town in the South-eastern part of Nigeria. I will assist the team with providing Primary care to patients from the area. My overarching goals for this rotation is to provide healthcare and health education to patients that do not have regular access to care, improve my physical exam and diagnosis skills, and enhance my public health research skills. This rotation is designed to fulfill all of the six core ACGME competency requirements, while providing me with a unique opportunity to learn about a different aspect of medicine that I would not otherwise be exposed to. During the rotation, I will have the opportunity to learn how to independently manage common primary care ailments in a resource poor setting. Particularly, I will learn how to provide safe and cost-effective care for patients with limited resources. Practicing medicine in a different country will also provide me with a unique perspective for understanding and navigating cross-cultural differences in doctor-patient relationships. I will also learn how to collect data and use it to improve upon the care that I provide to patients, during this rotation. The practical knowledge and skills that I will acquire from this rotation will be help me to achieve my goals of training to become a Physician that provides excellent Primary care for patients in underserved communities.
African Primary Healthcare Foundation (APHF)
As someone with a strong interest in improving healthcare delivery in developing countries, I was excited by the opportunity to work at the frontlines of global healthcare delivery with the African Primary Healthcare Foundation (APHF). The organization has been providing free healthcare services to patients from Ovim, a small town in the South-eastern part of Nigeria for the past 20 years.
I spent my initial days in Ovim in anxious anticipation, as I worked with my Mentor (Dr. Emeruwa) and fellow Healthcare Providers to discuss the general work-flow for the clinic and prepare the clinic for the high volume of patients that we were expecting to see. I was designated to be one of the Physicians that would take care of adult patients with Internal Medicine-related complaints. In this role, I was directly involved in all aspects of patient care, while working under the close supervision of my Attending Physician mentor. I screened, diagnosed and treated patients with several common and uncommon primary care ailments such as diabetes, hypertension, HIV, malaria, arthritis, GERD, among others. This involved reviewing the patient’s vital signs, interviewing patients regarding their medical history and history of current presentation, performing a thorough physical exam, performing basic point of care laboratory testing, formulating a differential diagnosis, and coming up with an appropriate plan of treatment. I prescribed medications, when appropriate, and also facilitated necessary follow-up for patients requiring closer monitoring. All together, I saw 211 patients during the course of my rotation.
The rotation also offered me the unique opportunity to improve my ability to share my medical knowledge with patients and their families. In addition to counseling patients during clinic sessions, I was able to hold a workshop for patients on hypertension and diabetes management. I conducted the workshop in Igbo, the local language. I was amazed by how little the patients knew about these common ailments and how curious they were to learn about how to manage them.
Finally, I also used this time to enhance my skills in the use of Public Health population research methods to improve patient care. To accomplish this, I recorded data on common ailments I treated and also conducted a general needs assessment survey for the clinic, at the end of my rotation. My hope is that the information that I have gathered will help improve upon the care provided to members of the Ovim community, in the future.
Ultimately, this rotation provided me with the opportunity to learn how to independently manage common primary care ailments in a resource poor setting. Particularly, I learnt how to provide safe and cost-effective care for patients with limited resources. Practicing medicine in a different country also provided me with a unique perspective for understanding and navigating cross-cultural differences in doctor-patient relationships. The practical knowledge and skills that I acquired from this rotation will be useful to me as I continue to work towards my goal of becoming a Physician that provides excellent Primary care for patients in underserved communities.
Left: Teaching patients about diabetes and hypertension, with a colleague. Right: Me at my desk, where I interview patients.