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Africa, Inequality of Access to Medical Care

On Wednesdays, I was the only visitor for Jorge, an elderly patient in the AIDS and Tropical Disease Ward at Carlos III Hospital in Madrid. A native of Equatorial Guinea, Jorge had full blown AIDS and had been living in Spain illegally because, according to Jorge, his country lacked enough resources and trained doctors to provide an adequate level of treatment. Over several weeks I witnessed his losing battle, not only with a terminal illness but also with cultural incongruence and a continual feeling of unease, thousands of miles away from home. Talking with Jorge during my experience as a volunteer for the NGO Soldarios Para el Desarollo in the fall of 2001, led me to question the justice of health care discrepancies that make it so difficult for people like Jorge to get sufficient treatment in underdeveloped nations. Jorge was a victim of health care inequality, a subject that has been at the forefront of my mind since enrolling in “Race and Medicine in America” during my sophomore year. The course revealed to me the historically poor distribution of quality medical attention and how treatment continually evades socio-economically disadvantaged communities. I came to understand how, in the US, a national shortage of physicians and unlikely prospects of financial gain have caused few doctors to take an interest in these communities, leaving a diminishing level of access to services and expertise. This unfortunate reality inspired me to take an interest in treating these populations, in hopes of helping to improve the care for our 
country’s poor and underserved. Jorge’s story broadened my perspective, as I further realized that this need is exponentially worse in developing nations. The combination of my studies and real world experience strengthened my desire to practice medicine focused on treating underserved populations, nationally and abroad.

In pursuit of my goal, I sought additional exposure to medical conditions in the developing world. During the summer of 2002, I contributed to a public health research initiative in Ghana. My research on malaria infectivity in and around the capital city Accra sent me to shanty town communities with poor hygiene and chronic illness and gave me yet another perspective on the impact of economic disparity in health outcomes and treatment options. Exorbitant patient volume and endemic disease are but a few of the many obstacles to doctors serving these communities and trying to provide quality care. Despite theses difficulties, I witnessed skilled physicians in this setting performing complex procedures in substandard conditions. At the Komfo Ankye Teaching Hospital in 7 the urban village of Kumasi, I scrubbed-in during the removal of an osteosarcoma tumor from a man’s jaw and an ileostomy, where I saw a scalpel filling the role of an absent screwdriver and doctors working in a hot ward with minimal ventilation and only basic amenities. These resourceful doctors were still able to perform, reaffirming my expectation that despite complications, the addition of well-trained doctors can make a marked 
difference. I began to understand how, by taking my medical school training to such environments, I could serve as an intermediary - bringing first world knowledge into a third world context.

Since my time in Ghana, I have continued to participate to health care projects in poor communities. During the summer of 2003, I conducted research in an obstetrics ward of a public hospital in Sao Paulo, and the following fall participated in an infectious disease initiative that brought medical attention to impoverished suburbs of Lima, Peru. Most recently, I worked at a bilingual health clinic in Chicago serving a primarily Latino immigrant community. With each experience, I gained a deeper understanding of the complementary skills necessary to make a real difference. I have learned that medical knowledge, cultural understanding, and political savvy are critical components to a holistic approach to community health care and development, and are skills possessed by the most effective contributors to positive change. I continue to hone my language skills in anticipation of serving Spanish and Portuguese-speaking populations; and I am building an understanding of how to work in a complex funding environment and link medical treatment with public policy. I wish to pursue my medical training and a Master’s in Public Health, so that I can improve access to health care and serve as an effective physician.

My desire to perform medical public service developed from concern and sympathy for people in need of medical care, most specifically those with the least access. I further recognize the importance such compassion plays in effective communication between doctors and their patients. It was my childhood doctor’s ability to convey understanding and elicit trust that inspired my initial interest in the medical field. He combined calm and compassion with medical expertise in a thorough form of healing that I grew to expect, but have infrequently witnessed in poor communities. As I strive to bring better health care to 
underserved populations, I hope to do so with the same personal care and attention that I enjoyed in my youth.

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