This year, Dr. Gonzalo Bearman and eight medical students saw more than 800 patients — half of which were children — in less than a week.
It was the 11th year that Bearman, chair of the division of infectious diseases, professor of internal medicine and hospital epidemiologist at VCU Health System, led medical school students and residents on a trip to Honduras with Virginia Commonwealth University’s Global Health & Health Disparities program.
“Honduras and Haiti are the two poorest countries in the western hemisphere,” Bearman said. “(The program) should be looked at from two perspectives: meeting the direct or immediate clinical needs ... and the second part — which I’ve always argued is most important — is public health.”
The students work to improve water and indoor air quality and have done mass deworming for years that has helped reduce the impact of parasites and worm on the local population, along with other services.
“We’re making lasting changes,” Bearman said.
Eight students attended this year’s program in late June. The Global Health & Health Disparities program has gone to the same communities — La Hicaca and Lomitas, serving the same population of 2,000 Hondurans — since its inception in 2005, Bearman said.
That consistency has only helped with the work that the students do in the area, he continued. It has allowed him, and the other faculty members that participate in the trip every year, to build relationships with the members of the community.
“Many programs tend to be one year at a time,” Bearman said. “I think programs should be longitudinal, because that’s really the way to build more trust. Without the trust and collaboration, the quality and depth of impact is very limited.”
Returning to the same area year after year also allows the program to mature, opening up more opportunities as the coordinators better understand the population’s needs. Bearman said they plan to continue the program next year.
“When we started in 2005 it’s fair to say that we were pretty unsophisticated in our approach and didn’t have a good understanding of the program and population needs of that time,” he said. “Since then we’ve gotten much better at delivering the care, meeting those needs and collaborating with the locals to make sure things are done to meet those standards.”
According to the World Health Organization, Honduras is especially vulnerable to natural disasters such as hurricanes, flooding and landslides, which consequently makes it one of the three most vulnerable countries in the world to climate change.
Serving underdeveloped, resource-poor areas help students understand how to provide care in a culturally-sensitive way, Bearman said.
“You have to deliver care and meet expectations of not only the locals but of standards consistent with local needs while dealing with local pressures,” he said. “We have to meet the needs in the confines of the population at hand.”
Some students that participated in the program have gone on to further their work in public health and primary care in the third world.
“In resource-rich countries such as the United States, we have the ability to train personnel and disseminate them in areas where there’s a lack of an infrastructure for training and delivery of care,” Bearman said. “That gives us an opportunity to pay it forward.”