August 9, 2012
By Solanda Lee
Coming into this trip, I was excited to travel and study at the beautiful and historical Oxford University. I had recently studied abroad the summer before in Beijing and had fallen in love with learning and seeing how culture influenced the way people thought and acted. It also opened my eyes to views and opinions different from those I was usually surrounded by. I had been exposed to a diversity of ideas and thoughts, and had formed opinions of those outside our country, but actually living and experiencing a completely different culture with a different emphasis, and social norms and influences opened my eyes and challenged the way I formed my ideas. This unforgettable time triggered my love for learning and traveling, leaving me wanting to experience more.
I had heard about the class at Oxford from previous students who had raved about the amazing time they had. I jumped at the chance. This was another opportunity for me to gain an even wider cultural perspective. However, to me, it was an even bigger issue than just traveling, but to gain a wider academic experience. For the last couple years, I had been exploring different fields of study within health, trying to decide which one was best suited for me. The class would be exploring many issues related to tropical infectious diseases concerning global health presented by many of the top doctors and researchers in their respective fields. This class would really allow me to go in depth to complement if I in fact wanted to chose the route of either medical school or clinician, or enter in a more global health related career path. This issue weighted heavily on me as I just had completed junior year of college and was now entering my senior year. This class seemed like the golden opportunity, perfectly tailored to my current needs to explore my passions and solidify my decisions.
Throughout the time in Oxford, I learned so much about topics such as malaria, cholera, health care, and clinical trials. We took weekend trips to explore the English culture. On Wednesday, July 25 we traveled to London to visit a number of medical exhibit at 3 of London’s many museums. The one that stood out to me was the Hunterian Museum which is part of the Royal College of Surgeons.
The museum displays thousands of preserved anatomical specimens that date from the late 1700’s. Instead of being disgusted at the millions of dead animals, I couldn’t contain my excitement at examining all of them. I felt like a little kid in a candy shop.
In this museum, preserved in jars and carefully assembled in models, there were specimens of animals ranging from insects to deer, organs and limbs categorized by different diseases. It was like Body World but with smaller specimens and a wider diversity of animals. These were once used in medical anatomy classes.
The massiveness of the museum reminded me how much knowledge had been attained for and from it, but also how much more was waiting to be unraveled and understood. Each specimen and contribution from previous experts built the knowledge and society we have now.
John Hunter was one of the most distinguished scientists and surgeons of his day and promoted the use of careful observation and scientific method in medicine. He didn’t only collect specimens to expand the knowledge of science; he also had his own medical school. He held viewings of dissections so that other medical experts could learn and share with each other. Edward Jenner, the doctor who discovered the smallpox vaccination, considered Hunterian a mentor, learning and exchanging discoveries with him. I was mind blown at the amount of history and importance that this museum stood for.
Throughout this entire experience at Oxford, I found myself rediscovering my passion. At the end of the day, learning about medicine was what made me lose track of time. I realized that back at school I was distracted by the calculated logistics of doing well; taking the right classes, getting on executive boards of clubs, doing research, volunteering etc, I forgot what my passion was in first place. However, the combination of learning about science leisurely through the museums with collections of scientists and doctors past, and gaining the academic stimulation, I realized that I had never lost my passion, I just needed to relight it!
Solanda is a senior majoring in Global Health from Plymouth, Minnesota.
By Austin Carter
What is the value of a human life? 1 million pounds? 2 million pounds? It just doesn’t seem right placing a monetary value on a life. Yet, when allocating money for medicine, there are times when the people in charge must make financial decisions that directly affect mortality numbers.
In one of our lectures we learned about a long study done in Africa researching the benefits of including routine CD4 count check-ups in the treatment of HIV patients in Sub-Saharan Africa. Contrary to what one might expect, her findings led to the conclusion that more lives could be saved by removing routine CD4 counts check-ups from treatment protocol. This arises from the fact that the difference in lives saved when routine check-ups were not included was so small that the resources used on check-ups could be allocated elsewhere. When you boil it down to pure numbers and resources, more people would live if the resources formally used on routine check-ups were instead used to provide first line treatment for more Africans.
This example brings to light the greater conflict between the formation of public health policy and a physician’s personal treatment of patients. It is much easier to make a decision about patient care from a distance, using numbers and data, where the actual effects of the decision are not seen first-hand. When a doctor must actually carry out these decisions, the results are much harder to digest. In the example of HIV treatment, the best possible thing a doctor could do for her individual patients might actually conflict with what is best for the people as a whole (because of relatively unnecessary expenditures). Keeping perspective as a physician must be difficult when even the slightest changes in patient care can have direct effects on individual patients.
We are living in a time in history where there is more technology and data than ever before to make informed decisions about health. As with all changes, there is always a resistance to abandon old ways. But in the case of medicine, a doctor’s inability to quickly adapt can have terrible adverse effects on patient health.
I hope that progress can be made to streamline the dissemination of research results which might decrease mortality on the macro scale. While my views may not be completely developed or informed, I believe that the administration of medicine in resource-poor areas should be completely numbers driven, aiming to save as many lives as possible. I realize that there are ethical issues in not providing the best care possible for individual patients, but unfortunately the current disparity in wealth throughout the world does not allow for equality of treatment worldwide. Difficult decisions must be made in order to protect the greater population as a whole.
Austin is a sophomore double majoring in Global Health and Economics from Beaverton, Oregon. He hopes to one day be President of the World Bank.
By Natalie Friedricks
Following proper treatment protocols and approaching disease with caution is wise. This fact was really driven home by today’s lecturer Dr. Guerin. Besides possible obvious dangers such as patient death, there exists an added risk of resistance. In the fight against infectious diseases this is possibly one of the scariest factors. In areas where most people have access to very few medicines at all, many will die if a resistant strain emerges.
The focus of this discussion was on malaria, one of the world’s biggest killers. Ranked currently as one of the top ten most deadly diseases across the world, malaria affects over 250 million people presenting as a quick killer or chronic illness. It is caused by the infection of a person with a Plasmodium parasite, and is transmitted via mosquito vectors. The parasites settle in the liver, replicating and later destroying red blood cells causing possible anemia and blood flow problems to vital organs. This is a big problem in many developing nations where proper conditions (high temperatures, low elevation, etc.) and low levels of industrialization occur. The good news, however, is that malaria is both a preventable and curable disease. But, a lack of general resources in developing countries makes this very difficult.
The WHO recommends using combination therapy to combat malaria. This technique involves taking multiple medications to treat the disease to prevent the rapid development of resistance. But a problem with this technique that Dr. Guerin pointed out today was that when people had very little medication, or had to travel long distances to reach the nearest health center, many of them did not take all of the drugs at once. These people would instead save some of the pills for later use, or even share them amongst family members. By not taking the full prescription, these people are promoting resistance as they let existing parasites in the body adapt to the new medication. These parasites, now resistant to the medication, can then be transmitted to other people causing mortality levels to rise as drugs are rendered useless. In a more developed country, this would not be as big of an issue due to the availability of alternate medicines. But in a country such as Mali where medications are in short supply, this could result in many more severe malaria cases. This lack of access to healthcare then led to these more dangerous strains developing, making this not solely a concern for people in medicine but for political and economic leaders.
With our discussion following the lecture we tried to brainstorm on what the problem in our global society was that could be targeted to alleviate some of these problems in developing nations. The talk moved from science immediately to socioeconomic factors. The largest being what we and many of our lecturers described as a lack of equity. What we meant was that some areas of the world have better healthcare than others, as well as more resources. To alleviate this unequal care giving, aid groups from various governments and NGOs have popped up. These groups have made a large impact, but more could be done. With social pressure large companies could also be forced to donate more to these causes making it not only the right thing to do, but an economically smart thing to do to promote their products. Governments around the world must also make the development of Africa a priority. Many of the challenges Africa faces are due to the problem of overpopulation, and with education and industrialization their birth rates may decrease and their dependency on foreign aid may also be diminished.
These goals are definitely hard to accomplish. With recent the recent economic decline, aid groups are giving less and less every year. There is also a lack of awareness in more affluent countries such as the United States that makes reform of any kind all the more difficult. But, there is some hope. Perhaps if we educate ourselves on the problems within our global society, we can work together to fix these problems. As our professor Dr. Quinn said, “Act locally, think globally.”
Natalie is a sophomore majoring in Biology from Los Angeles. She hopes to attend medical school to become a surgeon someday.