Long Live The Sar

A few people have asked where they can make a donation to help the refugees.  The organization I am volunteering with is called  MedGlobal.  They are doing great work in the camp by providing top-notch medical care in an underserved area of the camp. They are also supporting the work of their local NGO partner, Prantic Unnayan, and the health initiatives of OBAT Helpers. They also run missions to Greece, Lebanon, Sierra Leone, and Venezuela.  If you want to donate to broader refugee relief efforts that address issues beyond healthcare, check out the  International Rescue Committee  (disclosure - my sister works for the IRC, great organization) or the  UNHCR .  =============================================== Thirteen days, eleven shifts, and at least 300 patients. Thirteen breakfasts of rice and vegetable curry. At least 40 hours driving through the countryside to-from camp. A few tom-tom rides and three morning beach runs. A few highlights - The sounds of the camp. Very few car

It's weird to write about a problem when you feel like you're part of the problem. For example, this refugee crisis. I didn't personally displaced anyone, certainly didn't commit any violent acts, threaten, or attack anyone. But in trying to be part of the solution, I feel like part of the problem. For one, any refugee crisis screws up the local economy. Before the Rohingya arrived, Cox's Bazar was a small but rowdy beach resort town for Bengali tourists. A few nice hotels, a few average hotels, 75 miles of beach, parasailing, air force base, some other government offices. When the population of the Kutupalong-Ukhia camp exploded in 2017-2018, the district of Cox's Bazar did as well. In one year, the population of the district went from 400,000 to 3.2 million. As NGOs pour into town, demand for nearly all goods rises, housing/food/raw materials supply is slow to catch up, and the cost of nearly all items rise. Basic inflation. Long-term rentals in hotels that

A few people have asked where they can make a donation to help the refugees.  The organization I am volunteering with is called  MedGlobal.  They are doing great work in the camp by providing top-notch medical care in an underserved area of the camp. They are also supporting the work of their local NGO partner, Prantic Unnayan, and the health initiatives of OBAT Helpers. They also run missions to Greece, Lebanon, Sierra Leone, and Venezuela.  If you want to donate to broader refugee relief efforts that address issues beyond healthcare, check out the  International Rescue Committee  (disclosure - my sister works for the IRC, great organization) or the  UNHCR .  =============================================== In this post, I want to share a few musings on what the future may hold for the Rohingya refugees. A disclaimer: First, I am NOT an expert on this topic. I have spent all of nine days in Bangladesh working in the world's largest refugee camp but there are thousands of pe

Hard to believe I've been working here for six days already. Unlike an ED shift where volumes ebb and flow throughout the day, patients line up in the morning before we arrive and are then shuffled around the clinic until we see our last patients around 3:45PM. Similar to the ER, there's always someone else to see. For starters, it was not easy to find an organization to volunteer with in a refugee camp. Naively, I thought it would be easy to find volunteer opportunities with organizations doing this type of work. I found a handful, emailed them, and none got back to me. So I sent another email, and then a third email. Finally I made a phone call and only after that did I hear back. And these were the organizations that returned my calls at all. I ended up signing on with MedGlobal after hearing many good reviews from fellow emergency docs. In Bangladesh, MedGlobal is working with OBAT Helpers and a local partner, Prantic Unnayan Society , to staff an outpatient clinic in

It has been a successful whirlwind jumping headfirst into work in the refugee camp and I want to share some of my initial impressions. 1) The scale of the Kutupalong refugee camp is overwhelming 2) So is the level of development 3) The medical problems are real but ... many are related to social stressors 1 - The refugee camp is massive. We are on a hilltop near the edge of sectors 4 and 17 overlooking the sector 4 expansion . The original refugee camp land was reportedly government owned national forest land that used to host monkees, herds of Asian elephants, and lots of other wildlife. As the refugee population has grown, the impenetrable jungle-clad steep hills are clear-cut, the animals have been pushed out (though many refugees are still scared of an elephant possibly wandering into camp), and ordered chaos emerges. From our clinic, we can see a new camp sector being built with right-angled rows of houses, hundreds of refugee workers wearing neon orange vests filli

November 30, 2018 I finished residency 5 months ago. I have worked approximately sixty shifts as an attending. Let's call it roughly six hundred patients treated (though maybe a few more). And I'm already bored. Not bored like, "why the hell am I doing this?" but bored like "fever, cough, abdominal pain, for more than two months? yeah, you'll be alright." Now my job has some awesome pathology. Good sick folks who really need an ER doc, and the thought of that gets my heart pumping! But there's plenty of pathology as well where there's nothing acute, nothing emergent that I can reverse, nothing that acutely needs an ER doctor and may be better treated by a PCP. I'm always happy to listen, happy to help as best I can, and try to do what I can with what I got, but it's time for an adventure. And so that maybe explains why I find myself cruising along at 35,000 ft, with the Himalayan mountains out the left side of the plane and the Indian

What a whirlwind. Four weeks come and gone. Countless patients, great adventures, some work, lots of play, and another month in Addis in the books. It was by turns exciting, frustrating, beautiful, sad, and inspiring. One of the exciting things about spending a month in Addis is that you never quite know what each day will hold - it may be a day of morning lectures, critical care rounds, a relaxed lunch, a visit to another hospital in the afternoon and then dinner and drinks at night. Or it may be lecture followed by a crashing patient with no one else around, a walk between hospitals that takes you through a sketchy used car and farm fresh vegetable market, being followed/harassed by street children begging for money, a wedding with building-shaking music that lasts til midnight, and routing traffic jams while cars are stopped across the city for visiting African Union dignitaries. You just never know... So let's hit on a few highlights and I'll try to keep it relatively no

I've been trying to write a post on "The State of Medicine in Ethiopia" since my last blog post. A small topic. Needless to say I have failed to conjure any new ideas, synthesize my own feelings, or fully encapsulate my experience thus far (a full 11 days). Add to the mix the fact that I am currently sitting on the balcony of an apartment I rented in Dar Es Salaam for the weekend. Muhimbili Hospital in Dar Es Salaam started an ED Department and residency program 1-2 years before the Addis program started. Famous for building one of the continent's best ED departments and setting the standard for emergency medical care in East Africa, not to mention frequently training visiting residents from nearby countries such as Ethiopia and Mozambique, this program is amazing and further deepens/conflicts my feelings about Addis. But that's going to be its own post. Rather than delivering a treatise on healthcare in Addis today, I thought I'd simply share some of my re

Tenastellegn Addis! Has it really been 6.5 years since I was last here? It must be because while so much of the city is comfortably recognizable, the daily reality of 2018 Addis is full of new surprises, challenges, and landscapes. In the summer of 2011 I had just finished my first year of medical school, was excited to show off my knowledge to my mentor, Rick Hodes, still couldn't tell the difference between a systolic or diastolic murmur (I think I finally can now?) and had only the slightest inkling of how much medicine I didn't know. Now, 78 months, 2 degrees, 83% of a residency, a marriage, and a dog later, I'm back. I will be in Addis from January 1-28, 2018 as part of Emory's Global Health Residency Scholars Program working with and learning from the Emergency Medicine residents at Addis Ababa University and Black Lion Hospital . For those worried that I am cockier than before, don't worry, I am now acutely aware of just how much medicine I still don