Global Health

The Lawrence Family Medicine Residency is committed to preparing residents to serve underserved people, wherever they are, in both high and low resource environments. We believe global health experiences are an important part of our residents’ preparation for this mission, a mission which transcends national boundaries. Lawrence, Massachusetts proudly calls itself “The City of Immigrants” and is a gateway to the US for many of our patients; gaining insight outside the US healthcare context is therefore valuable. In addition to our Spanish curriculum, we believe cultural competency is an important trait of an optimally trained family physician. There is also no better way to experience a bit of what our patients feel as new immigrants by spending time in a non-English-speaking country, with a different culture.

These rotations are distinct from our Spanish immersion curriculum, which take place at language schools in Central and South America and Mexico, as well as our first year resident class trip to the Dominican Republic.

Although we do offer an Area of Concentration in Global Health, virtually all Lawrence residents participate in our global health curriculum during their residency. Our global health experiences are characterized by several important qualities:

  • Global health experiences are led by core Lawrence Family Medicine Residency faculty, who work with our residents (1-3 at a time) in an ongoing medical clinic or hospital. The depth of the medical and cultural experience for residents is therefore much deeper than a “medical tourism” approach to global health.
  • Our faculty members all have a very long-standing relationship with these communities that go back many years; in some cases the faculty member held a previous full-time job there prior to coming to Lawrence.
  • We offer a wide variety of types of medical experiences, all with a particular “flavor” of curricular emphasis besides the different countries and cultural immersions. For example, our Guatemala rotation emphasizes hospital and maternity care, our Nicaragua and Nepal rotations both feature remote rural experience, our Zambia rotation an HIV/ID emphasis, and our Ghana experience has a surgical emphasis.
  • “Resident as Teacher” is a major component of all our global health rotations- we want our time there to transcend our presence. Project sustainability and empowerment of those we serve are our overriding goals.
  • Residents may, of course, set up independent rotations in other countries depending on their interests or career goals.

Global Health Elective Rotations with Lawrence Family Medicine faculty:

(in alphabetical order)

  • Ghana
  • Guatemala
  • Nepal
  • Nicaragua

Ghana Global Health Elective

Lead Faculty Member: Vince Waite, MD MPH TM, (15 years of previous full-time practice at the designated clinical site)

Location: Nalerigu via Gambaga, Northern Region, Ghana, West Africa

In country affiliate – Baptist Medical Centre – Established nearly 60 years ago, The Baptist Medical Centre in Nalerigu is a respected mission hospital located in the Northern Region of Ghana. It was founded through the joint efforts and vision of the Ghanaian Baptist Convention (Gold Coast Baptist Conference) and the International Mission Board (Foreign Mission Board at that time) in 1958. In 2014, the IMB handed the hospital over to the Ghana Baptist Convention who now manage and maintain it. Currently the BMC is a 123 bed hospital whose reputation brings people from as far south as Accra, as far east as Togo and Nigeria, and as far north as Burkina Faso and Mali. Most recent yearly statistics are as follows: 60,000 outpatient visits, 10,000 inpatients, 1,200 major operations, and 2,500-3,000 minor procedures. www.baptistmedicalcenter.org

What we bring: As volunteer physicians, we provide basic support in covering inpatient and outpatient services.  We also help contribute to the overall educational mission of the hospital by sharing in regular teaching sessions and skills development workshops with local healthcare workers.

Why we go: Residents experience the practice of medicine and surgery in a radically different, resource limited practice situation. They improve clinical diagnostic and treatment skills, without the usual diagnostic support of modern medicine. Residents also improve surgical diagnosis and procedural skills, and gain experience in Clinical Tropical Medicine and Surgery.

What do residents do?:  The elective provides a 3 week cross-cultural experience in Tropical Medicine and Surgery in a very rural African District Health Hospital in Ghana. The Resident will rotate through all the services of the hospital including general medicine, pediatrics, obstetrics, and general surgery. An emphasis will be placed on general surgical principles. The Resident will participate in the evaluation and treatment of patients in both the outpatient and inpatient settings.

Other parts of the experience: When not working, residents also have opportunities to explore the surrounding community and observe Traditional Healers.

Guatemala Global Health Elective

Lead Faculty Member: Andy Smith MD MPH- lived and worked in this community for 2 years besides recurring service trips

Location: Santiago Atitlan – the largest indigenous community in Latin America, set on the banks of Lake Atitlan in the western highlands of Guatemala

In country affiliate – Hospitalito Atitlan – a non-profit private hospital serving the local Tzutujil community of 50,000-60,000 as well as a larger catchment area.  H.A. provides 24 hour emergency, inpatient and maternity care and is the only facility that can provide inpatient obstetric and hospital care within 2 hours.

What we bring: As volunteer physicians, we provide basic support in covering inpatient and outpatient services.  We also help contribute to the overall educational mission of the hospital by sharing in regular teaching sessions and skills development workshops with local healthcare workers.

Why we go: We hope to foster in residents an appreciation for the challenges and joys associated with global health work while working alongside the local healthcare providers in their remarkable mission of bringing healthcare to a vibrant but often oppressed people.

What do residents do?:  During the 3 week elective, residents work in all the hospital settings.  Typically a resident would take call every 4th or 5th night and be in clinic 2 or 3 other days.  Additionally residents help by doing outreach clinics to more remote villages, being on call for transfers and deliveries and helping with any visiting surgical teams.

Other parts of the experience: When not working, residents can explore the rich culture of the town, climb nearby volcanoes or work with a Spanish tutor to sharpen language skills.

Nepal Global Health Elective

Lead Faculty Member: Rob McKersie MD

Location: Dhading Region, Nepal. The Dhading Region is north of Kathmandu and stretches to the Tibetan border. 340,000 people live in its 50+ remote villages that are only accessible by foot. We will be trekking to three of these villages (Tipling, Shertung, and Lapa) over a two-week period in the spring and fall of each year. The trek will encompass trekking in the Himalayan Mountains over two high passes (14,000 ft).

In country affiliate: Himalayan HealthCare, Inc. HHC is a non-profit, non-denominational NGO founded in 1992. HHC provides primary health care, education, and income generation assistance to people living in remote and impoverished regions of Nepal, not reached by government and non-government organizations. HHC encourages local participation and involvement in all of its programs to ensure sustainability. Above all, HHC strives to help people help themselves.

What we bring: Our positive spirits, strong backs, collaborative can-do attitude, and willingness to trek into one of the most remote and beautiful mountainous regions in the world.

Why we go: There is a need: Nepal is ranked 157 (out of 187 countries) on the WHO’s Human Development Index and has some of the world’s poorest healthcare indices (IMR, MMR, under-five mortality rate). In addition, giving residents an opportunity to experience healthcare delivery in a challenging international environment is rewarding for both the residents and the recipients of their care.

What do residents do? During this 3-week elective, residents will practice evidence-based and competent medicine at three medical camps. The Residents will be part of a medical team, comprised of 10 other medical clinicians and 60 support staff, who will see patients in a primary care setting at rural clinics. We will work alongside; teach, in both informal and formal settings, (and learn from) HHC’s Nepalese healthcare providers that work in the village health clinics year round.

Residents will have an opportunity to meet traditional healers as well as work with local providers who have knowledge of medicinal remedies.

Other parts of the experience: Residents will have two days before and after the trek to enjoy Kathmandu and the rich cultural experience it has to offer. All participants, prior to the trek, will have a full-day tour of Kathmandu’s many wonderful cultural sites. Participants can also extend their stay in the region and experience a multitude of outdoor activities the country’s tourism industry offers: bungee-jumping, white-water rafting, tours of national wildlife parks, etc. Traveling to India has also been a destination of past participants.

For Personal Account of HHC’s Earthquake Relief Efforts by LFMR faculty Dr Rob McKersie click here.