I have just wrapped up another exciting and challenging week 2 and 3 at Cape Coast Teaching Hospital (CCTH). I have started providing once a week outpatient echocardiographic imaging for the hospital besides providing free heart imaging for several children and adults who are inpatient. The two internal medicine residents who are training in the focused echo imaging are making significant progress. Getting and echocardiogram is difficult and expensive in Ghana. It cost $80 - $100 to get an echo done and sometimes one has to travel to the capital city which is 3 hours away. So far together with the trainees we have provided free cardiac imaging for nearly 80 patients for the past 3 weeks. One pediatrician has also started training for focused echo this week. I am looking forward to the first of 3 evaluations for the trainees in week 4.
I have just completed my first week at the Cape Coast Teaching Hospital, Ghana and have started week 2. It has been an interesting experience so far. My travel to Ghana was uneventful. My first day was very busy and started with echocardiogram of a Man with pulmonary tuberculosis and heart failure. Given that I have a handheld echo machine it was easy to image him at the emergency unit. I took the opportunity to start teaching the two providers who are participating in the focused echocardiogram training. The hospital has a standard echo machine but have no providers to do echocardiograms, so this training will be extremely beneficial to the hospital and the patient population they serve. The CEO wants me to set aside one day a week to provide echocardiogram service for outpatients. I will continue to perform inpatient echocardiograms with the current two trainees every day throughout my stay.
Frist Global Health Leaders: Taylor Matherly – Weeks 3 & 4 in Quetzaltenango

Over the past couple of weeks, I’ve continued my engagement with Primeros Pasos’ Nutrition Recuperation Program. In addition to administering the surveys developed during my first two weeks here, I’ve also begun leading “charlas” (chats) alongside Primeros Pasos’ nutrition outreach coordinator, Monica. These charlas are designed specifically for mothers of school-aged children who have been identified as being either malnourished, underweight, stunted, or overweight. Charlas are held monthly in each target community, of which there are four in total.
My two-month Masters of Public Health practicum placement with Primeros Pasos in Quetzaltenango, Guatemala started off on a dramatic and tragic note. Upon exiting Guatemala City’s La Aurora Airport, I immediately noticed an odd-textured rain falling down on me while I waited for a taxi to transport me to one of the city’s many bus terminals. Also noticeable was an intense smoky smell and texture of the air, which I at first attributed to air pollution. Once I arrived at the bus terminal, the bus driver urgently shepherded everyone waiting around onto the bus, informing us that the nearby volcano named “Fuego”, Spanish for “fire”, had had a major eruption. In order for the bus to get to its final destination of Quetzaltenango, it was necessary to first drive towards the volcano before passing it for higher ground in the Guatemalan highlands. Traffic, sirens, and noticeably thick and discolored air were a constant until we had traveled for about two hours north. It was at this point that my fellow passengers and I overcame our initial panic enough to realize that we all had what we now knew was volcanic ash coating our hair and clothes. After the strange “rain” had settled and dried, it had a sand-like consistency and a dark-black appearance.
Thoughts from a remote village in Kenya.

I remember more than 15 years ago before I started medical school, I attended a small global surgery seminar where several residents and invited speakers introduced the community to global surgery and the needs of health care in third world countries. The night started with a surgical resident saying the following statement “hospitals in third world countries are places where people go to die, not get better”. I still remember my reaction and how infuriated I was with such statement. I was born and raised in Colombia, South America and thought about all the times I had been sick, taken to the hospital, and here I was, alive! I had been inspired in the same hospitals to become a doctor, help people and save lives.
It is hard to believe this trip is coming to a close! A lot has happened since my last post. We traveled to Siem Reap and experienced the beautiful ancient temples including Angkor Wat and Angkor Thom. These temples left me speechless. Truly marvelous to think they were built in the 12th century by nothing more than elephants and man power!
Jambo from Nairobi!!

We are currently sitting in the Nairobi airport at the conclusion of an amazing, eye-opening, and life-changing trip.

Our week started out with a bang! We were on ICU call Sunday, but Dr. Newton was so kind and covered the unit after rounds so that we could explore. We drove out to Mount Longonot for a day hike and did not know what we had gotten ourselves into! The hike up was a challenge, since many of the trails had been washed out from all of the rain this season. However, once we made it to the top, it was all worth it. The views from the crater were absolutely breathtaking!
Week 3: By week number three we felt comfortable in Cambodia; we were starting to pick up on some of the language; we were making new friends…. But we were also starting to feel a little bit home sick. But by the time we departed, I can honestly say I was sad to go back to our materialistic lives in America. I cannot WAIT to have the opportunity to go on another mission trip.
Jambo from Kijabe!

We have just wrapped up another exciting week in Kenya! Our week started off with an African adventure full of beautiful sights, wild animals, and great hiking. Then, we spent the rest of the week working in the “theatre,” which is becoming more familiar now J

This Sunday, we joined with Gretchen, a surgical resident from Vanderbilt, to see what Kenya is like outside of Kijabe. We woke up early in the morning and drove about an hour to Lake Naivasha and took a boat to the Crescent Island animal sanctuary. We were the first ones there and got to see all of the animals in their morning routine. There were giraffes, zebras, gazelles, wildebeests, and even hippos!
One of the many challenges faced in the complex management of a surgical patient here in Kijabe is the post-operative period – the days and weeks after the operation in which the critical nature of a patient’s illness frequently manifests itself. Whereas back at Vanderbilt there is an entire building filled with intensive care units containing hundreds of ventilators and innumerable critical care providers, here at Kijabe there are currently five ventilators available to adults and two to children. Before initiating an elective operation, the surgeon has to anticipate the post-operative condition of the patient to determine if he or she will need a bed and/or ventilator in the ICU. If this is not available, the operation is often postponed.

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