Thursday, April 21, 2011

Stephanie Holt - Thailand

Stephanie is a Pharmacy student at the University of Utah pursuing her Doctorate degree. She traveled to Thailand with the college of pharmacy to complete a clerkship there this past Spring.

The college of pharmacy collaborates with the study abroad office to offer pharmacy students the opportunity to be exposed to and participate in healthcare in a developing country. This spring semester, 12 pharmacy students traveled to Thailand for 5 weeks to learn about unique disease states and the healthcare organization offered there. Through my travels, I not only learned different aspects of tropical medicine, but I also gained a better understanding and appreciation for different cultures. I was surprised when I saw how directly culture and economic status impacts both patient outcomes and the quality of care.

Thailand has a very different patient population and epidemiology compared to the United States. I am familiar with patients being treated for chronic disease states like diabetes and high blood pressure, but in Thailand I was exposed to less familiar conditions such as leprosy, malaria and tuberculosis. These are more prevalent in underdeveloped countries, so I do not receive much experience with them in my clerkships. This experience gave me the unique opportunity to see how these conditions are presented in actual patients. I was able to sit in clinic visits as physicians followed up on patients with leprosy. I have read about leprosy in books, but when I saw the patients in clinic, it made much more sense to me. I gained a new respect for the causative organism and the severe symptoms they can cause in patients. It was very educational to learn from physicians who had a lot of experience in this area. The patients were always so grateful for their care.

We toured many hospitals. This was very informative and eye-opening. The hospitals we saw only had hard benches in the waiting area with no air conditioning. There were several beds in every room with nothing for the patients to look at except for the wall. I felt bad for both the patients and hospital staff. It would be difficult to practice medicine in these circumstances once accustomed to more elaborate buildings such as those in the US. The medical team of nurses and physicians was always very attentive toward its patients. We discussed treatment plans with physicians and compared the differences of medical practice between the two countries. It was really interesting to see the different treatment regimens and this again supported there are many different ways to practice medicine.

Thailand is very proactive when dealing with alternative therapies of medicine. Healthcare providers utilize traditional medicine more heavily than in the United States but still implement many philosophies of western medicine. Most practitioners have experience with both perspectives. I had the opportunity to be exposed to many different types of traditional and alternative medicine. A common belief is that illness occurs because there is an imbalance of the body’s natural state. Thus, natural methods and products will help remedy many conditions. Healthcare providers are trained in various massages, acupuncture or cupping to provide natural ways to provide patient care. They also rely very heavily on herbs for health prevention and management.  Interacting with providers and researchers in Thailand gave me an appreciation for alternative therapies and helped me relate to and understand better patients interested in these options.

We visited poorer areas of Thailand such as an orphanage and the slums. At the orphanage, the children were so excited to play with us. Many of the children who are HIV positive will never be adopted. It was sad to see how prevalent HIV was and the real impact it has on individuals and society. I couldn’t have understood what the slums were without actually experiencing them myself. It was unlike anything I’ve seen before. Our guide informed us the slums are a part of the evolutionary process to post-industrialization. America had slums after World War II, and it is economically necessary for Thailand to have slums and proceed through the same process. One image that stood out in my mind was a little girl around five years old skipping home from school with a pink backpack on. She went to what looked like a shed (the size of what could occupy a Honda civic) and unlocked the bicycle lock on the door. When she opened the door, I had a view of her entire living area. There were 2 bookshelves, a television and a stove all tightly snuggled into that tiny area. There was a little square piece of carpet left where I’m sure the family sat on the floor to watch TV and eat dinner. That was what they lived in. It was unreal. This experience taught me and all of my classmates about compassion and thankfulness for what we have in America.

My clerkship abroad exposed me to new circumstances and experiences I could not have received in the United States. This amazing opportunity helped prepare me to interact with patients from different cultures and be open-minded to different options of therapy. Ultimately, this program facilitated my education and has helped me provide better patient care.

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