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[Auto-generated transcript. Edits may have been applied for clarity.]
Alex Walters: What's up everyone. Welcome back to the Learning Curve.
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So I'm excited to share this special episode that features two College of Pharmacy students, Ashlyn Gregory and Melisa Davis.
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Ashlyn and Melisa. Join me to discuss their global health mission to Uganda and their experiences during this time.
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We chatted about their expectations before the trip, how their interactions influenced how they view health care now,
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the experience working and living in a different cultural context, and how their adventures influence their perceptions of the health care field.
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This is a very exciting episode for me, as it is the first to feature students at MUSC, so I hope that you enjoy this episode of The Learning Curve.
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Alex: Uh, so we'll just kind of jump into it, if that's okay with you all and just kind of, uh, start talk a little bit about, um, your adventures.
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So, um, so whoever would like to start, um, can you briefly just do a quick introduction?
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Um, describe where you went and what your role was during this global health mission.
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Melisa Davis: Okay. Hi, I'm Melisa Davis. I'm a fourth year pharmacy student here at the Medical University of South Carolina.
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Um, and me and my classmates, Ashlyn and Tanya, we went to Miss Cindy Katara Hospital over in Uganda.
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Um, we went for the month of September, and we were there basically as pharmacy interns,
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um, to spend a month there and, um, shadow the doctors over there in the hospital.
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Cool. Ashylyn Davis: Hi, my name is Ashlyn. I'm also, uh, P4 at the College of Pharmacy here.
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MUSC. And, um, like Melissa said, her and Tanya and I went to Uganda.
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Um, and our primary roles there were, like she said, shadowing, but also, um, trying to make, like, patient recommendations,
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medication recommendations and then also, um, pointing out good points for like, patient counseling.
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Um, so those were the main things that we did there. Awesome. Uh, okay.
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So let's, uh, talk about before you went, okay, let's talk about expectations, because I'm sure as you were getting ready for the trip,
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you were kind of, you know, thinking in your head, what's this going to be like? What's going to happen?
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What what's you know, what's what's the deal, essentially.
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So, um, whoever would like to start, can you talk a little bit about, um, what expectations did you have prior, uh, to going?
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Ashlyn: Yeah. Um, so honestly, we weren't really sure what to expect.
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Like, we were both. Well, all three of us, we were really nervous.
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We had never gone on a trip like this, and especially not for a month.
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Knew what we were there doing. Um, but we had seen a lot of pictures of people going there and doing outreach programs,
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and a lot of the pictures were these people going to areas that didn't have any, um, resources.
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And they were basically just like checking blood pressure, checking blood sugars.
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And then that was it, like mostly checking vitals, you know?
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Right. So that's kind of what we thought we were going to be doing. Okay.
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We were going to be going like checking vitals and like helping just make sure people had an understanding of like their disease states, I guess.
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Um, um, and that was not at all. Well, okay too.
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And it was in a good way. We actually really enjoyed what we ended up doing, but it was not at all what we expected.
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So. Right. So yeah. So you definitely got to love when you like are thinking it's going to go one way just based on what you've seen.
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And then it's a complete like 180 from, from what you actually experienced.
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Okay. Yeah. Yeah. Melisa: But the people over there were super kind and welcoming.
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It took I would say it took us around 30 hours of traveling just to get to, um, the airport in Uganda.
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Um, and then we were picked up right away by our driver, Joel, who was super kind,
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um, and took us to an airport hotel because we didn't land until around midnight.
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Um, at the hotel, one of us was talking about how hungry we were because of the time change.
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Yeah, right. And the hotel staff heard us and made us a full meal at midnight.
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Oh, wow. They gave us chicken salad. Yeah, yeah, it was through the roof.
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So they were like, go in the kitchen, give me 20 minutes, I'll cook you up a meal.
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That's awesome. Yeah. That was our first. That was that was our first invite of how you going to hospitality was.
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And it was so amazing. That's amazing. That's, uh, definitely a fun start.
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Like, you get a full meal. Yeah. Because the time changing. Yeah, yeah.
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And the next morning, um, Joel picked us up to drive us four hours to our, um, where we were staying in the hospital.
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And the staff welcomed us and showed us where our rooms were.
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It was a nice, beautiful, um, home and located in the hospital grounds.
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And they filled our fridge with food, um, gave us a bunch of fruits, and it just felt very welcoming.
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That's awesome. That's awesome. Uh, again, that's a great way to start the experience.
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Yeah, sure. Um. All right. So so now you're kind of there.
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You're you're embedded. Um, can you share a moment or an interaction or just anything that really stuck with you throughout this experience?
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And then also, um, how did that interaction potentially change how you think about health care?
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Yeah. Um, interaction that stood out to me was, um, a little boy.
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He came in and he could not we didn't know what was wrong with him.
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We ran every test we could. He, um, could not stay awake, so we couldn't figure out what was going wrong with him.
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And we, um, a couple days went by with it showed no improvement.
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So us being the students there, we were worried that he wasn't going to make it.
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And he was a child. Um, so one night we asked the doctor, like, what are we going to do about this little boy?
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He's not getting any better. We're not seeing any. And. We tried everything that we could think of,
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and they said that that night they're going to go in this little boy's room and pray for him, and in three days he will get better.
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Okay. And we we were not expecting that because in, in the States we never hear that.
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Um, sure enough, that night they went into the little boy's room and three days later he was better.
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And he was an interesting. Yeah.
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So compared to the United States, like, uh, like we have, like, we have our own, like, faith and resilience and like, within ourselves.
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But over there in Uganda, they had it as a culture, like they, oh,
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every morning we came out of our house, we came to go worship right outside of our house.
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And then after worship we would go to around. So faith was a really big part of their, um,
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culture so that they very much embrace like spirit spirituality and like faith in terms also in relation to health care.
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Um, obviously. So that that's really interesting. That's. Yeah. Yeah.
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And we were not expecting that at all. Oh of course. Yeah.
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It was awesome though, because like the way that they put it was that they were going to go pray for him.
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And if it was God's will then he would be better in three days. And if not, they were just going to do what they could do.
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And it was just insane that he actually got better in three days with no changes in medical, um, like just approaches or anything.
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It was the most. Yeah, it was honestly like the most insane thing I would say.
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Yeah. That's amazing. Um, were there any other interactions or moments that that stuck out outside of that, uh, specific one?
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Yeah. Oh, yeah. We had plenty. Okay. Yeah. One of the big things was that they do a lot of, like, C-sections there.
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Um, and we made friends with the doctor, like right off the bat that we were rounding with most of the mornings.
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And so the first time he had to go in for a C-section, he was like, I'm doing a C-section.
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You should come. And so us being pharmacy students, we've never scrubbed in to any course sterile IV room.
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So like we're like, okay, so we scrubbed into surgery, um, and we watched them do a C-section.
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We'd never seen anything up close and personal like that ever, right?
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It was like Gray's Anatomy. Yeah. Like it was so cool. And then after they took out the baby, they, like, immediately handed the baby to us.
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And we're like, here, give them there. Wow. Yeah.
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The vitamin K. And then I had to cut the umbilical cord. Yeah, yeah.
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We did some really crazy stuff like immediately that we were like, wait, I don't think we're I don't think we should be.
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So, so it seems like immediately there was a real sense of trust. Yeah.
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Um, just from the start, um, did that continue throughout your entire experience?
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Were there other situations where you really felt like you were just being, like, immediately trusted?
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Yeah, I would say definitely. Um, so in there in Uganda, the doctors go to school.
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As long as we go to school, the doctors, so they they looked at us like real pharmacies.
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Okay. Yeah. Yeah. So like on rounds, we would be, like, making a recommendation.
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And I remember one time, um, a patient came in with a, uh, he had a diabetic foot infection,
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and the doctor wanted to prescribe him two of the medications that were in the same class.
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And I was right away like, no, we don't need to. We don't need to do that.
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And he was like, okay, we won't do that. Okay. Right away. Yeah. I immediately yeah.
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And I was like, okay, uh, you trust me and I yeah I respect that.
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Yeah. That's that's amazing.
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And I'm sure that did a lot just throughout your experience like build that comradery and just that, that trust with the doctor.
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You know they trusted you. So you probably trusted them in return. So you probably had a nice like community essentially going, that's awesome.
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Yeah. We wanted we definitely wanted to prepare more. So after rounds,
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we we would do our own like education and make sure we were prepared on the like their
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disease states that they have out there and their common conditions like malaria or disease.
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Um, so we were just prepared off the bat, right?
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So, um, obviously before this trip, um, you had been in classrooms and, you know, done, done that whole thing.
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Um, what's something you think you took from this experience that you never,
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ever would have learned, either from the classroom or even from clinical experiences in the US.
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So what's something that kind of stuck out, um, in terms of that?
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Yeah. Um, so we realized pretty soon, like when we got there,
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that obviously the resources there are very limited, so they don't have the same treatments that we have.
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They have a lot of the same, like the same ones, but they don't have any narrow spectrum or narrow spectrum antibiotics.
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Right. Um, or anything that we would typically reach for in a serious situation.
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Um, so in the classroom, we're taught that when somebody comes in, they have a really bad, like skin infection that, you know, we do cultures.
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Well, they don't really do cultures there because it takes too long to get back from the lab.
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Um, so they just have to go by what they think might be the infection.
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And we were thinking that this little girl that came in, she had actually been ran over by a tractor and she had to get rods put in her foot,
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and she had a really bad infection because she'd been there for a really long time. They don't have a lot of sterility there.
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Right. Um, so. We were thinking, you know, like probably MRSA.
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We. Yeah, right. What about vancomycin? They're like, oh, we don't do that. Well, okay.
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What's next? Like, what about linezolid? And they're like, we don't do that. We're like, okay, what do you.
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Yeah. So all the top three things that we would think right off the bat they didn't have there.
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And actually this just forced us to think outside of what we learned in a textbook and classroom situation.
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And what is like the last line, because here we're taught that you need to just do whatever first, second, third line is sure.
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Go further if you need to. But we had to like automatically go to whatever the fifth or sixth line treatment was right for this infection.
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So that was crazy for us. We ended up having to do clindamycin and this little girl, um, or that that's what they ended up picking, which was fine.
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Um, but after a couple days of treatment. We were just thinking about, like side effects that we learned about.
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One of the big ones is stuff with clindamycin that's like a really big side effect.
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And so we were like, I wonder if we should start asking about these things, or a one of the doctors had,
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because they were speaking in a little bit of a different language that we couldn't always understand.
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Um, so we asked the doctor if he had asked any changes about like, um, urine output or stool, like any changes in like, all movements.
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And he was like, no, I don't think we need to do that.
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And we're like, no, I think we probably should just because she's been on clindamycin for a little bit, right.
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Well, sure enough, like they asked about that and she had been experiencing like a lot of like runny stools.
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So we were like, oh, we're gonna this could be cedar. Um, and of course, they don't have any, um, it's called, like, quick labs to check.
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Um, well, that but they don't have any, like, they don't have any.
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What am I thinking? Test to rule it out.
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No. Like the protective factors for like, something like see this?
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Oh, like their treatment to Fauci to just if somebody has seat of here like you
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can't go in their room without like only like a specific person can go in there.
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Right. So it's very limited and restricted. Yes. It's like we're all in their face okay.
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So it's like it's up up close and personal care just all the time essentially it's not rooms, it's curtains.
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Right. Right. Yeah. So so it sounds like you're obviously like your critical thinking skills probably took a leap just
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by the nature you said you knew automatically you had to go to that fifth or sixth you know,
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thing down the line. So that's that's really interesting. Um, let me ask this question kind of as like a follow up.
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Um, in a perfect world, you're designing a College of Pharmacy curriculum.
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Would you mandate that everybody should have to have one of these experiences?
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What are your thoughts on that? Do you think it would be?
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It's been it'd be beneficial for everyone to to have a type of global health experience like this and why.
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Um, I, I, I think yes.
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Okay. If, if it is possible. Sure.
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If it to say that money is right. Yeah. Yeah. Perfect world right.
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Correct is an issue. Yeah I think yes. Because going there, it kind of taught you stuff that you wouldn't see here in the United States.
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Like we treated a lot of malaria. We probably will never see that here in the United States.
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Right. Um, and you're able to adapt and problem solve and respect the reality of the health care culture out there.
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Right. Um, and not just base your what you learn in the classroom on the first,
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second, third, um, treatment guidelines, you have to be able to problem solve.
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Mhm. Definitely. Um, so and we've kind of touched on this already, but is there anything else, um,
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that's working in this cultural context changed how you approach health care now.
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Is there anything additional that you would like to share? Yeah, I know you have talked a lot about this.
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Um, one thing I want to say that I didn't really think about until earlier when I was thinking about coming here today, was that.
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The feeling that we had coming back was just so like we went there not knowing what to expect, and we came back with a real sense of peace.
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Um, they have a very peaceful situation where they don't have the opportunities that we do.
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Um, they don't have the resources that we do.
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And they're all so happy, like, all they have is their family and their faith.
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Right. Some of them may have a job. Right?
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Um, but other than that, like, they're still super happy because they don't have the opportunities that we do and have to make the decisions we do.
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Sure. And that meant a lot to all of us. We all came back in such a good headspace and just felt so happy.
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Like spiritually. Right? Yeah. Yeah. Like, not even two days later, we had to start our next rotation.
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Mine was like in a community pharmacy, but in the it's obviously like really high stress in there.
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There's a lot going on. Yeah. Oh I was thinking the whole time was like, I am so lucky to have the opportunity to work in a place like this.
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Like, I'm so lucky to have what we have here. And it was I was happy all day.
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It wasn't like a typical situation where you're working. You're thinking, oh, so stress.
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I want to go home, right? You're thinking like, how lucky are we to get things like this?
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Because they don't get that over there. Sure. Um, so it just really changed the way that we had an outlook on, like, our our jobs.
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Right? Yeah. So left you with that sense of peace and, and, you know, just kind of your,
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your day today just a different feeling about how maybe you approach your work or just approach,
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you know, like I said, just being there, just being there is, is is awesome.
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Um, anything else in terms of, um, kind of like thoughts around cultural context or how that's affected your outlook?
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I think Ashland really answered that in a really good way.
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Um, it really taught us like kind of just to slow down and listen and like, right over there in Uganda, there were there were so peaceful.
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And they were like, okay, you worked enough. Go have a break.
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Go relax. And I know here in the States are there just like work, work, work, right.
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Um, so we kind of like,
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have to take a step back and kind of just calm ourselves down when we're working out here and just kind of put our minds at ease,
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like, we're going to get through. We're going to get through this, um, just one step at a time.
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Um, so kind of a follow up to that, would you say that there maybe they have a more holistic approach to health care in
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terms of they're not only treating like what might be the illness or the problem,
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but they're also thinking about, you know, uh, mental states or just just, ah, especially in, in terms of y'all's work to, like you even said,
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like, maybe you need a break or maybe is would you say that's the approach that, that you saw over there?
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Yeah, absolutely. I think like Melissa said, um, their religion as a part of their culture.
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Right. Everyone has the same beliefs there. And if they don't, then it's like very unheard of.
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But, um, they use that in their approach to like, treat patients.
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So, um, I wasn't going to say I think that like the way that they have an outlook on life and their religion and their culture and everything,
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like allows them to do more with the way that they treat patients.
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Right. Um, and allows them to put more patients at mind like or at ease, like, ah, I can't speak right now.
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I'm sorry. No, I think I remember what they're saying.
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It's, um, when patients come to the hospital, you know, they're actually sick because before going to the hospital, they're going to pray.
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They're going to do everything they can to not go in because, you know, it costs money to be there.
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Of course. And, um, so I think, like, if they can't heal themselves outside of the hospital, they're going to go ahead and go in.
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And that's when, you know, they're actually sick and they're going to need the treatment. Right.
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Um, but they're obviously going to still want prayer, um, to get better.
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So, sure, not only the medication but faith. Sure, sure.
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So definitely so so there's multiple factors when it comes to treating a patient because obviously like you said,
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they they're not going to show up if they haven't already. Try to try to see things, particularly the spiritual part of things.
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So that's that's really interesting. And you know, definitely, um, definitely different from here, like as you all mentioned.
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Um, all right. So, so final question, uh, let's talk about the future a little bit.
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So how has this experience influenced how you think about the future in, in health care?
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And it can be specific to pharmacy or just general health care.
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Um, how have you been influenced like overall by this, um, experience?
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Yeah, I have a good answer for that. I think that when you go to these foreign places off the bat,
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you're an outsider and they see you as immediately because they're like, you're not familiar to me.
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Um, and one of the big things that we realize that was really important was learning their culture and also learning their language,
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like learning a language means a lot to them there.
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Um, so every morning we were, um, like immediately trying to learn a new word and then use it the next day when we would see those patients.
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And that means a lot to them. And I think that that's something that I'll take with me through residency and through my future as a pharmacist.
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Um, whenever I have a patient that might not speak the same language, I think it means a lot of that means a lot to them,
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and then also gives them a sense of trust when you can get on their level, um, and they can see that you're trying to get with their culture.
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Right? Yeah. I think just showing that level of just care.
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Like like embracing their culture and just showing that you care and you care about being there.
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I think that I think that means a lot. Um, how about in anything else?
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Yeah, yeah, I think what Ashlyn said and then what we said about, um, said earlier about the culture, um, in context.
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And I think I came back with like a different perspective.
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I'm still passionate about pharmacy, but now I think more about like access,
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affordability, culture, um, and what patients actually have available to them.
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Um, um, so that's something I'll carry with me, um, throughout my career.
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And I think it was a very eye opening experience, and I'm very grateful that we went.
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That's awesome. Um, so I know that was a final question, but I have one more. Um, would you return?
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Um, and then also, have you kept in contact with any of the, um, folks that you that you worked with?
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Um, yes. Say so. It's a two parter. Yeah, yeah, yeah. So, um, over there in Uganda, we use a different app for text messages.
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Yes. It's WhatsApp. Right? Yeah. Okay. WhatsApp. Sure. Yeah, yeah. I'm not accessing.
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So not here. Right. Um, so before we, we were thinking we were going to delete the app as soon as we left the country, but we did it.
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Okay. Held on to it. Yeah. So now every like holiday Joel, who was our driver and he took us around, um, to explore.
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He always Texas like happy new year and. Oh. Very cool.
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Yeah. Um, how are you doing today? And then Doctor Paul too.
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And Samy, who was our main doctor who took us to church on Sundays, Thursday nights, um, and also took us to get food in the, in the town.
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Um, he will always text us about, like a worship meeting that they're throwing on Saturday.
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Um, and he also was the doctor that took us to, um, out of, uh,
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two different orphanage sites around Gondar, which was a really another cool experience that we got to do.
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Yeah. Um, and then our preceptor, our doctor, Bob, um, he always messages us.
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He actually sent us a picture of him and his wife had a baby.
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Oh, wow. After we left and he was showing us pictures of, um, their little babies.
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So we were really grateful to, uh, to stay in contact with them.
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Like, we talked to them a lot, especially Paul. Doctor Paul. Um, he's RH oh, really interesting.
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Okay. Yeah, she's Asian, but he's also RH. So we have a really good connection with him.
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Very cool. Um, and we talked to him often. We actually called him the other day because it's not often that Melissa and I are together.
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Right. Because we're on rotations right now. Yeah. Um, but we were together the other day.
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We all called him, and he was so happy to, like, see years and hear a voice.
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But we would I think that we would all like we've definitely said we want to go back and,
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uh, we've talked about making it maybe like a every two years thing.
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Even not maybe not for a whole month. Again, that was a bit long and.
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Right. Yeah. Know that's a long time and days or something. Yeah. Just go in there and training.
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You like seeing the culture I think. And we made a lot of friends there.
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Yeah. And Doctor Paul was like, you guys are going to come to my wedding, right?
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Oh cool. Let invite even better. Yeah, yeah.
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There's a reason and, uh, yeah, reason to make the trip.
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So we got to go visit, um, Doctor Paul, um, and for the wedding, and also see Doctor Bob's baby and visit our, well, our friends out there again.
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Very cool. Um, so that's amazing. I'm clear. You all. Clearly you all had did some amazing and impactful work.
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And especially these lasting relationships are are very interesting, um, to hear about.
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So. Yeah. Um, well, yeah, I think I think that'll do it for today.
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Um, I want to thank you all for being here. Um, that was amazing. And yeah, thanks again and thank you so much.
