Going Global

The Going Global blog is an opportunity for emergency physicians to share their experiences practicing and teaching outside the United States. Submit an article about your experience to EMN at emn@lww.com. Be sure to include a brief biography and photographs of the authors. Photos taken during time spent abroad are also welcome, and should be 300 dpi and in jpg, tif, or gif format.

This blog was started by the emergency medicine residents of Palmetto Health Richland in Columbia, SC, who travel the globe on medical missions. The program is under the direction of Thomas Cook, MD, who oversees one of more than 40 academic departments of emergency medicine that sponsors Global International Emergency Medicine Fellowships.

Friday, October 11, 2013

Teaching Ultrasound in Guatemala
By Peyton Hassinger, MD
I spent a week working with Mayan Medical Aid in a small Guatemalan village called Santa Cruz this past March. I traveled to the clinic, which was located on Lake Atitlan in the country’s volcanic highlands, with my fiancé who is an emergency medicine nurse at Palmetto Health. We treated patients with a variety of acute and chronic complaints, including prenatal care, and referred patients back to the primary clinic in Santa Cruz when necessary. We also ran outreach clinics to small and remote villages that could be reached only by foot and boat.
One of the greatest parts of the trip was the opportunity to teach basic ultrasound skills on a machine that was typically used for determining fetal position during prenatal checks. One of the local technicians at the clinic was very interested in learning about the technology, so we practiced taking other basic fetal measurements during prenatal visits, such as heart rate, femur length, crown-to-rump length, biparietal diameter, head circumference, and amniotic fluid index. We also spent time looking at the aorta, gallbladder, kidneys, and heart.
My time in Guatemala also provided me with a great opportunity to teach medical students. The clinic is largely funded by American medical students paying for four-week electives to see patients and learn medical Spanish. I oversaw four students every day, and helped them to develop differential diagnoses and treatment plans. Most of our diagnoses were clinical because diagnostic testing was very limited; we were only able to do dipstick urinalysis and urine pregnancy tests. Any patients who required radiographic studies were referred to Sololá, a city six hours away.
Mayan Medical Aid is a nonprofit organization run by an emergency physician from the United States who now lives in Guatemala. It often accepts residents and medical students for electives. I first heard about the organization while traveling through Guatemala in 2004, and ended up spending six weeks in Santa Cruz during medical school. The town is small and quiet, and the locals are friendly and enjoy working with American volunteers.
I had a great experience working in Guatemala, and would recommend it to anyone who is interested in practicing medicine in the developing world.
Dr. Hassinger is a graduate of the Mayo Clinic School of Medicine. He is an emergency medicine resident in the class of 2014 at Palmetto Health Richland.