After years of searching for an opportunity to create an international medical mission as an elective for his pediatric resident physicians, David DuBose, MD, finally found his match. Dr. Dubose is a faculty member of UTMB-Austin's Pediatric and Consultation Referral Service.
Through an introduction to The Holy Cross Order of the Catholic Church by one of our hospital priests, Father Frank Zlotkowski, Dr. DuBose was able to contact the priests and brothers who do missionary work in Peru. The same religious order heads St. Edwards University here in Austin and the university students have taken missionary trips to Lima, Peru.
Dr. DuBose was at last able to develop the course for his resident physicians. Because he was looking for a mission trip to serve a Spanish-speaking population who needed medical care and a culture very different from that of American culture, this seemed to be a perfect fit.
Canto Grande, Peru
Over the course of four weeks, Dr. DuBose and two of his senior residents, Tiffany Turner, MD, and Jaya George-Abraham, MD, got a true sense of Latin American culture in Canto Grande, just outside of Lima. Upon their arrival, the physicians were greeted at the airport by Father Robert Baker, presiding priest of The Holy Cross order and were taken to the foothills of the Andes where they would spend the next several weeks intimately delving into the lives of people in great need of medical care.
Drs. DuBose, Turner and George-Abraham rotated through schools, hospitals, clinics and, most importantly, homes to visit families with children living with severe disabilities, mental delay or retardation. Yancana Huasy Clinic was the main clinic for our physicians who worked tirelessly five and half days a week. They worked Saturday mornings, sometimes well into the afternoons, and had Sundays off to explore the terrain. The doctors saw upward of 70 patients a day, more than half of them before lunch time.
In addition to the exploration of landscape and make shift architecture, our American doctors also explored unusual cuisine, native to this part of the world. Cuy (pronounced coo-ie) was the most interesting of the delectable treats; cuy, of course, is guinea pig!
"Seeing how poor these people lived was not that much of a surprise to me," Dr. DuBose said. "Growing up along the Texas/Mexico border and having done mission work inside Mexico, I have been introduced to such conditions. I think for my residents, though, it was quite a surprise.
Dr. DuBose also mentioned the class structure in that, the farther you travel up the mountain, the poorer you are. Sometimes, the three physicians would walk 10 miles a day, visiting families needing medical attention. The doctors were pleasantly surprised to find that "even though these families were very poor, their disabled children were very well cared for. The houses and children were clean," Dr. DuBose added. "It was quite obvious that the families loved their children." The families do well with what they have, but were extremely grateful for the medical care these dedicated doctors gave them.
Working Without State-of-the-Art Technology
Without the use of modern technological conveniences such as high-resolution imaging and laboratory equipment, Dr. DuBose taught Drs. Turner and George-Abraham to spend time listening to the family and really examining the patient. "With the advancement of technology, in the States we have a tendency to test, test, test and rely on the results for diagnosis and prognosis," Dr. DuBose explained. "But when you are without such conveniences, you must pay attention to details and subtleties and use reasoning and diagnostic skills to make critical and accurate decisions." This is the basis for the international residency; to provide pediatric resident physicians a classroom "without modern walls" to help round out their education.
Not only did the residents learn to diagnose with the use of very simple tools, but they also made use of very simple household items for use in therapy. "We use peg boards here in the States, but when youre in a home that only has three walls, built into the side of the mountain, you have to look around and build your own therapeutic equipment," Dr. DuBose said. And, remember too, that the families and children they were working with only spoke Spanish. "Our Spanish got better throughout the month, but it was still an interesting experience."
This whole notion of therapy is critical to the survival of the family. Therapy allows these children, who in the past were left to be "watch dogs" for the family, howling at the sight of a stranger, to become productive members of their family and society. The medical attention Dr. DuBose, Dr. Turner, and Dr. George-Abraham provided will give these children the capacity to execute a life skill such as sewing, card-making, cleaning, etc., which in turn will allow them to someday contribute financially to the independence and success of their families.
C. David Dubose, MD
UTMB-Austin Pediatric and Consultation Referral ServiceDell Children's Medical Center
4900 Mueller Blvd., 3rd Floor
Austin, TX 78723
Phone: (512) 324-0165
Dr. DuBose is board certified in both Pediatrics and Family Medicine. An experienced faculty member, he has also supervised residents at UTMB in Galveston, the University of Kentucky and Texas Tech University Health Sciences Center. He received his MD from Texas Tech. He completed his own Family Medicine residency at West Virginia University Hospitals and his Pediatric residency at Texas Tech.
