The Right to Surgical Care: Expanding surgical care delivery in Chiapas, Mexico

Emily Meara, University of Notre Dame

Abstract: There are 26,628 people who live in the municipality of Ángel Albino Corzo within Chiapas, Mexico. The Hospital Básico Comunitario Ángel Albino Corzo (HBCAAC), located in Jaltenango de la Paz, serves the people of this municipality. Spending six weeks in rural Jaltenango this summer, I was able to understand the fundamental barriers that patients face in receiving surgical care through analysis of the patient referral data recorded from June 1, 2016 to June 1, 2018. Looking at the 205 surgical referrals, the top five referred surgical diagnoses were appendicitis (83), other (44), cholecystectomy (31), hernia (21) and acute abdomen (14). The majority of the surgical referrals are community based general surgery cases of low complexity. These cases could be treated in a community hospital setting and should not require referral. Often, the patient sacrifices a day of work and travels great distances by foot only to be sent away. In many cases, the attempt to seek care stops there. The patient cannot afford the expense of traveling to a farther hospital, nor can they leave their children alone or access feasible transportation. In turn, the patient unknowingly waits until the initially low risk surgery becomes an emergency. This data helps to illustrate the enormous potential for improving access to safe, equitable surgical care in Ángel Albino Corzo. This is of critical importance on the global health agenda in order to further prevent surgery from being viewed as “the neglected stepchild of global public health”

Bio: A proud member of Ryan Hall, Emily is a Spanish Pre-Health major at Notre Dame. She is a member of the      International Scholars Program, Spanish Club, GlobeMed Club, and the Preprofessional Club. Emily’s research interests include global public health, international development, and health care delivery in rural regions.  During her research, Emily met Florita, who was one of the many cheery friends she met while in Mexico. Florita was born with Treacher Collins syndrome which results in deformities to the ears, eyes, cheekbones, and chin. In the United States, most babies born with this genetic disorder undergo several reconstructive surgeries in order to elongate the chin, reposition the eyes and shape the ears, as well as obtaining hearing aids and attending speech therapy. Florita did not have access to nor the funds for any of these common treatments in the US, but she was still growing up like other four-year-old girls Emily knew at home.  As a result, Emily frequently thought about the idea that surgical care is a human right and not a privilege. After six weeks in Jaltenango, it was an accomplishment to know that a surgeon would be arriving in late July to put our preliminary work into practice. This gave hope for mothers with complicated deliveries, individuals demanding emergency surgeries, and children like Florita.

The Source of the Nile Grandmothers and Orphans Support Project Impact Evaluation

Rebecca Angoyar, Northwestern University

Abstract: This research study implemented a monitoring and evaluation of the Grandmothers and Orphans Project at St. Francis Health Care Services in Jinja, Uganda and its surrounding communities from 2011 to 2015. This study was initiated on June 19, 2017 and concluded on August 17, 2017. The research question was as follows: To what extent is St. Francis reaching the initial targets set out for the grandmothers and orphans project over the course of five years? To assess the impact of the project and contribution of St. Francis on the reduction of vulnerability within the households, data consisting of qualitative methods with quantitative aspects from the St. Francis community members must be obtained. The research methods in this study included document review, key informant interviews, and focus group discussions with community members including the project implementation team. These activities were evaluated through the following populations: projects officers, grandmothers, and orphans and vulnerable children (OVCs). This monitoring and evaluation project revealed that the St. Francis Grandmother’s Project has been able to dramatically alleviate the effects of the HIV/AIDS epidemic throughout Jinja by implementing enacting several projects that specifically served grandmothers and their orphaned children. The grandmothers experienced increased morale, physical health, and financial stability through the HIV/AIDS awareness programs, income generating activities, savings and loans association, and home based care. The orphans and vulnerable children living in these households experienced an increased quality of life through the initiation of the school fees program, vocational training/apprenticeship program, HIV/AIDS awareness programs, and youth groups.

Trends, Attitudes, and Action Surrounding Childhood Bronchopneumonia in the Ashanti Region of Ghana

Isabella Martin, University of Chicago

Abstract: Sanitation and environmental air pollution are major public factors affecting child health in sub-Saharan Africa; due to this, childhood bronchopneumonia has become a leading cause of under-five mortality in Ghana. This study aimed to identify the challenges faced by patients and hospital staff in preventing, diagnosing, and treating bronchopneumonia. Interviews assessing patient demographics, knowledge about pneumonia, and experiences concerning the Ghanaian health system were administered to hospital staff and caregivers of pediatric patients with and without pneumonia. 60 interview subjects (20 key informants, 20 caregivers of patients with pneumonia, 20 caregivers of patients without pneumonia) were identified by ward doctors and nurses; verbal consent was obtained before administering interviews. Despite seeking hospital care, the majority of caregivers knew little about pneumonia; those with some understanding of the disease could relay preventative measures. However, most caregivers could describe the causes and/or symptoms of malaria, another leading cause of under-five mortality, which has received significant government funding for awareness campaigns throughout the country. Hospital staff predict that the burden of pneumonia will significantly increase in the future unless education surrounding pneumonia prevention and identification is improved. Further, while satisfaction with hospital care was high, both staff and caregivers often noted concerns about the high personal financial cost of healthcare. Thus, this paper recommends that health care officials invest in both pneumonia-focused health education, with an emphasis on prevention, and in targeted infection preparation in hospitals and clinics to curb the spread of infection in the central regions of Ghana.   

Bio: Isabellais a Biological Sciences and History major at the University of Chicago. She is the president of her university’s historically female a capella group, Men in Drag, and the president of the University of Chicago Folklore Society.  With the Folklore Society, she helped organize the annual folk festival - a 2-day music festival that celebrates traditional folk music from various regions. Isabella is also a crew chief on the Emergency Medical Services unit. For her research, Isabella focused primarily on global health, pediatric health, and communicable diseases.  Moving forward, she would like to explore environmental health and health policy.

Development of Health Rehabilitation in Mainland China: From Traditional Chinese Medicine to Modern Western Rehabilitation Methods

Michelle Moy, University of Illinois at Chicago

Abstract: The aim of this study is to understand the changes occurring in China, leading to the development of health rehabilitation. This study will portray the shift of traditional Chinese medicine (TCM) to modern influences of Western rehabilitation, and will also introduce the idea of an integrated model of TCM and Western Rehabilitation.    Observations were held at a TCM hospital, a rehabilitation hospital, as well as a TCM hospital that provided modern rehabilitation services. Two online questionnaire surveys were sent out to rehabilitation health professionals working in mainland China, one of which collected quantitative data while the other collected both qualitative and quantitative data. 10 responses were collected in the quantitative survey while 21 responses were collected through the qualitative and quantitative survey. Two formal interviews were conducted with a massage therapist and TCM rehabilitation physician. Guided assistance and conversations also helped gain a useful background for this study.    In conclusion, majority of respondents expressed that rehabilitation in mainland China is slowly developing, but is improving with the knowledge and influence from other countries and regions. In terms of cost and location, Western rehabilitation is inaccessible. However, traditional Chinese rehabilitation therapy is more affordable and available. The study presented that integration of both TCM and modern rehabilitation is beneficial and effective.

Bio: Michelle is a Rehabilitation Sciences major at the University of Illinois at Chicago. On campus, she is the President/Co-founder of UIC Rehabilitation Sciences Club, President of UIC Applied Health Sciences Student Council, and a member of UIC's Pre-Occupational Therapy Club. Her primary research focuses on international development in health and rehabilitation, in particular to mainland China and other Asian countries. Michelle is also interested in examining traditional Chinese medicine and modern rehabilitation methods and introducing an integrated model of both practices. During her research, Michelle had the incredible opportunity to spend four months in mainland China and experience both sides of health practices - traditional Chinese medicine (TCM) and modern rehabilitation. TCM is the primary practice in mainland China due to its affordability and the long history of the practice. She started to realize that many can not access modern health services due to high costs and lack of services. Modern rehabilitation is only seen in larger cities of China such as Beijing, Shanghai, Kunming, but is run in a private hospital that only the wealthy can afford. The exposure to these events motivated her to spread awareness on the lack of modern health services in mainland China. Michelle hopes to play a role in China’s development of modern rehabilitation in the future and improve accessibility to these services for the Chinese population in both urban and rural communities. This is Michelle’s first HDC conference, and also her first time speaking at a conference. She is beyond excited to have this opportunity to share her work on a topic she is very passionate about.