How osteopathic is that

April 8, 2014 | 1 Comment


Fifteen students, faculty and staff from the Campbell University School of Osteopathic Medicine made the school’s first international medical mission trip during Spring Break.

Article by Cherry Crayton with reporting by Shelley Hobbs

CHOLUTECA, HONDURAS -- The medical mission team from Campbell University’s Jerry M. Wallace School of Osteopathic Medicine was several days into running a health clinic in a remote village in Honduras when a girl, about 10 years old, came in with a fever. A very high fever. She was haggard and helpless. She had to be carried.

The medical team tried to give the girl an IV, but she was too dehydrated. Dengue fever, they suspected. The mosquito-borne disease was responsible for 25 recent deaths in the village. But there were no advanced medical equipment, technologies or medications to diagnose and treat the possible dengue fever and its complications. The girl needed to be in a hospital. Now.

Her parents didn’t have a vehicle and couldn’t afford bus fare. So Dr. Brian Kessler, professor of family medicine at Campbell and the lead physician on the trip, scooped the girl up in his arms and carried her to the vehicle the group had been using. A translator working alongside Campbell’s team rushed the girl and her family to the nearest hospital.

Given the lack of resources in the village, the girl most likely would have died if not for the Campbell medical team, said Col. William Pickard, Campbell’s chair of clinical research who served as a clinician on the Honduras mission trip. “God’s providence had us there that day.”

“Us” was the first medical mission team from the School of Osteopathic Medicine to serve abroad. Specifically, eight students and seven faculty and staff members from the medical school spent the week of March 9 -- their Spring Break -- operating health clinics in two remote villages near Choluteca, Honduras. Over five days, they provided health care to at least 219 adults and children.

“I never expected to be learning and applying so much medicine my first year of medical school,” said Leslie George, one of the eight medical students who participated in the missions trip. “There are so many different situations and circumstances I encountered on this trip that I hope will change me for the better in the way that I care for my future patients.”

A new level of commitment

Plans for the School of Osteopathic Medicine’s first international medical mission trip began before the school even welcomed its first students in August 2013. Pickard traveled to Honduras last year with his wife, a nurse who speaks Spanish, and a couple of other Campbell staff members, including Betty Lynn Johnson, academic coordinator of the physician assistant program. They evaluated how Campbell’s medical program could fit into the missions work the N.C. Baptist Men (N.C.B.M.) does in the Central American country.

Campbell and the N.C.B.M. have long had ties, and the N.C.B.M. has long had a presence in Honduras. For the past 16 years, the organization has sponsored and coordinated largely construction- and evangelism-related mission trips to the country. Campbell’s medical team was the first to serve in Honduras with the support of the N.C.B.M. The organization handled the trip’s logistics, helped acquire drug treatments from a pharmaceutical company, hosted the team at its compound in Choluteca, and raised awareness about the clinics.

“Our first medical clinic was a huge success and we all walked away with so much more than we went there with,” N.C.B.M’s on-site coordinators Mike and Ginger Greene wrote on their blog N.C.B.M. Honduras. “[The Campbell] team took their medical responsibilities to a whole new level of commitment.”

From 8 a.m. to 4 p.m. over five days, the eight medical students and seven clinicians and physicians who supervised them interviewed patients, performed physical exams, made possible diagnoses and offered possible treatments. Working alongside them were five translators and a Honduran doctor they called “Dr. Brenda.” They spent part of the week running a clinic in the Colonia Williams village and the other in Aqua Agna.

Many of the patients the team saw rarely had seen a doctor in the past, if at all. Most came to the clinics experiencing aches and pains that could be traced to the demanding physical labor characteristic of their agricultural lifestyle. That included a woman who had been experiencing abdominal and back pain for two months. The pain was getting worse each day, she said. She could no longer do her daily household chores.

The medical team examined her and discovered one of her ribs was stuck posteriorly. The only exam table in the clinic had two broken legs, so the team stabilized it with two benches for the woman to lie on. Kessler, the lead physician, then used a joint manipulation technique and popped her rib back in place. The woman’s pain subsided. She breathed a sigh of relief.

“It was incredible to see this pan out right in front of me,” George said. “It was amazing to be able to connect the skills we learned in school with the limited resources we had abroad to treat our patients.”

A proud tradition

Placing medical students in areas with limited resources is intentional, said Dr. John Kauffman, the founding dean of the School of Osteopathic Medicine.

Since its founding, Campbell University has embraced and emphasized serving the underserved. One way to continue the university’s “proud tradition” while preparing students for careers as doctors of osteopathic medicine (DOs), Kauffman said, is through medical mission trips. “We attract a higher caliber of student through the mission opportunities we provide as well as our medical missions track, designed to train the next generation of medical missionaries,” he said.

Such mission experiences give medical students the opportunity to work with patients who may have never visited a doctor before, to see diseases not common in the U.S., and to work in areas with limited resources. They also allow students to focus on treatment priorities and to show Christian love through caring and healing, Pickard added.

Plus, DOs specialize in musculoskeletal treatments, said Dr. Charlotte Paolini, chair of family medicine who served as a preceptor on the Honduras trip. And the No. 1 complaint people bring to health professionals in agrarian cultures like Honduras? Back pain, which is a common musculoskeletal pain, she said.

The mission trip allowed “our students to get a lot of hands-on experiences treating people with real complaints and real concerns with musculoskeletal pain and problems,” Paolini added. “Students see how OMT (osteopathic manipulative treatments) can be helpful in those setting where you don’t have access to pills and X-rays, and they get to see the fruits of their labor.”

The students, in other words, get to practice, in real settings, the full tenets of osteopathic medicine, which emphasizes treating the whole person -- mind, body and spirit.

The medical mission trip to Honduras certainly offered that, said medical student and mission trip participant Erasmo Espinso. “Due to our limited logistical resources such as advanced medical equipment or medications, we at times felt restricted or inadequate to be able to deal with the vast medical problems that these patients are dealing with,” he said. “However, the inhabitants of these isolated villages truly interpreted our presence as an extension of God’s work -- an answer to their prayers.”

The hope, Pickard said, is that such experiences will allow Campbell’s medical students to see for themselves health disparities, as well as to further instill in them a passion to serve in underserved areas and to give back throughout their professional careers, either through part-time or full-time medical missions.

The Honduras trip, again, did just that. “After becoming a physician,” medical student Shaina Paulraj said, “I would love to go abroad and serve my people in South India.” Another student, Liza Kessling, said: “God has called me to full-time missions, and I plan to go abroad again.”

Mighty works

The School of Osteopathic Medicine is already in talks to offer more medical mission trips abroad, including to Tanzania and Haiti with a regular destination to Honduras. There, the N.C.B.M. has purchased 36 acres where it plans to build a chapel, a health clinic and a dormitory to host medical missions teams like Campbell’s.

The first Campbell “medical team provided a lot more than health care to [the] people [in Honduras],” the Greenes, N.C.B.M’s on-site coordinators, wrote on their blog. “They offered hope. . . . These young people took their Spring Break and served God in mighty way.”

Victor Appau, a first-year medical student at Campbell, provides one example of those mighty works.

A 64-year-old woman came into one of the Campbell/N.C.B.M-run clinics complaining of throat irritation and trouble swallowing. She also looked frail and older than her years, Appau said. He examined her. Based on her history and exam results, Appau and his preceptor suspected she most likely had advanced stage cancer. But what could they do about it? They were in a remote village where there was no MRI or CT and no chemotherapy or radiation. “Now what?” Appau wondered.

“With nothing more to give,” he said, he asked her if he could pray for her. As he prayed, she wept. When he finished the prayer, she smiled and hugged him. After she left, Appau thought about what had just happened. The words of one of his Campbell professors, Dr. William Morris, chair and professor of osteopathic manipulative medicine, came to mind. “You can always do something,” Morris has said, “even in the most seemingly hopeless situations.”

The experience, Appau realized, captured osteopathic medicine. “There is just something powerful about connecting with your patients on a physical, emotional and spiritual level that transcends the impact of just pills and procedures,” he said.

His examination of and prayer with the woman? “How osteopathic is that?” he said.

 
  • In their own words

    Some of the 1st-year medical students who participated in the medical mission trip to Honduras talk about why they went, what they learned, and what they’ll always remember.

    “It has always been my desire to someday bring primary medical care to rural and underserved populations both locally and abroad. Hence, having never been on a medical mission trip, I went on this trip to serve and to learn what medical missions was all about.” -- Victor Appau

    “Giving up a break in between block was difficult. There are a million things a medical student with one week of freedom wants to do. However, going to Honduras was probably the best decision I made. I learned so much, from conversational Spanish to doing a whole patient encounter solo.” -- Shaina Paulrag

    “I learned that for all of the lack of resources, technology, financial stability, access to health care, and other basic privileges that many Americans take for granted, the underprivileged people of Honduras whom we treated make up [for it] in faith. . . . The overall experience was quite humbling and it was the consensus of the medical team who participated that we gained so much more from the exchange than we could have imagined.” -- Erasmo Espino

    “The people were full of love. I almost cried when the second village used their gas generator to provide us with a light and fan when we were expecting nothing.” -- Liza Kessling

    “One day I grabbed a soccer ball during our lunch hour and within seconds I had a swarm of young children running my way and toward the dirt field. I played with them for a while, and it created a bond that both shocked and saddened me when we had to leave the site. They challenged me in a way that forced me to confront the language barrier, and before I knew it we were talking about what they were learning in school and a variety of other topics. Taking time out of my day to play soccer and chat meant the world to those kids, and the smiles on their faces made my experience incredibly rewarding.” -- Dominique Stasulli

    “I was so touched by the joy and smile these children have every day. They are playing with dirty and broken toy pianos and accordions. But watching them scream at the top of their lungs to make music has left me speechless. They do not complain about the fact that their piano or accordions were broken, but instead they played as if they had the most expensive instruments in their hands. This was a huge selfless experience in which you learn to use the resources you have and accept the fact that you are limited in what you can do.” -- Leslie George

  • Who made the trip

    A list of the 15 people who comprised the School of Osteopathic Medicine’s first medical mission team.

    1st-year medical students

    • Victor Appau
    • Sara Cowles
    • Erasmo Espino
    • Leslie George
    • Liza Kessling
    • Shaina Paulrag
    • Irina Severenchuk
    • Dominique Stasulli

    Faculty/staff

    • Dr. Francine Anderson, chair and associate professor of anatomy
    • Dr. John Kauffman, dean 
    • Dr. Brian Kessler, associate dean for clinical affairs and professor of family medicine
    • Dr. Charlotte Paolini, chair of family medicine
    • Col. William Pickard, chair of clinical research
    • Rebecca Schlichter, administrative assistant with the School of Osteopathic Medicine
    • Dawn Stull, director of graduate medical education