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What I Learned: Reaching Patients In Central America

Sep 28, 2010

William P. Albanese is a Pharm. D. candidate, class of 2011, University of Maryland School of Pharmacy

When a friend invited University of Maryland pharmacy student William Albanese to travel to Honduras to help run a mobile medical clinic with Global Medical Brigades, a student-run non-governmental service organization, Albanese jumped at the opportunity. He thought it would be a chance to use his pharmacy education to help those with limited access to care, and he looked forward to getting practical experience counseling patients on the finer points of their medications. He didn’t think he would be talking about shampoo.

“It was a rural situation where roads are the exception and not the norm, and over half the population is more than 20 miles away from a medical professional,” Albanese said. “That takes it beyond medicine into basic health, and I did a lot of things that I didn’t expect to do. I wasn’t titrating drugs and getting labs. It was more like, ‘Here’s how to brush your teeth, and here’s how you use shampoo.’”

Facilitating Patient Care

That’s not to say that Albanese didn’t get the practical experience he craved. Quite the opposite. “From a pharmacy perspective, we became facilitators of the whole mission,” he said. “The physicians relied on us for a lot of things—assessments, therapeutic interchanges when drugs ran out, and just thinking on our feet. We had to be quick, yet precise.”

In one case, student input changed a diagnosis. A patient had come to the clinic with what physicians thought was asthma. “But when he described his situation, it sounded more like chronic obstructive pulmonary disease (COPD),” said Albanese. “We spent an extra five minutes going over his symptoms, and we learned that he’d been smoking for 60 years. When we spoke with the physician about it, he changed the prescription on the spot, and the patient walked away with three months of COPD meds.”

Events like that made getting up at 5:30 each morning, trucking for two hours over rough terrain, and getting back to the campsite at 6 or 7 p.m. well worth the effort, he added.

“Here in the U.S., students are often taught how to do physical exams and be more of a primary provider, yet we never get to actually experience it in person,” he said. “My first experience with an actual patient was in Honduras. After just three or four screenings, I felt so much better about being able to do exams properly.”

Realizing One’s Potential

Albanese feels that student opportunities like the one he experienced are all about realizing potential. “In an international setting, physicians wanted to see what we could do,” he said. “It was all under the supervision of a Honduran doctor, but we were given a chance to make things happen.”

The interdisciplinary interactions were priceless, he said. “The physicians asked a lot of questions, and allowed us to ask questions in return,” Albanese said. “Our input was an important part of the morning meetings.”

The experience taught Albanese something about himself, as well. “It made me realize that I need to interact with patients to be happy in the profession and in my career,” he said. “That’s what I crave. I can’t be a pharmacist who works from a remote location or behind a counter. It made my career take a different turn.”

Albanese plans to return to Honduras with Global Medical Brigades this winter. He will pack a suitcase of clothes and one of supplies and medications provided by the organization. While many students will be enjoying the holidays with their families, Albanese will be deep in a Central American jungle, keeping formulary records, educating patients about their medications, checking blood pressure—and explaining shampoo.

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