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Elective Rotation: Companeros En Salud

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Contact: Ember Keighley

Location: Chiapas, Mexico

I spent elective away time with Compañeros En Salud, Partners In Health, in Chiapas Mexico teaching the Pasantes in rural clinics. Throughout Mexico, upon completion of medical school, doctors are required to spend a year in social service as a Pasante, local doctor working in a rural or underserved clinic. This year can often be an isolating and overwhelming experience without any supervision, few medications and little support. Doctors often finish the year so discouraged they do not return to underserved areas to work. Compañeros en Salud focuses on bringing Pasantes to underserved areas in the Sierra Madres of Chiapas. These areas traditionally had little access to medical care, and in some cases the prior Pasantes were the first doctor to ever be in the community. Compañeros en Salud works to provide the Pasantes with assistance, support and teaching. The end goals include not only improving local health, but training a new generation of local doctors who are able to work effectively in underserved areas and who are well-versed in global health. While there, I worked in two separate communities teaching and seeing patients side-by-side with the Pasantes. We saw a wide range of patients with medical problems stemming from malnutrition to acute trauma to prenatal care. We treated everything from machete wounds to new diagnoses of schizophrenia to childhood pneumonia. As the only medical care for 1-4 hours we served as the front line for access and worked to develop close-knit ties with the communities. In addition to time in the clinic, we conducted home visits to the most sick and elderly in the communities, and coordinated care for complex cases needing referral to tertiary care centers. Perhaps the most gratifying aspect of my time there was teaching new skills, perspectives and knowledge to the local Pasantes. I was able to focus much of my energy on working with them to educate and empower the community members whom they will be caring for all year. At the end of my time in Chiapas, I taught lectures in well child care and prenatal care during a monthly course for all of the local Pasantes. I was able to use these lectures to focus not only on the medical fund of knowledge for such care and how to adapt to provide care in severely under-resourced areas, but also place emphasis on the broader context of global health and how on the individual level to educate and empower local community members. Please feel free to contact me with any questions or interest.

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From: Tyler Gray

I also did the above rotation. See Ember's great description of the program. In brief, its like a mini residency that has been developed for the pasantes and you get to work like a preceptor and help teach, both with hands-on training in the clinic as well as lectures in the monthly course. You need to have 4 weeks of EA for this, and your Spanish should be fairly strong. They love family docs, because they are practicing family medicine down there, and the medical director is an internist and loves it when people can help more with peds and OB/women's health. I'm happy to answer any questions as well.

From: Wendy Dryden

I also joined Comaneros en Salud in Chiapas. Ditto to Tyler, you will probably get the most out of the rotation if you spend closer to 4 weeks there than the 3 minimum that they require. I enjoyed serving as a junior preceptor with the pasantes, but will say that our skill set often directly overlap with some of their needs - I was overwhelmed daily with how to manage seizure disorders and crazy dermatological complaints, with little to no diagnostic evaluation. I do highly recommend, and am also happy to answer questions.

From: Wendy Dryden

I will add that I was very impressed by the pasantes' knowledge set, and felt somewhat superfluous some of the time! I surely gained more from the experience than I provided to the local doctors and community.