I requested and have been scheduled for a month-long Internal Medicine elective working with the Baylor International Pediatric AIDS Initiative (BIPAI) site in Lesotho. I will be there from early January to early February 2025, working as physician staff to train in a resource limited setting with an underserved population. My work will primarily be outpatient; with adolescents and adults living with HIV, and will help mitigate the effects of a physician shortage in Lesotho. I am in my final year of Med-Peds residency, and I have experience working with children, adolescents, and adults with HIV.
My project will primarily serve adolescents and adults who are living with HIV in urban and rural Lesotho. I grew up moving around the world, and these early experiences sparked my interest in global health. Throughout my medical training thus far, I have reached for opportunities to explore this further, from working on the Navajo reservation in New Mexico, to being the first point of medical care for refugees arriving in San Diego. Although my family spent almost a decade living in sub-Saharan Africa, I have yet to provide direct clinical care in this setting. I jumped at the chance to practice medicine in Lesotho and gain more exposure to global health through a well-established program such as BIPAI. As a Med-Peds physician, I have extensive experience caring for medically complex children and adults, including those living with HIV. This experience will be my first international global health opportunity and I am excited to apply my unique perspective and skillset to this population.
My participation in this program will increase the number of patients that can be served in the community, therefore leading to increased access to care for patients living with HIV in Lesotho. Baylor started BIPAI in Lesotho in 2005, and resident participation in the BIPAI elective strengthens the bonds between the two organizations. I will be amongst the first residents to participate in the elective through the Internal Medicine program, ideally laying the groundwork for more trainees to gain exposure to global health and help offload the clinical burden of treating these vulnerable patients alongside local physicians and staff.
Finally, this program will expose me to a new healthcare setting, treating patients in a resource-limited environment. I believe this experience will be invaluable in my future career, working in the Global Health sphere as an Adult Congenital Cardiologist.
I interacted with a variety of different people during my month in Lesotho. A lot of my time was spent in the clinic with local physicians, seeing patients living with HIV along with other walk-in patients. Although the first few days were an adjustment, eventually I was able to help offload some of the work from the physicians there and learned quite a bit about HIV-primary care. We saw upwards of 60 patients a day, and I sent several patients to the hospital next door for specialty or emergent care.
I also spent a week at a district hospital in a different city and saw inpatients there, again helping offload work from the interns/residents. We admitted a young patient who had an un-diagnosed cardiac condition and who will be connected to specialty care in South Africa.
As much as I learned from the other physicians, I also think that my own training was a valuable resource to them. On my last day at the clinic, I gave a lecture on hypertension management in the primary care setting to the clinic staff which included physicians, nurses, and social workers. I focused most on the increased rates of cardiovascular events amongst patients with HIV and underscored the importance of early and aggressive blood pressure management and the differences between American and Lesotho guidelines.
And finally, spending a month immersed in the global health sphere confirmed my desire to get involved with international health care once my training is finished.
