In collaboration with the Georgetown Public Hospital (GPHC) in Guyana, I have set up a 2 week medical mission trip in January 2019 to provide their underserved population access to life saving endoscopic procedures.
Currently GPHC does not have any Gastroenterology consultant and thus endoscopy procedures are not being offered at this center. Occasionally, when a visiting surgeon's schedule permits he is able to perform 1-2 procedures/week, thus leaving a very long waiting list of patients or forcing patients to spend beyond their means to try get these procedures done at the private clinics. With my advanced training in endoscopic techniques I will be able to fill this void and perform 10-12 procedures/day and thus increase access to these vital procedures.
Georgetown Public Hospital is the largest public and government run hospital in Guyana. Located in the capital city, it attracts a large proportion of the underserved population. It also has a thriving internal medicine residency in collaboration with Canadian universities.
While the hospital does have surgeons, and certain medical specialists such as cardiologists and nephrologists, there are currently no on staff gastroenterologists. Thus no physician is currently trained in performing endoscopy and colonoscopy for evaluation of common diseases such as gastro-esophageal reflux, dysphagia, inflammatory bowel disease or colon cancer. Furthermore, since none of the residents have the opportunity to watch or participate in these procedures their training in this vital skill set is deeply lacking.
During my time there I aim to mediate the following benefits:
1. Perform 10-12 endoscopy/colonoscopy per day, 5 days a week and thus provide vital diagnostic and therapeutic care for patients, at no expense to them.
2. Allow for resident participation in procedures and training them on basic aspects of endoscopy, thus enabling them to get their first exposure to such procedures.
Once I establish this collaboration with GPHC and expose the local residents to these aspects, as a next step I will work on helping the most interested residents apply for the international training grant offered by the American College of Gastroenterology. This will allow for the residents to travel to my home institution in the US to obtain a 6 month long training in advanced endoscopy techniques. With these initiatives we aim to get 1-2 local residents well trained in endoscopy to expand their own repertoire and to ensure continued access to endoscopic procedures for the GPHC patient population.
I had a special opportunity to work as a Gastroenterology (GI) consultant at the Georgetown Public Hospital (GPHC) in Georgetown, Guyana and introduce their trainees to endoscopic techniques in January 2019. Until 3 months ago, there was no gastroenterologist at GPHC and endoscopic procedures were only being performed intermittently by a general surgeon during free periods in his operating schedule. In addition, majority of the internal medicine residents did not have a chance to observe or participate in these procedures, thus limiting their knowledge of these techniques.
During my two week rotation, I organized a schedule of didactic sessions that covered procedural basics, indications, contraindications and preparation for endoscopy. Next, I assisted the medicine residents in identifying suitable hospitalized patients, as well as those seen in the GI clinic and booked them for endoscopy. We then arranged two endoscopy sessions, which included patients with a variety of clinical diagnosis and procedural types and facilitated attendance of all 12 medicine residents. Real time teaching during the endoscopic procedures was also done for the residents.
At the end of the rotation all residents remarked on it having been unique and valuable. One of the residents is actually seeking formal Gi and endoscopic training in Canada, after the positive experience during my rotation.
I thank Doximity and all the members at GPHC for this incredible experience and look forward to continued collaboration with this institution to further strengthen their endoscopic set up.
