Serving patients who need it the most: Stritch students reflect on Bolivia fellowship

Loyola's Stritch School of Medicine M4 Brain Borah laughed as he remembered trying to refuse a sack of potatoes from his patient at a local market in Bolivia. Even though he and his fellow volunteers had plenty of food, the patients would insist on giving them as a way of thanking the volunteers. Early on, Borah realized the satisfaction of serving the Bolivian community.

The Bolivian clinic Borah worked at is Centro Medico Humberto Parra, founded by Dr. Dougas Villaroell and Dr. Susan Hou, a Loyola professor of medicine in 2001. University Ministry and the Center for Community and Global Health at the Loyola’s Stritch School of Medicine joined together to provide students the opportunity to carry out the school’s mission through service.

Ignatian Service Immersion (ISI) trips offer students the opportunity to provide health care across the globe and in local clinics. The school’s partnership with Centro Medico Humberto Parra allows them to participate in a two week, one month, or one year service trip.

M4 Mitch Day and Borah returned in July from their year-long fellowship, along with Brian’s sister, Katherine Borah, a nursing student at University of Illinois-Chicago. Marcella Niehoff School of Nursing student Maria Fox and Stritch M3 Jennifer Van Swol departed in mid-August. Day and Borah shared their experiences while Fox and Van Swol shared why this trip is important to them.

 

Q: Why did you chose to come to Loyola?

A, Brian Borah: I was looking for a place with a strong sense of community that was focused on the human aspect of medicine... what has driven me toward medicine is interacting with people.

A, Jennifer Van Swol: I like the global health aspect of Loyola. There were so many opportunities available to go abroad and also just in Maywood to make a difference. Those opportunities were built into our education a little bit.

All four students have been to Bolivia before through an ISI trip either one or two years ago.

Q: What made you want to go back?

A, Maria Fox: I went on the two-week ISI and I was the only nursing student with all the med students so I was so scared. I was talking myself out of it the week before like, “why am I doing this? Oh my gosh.” But by the end, it was such a great experience by working with all these great people that I realize that it was something that I’d like to do for a little bit longer than two weeks.

A, Van Swol: While I was there I was thinking about what it’d be like to come back [my] fourth year because the coordinators who were already down there when I was a first year told us all we should consider it because they were having a great time. So it was a really unique opportunity. So while I was down there I was already thinking, “I could come back and this would be a great experience.” It definitely played a role.

Q: What mental support team did you build while you were in Bolivia?

A, Borah: For me, it helped because my sister came down for the whole year. She is a nurse also. It was nice having her down there also, but I think all of us, us three, were each other’s support a lot during the year. I think we all each had our small network of support back in the states that we could call on. But after a month, definitely in the second half of the year, the people you live with down there become like family members too. So they’re there for support as well.

Q: What’s experiences did you have that where you needed mental support?

A, Day: Getting down there and adjusting to so many changes...you cling to what is familiar. The English-speaking part and the connections you have from Loyola are really helpful. I’m finding, and I expect to find more of this, as Brian and I reintegrate back into Loyola community now that we’re here, to rely on each other because our past year was so radically different from anybody else.

Q: Where does your motivation to serve stem from?

A, Borah: I just remember my first year. Every year, the coordinators come back and give a presentation. It was like August and school was beginning so I was at least thinking about it by that point. But I even think during my medical school interview someone told me about it and I was like, “Ah yeah, that sounds cool. I’ll think about that.” But as far as where it stems from? I don’t know. The same reason that’s driving me toward medicine, I guess. To me, they’re inseparable. Practicing medicine and doing it for people who need it most.

A, Day: I agree, there’s something, some kind of calling, some kind of motivation, something satisfying about serving the patients who need it the most. Sometimes I think we can get away from that in a big academic center, with a pretty affluent patient population. So Loyola offers avenues to stay in touch with that type of surrounding Maywood community and abroad.

A, Van Swol: I think for many of us it’s probably kind of ingrained, something that’s just probably come naturally to us. The first time that I remember ever thinking about service was actually when I was quite young, I was five. I was in church and a missionary came and presented on hunger in Ghana because she had been over there and lived over there and was coming to us asking for help. I remember, even at that age, as naive as I was I thought, “you know I have food. I can bring them food.” I think that’s just that childlike interest and urge to go and do and act. I think that has stuck with me. Hopefully, I’ve become a little less naive over the years of things I can actually do.

Q: How do you think Loyola has prepared you for the trip?

A, Day: I think the biggest source of assurance and motivation was remembering the example of Loyola doctors who I think instill the culture here and the students enforce that. But I think it’s really motivating to see the doctors. Some of the doctors Brian and I work with in the hospital dedicate so much time to those types of communities in need in Chicago, and then to be able to have the opportunity to do that and emulate them. For me, I don’t get super excited about doing research. Some people do and some people are very hesitant to commit a year abroad, but that felt like a need that I had a skill set and a desire or passion to do, so I felt I could connect the two.

Q: What’s something that people wouldn’t know about Bolivia unless they’ve been there?

A, Borah: Captcha which is a dice game you probably have never heard about.

Day: Yeah the landscape, the topography is so different across the whole country.

Borah: It’s everything. Where we were it was jungle, lowland region. We we’re at sea level essentially, then it shoots up to 15,000 ft. and then there’s a big plateau. There’s mountains towering over that plateau, there’s desert, there’s a salt plane, there’s a swamp region. It’s got everything.

A, Van Swol: Something unique I noticed about Bolivia was the family-oriented aspect...When I was in college, I worked for hospice for a couple of years. So it was a parallel for what I saw in hospice care in the US and what I was seeing in Bolivia. I saw entire families spending time with their ill parent. It was amazing to see how focused everyone was on family and when the time came for someone to need help, the family came together and helped. It was very inspiring to see families come together to help one another that you wouldn't see as much in the US… It was something I never saw working my two years in hospice.

Q: Does the geography make it difficult for patients to travel?

A, Day: There are people in rural areas, but also the roads are not in the greatest condition so that’s probably what keeps people from moving as freely as they otherwise would… especially in the rainy season, the muddy season. When the roads aren't working, the car would get stuck.

Q: What was the biggest barrier your patients had to go through?

A, Day: “Bolivian Barriers” was like the theme of my trip. Everything from transportation to the road itself is pretty horrendous: our medication supply, their compliance, simple things like diabetes and their insulin. Do they have a fridge or do they bury their insulin underground to keep it? There’s so much room for error in that whole process.

Q: What’s something that happened or that was said to you that will always stay with you?

A, Day: We had one volunteer physician, he was from Northwestern. He’s been coming for the last 15 years, he’s in his late 70s. He told me one time, right before he went to sleep, “Mitch, medicine is an intellectual feast.” We got satisfaction from serving them too. Like Brian and I had this lady who needed a hysterectomy and we got it done the last day of the surgery campaign and we jumped through all these hoops. She came back every month after that and brought Brian shoes and her husband would bring us bread. Once or twice a month it was a visible tangible reminder that we had positively impacted someone.

Q: Has your experiences in Bolivia helped you decide what type of residency specialty you want?

Borah: For me, it reaffirmed. I was thinking medicine or med/peds, which is a combined medicine and pediatrics program. It just confirmed that I like that type of medicine and it confirmed for me too that I like adults instead of kids so I’m just going to do internal medicine.

Q: Do you plan to work or live abroad in the future?

A, Borah: It’s definitely on my mind. It’s definitely something I’ll look for in a residency program whether they are accommodating of that kind of medicine.

Q: What are you most excited about?

A, Fox: I’m looking forward to getting to know the people down there better, not only the people affiliated with the clinic, but also the patients that we worked with. I’m looking forward to really immersing in their culture and learning where their values stem from.

Q: What’s your biggest fear for this trip?

A, Van Swol: My biggest fear is always that I’ll do harm or get more than I give from these trips. I’m hoping that being there for a year that there will be things I can help with and make a difference that I don’t even know about yet. I hope I can just listen and observe.