Back to Basics in Borneo: Why Rheumatologists Are Meant for Medical Missions
Patients are charged on a sliding scale for the clinic visits and the medications. A unique element of the Health and Harmony program is the availability of barter options; patients can offer to work in place of payment, usually on the forest preserve or the organic farm, or they can pay in a variety of different crops.
As in America, a good 20% of people presenting to a clinic have musculoskeletal complaints. These are just the kinds of ailments that rheumatologists hope to diagnose and treat.
"It is more important for you to share your expertise in your specialty than for you to be an expert on indigenous conditions."
"I saw patients with rheumatoid arthritis whom we treated with methotrexate. We had a difficult time getting some lab tests, but not others. We were given a machine for blood counts, but we couldn’t do liver function tests. We were able to give patients folic acid supplements, and hydroxychloroquine was available. Of course, we didn’t have any biologics, but we had sulfasalazine," Dr. Albert said.
"We had some cases of septic arthritis. We had both intravenous and oral antibiotics to give them, so that wasn’t a problem," he said.
"Of course there were some patients that we weren’t able to help. We had people show up who were sick with a fatal disease like cancer, and we would have to say that we couldn’t do anything for them. We sent only a very few people elsewhere for treatment, largely because making such a trip with a very sick patient is such a difficult proposition. While I was there, the closest x-ray machine was about 2 hours away, and cost a lot of money, so we tried to work without much imaging. If we needed to send anyone for surgery, they had to go to a town that was 4 hours away by boat. Fortunately, there weren’t many surgical cases," he said.
Medical trips such as Dr. Albert’s to Borneo are for the adventurous. "We didn’t have running water, but we had water available in pots that felt great to pour over your head a few times a day, given the hot temperatures and high humidity. And it was perfectly fine. We also had bottled drinking water. I think volunteering at a remote medical clinic is a far better way to get to know a country than traveling there as a tourist. You come away with a deeper understanding of the culture and people, and I think you get a new perspective on happiness, seeing how people can be so happy with so little, compared to what we have in the United States."
"Not everyone can take a full month for this type of trip, but I have some flexibility in my work schedule that allows me to make up time before and after the trip. I advise anyone considering this type of trip to look for a well-run organization, such as Health in Harmony," Dr. Albert said.
