A Global Links Intern Ponders the Realities of Global Health

Global Links reaped the benefits of some very talented interns this summer. As her internship comes to a close, Georgetown University junior Dale Barnhart shares some reflections.

Improving health in Guatemala with resources we have right now

When I tell people I am majoring in global health, their initial reaction often betrays a pessimistic outlook.  I understand what they are thinking.  News about global health often focuses on an impossibly big picture– how many cases of malaria are diagnosed each year, for example, or the difficulty of creating a cure for AIDS.  What you don’t hear about are the sort of simple projects that inspired me to study global health because they address problems with resources and capabilities we have right now.


Having doctors come from the community boosts patient confidence.


Two of these projects are Global Links and the Latin American School of Medicine (ELAM), a Cuban medical school that educates students from underprivileged communities for free.  In exchange, students promise to return to serve these communities as doctors.  Since 2009, Global Links and ELAM graduates have been working together in Guatemala to address some major health problems with surprisingly obvious solutions.   How do you reduce infant and maternal mortality?  How do you systemically improve regional health?  The simple answer is to send doctors that are well-equipped with both cultural knowledge and medical supplies.

If this solution seems too simple, consider the Ixil Triangle region.  Between 2009 and 2012, Global Links has sent four shipments to this region, and ELAM doctors are using these materials in exciting ways.  Cotzal, a health center that was unable to attend births before the arrival of ELAM grads and Global Links supplies, increased its institutionalized birthrate by over 240% between 2009 and 2010.  These ELAM doctors could attract pregnant women to the health center because they too had been born in the Ixil region, knew which culturally-appropriate birthing practices to adopt, and spoke with local midwives in their native language.  Now that these doctors have earned their community’s trust, they have started to work with each other to create a three-year health plan for their community and will be partnering with Global Links to distribute the supplies needed to fulfill this plan.

This new mother recovers from childbirth at San Juan Cotzal in a bed from Global Links.

 While it is intuitive that ELAM-Global Links partnerships would improve the effectiveness of ELAM doctors in Guatemala, it is also exciting to watch stories about our ELAM partners reenergize those of us working at Global Links.  They remind us that opportunities to improve health are readily available using knowledge and supplies that we already have, and that is certainly something to be optimistic about.

Global Links and ELAM: Partnering for success in Honduras

I have spent this summer researching collaborations between Global Links and graduates from the Latin American School of Medicine (ELAM).  When I describe to friends and family how hospital surplus – materials that would have been thrown in the trash if it weren’t for Global Links—ends up in the hands of doctors who were trained for free in Cuba, questions of quality often arise.  How helpful can hospital “leftovers” really be?  How prepared are the doctors from ELAM?  The short answer to both of these questions is, very.

Dr. Luther Castillo Harry, a Garifuna himself, examines a little girl in Ciriboya.

Take the First Garífuna Hospital in Ciriboya, Honduras.  The hospital – which, in 2007, became the first-ever hospital for isolated Garífuna communities—was furnished with Global Links’ hospital surplus and is staffed by ELAM doctors.  These resources are actually better suited to improving health care quality than new equipment or U.S.-trained doctors might be.  Consider that the hospital is solar-powered.  Obviously, powering medical equipment, like nebulizers, EKG machines, and lamps, is vital. Powering the newest electric beds is not, so Global Links sent hospital beds that can be adjusted with hand cranks.  Or consider that, in Northern Honduras, poverty is common but health insurance is non-existent.  ELAM doctors, whose training has emphasized preventative medicine and universal health care, provide free consultations and seek to prevent costly treatments by focusing the root causes of illnesses.  For example, rather than repeatedly prescribing painkillers to women who injure themselves collecting firewood, the hospital distributes solar stoves to decrease the chance of repeat injuries.  In addition to providing high-quality care, the hospital has delved into medical research so that they can isolate regional trends to better prevent certain diseases.

Recent ELAM graduates working in Honduras.

The First Garífuna Hospital is not Global Links’ only successful partnership in Honduras.  The Wampusirpi municipality has received the “Malaria Champion of the Americas” award from the Pan-American Health Organization despite having limited roads and electricity.   Members of the historically-neglected Miskito communities are being served by doctors who are willing to advocate for their patients.  For these Hondurans, quality of health care is not improving because of flashy equipment or doctors with pricy medical degrees. Quality is improving because of medical supplies and doctors that are attuned to the needs of the community.




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