CLINICAL TROPICAL MEDICINE IN ZAMBIA

Gretchen L. Birbeck, MD MPH

Departments of Neurology & Epidemiology

Core Faculty African Studies Center

 

 

Reading Elective Pre-Requisites (1 month): Students must be enrolled in the College of Human Medicine and must have satisfactorily completed their core clerkships. 

 

International Clerkship in Zambia Pre-Requisites (minimum 1 month): Students must be enrolled in the College of Human Medicine, must have satisfactorily completed their core clerkships, and must successfully complete a 1-month reading elective in Clinical Tropical Medicine or Dr. Taylor’s COM Tropical Medicine course prior to their departure. 

           

Location: Chikankata Health Services, Mazabuka, Zambia

 

Language:  Although few of the patients speak English, the physicians and nurses working in the hospitals are English speakers. Students will be expected to learn basic Tonga greetings and courtesy phases prior to their departure.

 

General Description:  Dr. Birbeck offers a true “bush” experience in rural Zambia where she currently does her research.  The experience offers a wide variety of clinical material through a general tropical medicine rotation, which includes duties in the Outpatient Department (OPD), attendance on weekly rural clinic visits, on-call duties with an attending physician at least once weekly, and rotations through inpatients wards of Medicine, TB/HIV, Surgery, Pediatrics, and OB/GYN. Opportunities to participate in the ultrasound clinic and diagnostic laboratories also exist. Appropriate students may be considered for involvement in the ongoing research at Chikankata Hospital.

 

Application Process:  Students should prepare a letter of request to Dr. Birbeck’s Office by December of the year prior to the elective. Housing is limited and arrangements must be made a minimum 9 months in advance. Acceptance is subject to housing availability. The materials may be sent or e-mailed to Dr. Birbeck at A 217 Clinical Center, MSU, E. Lansing, MI 48824, gretchen.birbeck@ht.msu.edu. The letter must state the student’s status as a 4th year student, their preferred dates, and a current curriculum vita.

 

Length:  This clerkship requires a minimum of a 1-month experience between January-March annually. Students must be in their senior year of medical school. The area is quite isolated, so students would benefit from selecting to do this clerkship in pairs. For each 4 weeks on-service, students will be released from duties for a 4-day weekend outside of the compound. Travel beyond this cannot be accommodated within the 4-week elective. Students wishing more extensive travel opportunity can do so, but will need to plan for the additional time overseas and will be responsible for arranging their own accommodation and transportation during this time.

 

Objectives*:  This opportunity provides an introduction to the practice of medicine in a tropical, resource-poor setting.  The overall goals are:

  1. *To understand the major public health issues experiences by people in rural Zambia
  2. *To acquire some knowledge of the optimal public health and medical interventions required to address these issues
  3. To appreciate the limitations of the existing system and the modified care provided in such an environment
  4. *To develop some basic knowledge of the commonest medical problems presenting within a rural African hospital
  5. To function successfully and professionally contribute in a non-American culture where expectations and values differ substantially from their own

 

Requirements: This region is very remote and advanced medical services are not available. Student with pre-existing medical conditions that may require care during their clerkships are not recommended for this rotation. Before departure, all students will be required to be seen at the MSU travel clinic (documentation required) and to provide Dr. Birbeck’s office with a copy of their evacuation insurance policy.

 

Evaluations:

            *Reading Elective

                        -Brief short answer test

                        -Brief paper (5 page)

                        -Language competency assessment

(Limited to those planning the clerkship)

           

            *Clerkship

                        -Clinical evaluations to be provided by Chikankata physicians

                        -Clinical evaluation by one senior nurse or other support staff

                        -Written report (8 pages)

 

Travel and Accommodation:  Travel arrangements are not difficult but must be made in advance, especially if leaving at holiday times.  Flights from Europe leave for Zambia 3-4 times per week on British Airways, and KLM.  Flights via Atlanta-South Africa are also available on Delta and South African Airways. Round trip costs from Detroit are approximately $2,000-2,500.  Accommodation is provided in a student block offering a private shower, shared restroom, and shared kitchen. Accommodation and rotation fees are $50 monthly. Food can be purchased locally, but students are cautioned that tap water and non-pasteurized dairy products require boiling. A maximum of 2 students can be considered for this clerkship each month. 


 

* These objectives apply to the reading elective, too