Exploring Duke & the Orange County Health Department (Laura Read ’20)

The second day of August began in the sluggish morning haze when Mariana, Michela, and I made our way downstairs to have some of the hotel breakfast. At 8:15, everyone gathered their things and to head onto the bus, where Roy was waiting outside.

Our first stop of the day was Duke University, where we met with a representative from GPSA, Brittany Ploss. Since we arrived early, we of course had to seize the opportunity to take the classic GHF picture on the steps of the Chapel. It was interesting to hear directly from GPSA, since we work so closely with them. Brittany presented on her life work in part with neurosurgery in Uganda. She gave fascinating statistics: that Duke Hospital has 13 neurosurgeons to serve less than 300 thousand people, while Uganda has just 2 neurosurgeons to serve 39 million people. Mulago Hospital is the only national referral hospital in the entire country. However, while equipped with quality care in the ICU, the four beds are not enough to meet the demand. Patients often have to wait for access to ventilators to receive care, which could mean days or weeks on the waitlist. Beyond surgery, there is little to no acute monitoring of patients due to too much need and not enough nurses. The hospitals Mbarara and Gulu are also equipped to deal with neurosurgery, however, the deal with the same issues as Mulago in addition to nonfunctioning machinery and a lack of biomedical technicians and engineers. Innovation is a crucial component of hospital work in Uganda. For example, without access to bone drills, doctors and nurses working in orthopedics adapted a power drill to function the same way. Brittany’s next steps are to continue to plan for neurosurgery expansion to other sites and work on funding for CT scanners, service contracts, and local infrastructure.

Our next location was the Duke Clinical Research Institute, where we met with Dr. Kevin Watt and Dr. Kanecia Zimmerman . We had an interesting discussion about the meaning of clinical research, which involves the ways medicines work and how different bodies metabolize different drugs. In fact, 25% of all drugs prescribed to children are not approved by the FDA, which suggests there is not sufficient research to determine if they are truly safe for use in pediatrics. The Clinical Research Institute’s job is to appeal to the FDA following research to prove the efficacy and safety of doses. Study, design trials, collaboration, and data analysis are all critical factors of working in this field.

After driving to Orange County, we had a brief half hour window to find and eat lunch. Being a small town, the restaurants were all family owned and sit down. It was a bit of a struggle having to find a fast place, but we eventually settled on a grocery store on Weaver Street. 

Our final stop was the Orange County Health Department. We met with many representatives and discussed the public health system in North Carolina. Dental health, translating across different languages, opioid prescription lock boxes, and risk management were just some of the topics covered. It was interesting to hear about sanitation in public health: Pools turn out to be much more gross than they seem, especially when everyone carries about 0.14 grams of fecal matter with them when they go into the water. 

In the evening, Ells selected Blaze Pizza for dinner. Personally I had vegan dough with mine and it was very enjoyable. We concluded the day with roses and thorns, which is always a good time for laughing and bonding. Afterwards we left to our rooms to continue work on our case study competition for the next day. 

Overall, the days were long but the week was short. I enjoyed spending time with my fellow peers, amazing directors, and learning in depth about such an interesting field. I think my last retreat as a 2020 fellow was a success and I will definitely miss these trips. I’m so grateful for all the opportunities this program has given me, and it’s hard to believe that it’s already the beginning of the end.

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