The Journal of the College of Physicians and Surgeons of Columbia University

Extending the Boundaries of Learning

By Naomi Starobin

Hospital de Ramon Castillo in San Martín de los Andes, Neuquen Province. Kate Gaynor’01 spent a day visiting homes with a representative of a public health agency to take blood pressures and give diet advice.

Jason Scott Shapiro’00 spent the summer between his first and second year of medical school working with a mobile surgical unit in Ecuador. “Getting cultural perspective is invaluable to people going into medicine,” he says. “It’s easier to make connections with patients.” He found contacts, set up the internship, made travel arrangements, and got the required immunizations on his own.

Now, he and several other P&S students are working to make it easier for others to pursue international health care and to expand the college’s role overseas. They have formed the International Health Organization (IHO), part of the P&S Club.

One part of the program is REMEDY, Recovered Medical Equipment for the Developing World. Students collect, sort, inventory, and pack discarded but usable medical supplies from CPMC and ship them to developing countries. So far, they have donated hundreds of thousands of dollars worth of medical supplies. According to Kate Gaynor, the second-year student running REMEDY, the program is planning to expand by collecting supplies on an ongoing basis from Milstein operating rooms and by creating a database of the inventory to facilitate distribution. A third-year student, Anand Joshi, organizes the sorting of supplies and inventory. Last year’s director of REMEDY, Dan Chrzanowski, remains involved with IHO.

**Jason Shapiro’00 with a public health worker in Ecuador**

A key goal of IHO is to make it easier for students interested in overseas experiences to get information about contacts abroad and funding sources, not only for fourth-year electives, but also for the summer after the first year at P&S. “Between the first and second year,” says Ms. Gaynor, “the school makes it incredibly easy for you to do whatever kind of research you want to do. They give you a stipend and you’re all set for the summer.” But money is not available for students who want to go abroad, which she considers as great a learning experience as doing bench research in New York. She set up her pre-clinical summer elective at a mental hospital in Argentina by talking to professors and other students about opportunities abroad.

Mr. Shapiro created IHO’s web site (http://cpmcnet.columbia.edu/student/intmed), which has a list of overseas electives, a four-year timeline for P&S students, and links to other international health web sites. He has added a searchable database of overseas opportunities and contacts, based on information from professors and surveys of fourth-year students returning from electives. An anonymous $10,000 donation to IHO funded the computer and other equipment the students use.

The IHO holds gatherings to welcome foreign students and arranges lectures for students thinking about overseas work. In early December, 20 students attended a talk on travel medicine.

How do Mr. Shapiro, Ms. Gaynor, Mr. Chrzanowski, and Rebecca Allen, also active in IHO, make the time to help out? “We’re all very interested in international health and issues abroad and we’ve all traveled,” says Mr. Shapiro, “and it’s important for us to have some balance in our studies.” So they squeeze in a call during a break or stop off at the office to update the web site in the evening. Students get together to sort the incoming REMEDY material one evening every other week.

While the students have been responsible for all of the legwork and a lot of the inspiration behind IHO, they are not without guardian angels. Dr. Edgar Housepian, special adviser for international affiliations, who has long been involved in international work himself, started the program and is on the IHO advisory board. “The thing that makes it run so well is that it is totally student-run,” says Dr. Housepian. “My job is to steer them away from rocks and shoals.”

The students agree about the rocks but give him more credit. “We tool along and get as far as we can,” says Ms. Gaynor, “and then we hit a rock and we flag him down and he pushes the rock out of the way.”

Also on the IHO advisory board are Dr. Linda Lewis, associate dean for student affairs; Dr. Allan Rosenfield, dean of the Joseph L. Mailman School of Public Health; Dr. Pat Molholt, associate dean of scholarly resources; and Dr. Dickson Despommier, course director of tropical medicine and parasitology.

The IHO students are certainly breaking new ground, but interest in international health is not new to P&S. The 1956-57 P&S handbook for student activities lists an overseas book and clothing drive, and the 1968-69 handbook lists an overseas book committee, which sent medical texts to overseas medical schools.

Andrew Moran’01 is pictured with the Cinterandes mobile surgery unit, parked in Pujili, Ecuador. The mobile surgery unit travels to small towns in Ecuador to perform general surgeries. Students traveling with the unit scrub in to observe and assist. They also spend time with family practice doctors working in Ecuador’s small public clinics. A student from another medical school is shown with Mr. Moran. Mr. Moran took more than $2,000 worth of supplies from REMEDY to Ecuador.