190125 Reconstructing Medical Service Trips as a Means for Establishing Primary Care Infrastructure and Accessibility

Monday, October 27, 2008

Paul Park , Indiana University School of Medicine, Carmel, IN
Patricia Barrera , Asociación Pop-Wuj, Quetzaltenango, Guatemala
Christian Mendez, MD , Health Clinic, Asociación Pop-Wuj, Quetzaltenango, Guatemala
Short-term medical trips are oftentimes criticized for lacking sustainable accessibility to health care. In December 2005, a volunteer student led a medical team to Guatemala in order to diagnose the feasibility of implementing a new model for medical service trips – one based on establishing community-level, primary care infrastructure through global partnerships.

A retrospective descriptive study examining model impact was performed through the patient register and local NGO documentation. Analysis included patient-load and follow-up trends, and a description of infrastructure design.

The new model was initiated by publicizing the local NGO's new health services via direct patient care and education in the community. Four clinic days established a medical records system (MRS), pharmacy, hospital referral system, and training of community health workers (promotores). Additionally, a community needs assessment was performed.

The MRS began with 320 patients and has increased 30% annually with over 70% of patients fulfilling return visits. Approximately five hospital referrals are made each year at no patient cost. The community needs assessment resulted in 100% fulfillment of the five most common needs. Two U.S. NGOs accepted long-term partnerships with the Guatemalan NGO, which will receive consistent provisions of medications, equipment, follow-up medical service trips, and finances.

The establishment and growth of the local NGO's health services substantiate the medical service trip objective of establishing primary care infrastructure as a means of creating accessibility. Future challenges include, utilization of community-level insight of promotores to adapt the strategic elements of the follow-up medical service trips to the community's changing needs.

Learning Objectives:
Recognize each strategic element of the medical service trip model and its application. Design and implement specific and necessary elements of primary care infrastructure in a community setting. Measure accessibility of primary care through post-implementation analysis.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have over 5 years of experience with establishing medical infrastructure in 6 different countries spanning 3 continents.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.