by Ann Blackford
What began as a small medical mission trip to Ecuador in 2002 for a group of pediatric medical residents led by Dr. Thomas Young, professor of pediatrics at the University of Kentucky College of Medicine, has evolved over the years into a large multidisciplinary, interprofessional partnership between UK and the local community working together to discover new and improved ways to teach, learn, and serve vulnerable and resource-poor communities in Ecuador.
UK's Shoulder to Shoulder Global (STSG), formed in 2005, is a UK-based initiative devoted to improving the health and quality of life in Ecuadorian communities suffering the effects of poverty, including high rates of preventable health problems, violence, low educational attainment, and lack of safe drinking water, among other issues.
"After three years of medical trips, it became clear that in order to make a real difference to families in Ecuador, I needed to find a way to have a permanent presence there," Young said. "After meeting with community leaders in Santo Domingo, we began planning a medical clinic with the goal of addressing health and poverty."
With the assistance of a local non-profit social services organization, STSG launched Centro Médico Hombro a Hombro (CMHH) (translated Shoulder to Shoulder Medical Center), a small clinic in the poor community of Carlos Ruiz Burneo, located in the outskirts of Santo Domingo where more than 20,000 people live in poverty. The clinic is run year-round by local health professionals, including physician Cristian Carrión, who has been the medical director since the opening of the CMHH five years ago. The clinic is mostly supported by donations and by the health brigades from UK.
In 2006, Claudia Hopenhayn, associate professor of epidemiology in the UK College of Public Health, director of the Graduate Certificate in Global Health, and chair of the STSG Council, joined Young and together they expanded STSG's reach by inviting faculty and students from UK's other health colleges as well as members from the community to join the effort. As interest grew, the term 'medical mission' was replaced by 'health brigade' to reflect the change in scope and contributions of many disciplines to individual and community health and well-being.
Today, health brigades made up of students, faculty and staff from the UK Colleges of Medicine, Dentistry, Health Sciences, Nursing, Pharmacy, Public Health, Arts and Sciences, and other colleges, as well as local community volunteers, make three trips a year to Ecuador serving approximately 2,000 patients annually. Besides providing basic medical and dental care, brigade members provide health education on the importance of hand washing, how to brush teeth, the importance of boiling water, and good nutrition among other healthy habits.
In addition to the the health brigades, a number of other projects have been implemented in the Ecuadorian community by STSG; members from the UK College of Design built a school food preparation and distribution center. Members from the UK College of Education worked with teachers to develop the school curriculum. Additionally, they wrote a tri-lingual book with the Tsa'chila community to be used in the schools, as well as a companion teacher's guide to go along with the book. A pilot water project was just completed showing the success of using simple, inexpensive and efficient household water filters to provide clean, safe water to families.
Students can also undertake internships or rotations to fulfill academic requirements in several programs, and starting in 2011, students who participate in the health brigades can earn academic credit through an embedded interprofessional course.
“The brigade was one of the most powerful experiences of my life," said Katelyn McNamara, a senior neuroscience and Spanish double major at UK. "I believe that it helped to provide a strong, collaborative network not only between two nations, but also to promote understanding between groups of people that differ in education, socioeconomic status, cultural belief and social behavior.”
UK's STSG will be recognized as an Exemplary Program by the Association of Public and Land Grant Universities (APLU)/Kellogg Foundation at the National Outreach Scholarship Conference in Tuscaloosa, Ala., held Sept. 30 - Oct. 3. Representatives from UK's STSG attending are Hopenhayn, Melody Ryan, associate professor in the Department of Pharmacy Practice and Science in the UK College of Pharmacy and in the Department of Neurology at the UK College of Medicine; M. Lynn English, associate professor and director of clinical education, Division of Physical Therapy at the UK College of Health Sciences; and Katherine McCormick, professor in interdisciplinary early childhood ducation at the UK College of Education.
"I am proud to represent our organization in receiving this recognition," Hopenhayn said. "Many people, both in the U.S. and in Ecuador have worked hard to make STSG a success, as it continues to expand in numbers, reach and scope of work. At the University of Kentucky it provides opportunities for students, faculty and staff in teaching, learning, research and service, within and across disciplines, in addition to offering amazing cultural and human experiences that enrich us in more ways than we know.