A Heart For The Work : Journeys Through An African Medical School

Katz states, “the conviction that physicians should decide what is best for their patients, and, therefore, that the authority and power to do so should remain bested in them, continued to have deep hold on the practices of the medical profession “(214).

Katherine Dettwyler’s work in the field while she was in West Africa was exciting, filled with humor and even terrifying at times. She dealt with seeing various life-threatening diseases that affected the lives of children her daughter’s age, as well as adults. Dettwyler found that almost all of the people she came in contact with were completely oblivious and uninformed of the ways to prevent diseases such as malaria, Schistosomiasis, malnutrition and other infectious diseases unique to their region of the world. In her book, Dancing Skeletons: Life and Death in West Africa (1994), Dettwyler discusses tons of the health problems she comes across, in

The American Medical Association (AMA) published a Code of Ethics for Physicians that includes a list of certain principles physicians should follow in order to be good physicians, practicing in an ethical fashion. This list, which was first adopted in June of 1957 and revised as recently as June of 2001, demonstrates some principles that are not universally accepted to be critical to the ethical practice of a physician. In particular, all physicians do not completely believe the claim that “A physician shall support access to medical care for all people” (Principles of Medical Ethics). Theorist, H. Tristam Engelhardt believes that the lack of access to care for some may be unfortunate, but it is not unfair and that this access does not need to be mandated, nor does believing it should be make you an ethical physician. In fact, Engelhardt supremely believes that by providing access of care to all, you will hurt certain patients that already have access to care, negating your function as a physician practicing beneficence. Engelhardt would retract this statement from the Principles of Ethics. However, this belief of and drive to implement access of care to all is critical to one’s job as a physician and it goes against core values of physicians to claim otherwise. Theorists such as Tom Beauchamp and Norman Daniels would agree that the universal access to health care is a critical component of the values physicians hold.

I wasn’t going to take this class. I’m already taking Emerging and Reemerging Infectious Disease on Thursday so I thought I filled my Professor Gezmu quota for the semester, but the first day of class I was reeled in. I’m pretty sure I was staring at Gezmu with the most dumbfounded shock-filled face of all time. Prior to the class I really did think I was a cultured person. I’m Nigerian in America. I can pretty much play the race card whenever I want and people think I’m so sophisticated. That was the totality of my racial, cultural, socioeconomic identity: first generation Nigerian Christian living in America from an upper middle class Jewish and Asian town. That was who I was, that was where my opinions came from. And to be honest, I read one of my father’s books about transcultural nursing so I thought that’s what the class was going to be about. Wrong.

Even though this occurrence happened almost 70 years ago, the prevalent themes still exist today. The allure of pharmaceutical money and the use of drugs on patients, for instance, sway some doctors, even when they are unnecessary or, worse, harmful (Koch 1). Reading about Lacks, it is clearly recognizable how necessary it is to have a moral compass in a field that requires utter respect towards

Edmund Pellegrino’s account of virtue based ethics practiced by a physician reaches an extremely high moral standard and involves the expression, at the highest level, of benevolence, temperance, fidelity to trust, integrity, justice and compassion which goes over and above what is strictly required of a physician; whereas, legal and rights-based ethical conceptions involve a physician adhering to the duties imposed on them by the laws of the land-such as physician licensure, good Samaritan laws, anti-discrimination laws, etc., and medical ethics codes and duties which are more obligations and duties to what strict ethics spells out.

Cultural diversity in the medical field is, at times, greatly hindered because of religious beliefs, language barriers, and the hierarchies of diverse cultures and these have the propensity to affect the continuity of care for the patients. “Every person has different aspects that constitute their identities, according to how they see themselves….This means that seeing an individual in terms of

A physician must be well rounded in a variety of fields to provide effective care. First, an interest in learning scientific knowledge must be accompanied by the ability to translate that knowledge into methods of treatment. Because science is constantly changing and improving, a physician should be continuously expanding their scientific learning within and outside of their respective fields. Most of the coursework that I have taken reflects my interest in the intersection between biomedical science and its applications through an anthropological lens. For example, I have performed public

Addressing the extent of formal health care and use of medicines among African immigrants requires careful attention to cultural attitudes and perceptions that influence health care-seeking behaviors. There is tendency for culture and certain traditions to affect people’s perspective about prescription medications. I am writing about cultural clash with modern medicine. There are a lot of cultural barriers that could affect medication adherence especially for African immigrants. The reason I selected this topic is that I can relate to it very well. Also, I am going to be serving in a community where there are a lot of Africans and people migrating from Africa.

a) Dr. Sandra Soo-Jin Lee focuses on sociocultural ethical issues in her field of medical anthropology. She studies with an intersectional approach to data and science. (“Sandra Soo-Jin Lee, Ph.D.”, n.d.).

This revised/reorganized fifth edition of a classic exposition of a secular "principlist" approach to bioethics makes the text more accessible to readers who are not well versed in moral theory. The book addresses critiques of the approach as presented in earlier additions; new developments in theory; and new issues in research, medicine, and health care. The original framework containing four clusters of secular principles--respect for autonomy, nonmaleficence, beneficence, and justice--is upheld as "the common morality" accepted by "all morally serious persons." Often referred to as "the Georgetown mantra" (after Georgetown's Kennedy Institute of

Three weeks in Zambia significantly impacted my life and I will be forever grateful for the experiences and people I encountered. During my time in Lusaka working at Beit Cure Hospital I was able to help the medical assistants and nurses clean and take vital signs of the patients in the children’s wing. It was during this time that I truly got to know the patients and their families. One of my favorite memories is that of my time spent with a little boy named Promise and his father. Promise was an extremely shy three year old and he would not interact much with any of the staff or children in the hospital. One day as I was talking with his father, Promise started acting silly by making faces at me. From that point on we became friends. Over the next days Promise became more social and played and interacted more with the other children and staff. This was a rewarding experience for me because I was able to help Promise come out of his shell. During my time at the hospital I was also able to observe Dr. Kachinga Sichyzia perform a hydrocephalus surgery on a baby. This was my first time in the OR and an amazing opportunity to watch Dr. Sichyza work. Not only is Dr. Sichyza one of only three neurosurgeons in Zambia but he writes, composes, and records music, has published two novels, and previously ran for president of the country. Seeing all that he has done has been a great example of all that one person can do and it helped me to

Imagine you are injured or sick and have sought a doctor’s help. Although you trusted your doctor, something, something seemingly very in control of the doctor, went wrong. You are angry and confused, but also think of the commonality of medical malpractice. So, why do doctors, who are supposed to help, harm? Though many flaws influence it, malpractice can be, and often is unintentional. Most doctors aren’t trained to harm their patients. Inexperience and lack of medical discovery led to unintentional suffering of the patient. Personal flaws, like lack of willingness to abandon previous medical methods and shortcomings in communication also harm patients. Further reasons why doctors harm are socio-medical understandings that breed hate, prejudices stemming from a society’s belief about certain people, such as the medical practice under the Nazi regime. Additionally, displayed in the case of Ignác Semmelweis, judgement of one to oneself can be detrimental to any progress one’s ideas could make. We will examine these concepts through Jerome Groopman’s “Flesh-and-Blood Decision Making”, Sherwin Nuland’s The Doctors’ Plague and Barbara Bachrach’s “In the Name of Public Health”. Those who practice medicine are, unfortunately, unfree from the imperfections that plague all of humanity. Through these intimate and varied faults, doctors do harm.

Ethics, in medicine, is described as applying one’s morals and values to healthcare decisions (Fremgen 2012). It requires a critical-thinking approach that examines important considerations such as fairness for all patients, the impact of the decision on society and the future repercussions of the decision (Fremgen 2012). According to Fremgen (2012), bioethics concerns ethical issues discussed in the perspective of advanced medical technology. Goldman and Schafer (2012) state bioethical issues that arise in medical practice include antibiotics, dialysis, transplantation, intensive care units, issues of genetics, reproductive choices and termination of care. In clinical practice the most common issues revolve around informed consent, termination of life-sustaining treatments, euthanasia and physician-assisted suicide, and conflicts of interest (Goldman, Schafer 2012).

Cultural boundaries have been the epicenter of driving apart individuals from different cultural backgrounds. The movie The African Doctor is the perfect example of such differences. It also portrays how and why overcoming these boundaries is significant to the wellbeing of the community. The community in which the African doctor is integrating has multiple things in common but the uncertainty avoidance that the community had was too high to permit any exchanges between the two cultures. The way the African doctor adapted to the way the locals where is proof that communication competence is key when it comes to dealing with and ingroups when being part of the out group. And trying to break the barrier of closed minded people that were born and raised in a specific environment that wasn’t proan to interact with anything other than themselves is very difficult, but in fact possible. The African Doctor shows us the tenacity of how to deal with these instances. Overcoming the obvious boundaries that exist between two separate cultures by focusing on how beneficial they are to each other is key to improving the eachothers lives.