Joining the fight for global health

 MBA candidate Megan Stokke ’04 and medical student Kalen Abbott ’05 research trauma medicine at an emergency hospital in a township in Cape Town, South Africa.

By Scott A. Thompson
Editor

On a busy night, the emergency room at the GF Jooste Hospital in Cape Town, South Africa is a picture of chaos. The tiny 40-bed hospital serves a population of over 1.2 million people, most of whom live in townships where gang violence is rampant. Scores of patients bleeding from gun shot or stab wounds will often cram into the waiting area, forcing doctors to decide who gets treated first and who waits – quite possibly to die.

This is the world that fellow WP alumni Kalen Abbott ’05 and Megan Stokke ’04 entered to work on a two-month medical research project last year. Abbott had just finished his first year at the University of Colorado School of Medicine in Denver while Stokke was heading into her final year of a dual MBA and Master’s degree in international development at the University of Denver. Both had chosen global health as a specialty.

Abbott and Stokke – who are dating – were interested in finding a project they could work on together that would satisfy research requirements in their respective programs. When Stokke heard Denver physician David Richards speak about practicing trauma medicine in South Africa, she followed up. As it turned out, Richards needed help with a study in Cape Town examining the prevalent use of chest tubes to treat collapsed lungs. The study theorized that given the high levels of tuberculosis (an infection of the lungs) and HIV / AIDS among the population of Cape Town, chest tubes might actually do more harm than good.

“There’s been very little research on what the best treatment for a [collapsed lung] is,” Abbott said by phone. “If we get these patients who have TB, their lungs are scarred up. If they have TB, they likely have HIV and so they are immune compromised. Are we doing them a favor by putting a tube in their chest?”

As part of the study, Stokke, Abbott, and a second University of Colorado medical student named Rusty Lieurance, examined the charts of 500 patients who had been treated with chest tubes. The goal was to cross-reference their ID numbers with a national tuberculosis database to see if the patients were later flagged as having TB and if complications emerged.

“All the data had to be put into the computer and a statistical analysis of the data done,” said Stokke, who majored in Human Development at Warner Pacific. “All of the records were paper copies. Most steps took much longer than [they would have] in the U.S., but it became more and more exciting the longer we did it.”

While the chart project took up all of Stokke’s responsibilities, Abbott split his time between the study and assisting doctors in the ER. He ended up doing procedures that medical students in the United States don’t typically attempt until their residencies, including spinal taps on meningitis patients and chest tube insertions.

“We ran around taking blood, trying to interpret labs, and report to the attending [physician] when we had no idea how to treat a patient,” said Abbott, a former Biology major at Warner Pacific. “They would, in turn, teach us procedures. If it got real busy, like there was a knife fight at a bar and ten people were stabbed, we would just spend all night suturing and helping them out.”

One service that Abbott and Lieurance offered physicians involved using an ultrasound machine to check for internal bleeding, a technique they had learned back home. With so few operating tables available, the scanning enabled doctors to more efficiently decide which patients had priority. In one case, Abbott and Lieurance scanned a young man with a stab wound to the chest after doctors couldn’t decide whether he needed immediate surgery.

“We scanned him and realized his heart had been stabbed,” said Abbott. “The surgeons took him to the O.R. Later that night, the surgeon came out of surgery and thanked us.”

Dr. Richards and his team are still analyzing the data that Stokke and Abbott collected in Cape Town. Richards says the success of the project depends entirely upon the quality of the students taking part, and that Stokke and Abbott were impressive.

“We absolutely must have students that are self motivated, have great communication skills, are skilled in professional interactions, and are culturally competent,” Richards wrote via e-mail. “Kalen and Megan were extremely well prepared for this project and their professionalism has set the bar for future students.”

For more, visit Stokke’s blog at meganstokke.blogspot.com.