Podcast

In the past, malaria killed two out of three missionaries in certain locales. Depending on the prevalence of disease, the missionary must decide on how many layers of protection are needed. Strategies include sleeping under an insecticide-treated net, avoiding outside at dawn and dusk, screening windows and doors, wearing mosquito repellent, reducing mosquito breeding sites, taking malaria prophylactic medication, and evaluating and treating every fever within 24 hours of onset. The decision about which strategies to employ should be made in consultation with medical providers with knowledge of local patterns of disease. Diagnosis may be affected by presence of prophylactic medications, test kits that only detect certain species, or variable experience of lab personnel. Recurrent malaria may be due to reinfection, recrudesence, or relapse, and diagnosis and treatment requires knowledge of disease patterns related to P. vivax and P. ovale. Testing will often be negative and disease may occur weeks to years after leaving the malarious area, making treatment more difficult, especially if the missionary is back in his/her passport country.

As we see an increasing number of culturally diverse patients in our practices, there is no doubt of the importance of cultural competency in medicine. Specific circumstances and miscommunications have been well documented. But how can we develop an eye to see where a patient’s values and worldview may differ from our own? We will review an approach to cultural competency highlighted by medical missions case studies.

We will address the challenges and advantages of being single on the mission field.

Oftentimes short term mission trips sideline the indigenous church. The local church is the key to transformation and must be empowered to participate in the Great Commission. The members of the local, indigenous church are the best people to reach their community with the Gospel. They speak the same language, look the same, and understand the culture. By giving the local church the responsibility, allowing them to be in the driver's seat, we will be able to empower them with skills that will meet the biggest needs in their own community. Missions is designed to be a relay race. We will discuss seven principles to assist us in our short term mission trips to have sustained, long term impact without creating dependency.

The United States spends more money per capita for health care costs than any developed country in the world. It, also, has the worst health outcomes of any developed country. This presentation will review US health disparities in marginalized communities from the lens of health equity, health inequality, health disparities, and social determinants of health. The health care outcome review will be made nationally, regionally, and locally in the context of historical and current policy decisions affecting US health care outcomes. The deficiencies of the current system are underscored in the increased disease burden of COVID-19 cases and mortality in US marginalized communities mirroring similar occurrences in chronic disease manifestations. Recognition and identification of factors contributing to health inequity is the first step in achieving improved health care outcomes in marginalized domestic populations. Participants are encouraged to take the Harvard Implicit Bias test prior to this session at https://implicit.harvard.edu/implicit/takeatest.html