U Physician Assistant, Public Health Students Get Firsthand Look at Infectious Diseases in Thailand

U Physician Assistant, Public Health Students Get Firsthand Look at Infectious Diseases in Thailand

Aug 30, 2004 6:00 PM

Graduate students and faculty from the University of Utah' s Physician Assistant and Public Health programs recently returned from a four-week expedition studying infectious diseases in Thailand.

If a month sounds like a long time, it wasn' t, said Lyle Van Orman, a graduate student studying international public health. "It's one thing to read about public health issues and study them in the classroom, but to observe them firsthand in a developing nation was a learning experience I'll never forget," Van Orman said. "The lessons I learned in Thailand will help me wherever I go in the service of international public health."

Both the Utah Physician Assistant Program (UPAP) and the Public Health Program have been sending faculty and students to developing countries for several years, but this trip was the first "international elective" course, where the students received academic credit toward graduation. The expedition also marked the culmination of an effort that began in the mid-1990s to develop a curriculum in international health.

"When PA students travel abroad, they usually do what we call a clinical rotation, where they see patients, but there's no formal curriculum," said Don Pedersen, Ph.D., professor and UPAP program director. "This international elective is a well-engineered teaching and clinical program of study."

The team consisted of three graduate students and a faculty member from both UPAP and the Public Health Program. All members of the team paid most or all of their own way - approximately $2,000 for travel, accommodations, food, etc. - to participate in this educational experience.

Supported in part by a $4,500 grant from the national Physician Assistant Foundation, the curriculum was developed for physician assistants who want to work internationally, and a significant portion of the curriculum is geared toward public health issues. "A strong public health background is essential, both medically and economically, for physician assistants to understand and succeed in practicing international medicine," says Dan Crouse, MPAS, PA-C, leader of the physician assistant contingent, "because most public health problems in developing nations are the result of economics."

The curriculum included 60 hours of lectures from English-speaking Thai professors and physicians from the Thai Ministry of Public Health. The lectures focused on clinical topics, such as tuberculosis, AIDS, and malaria, as well as cultural topics such as poverty and the role of women in society.

The cultural exposure is an important part of the program, said Pedersen. "Students are getting to see cases of exotic illnesses such as malaria, and drug resistant tuberculosis," he said. "And that's important. But it's also important to examine the root cause of why these and other diseases are so prevalent in this society."

When not attending lectures, the group visited specialty clinics in and around Bangkok. During their first week, for example, they studied poverty's effect on the health of the residents in Bangkok's slums. They also learned about the health problems of women and children in a developing country, including micronutrient deficiencies, and about occupational health and safety issues that affect factory workers in Thailand.

In subsequent weeks, the group traveled to specialty clinics where they learned from world-renowned experts about the diagnosis and management of HIV/AIDS, drug resistant tuberculosis, Severe Acute Respiratory Syndrome (SARS), avian flu, and leprosy. They also visited a number of sites where researchers are studying the control and treatment of malaria and other emerging and re-emerging insect-borne diseases such as dengue fever.

This area of study was especially pertinent because of the appearance of West Nile Virus in Utah, said Audrey Stevenson, MSN, FNP, MPH, a public health doctorate student and director of the Family Health Services Division for the Salt Lake Valley Health Department.

As the SARS epidemic showed in startling fashion, public health threats no longer have boundaries, Stevenson observed. Air travel has made it possible for individuals to spread diseases across continents before they even know they're infectious. That makes it all the more valuable to study and understand public health issues from around the world.

"Immigration of individuals and groups from other countries, as well as travelers coming into Utah, may bring a host of infectious diseases for which we have not had previous experience," she said. "In addition, emerging diseases such as West Nile Virus and new diseases that may be introduced as bioterrorist agents make it imperative that we are more familiar with the recognition and treatment of these diseases."

During the final week, the team visited the refugee camps near the Myanmar (Burmese) border, where they observed the care of people who've been displaced from their homes.

"The movement of people and products across borders has increased in volume and speed, giving birth to an increased risk of disease transmission," said George L. White, Jr., Ph.D., M.S.P.H., professor and chair of the Public Health Program. "The Thailand experience provides an excellent opportunity for both UPAP and public health students to develop essential public health competencies that will be crucial to understanding public health issues in the 21st century."

UPAP and the Public Health Program are graduate-level programs that were rated fifth and sixth, respectively, by their peer programs in the 2005 Annual Graduate School Rankings issue of U.S. News & World Report. Both programs are in the Department of Family and Preventive Medicine at the University of Utah School of Medicine, and each program has approximately 800 alumni serving in health professions in Utah, across the country, and around the world.

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