Crossing Boundaries: Mentorship in Global Health.

Abstract

* Abbreviation: GH — : global health On my first day in the NICU in Malawi, I helped care for an infant who suffered from severe lack of oxygen and trauma due to a difficult birthing process. Before this experience, I had felt ready to work at a Malawian hospital as a pediatric resident. I had taken a tropical medicine course, and my home institution mentor had run simulations and led discussions addressing the practicalities and ethics of practicing medicine within resource-limited settings. But that afternoon, when the infant became apneic, personally experiencing what had only been simulated felt much harder. The 1 available nurse and I performed compressions and manual breaths, but he never recovered spontaneous respirations. My host institution mentor arrived soon after we discontinued resuscitative efforts. With his guidance, I spoke to our patient’s family and witnessed the Malawian expression of grief in the form of wailing songs and prayers. Afterward, he and I discussed questions with which I was struggling, namely, at what point would I be causing more harm than good by continuing to resuscitate this child, knowing the limited long-term care resources available in Malawi? Both home and host institution mentors helped me navigate this clinical situation and process my patient’s death, ultimately enriching my global health (GH) experience and … Address correspondence to Maya I. Brasher, MD, Division of Neonatal-Perinatal Medicine, Department of Pediatrics, McGovern Medical School, UT Health Science Center at Houston, 6431 Fannin St, Suite MSB 3.244, Houston, TX 77030. E-mail: maya.i.brasher{at}uth.tmc.edu