An article by Amy Tsai (2nd year medical student)
With the mention of “Global Health”, many students think of helping under-developed countries, and gaining amazing experiences and insight from the extensive traveling that comes along with global health projects. Dr. Maureen Mayhew exemplifies this model of global health, but also illustrates the sacrifices that one must be willing to make to become a successful health advocate for under-served populations.
In the year 2000, Dr. Mayhew undertook her first project in Afghanistan, around the time of the Taliban attacks. She was in charge of an outpatient clinic that focused on the health of women and children. Dr. Mayhew knew that in order to build a sustainable clinic, her role was not to treat patients, but rather to train others to provide treatment. In Canada, we are used to stepping in during busy times to treat as many patients as possible, but Dr. Mayhew took a different approach in Afghanistan. Even during busy times, she saw it as a golden opportunity for the local health care providers to be trained in patient care. Thus, rather than always stepping in to provide the necessary services, Dr. Mayhew helped to provide additional training for both physicians and midwives in caring for their patients.
“Practicing global health medicine in remote areas is very different from urban practices,” said Dr. Mayhew. “We had a case where a young boy, a shepherd, was chasing after his sheep, which were very valuable in their village. The young boy, in running after his sheep, fell off a cliff and cracked his skull open. You could even see some of the brain from the injury, but he was conscious. His family brought him to our outpatient clinic because the hospital was too far away. We didn’t have a neurosurgeon with us in such a remote area, but we did have a general surgeon. Keep in mind, though, that the general surgeon was a nurse who treated people in combat. Under these circumstances, we decided to give the boy palliative care with pain relief. He was well cared for by his family. His death, which was more than one week later, was well received by his family.”
Health care in remote areas speaks true to balancing the patients’ desires with actions that are most beneficial for the patient. The hospital closest to the village in which Dr. Mayhew was working was overcrowded and had poor patient services. It was also not well equipped to ensure the survival of this young boy. Taking these conditions into account, sending the young boy to the hospital would have decreased the quality of life for him. Palliation, although many times difficult, was one of the best choices for this young boy. This would be a rare scenario in developed urban medical care centers, where specialists and neurosurgeons would tend to this young boy and utilize advanced medical technology to keep him alive. However, it is through this example that one appreciates the art of balancing limited resources and quality of life.
Dr. Mayhew then started up four clinics in four different areas, which began in tents as they waited for the mud bricks to dry. “It was like going back to biblical times,” commented Dr. Mayhew. “We traveled on donkey or on foot to get to the next village. The culture there was also very different. The women were very trusting, and had a kind of child-like innocence because they were very protected by their families. Getting to know them allowed me to see people through different eyes. They felt sorry for me that I wasn’t married and didn’t have kids, and yet I felt sorry for them that they didn’t have the opportunities to work and travel. This struck me and I realized that many times what we see is clouded by our own judgment – I only saw women’s rights and missed the beauty in other cultures.”
Dr. Mayhew practices non-judgmental cross-cultural medicine, and exemplifies this through both her work and life. In addition to traveling abroad to 55-60 countries and working on projects mainly in central Asia, Africa, Thailand, and Cambodia, Dr. Mayhew also does research work locally at Centers for Disease Control and Prevention and refugee health work at the Bridge Clinic. She is also a clinical associate professor at UBC who teaches medical students, residents, and public health students, in addition to mentoring research projects within the field of family medicine.
Finally, some words of wisdom from Dr. Mayhew: “Stay open, and don’t narrow your field of vision. Don’t be judgmental. Stay out of debt as much as you can so you can do what you truly want to do.”
~Article by Amy Tsai