Travis Bias, DO, MPH, Diploma in Tropical Medicine & Health (DTMH) alumnus and family medical doctor, has spent a large amount of his medical career in East Africa – Kenya, Uganda, and Tanzania, where he has had the opportunity to see how other health care and educational systems operate up close.
Travis applied to study for a Diploma in Tropical Medicine and Hygiene at the London School of Hygiene & Tropical Medicine after doing a number of his medical rotations in rural Kenya and realising that his medical training had not completely equipped him to fully care for a rural Western Kenyan population.
As part of his DTMH studies, he spent three months in East Africa; six weeks in Moshi, Tanzania and six weeks in Kampala, Uganda. His first day at the School, however, did not go to plan, as his rucksack was lost in transit at Heathrow, which meant he had to go to class in the clothes he had been travelling in for three days. Fortunately, Dr. Phil Gothard, the East Africa DTMH Programme Director, let him borrow one of his shirts while he waited for his bag. On the course, Travis built good relationships with his classmates and considers a few of them as some of his closest friends. Although the overall cost of not working plus tuition of the course was high, Travis felt that ultimately it was worth the expense.
He found it beneficial to complete a course set in East Africa, as he was able to learn alongside young doctors working in the area. He taught in a new family medicine residency programme in Kenya for over four-and-a-half months and then taught for eight months in a public medical school in Eastern Uganda through a Peace Corps programme called the Global Health Services Partnership.
“One of the things I am most thankful for when it comes to working abroad is how it has expanded my perspective and changed the way I view the US health system, and how we practice medicine within it. The reason I have an interest in medical education is because all these practice patterns and habits start in medical school while you are observing physicians and continues into residency when you are learning practice habits from attending physicians.”
One his proudest achievements to date includes his guest blog post on CFR’s blog Africa in Transition. He considers this a culmination of multiple trips to sub-Saharan Africa, working in multiple settings, and running up against major barriers to good population health, namely poor governance. “As my career evolves, I aim to continue supporting the training and retention of human resources for health in low-income areas through highlighting opportunities for strengthening policies or influencing diplomatic efforts by the US (or other high-income countries) towards reduced inequality, health, and ultimately economic development.”
Travis advises current students interested in working in family medicine in low or middle-income countries to first, truly analyse and evaluate their motives for wanting to do that kind of work. “Once you have decided to do it and you’re planning a trip, make sure you understand how their practice — whether it’s through an NGO clinic or a governmental facility — fits in with the local country’s clinical guidelines, how their practice fits in with the local health system, and that you understand the context in which they are practicing. One of the things I have observed is sometimes health care personnel coming in from outside the country are practicing in a way that is not consistent with the local evidence base or it is something not well tied to what the local health system is doing. That kind of care is unsustainable and at worst harmful.”
Feature image and some content courtesy of the Texas Academy of Family Physicians
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