Thoughts from an Alumni – Rick Rohrer, MD
What to do with a new position at AP
I was delighted, a couple of months ago, when Patty approached me about carving out a new position at Amazon Promise, the “Director of Clinical Preceptorships”. Global health as a discipline has evolved rapidly over the last decade, and is a far cry from what it was over the first decade of AP’s existence. It makes sense to revisit the AP educational “curriculum”.
Global health is an intrinsically heterogeneous field of medicine. There are so many different healthcare delivery systems, so many social, economic, and geographic factors, and so many local variations on wellness and sickness to be considered. But certain common principles are gaining traction. The World Health Organization has steadily refined its list of essential medications, and the World Bank has just published a volume on essential surgery. All of the items included are there for a reason, and all of the items excluded were left off for a reason. You can learn a lot just by staring at the table of contents of these two publications! For those who come from complicated healthcare systems in the developed world, delving into global health can very much clarify the “What really matters, anyway?” question.
There’s another level of heterogeneity at Amazon Promise that I find very exciting: the people who collect from all over the world to take part in these trips. They come from four continents and are self-selected to be adventurous types. They may be college students, practitioners in training, or specialists with decades of experience. They could be into public health, nursing, medicine, or surgery. My job will be to meet everybody at their own level of experience and interest and, wherever that may be, encourage them to dive a bit deeper and provide the wherewithal to do so.
I feel that I’m in a good position to take this inaugural role. I have been on expeditions with AP since 2010, and I run a global health rotation for Tufts medical students in Nicaragua. Prior to that I have worked in Africa and Asia. I really enjoy getting my head around seemingly intractable problems, and sharing what I’ve learned in the process. I can’t wait to get started with the July group!
Having been to Peru pretty much annually since my first AP trip in 2010
An honor to be offered this position, main reward I’m told is to be able to attend the board meeting and eat a dinner prepared by Jackie Carroll’s husband (though I’d settle for simply meeting Jackie herself, for once)
I come at this from a somewhat academic angle, running the global health course for Tufts med students in Nicaragua as I do. But it’s really hard to characterize frontline global healthcare, as with AP, as “academic”. The time/space phenomena (ie, “Toto, we’re not in Kansas anymore!”), the sensory input (“OMG, that was a howler monkey?!”), and the 24/7 connection with great fellow travelers from all over the world simply overwhelm any sense of ivory tower academia. AP offers a bona fide global health experience coupled with bona fide adventure travel in a remarkable corner of the world. While most team members will want a balance of these aspects, some members will want to dwell on one more than the other. Still, even the most adventure-oriented person will want to know, for example, what’s up with the Zika virus in the Amazon, and on the other hand, even the most global-health oriented person will be unable to look away when someone first spots a pink dolphin. Patty, Jose Luis, and others in the crew will always be there to flesh out the nature commentary to whatever depth interests you, and I view my job as to organize the global health material in a similarly flexible way, from basic biology to treatment protocols to comparative organization of healthcare systems