2015-08-01 MDB Profile - Rishi Mediratta
We spotlight the work of one of our 2014-15 Mary Duke Biddle scholars through a Q&A.
Q:Tell us a little bit about how you chose this site for your MDB rotation:
I have been working in Ethiopia since my sophomore year of college at Johns Hopkins University. Every summer during college, I worked in Addis Ababa and Gondar, Ethiopia. My role included piloting a survey and implementing public health interventions for childhood diarrheal disease. My research inspired me to learn about programs that reduce preventable causes of childhood mortality. Ethiopia became the focus of my work as a result. After I graduated from college, I decided to live there for a year. During that time, I also founded a non-profit organization, the Ethiopian Orphan Health Foundation, which provides health care and education to orphans in Gondar. I also developed a longitudinal relationship with colleagues at the University of Gondar Hospital. The hospital is one of the few major teaching hospitals in Ethiopia and is a major referral center for patients in the Amhara region. I choose Gondar for my Mary Duke rotation because I wanted to participate in clinical work at a site where I spoke the language, knew the traditional customs, and could make a real, sustainable impact.
It was gratifying to see these little ones improve during their hospitalization and receive hugs from family members on the day of discharge.
What were some of the personal challenges or dilemmas you faced during your rotation?
One major challenge was not having access to some of the most basic medicines and resources we take for granted in the United States. For example, one morning during rounds, the team told a young patient with a new diagnosis of Acute Myeloid Leukemia that chemotherapy was not available in Gondar. Why did the child undergo a painful bone marrow biopsy if the medication to treat the disease was not available? I felt angry knowing that medications to treat childhood diseases were not available. But it was important knowing how to adjust to these circumstances to continue providing effective care.
Q: Given your previous work at the site, were there any ‘new’ insights or experiences this time that you can share with us?
There were several. First, I was surprised to learn that antibiotic resistance was an important driver of treatment failure among children with pneumonia. Pneumonia is the number one reason why children are admitted to the University of Gondar Hospital. Many of the children had received different antibiotics from different health professionals prior to their admission. Sadly, common antibiotics are resistant in treating one out of every three children with mild pneumonia in Gondar. This was eye-opening. Second, I witnessed how difficult a fee-for-service system without insurance was for families. Before an IV line could be inserted for a child with dehydration from diarrheal disease, the child’s family would have to buy a butterfly needle, syringes, and saline from a nearby pharmacy. This model undermines effective care, particularly for Gondar’s poorest citizens. Lastly, despite the lack of medications, laboratory tests, imaging, and electronic medical records, pediatric patients still improved if they received the right treatment. Physicians, nurses, and families worked tirelessly to care for children. It was gratifying to see these little ones improve during their hospitalization and receive hugs from family members on the day of discharge.
Q: Do you have plans to go back? If so, how and in what capacity?
Absolutely! I look forward to training as a pediatrician and continue working in low-income, developing countries throughout my career. I am excited to continue collaborating with my colleagues in Ethiopia, who are among the most capable, compassionate, and humble individuals I know to provide the best medical care possible in a resource-poor environment.
What is one thing you’d like people to know about the country you worked in or about your work there? How can people learn more?
Working in Ethiopia has changed my life. It is one of those rare places where one can make a real, lasting impact.
Working in Ethiopia has changed my life. It is one of those rare places where one can make a real, lasting impact. Although the health care system there has improved dramatically, there is still more work to be done to improve the lives of children. You can learn more by visiting my non-profit organization in Ethiopia, Ethiopian Orphan Health Foundation or by visiting the University of Gondar Hospital.
Rishi Mediratta, MA, MPH, is a fourth-year student at Stanford School of Medicine. He received his MPH from the London School of Hygiene and Tropical Medicine and MA in Medical Anthropology from the School of Oriental and African Studies. He traveled to Ethiopia as a Mary Duke Biddle Scholar, supported by the Center for Innovation in Global Health. Find out more about the Mary Duke Biddle program.