Honduran Sessions- The How and Why

It is not uncommon that we are asked why we go on medical relief trips to Honduras? Of course, we could launch into platitudes about doing good deeds for the sake of humanity, but that would give an oversimplified and false sense of purpose.

Of course, there is an element of medical and humanistic goodwill that drives our collaborative effort with local Honduran medical officials. Treating patients who live in extreme poverty for common illnesses that are easily addressed by primary care doctors and urgent care centers in the USA is gratifying. Providing clean water filtration systems, mass de-worming of rural populations and offering rudimentary dental care in areas devoid of both lasting health services and basic sanitation add to the mission’s humanistic appeal.  The opportunity to expose medical students and residents to medical relief work and its inherent rewards and challenges is stimulating and serves to train future leaders in global health. Last, our Honduran trips are accurately characterized as humid, dirty and uncomfortable. Perhaps that is part of the attraction, that is, it challenges us to display some fortitude, away from our comfortable stateside lives. All are noble goals.

Most importantly, during an intense 10 days in June, our yearly ‘Honduran Sessions’, lead us to an exploration and reaffirmation of what it means to be human, to witness suffering and need alongside survival and resilience. In doing so, we are inspired to collaborate and help, albeit on a limited scale, and are forced to reflect, individually, on what is truly meaningful in a world of growing disparity, tremendous wealth and immense potential.

Gonzalo Bearman

Michael Stevens

  

Vox Medica on Facebook

The blog is now on Facebook, if that is more convenient to followers, check it out.  

Handwashing and Masks Limit Household Influenza

The transmission of influenza can be halted, within a household, without antivirals such as Tamiflu. Here is a very recent publication on the role of hand washing and masks for limiting influenza transmission in households.

The investigators studied households with an influenza positive index case. Study groups were wearing a facemask and practicing intensified hand hygiene (MH group), wearing facemasks only (M group) and none of the two (control group). Main outcome measure was laboratory confirmed influenza infection in a household contact.


When the hand washing and masks were introduced early in households, there was a significant reduction in the odds of transmission in the household (adjusted odds ratio 0.16, 95% CI, 0.03-0.92).


In the event of high influenza activity, promotion of hand hygiene and household mask use may be of benefit, especially when begun within 36 hours of symptom onset on the index (first) household case.  

Public Health "Shock Adds" - The Full Frontal Truth

This is you brain on Drugs: 1987.
Source: NY Times

Here is a nice article exploring the controversy of using 'shock adds' as public health messages. The adds may be displeasing to some. The effectiveness of this tactic is certainly up for debate. In New York City, an aggressive anti-smoking campaign is partly credited with an all time low smoking prevalence of 14%.


Perhaps there is no single best way to display a public health message. There is no credible evidence, however, that aggressive public health 'shock adds' actually increase high risk behavior.


Below is an anti-smoking commercial. Until a negative health effect is established, press on.

VCU Global Health and Health Disparities

VCU students and medical residents- Honduras 2011

The Virginia Commonwealth University's Global Health and Health Disparities training program is taking shape. 


The budding program is in many ways the brainchild of my friend, colleague and collaborator Dr. Michael Stevens. With it, the dream of training students and physicians at VCU in global health is becoming a reality. I am proud to be part of the programs core faculty.


Please visit our new website, to learn of more about the program, its purpose, goals and manifesto. 

Bleach Baths to Control MRSA and S.aureus

Recently I saw a young, healthy woman in the clinic with recurrent MRSA boils.  Here is a paper on bleach baths to eradicate S.aureus colonization.


In a prospective trial, participants were randomized to receive no therapeutic intervention (control subjects) or one of three 5-day regimens: 2% mupirocin ointment applied to the nares twice daily, intranasal mupirocin plus daily 4% chlorhexidine body washes, or intranasal mupirocin plus daily dilute bleach water baths.

Decolonization was successful in 48% of the control group, 56% of the mupirocin only group, 54% in the mupirocin-chlorhexidine group, and 71% in the mupirocin-bleach group. 

An simple regimen of dilute bleach baths, intranasal mupirocin, and hygiene education effectively eradicated S. aureus.


It may be worth a try.

Antimicrobial Textiles in Medicine- Radio Interview

For those of you interested in my most recent publication on antimicrobial scrubs, here is my radio interview on WCVE-NPR. 


Thankfully, the radio interview is brief.