Questions

Questions generally begin with a what, why,how, when, where or who? Though I find "why" questions most intriguing and the answers multi-layered, the what questions are the starting point and require clear, concrete explanation. So to answer "What are you doing?"...

Until I complete exams on April 1st 2008, I am attending the diploma in tropical medicine course offered by the London School of Hygiene and Tropical Medicine. Class begins in the morning at 0900 after a brisk and sometimes wet 45 minute walk from north London to the All Souls Clubhouse classroom(temporary housing while construction occurs at the LSHTM). I walk with my housemate Kebir Ibrahim(KB) a Nigerian physician who works at home in a malaria control program. Class ends at 1700 followed by our walk home. To date the quiet evenings have entailed some reading and British TV watching in the room I rent from Mrs Finch.

Wednesdays are spent in discussion of cases or on rounds at London's Hospital of Tropical Medicine. Thursday afternoons are spent in the laboratory peering through microscopes at malaria infected blood smears or parasite cysts.

Perhaps more interesting is the question "What is tropical medicine?" Two professors have had a go at that question. Eldryd Parry co-author of Principles of Medicine in Africa and impressively experienced in the field, founding multiple African medical schools described it as a blend of poverty medicine and the medicine of climate. Tom Doherty, our course director, also emphasized poverty medicine and added that the patient population tended to be young, otherwise healthy people with reversible medical problems, often an infectious disease.

David Hilfiker MD author of Not All of Us are Saints describes his experience working with the poor of Washington DC and offers that his medical training did not specifically address poverty medicine. Though poverty medicine became his specialty as he worked with his homeless patients. He and my professors here emphasize that poverty medicine must consider more than the bio-medical problems. There are political, social and psychological considerations often under emphasized in traditional medical training.

I am fortunate to be learning from experts in the field teaching me poverty medicine.