Travel Health Consultation Medical Mission Trips: Surgical Strike or Sustainable Intervention… or Both?? Julie Lohre, MS, NP Travel Consultant Certificate in Travel Health™ Denver Public Health Travel Clinic Global Health Perspectives Program Global Health Internships Clinical Faculty Denver School of Nursing CCTHP Meeting Denver Health January 27, 2017 Leyte Island, Philippines Strongest Typhoon to make landfall hit this area in November, 2013 with 150 mph winds & 30 ft waves

Types of Travel Consults All inclusive packages or itineraries—Usually older (than 30!) or VERY old. Tend to be short-term Spontaneous, by the seat of their pants, don’t want any more than they can afford—Usually young—highest risk? Tend to be long-term Adventure, tend to be life-threatening or remote or both! The Bucket List, very old or terminal, willing to risk dying abroad to do/see something they’ve always wanted to do The Medical Mission trip—all different ages—want to serve in remote areas with little access to safe care

Adult Immunization Considerations Pre-travel consultation should always include assessment of the client’s routine immunizations Opportunity to update! Often not addressed at client’s primary care Pre-travel consultation will leads to improved adult immunization status The CDPHE website has resources available for pre-travel consultation in the Immunization section www.colorado.gov/pacific/cdphe/international-travel

The Pre-Travel Consultation Risk Assessment for Medical Mission trip travelers Purpose of trip? Established organization? Lodging and food set up? Awareness of cultural barriers? Able to speak local language? If not, are translators available? Plan for self-care in country? Emergency contingencies? Filipino village children

Global Health Perspectives program at Denver School of Nursing—Goals Sustainability Service learning Safety Support through partnership Global Health Perspectives program at Denver School of Nursing—Goals

Goals of Global Health Programs Sustainable interventions This means education of the local leaders Being invited into their country Use of their own renewable resources Sensitive and responsive to “their” needs There is power and dignity in us all. This is lost when dependency prevails. We believe that sustainability is achieved when solutions and resources are locally based, and can be replicated apart from outside intervention. When people invest their own resources and ideas into their community, sustainability is possible. The Mango Project Mission Statement www.mangoproject.com

Goals of Global Health Programs The concept of Sustainable interventions was introduced by Paul Farmer, a physician and anthropologist. His work in Haiti and development of the organization Partners in Health has influenced the World Health Organization’s approach to creating and sustaining healthier communities. Partners In Health strives to achieve two overarching goals: to bring the benefits of modern medical science to those most in need of them and to serve as an antidote to despair. At its root, our mission is both medical and moral. It is based on solidarity, rather than charity alone.   www.pih.org

Goals of Global Health Programs At the United Nations Sustainable Development Summit on 25 September 2015, world leaders adopted the 2030 Agenda for Sustainable Development, which includes a set of 17 Sustainable Development Goals (SDGs) to end poverty, fight inequality and injustice, improve access to health and education and tackle climate change by 2030. www.undp.org

Goals of Global Health Programs IMR provides access to medical care and community health education in underserved and vulnerable communities around the world. By improving the health and knowledge of people, IMR can assist in improving the quality of life of those populations most in need. This is done through short-term medical mission trips where volunteers give their time and services for the medical relief of the developing world. www.internationalmedicalrelief.org

Global Health Perspectives program at Denver School of Nursing—Goals Service Learning “learning while serving” Consider approaching your mission trip from the perspective of what will you LEARN from the experience, not what you will DO Be honest if your main reason to participate in a medical mission trip may be to learn about a different culture and society and expand your worldview Consider the local leaders/educators/healthcare providers perspective: What do they see as their needs? How can I support them? “It’s really frustrating as an African when people look down on us for being poor and sick all the time, but then are so busy "helping" us they basically leave us even more crippled”

Sustainability. - Educate the local community leaders Sustainability - Educate the local community leaders - Focus on resources available in the area - Work with the locally-based non-profits - Inclusiveness

Global Health Perspectives program at Denver School of Nursing—Goals Safety—we partner with organizations that are local and have invited us there

Goals of Global Health Programs

Global Health Perspectives program at Denver School of Nursing—Goals Support through partnership DB Peru Education and Healthcare in the villages of the Peruvian Amazon jungle www.dbperuong.com Love Takes Root Serving in an orphanage in Haiti www.lovetakesroot.org International Medical Relief Short-term Medical Mission trips with a focus on Community Health Education www.internationalmedicalrelief.org

Resources for Travel Health Consultation Online resources Travax Encompass™ subscription** CDPHE Immunization section—International travelers www.colorado.gov/cdphe ATHNA American Travel Health Nurses Association www.athna.org CDC Travelers’ Health www.cdc.gov/travel WHO International Health and Travel www.who.int/ith/en/ Colorado Coalition of Travel Health Professionals www.travco.org

Global Resources for Travel Health Consultation, Evaluation, Education International Society of Travel Medicine (includes listing of travel clinics world-wide) www.ISTM.org International Association of Medical Assistance to Travelers (IAMAT) www.IAMAT.org Mountains Upon Mountains: Healing the World By Tracy Kidder

Resources for Travel Health Consultation Other resources International SOS insurance information Travel products catalog (Travel Medicine, Inc.) Conferences ISTM (every other odd year) Wilderness Medical Society University of Washington (every other even year)

Myanmar (Burma) GHP Internship March 2016