Inaugural UPMC Dermatology Brigade to Honduras

On March 25, 2019, the inaugural UPMC Dermatology Brigade set out to Tegucigalpa, Honduras with nine large boxes of medical supplies in tow, breaking ground as the first ever dermatology brigade to serve in Honduras. Months of preparation from applying to various grants, gathering over $12,000 in medical supplies, and preparing dermatologic lectures had culminated in our 5-day trip to establish a dermatology clinic in San Lorenzo, Honduras, a city of 330,000 people with only one local dermatologist. Our team of nine was led by UPMC Dermatologist, Dr. Alaina James, and UPMC Dermatology residents, Dr. Jonathan Lee (4th year resident) and Dr. Hasan Khosravi (2nd year resident), and included 6 students from all levels of medical training from the University of Pittsburgh School of Medicine: Sophia Zhang (MS-3), Carlos Morillo-Hernandez (MS-2), Caroline Kettering (MS-1), Motunrayo Lydia Olawaiye (MS-1), as well as two undergraduate students, Maria Evankovich (rising MS-1) and Pragosh Saini (Freshman). After a three-hour bus ride from Tegucigalpa to the Southern coastal city of San Lorenzo, the team met with Global Brigades staff, interpreters, and local physicians to organize the medical supplies and clinic flow for the next five days at San Lorenzo Hospital.

The next morning, our team bus pulled up to the hospital, and we were met with rows of seats filled with Honduran patients, some who had traveled hours by foot and bus to be seen. After a team prayer, we opened the clinic doors. In a large open-room clinic setting, four consultation stations were staffed by a team of an attending or resident working closely with an interpreter and student. This unique, open-concept clinic set-up facilitated collaboration and educational discussions of challenging cases between attendings and residents, which maximized learning opportunities for students at all levels of medical training. Several inpatients that were hospitalized were also wheeled down for consultation. In this same room, a local pharmacist and student dispensed prescribed medications and educated patients on how to use them. After four days of clinic, we organized a day for surgical procedures, where four patient beds and surgical tables were set-up with a central table of supplies and instruments. To be in one large room of medical professionals and trainees working together to help patients created a synergistic, compassionate atmosphere of unparalleled energy. Together, with the support of Global Brigades interpreters, staff, and a Honduran dermatologist, we medically assessed and treated 561 patients in 4 consult days and performed surgeries on 18 patients with basic resources. Two flap reconstructions and a nail biopsy were performed. On the morning of the last day, UPMC dermatology residents, Dr. Lee and Dr. Khosravi, gave Grand Rounds-style lectures to local medical students and residents in Spanish. Dr. Lee presented on the effects of ultraviolet radiation on skin, non-melanoma skin cancer, and potential diagnostic mimics while Dr. Khosravi presented “casos calientes (hot cases)” seen during the brigade, highlighting the diagnosis and management of common outpatient and inpatient dermatoses.

Despite the language and cultural differences in Honduras, we were all able to have meaningful interactions with local patients and physicians who shared a great passion and dedication to patient care. Patients left our clinic with diagnoses, treatment plans, and answers to skin questions that they had been wondering all their life.  It was an enriching, humbling experience reminding us of why we entered medicine and the importance of extending healthcare across borders. We believe this inaugural dermatology brigade model can serve as both the foundation and catalyst for sustainable global health partnerships with local non-profit organizations and healthcare providers developing local infrastructure. Moreover, we plan to establish a teledermatology infrastructure with local physicians and community healthcare workers to provide follow-up care and inpatient consultations. Through these service-oriented partnerships, our goal is to advance health equity through global partnerships and shared education.

Watch this video of the trip:  https://www.dermrounds.com/video/upmc-dermatology-brigade-in-honduras

Article courtesy of:  

Sophia Zhang, BS1, Hasan Khosravi, MD2, Jonathan J Lee, MD2, Alaina J James, MD, PhD2

1University of Pittsburgh School of Medicine; 2Department of Dermatology, University of Pittsburgh