Brent Scharschmidt

Photo
Fellow: 
Award Year: 
2008
Country: 
Thailand

Brent spent a year on the Thai-Burma border in order to understand the obstacles facing health care delivery in conflict-affected areas -- as well as help find ways around them -- by implementing a malnutrition program targeting children under age 5. While serving as a PiA teacher in Chiang Mai, Thailand in 2005, Brent discovered that several of his students were from the various ethnic minority groups along the Thai-Burma border. Through their essays and presentations, he learned about the decades of ethnic conflict in eastern Burma and the resulting health crisis. He visited the border several times, each time better appreciating the impact that simple medical interventions can have on conflict-affected populations. Though Brent was medical school-bound, he decided to first spend a year on the Thai-Burma border working on these public health issues.

The Carriebright Fellowship is supporting the initial malnutrition training and subsequent follow-ups for local health workers -- the major capacity-building component of the program. Health workers will learn how to assess and treat malnutrition, and practice providing education so that families understand the risk factors involved in keeping their children healthy. Upon returning to their target areas following training, these health workers will initially conduct a nutritional survey of children under age 5. In addition to serving as a baseline to gauge program success, the survey will provide the first thorough assessment of the nutritional status of children living in these areas, forming the basis for future advocacy. The health workers will then enter malnourished children into a feeding program, providing treatment according to World Health Organization and border-specific protocols. In addition to training costs, PiA is supporting other capacity-building aspects such as educational pamphlets to be used in villages and protocol booklets for health workers in clinics.

An Update from Brent:

I am still involved with my project in eastern Burma, mostly through consultation from the US regarding protocol updates / revision and possible expansion to additional areas. I did go back to Thailand following my Carriebright year though, for two months in 2010, to check in on things. The malnutrition program continues to run in its original areas. Much has happened in Burma since the program started. Most notably, the government has started to make what appears to be a genuine moves toward democracy. This has given many of the NGOs working in and around Burma that the health situation will improve. Change has been slow to come to the border areas however, and our partner ethnic health organizations are continuing to treat preventable diseases. Last year, for instance, there was another measles outbreak in Karen State. Clearly there is much room for improvement. We feel the malnutrition program is doing its job and targeting the most vulnerable of children in Karen State - hopefully with improved nutrition, they will be less susceptible to at least some of the morbidity and mortality that necessarily accompanies life in an active conflict area.

As for me, I've just finished medical school at UCSF and am about to start my residency in Internal Medicine at Kaiser Permanente in Oakland, CA. It's really exciting to be finally seeing patients full time starting in a month or so. My work in Thailand and Burma was a frequent topic of discussion in my residency interviews, and it was really heartening that what might previously have been viewed by hospitals as a sort of esoteric interest in global health is now seen as a real asset in terms of what you can bring as a physician to your patients in the US. US health is global health, and I think this is becoming more apparent to everyone in the field. We have patients from all over the world, some of whom present with the kind of tropical diseases you don't expect to normally see in Northern California. More important, the kind of cultural understanding I gained by living in Thailand for 3 years is really invaluable; I find I am able to connect with people whose backgrounds are wildly different from my own, and I know much of that ability is a product of PiA, where I worked daily alongside people who were raised in refugee camps, or internally displaced person camps, or just in small villages along the Thai-
Burma border.

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