Wanting to change the world

Energy, willingness, enthusiasm, vision, courage of your convictions. If these were clues in the game show Jeopardy, the answer would be, " What does it take to get on a plane and travel 8,000 miles, to practice your profession, in a place completely foreign to you?" Or you might ask, "How can we take the first step in trying to bring hope along with appropriate health care to those sometimes lacking both. Better yet, you might wonder, "If we think we can change the world, how do we begin to explore the potential for doing so?" Tam Nguyen and Saomony Cheam have asked themselves these questions. In looking for the answers, they've exercised their energy, they are certainly willing, more than enthusiastic, have vision that will propell them far in providing healthcare to their communities, and their motivation, their fortitude, their comittment, and most importantly, their conviction for exanding their world to the global community, runs deep. They are to be commended and congratulated for beginning their professional lives in a way that firmly establishes them as global citizens. But by definition, their chosen profession and their desire to reach the world will require continued vision and growth. This is a bold and uncommon venture. Drs. Cheam and Nguyen are more than able to meet the challenge. I am humbled and honored to have been their preceptor as they begin this journey.

I travel frequently to Kenya and over the years have developed a passion for using my profession as a tool for delivering health care to underserved global communities. Approximately a year ago, two students were referred to me by one of my former professors to explore the possibility of traveling to Kenya to learn more about healthcare in developing countries. Thus began a year of discussion and preparation to travel to St. Mary's Missions Hospital in Nairobi, Kenya for 5 weeks of intense learning.

Warmly embraced by the staff in general, my colleague and close friend Dr. Michael Johnson (a U.S. trained surgeon who has been practicing in Kenya for over 20 years), facilitated this venture from the Kenya side, while I prepared the synopsis/curriculum from the U.S. side. James Kimani, chief pharmacist at St. Mary's, provided guidance and facilitated exposure to the pharmacy and inpatient care areas as well as the TB/HIV and hypertension/diabetic outpatient clinics. Establishing relationships with the medical staff was key in this learning experience, especially since at St. Mary's, clinical pharmacy hasn't yet become the norm. Yet acceptance on the wards readily occurred and Drs. Cheam and Nguyen's presence among the medical teams making morning rounds was highly encouraged, if not expected. Once familiarity was established, which was probably after the first few days, recommendations and perspectives on therapy were frequently requested. In this, the seeds of a deepening relationship between the profession of pharmacy and these medical professionals, were planted. Previously, there was little knowledge of the important contributions pharmacists could make to increasing the efficiencies of healthcare at St. Mary's. The economics of healthcare are relevant here too, and so the chief pharmacist and his staff spend little time on the patient wards. Therefore, Drs. Cheam and Nyguyen are setting a precedent and establishing a framework for advancing the cause and recognition of pharmacy practice at St. Mary's hospital. Again, vision and courage take center stage, in this, an area that has never been considered at this Missions hospital,..but, an area that has now been introduced. Remember the question about... "If we think we can change the world...?" The world at St. Mary's has already been changed.

The nursing staff at St. Mary's has been introduced to a different way of relating to pharmacists. A paradigm shift has been initiated in which nurses have begun to consider and question the acute and chronic implications of therapies they administer at the request of physicians. Culturally, this is a difficult matter to address, but this, like other difficult issues raised, will be handled with compassionate team work and a view toward increasing efficiencies for the ultimate benefit of the patient. The presence of Drs. Nguyen and Cheam on the medical team along with their CME lectures (more on this in upcoming posts) have prompted much discussion on enhanced healthcare efficiencies and the contribution of pharmacists towards realizing these efficiencies.

The learnings that Drs. Nguyen and Cheam have gained will benefit their patients regardless of their ultimate practice setting. In the immediate future, Dr. Cheam is headed for South Dakota to work for the U.S. Public Health Service as Lt. Cheam. Dr. Nguyen will be entering a residency program in Loma Linda, CA. In both instances their future colleagues will be blessed to serve at their sides.

So applause to Drs. Cheam and Nguyen, their parents and overall community for sending them forth with a vision and conviction for wanting to make a difference. A difference that has already begun.