Health Education Travels two ways: to Nicaragua and Back to the USA, An Interview with Dr. Brian Lisse
For the past eight years, Brian Lisse, MD has been traveling to Nicaragua with Bridges to Community to carry out his dream of providing medical care to people in great need. He has brought with him an ever increasing number of doctors, nurses, 4th-year medical students from Tufts University and even high school students with an interest in medicine.
“My strongest influence to practice medicine in a developing country came from my grandfather who was a country doctor in rural Maryland during the depression years. He was often paid with chickens and other produce if he was paid at all. But he loved his work and lived into his 80’s as a happy person,” relates Dr. Lisse.
The type of medicine that Lisse’s grandfather practiced was instinctive – making diagnoses with limited tools except for his knowledge and experience. After a month in Nicaragua, the Tufts’ students leave having learned to make medical decisions similar to those of his grandfather’s time. This experience builds their confidence in figuring out medical answers without the modern aids that are normally available in North America
For example, a student must hold a baggie of urine up to sunlight to see if it is cloudy to determine whether there is an infection without a laboratory test. They learn that transportation to medical facilities is another barrier for the rural poor to get the treatment that they need — especially when they are in Siuna which is many hours by bus to a hospital in Managua.
The medical group recently had to treat a very ill baby in the clinic at Rosa Grande, stabilize her and then make the decision as to whether it was riskier to send her in to the hospital in Siuna 1 1/2 hours away by truck or keep her at the clinic and hope for the best. Either way she could have died and, in fact, almost did just as the harrowing tuck drive to the hospital was ending. The baby not only survived but was discharged within a few days of treatment.
Dr. Lisse believes that having the volunteers live with the community residents gives the doctors the perspective that they don’t know everything. They learn that these rural Nicaraguans with limited education have much to teach them including farming and living skills. The participants have a true sharing experience with the locals that help them with their health clinic practice learning about nutrition, translation, and other cultural issues.
Many of the doctors in the Tufts’ group have returned to Nicaragua after their first experience. A number of the students have gone on to work in the global health field because of their experience with Bridges. Rarely do overseas medical programs provide the hands on medical and cultural experience that the students receive from their month in Nicaragua with Bridges.
“I would like to see all medical schools require a Bridges’ experience in a remote Nicaraguan town where there is no technology, transportation or money available to the locals,” says Lisse. The impact on future physicians is immeasurable.
