Case Presentation: A 15-year-old male with HIV and inconsistent antiretroviral therapy adherence presented to an HIV clinic in Lilongwe, Malawi with weight loss, night sweats, lower extremity rash, and diarrhea. The rash on his legs had been present for 4 months and then spread to his arms. On exam, his vital signs were unremarkable. He [...]

Background: Worldwide, the number of refugees continues to increase. By the end of 2017, there were an estimated 68.5 million individuals forcibly displaced worldwide due to persecution, conflict, or generalized violence. Refugees have unique and complex health care conditions and needs. Most physicians receive limited, if any, training on providing medical care to refugees. The aim [...]

Background: Imaging diagnostics such as CT and MRI are practically inaccessible to many of this developing nation’s 42 million citizens. Ultrasound, however, is more readily available but primarily limited to use in obstetrics. With proper training, the diagnostic utility of ultrasonography may be expanded to non-obstetric point-of-care examinations. In this study, we aimed to evaluate [...]

Background: The Lean-Kaizen approach of implementing patient-centered systems change by reducing waste and adding value has been widely used in health systems in the US to provide incremental process improvement. This approach to streamlining health care processes has been under-utilized in resource-poor regions of the world, even though the Lean-Kaizen approach was developed in under-resourced [...]

Background: This presentation will describe a novel study started during a sabbatical year in Colombia. It will briefly cover logistics of taking a sabbatical year and then discuss the ongoing project and preliminary results. Dengue, a neglected tropical viral disease transmitted by the Aedes egypti mosquito, is endemic in Colombia and serves as an ideal [...]

Case Presentation: A 33-year-old Kenyan male school teacher presented to the hospital with a 3-day history of a gradually worsening diffuse headache, nausea and vomiting, and fevers. His past medical history was notable for liver cirrhosis of unknown etiology (Child-Pugh class B), complicated by portal hypertension. He had no known history of tuberculosis. His vital [...]

Background: Syrian health system capacity has been devastated by a decade of conflict distinguished by frequent attacks on healthcare facilities and workers. The chronic nature of complex emergency created substantial gaps in formal training for what remains of the health system, leaving already impaired infrastructure vulnerable to the arrival of Covid-19 in mid-2020 to areas [...]