Dr. Michael Good

Guest Blogger: Dr. Michael Good

It has only been 16 months since I last volunteered on a medical service trip with HHI, but I have been astounded by the changes that have occurred in that short period of time. To my delight, I found that most patients are seen by appointment, thus concentrating on those with pressing medical needs and/or previously identified chronic diseases. While there are still walk-in hours, we can now focus on those most in need of the help of an experienced physician. Unlike last year, each patient who is seen now also has a medical chart which contains a problem list, a medication and allergy list, previous clinic visit notes, labs and x-ray reports. Given the cultural and language barriers that are present, having a chart very quickly gets a doctor up to speed on what the patients’ basic issues are and what their past experiences with HHI have been.

Dr. Good and Ricky, a medical interpreter, speak with one of HHI's chronic disease patients.

In the past, we relied heavily on surplus drugs from the U.S. donated by pharmaceutical companies. This was problematic in that many of the medications were expensive and inappropriate for the impoverished residents of our communities – once the samples we gave were gone, there was no way to continue with therapy. Now, however, HHI has a rational, appropriate formulary using locally purchased drugs at very low cost. Not only are we supporting the local economy, but we are able to provide low-cost therapies to patients on an ongoing basis.

HHI volunteers Mary Lockwood and Rebecca Good working hard in the clinic pharmacy.

There is now also the ability to make referrals for services such as labs, ultrasounds, x-rays and specialty consultations. By carefully selecting our referrals, we are able to subsidize this care, negotiating prices on behalf of our communities and then helping to foot the bill for both medical care and transportation. This is an entirely new level of integration with medical services that just last year were out of reach for our patients, either due to cost or distance. Most remarkable of all was the new corps of cooperadores, or community health workers, in each community. The cooperadores help organize the clinics, case-find sick patients and follow-up on chronic disease patients by making sure they are taking their medications properly and assuring that they come to their follow-up visit every four months.

Drs. Brad Wilkinson and Michael Good pose with the community health workers from Pancho Mateo.

On our first clinic day in Negro Melo, it was raining cats and dogs; Megan and Nicole were worried that follow-up patients would not keep their appointments. However, in spite of the pounding rain and rivers of water and mud, just about every scheduled patient showed up for their appointment! One wonders how many of our patients back home would walk through ankle-deep mud during a downpour to go to a blood pressure check! You just have to love it! I’ll be coming back next year and can hardly wait to see what new wonders of primary care HHI has created on the ground in the communities of Negro Melo, Severet and Pancho Mateo!

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  1. Posted May 12, 2011 at 1:38 pm | Permalink

    Dr. Good, I completely agree – it is amazing what 16 months, three amazing women (Laura, Meg, Nicole), a dedicated cohort of cooperadores, unforgettable and incredible communities, and remarkable volunteers can do. Thank you for your post and your service. Thinking of the DR…

  2. Leah
    Posted May 23, 2011 at 11:33 am | Permalink

    I second Angi’s comment…I’m overwhelmingly impressed (though not surprised, given the incredible leaders involved) at the leaps and bounds HHI has taken over such a short period of time. This post highlights just some of the ways in which HHI is constantly increasing its impact and its sustainability.

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