Julia Krakauer and Rachel Sverchek have only a few weeks left in DeSales University’s Master of Science in Physician Assistant Studies (MSPAS) program. Soon they will leave DeSales and start their careers. But Krakauer and Sverchek share something that only a select few of their peers or future colleagues do: lessons learned during a third-world clinical rotation.
The two traveled to Tanzania together for a five-week international rotation. They stayed at the Lumen Christi Institute, a higher education seminary in Arusha, and worked at both the seminary’s clinic and a local district hospital.
“Just being able to engage in the cultural exchange was such a thrilling opportunity,” says Sverchek. “When else would you be able to do this?”
Both students had traveled before and found their experiences to be life changing. Krakauer is interested in pursuing international medicine and thought an international rotation would help further that goal.
“It opens your eyes to how the rest of the world views your country and you learn a lot about your country by being abroad,” she says. “I wanted to have that experience in the realm of medicine.”
Both she and Sverchek admit to feeling overwhelmed after arriving in Arusha. Not only did they have to adapt to a new language and other cultural barriers, they had to learn how to provide medical care in a developing country where things are done at a much slower pace.
“It was fascinating from a medical perspective,” says Krakauer. “Preventative care just really isn't available. You see a lot of the end stage that you don't see as commonly here.”
Sverchek recalls an elderly patient who came into the hospital in a hyperglycemic state. With the doctor’s permission, she and several other students jumped in and began chest compressions when the woman didn’t have a pulse. “The doctors are very calm because it's a frequent occurrence,” Sverchek says. “Death is as much a part of life.”
The woman regained consciousness and even began talking. But because of her illness, she passed away 12 hours later. Her death was challenging for Sverchek. But considering the high mortality rate for patients who suffer cardiac arrest in the United States, she still takes pride in the fact that she and the other students were able to bring the woman back and buy her a little more time.
While death is a constant, both Sverchek and Krakauer also experienced the other end of the spectrum, helping to bring new life into the world. Krakauer assisted in a delivery and was even able to help cut the cord and conduct the pre-natal exam.
“It was just incredible,” she says. “You've got this little, tiny, slimy baby. You wrap them up in these bright, bold Tanzanian fabrics. It's magical.”
Their stories also speak to the strength and resiliency of the Tanzanian people. Pain medication is a luxury that most simply cannot afford.
A man whose leg was cut open, with his tibia exposed, limped into the hospital one day after some sort of construction accident. He rode the bus for several hours to get there, was given some lidocaine, and limped back out.
“Now we're so nonchalant about it,” Sverchek says. “Being there, you sort of just get used to the way things are done. Initially, we were more shocked. Then you just adapt your thinking.”
Adds Krakauer, “We worked really hard to come into it with an open mind and not to compare to the U.S. We didn't go in with the expectation that they were going to change how they were going to do things. We went in with the mindsets that we were students and there to experience their culture and their medical world. You have to keep everything in the context of a country that is still developing.”
During their time off, both women were also able to play the role of tourists on safari. Krakauer visited the Serengeti, while Sverchek traveled to Kenya. They also enjoyed walking around the huge outdoor markets, which sold everything from clothing and fabrics to fruits and vegetables. And then there was the food. Every week, they would go to a café in town for chips mayai – a French fry omelet served with ketchup and chili sauce.
Tanzania isn’t the only country PA students at DeSales can experience. The program also offers five-week rotations in Peru and one-week rotations in Honduras. Nani Cuadrado, assistant professor in the program, was the first DeSales PA student to establish an international elective, and she’s currently working on setting up another rotation in Bangalore, India.
Cuadrado encourages students to travel and says the international rotations aren’t just about medicine. “They're there to learn how people do everything with nothing. They come back with an appreciation for humanity.”
Their days at DeSales may be dwindling, but Krakauer and Sverchek are looking forward to the next chapter. Krakauer plans to relocate to Milwaukee with her husband while Sverchek is considering a move out west. Wherever they end up, they take with them the stories and lessons from their time in Tanzania.