University of Benin Teaching Hospital, Benin City, Nigeria
Trauma Surgery Team
4th Year Elective 2017

"I had previously gone to University of Benin Teaching Hospital in Nigeria during my MPH year between M3 and M4 for public health focused activities. I was very excited to return a year later to work clinically in-depth with the same amazing physicians, paramedics, nurses, and colleagues I had met the previous year in this busy urban tertiary teaching hospital.

"It was an excellent experience. The art and science of the "H&P" is so important when working in Nigeria. Nigerians become such excellent physicians and surgeons by relying on this fundamental basis of medicine. I also learned a lot about the difficulties of working in limited resource settings and having to constantly think about what is absolutely necessary for the most excellent care of the patient in terms of labs, tests, imaging, medications, procedures, and many other important decisions. The patient and their families must pay for everything out of pocket first to keep the system running, and not everything is always functional or in-stock.

"One frequent decision on trauma was how to allocate the only five functional ventilators in the ICU of an 800-bed hospital based on a real thorough evaluation of severity and prognosis. Working in an environment like Nigeria forces a physician to constantly think very critically about every decision they make from a medical, social, and economic point of view to best serve their patients and society.

"It was also great to learn about a different type of health care system all together. Nigeria is quite similar the United States in that it is a very diverse country in terms of ethnicity, culture, and language in addition to the reality that there are severe health disparities between the very wealthy few, the middle class, and everyone else struggling to get by. There are instances in Nigeria where limited wealth and resources are not allocated equitably or even equally, but in contrast, the United States chooses inequity with almost every resource imaginable and in abundance. It was a privilege to serve the people of Nigeria as they continue to progress their society in terms of health and many other sectors while learning from very committed and passionate physicians and surgeons. In Nigeria, you can't just be a doctor who checks out after leaving the hospital; you must also be a social and political advocate for your patients and the health care system."