April 2015 | ISSUE 17

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Growing overseas community involvement projects at LKCMedicine

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Berwyn Tan
Class of 2019

Dr Claire Canning
Lead for Introduction to Medical Sciences & Lead for Written Assessment, Phase 1

Building on last year's Overseas Community In​volvement Projects (OCIPs), several groups of students accompanied by LKCMedicine faculty and staff went on reconnaissance trips during the March holidays to understand overseas healthcare systems and explore new opportunities for OCIPs in Sri Lanka, India, East Timor and Cambodia. Our team headed to Sri Lanka and here are the highlights of our trip.

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Our team visiting a villager suffering from CKDu with a local government official

Together with Assistant Dean for Phase 2 & 3 Associate Professor Tham Kum Ying, Class of 2018 students Leon Tan and Joseph Wong and Class of 2019 Tan Wei Cher, we visited the North Central Province of Sri Lanka to learn more about the widespread chronic kidney disease of unknown origin (CKDu) from the perspective of patient, healthcare professionals and public health authorities.

CKDu has been spreading throughout the North Central Province over the last decade, affecting mainly male farmers in their 40s. Patients with this progressive kidney disease eventually require dialysis or a transplant. Unlike in Singapore, where chronic kidney disease is usually the result of diabetes or hypertension, the cause of CKDu in Sri Lanka is unknown. Factors suspected of playing a role in the disease include agrochemicals, chronic dehydration and heavily-treated well water.

Accompanied by Dr Dilantha Dharmagunawardene, the Acting Deputy Director of Training in the Sri Lankan Ministry of Health, and Mr Wije, a local government official, we visited patients in rural communities around Anuradhapura. We saw how they lived, giving us an insight into the ongoing projects to improve basic living standards.​

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Clockwise from top left:
The electrocoagulation plant; purified water is delivered to the villagers. CKDu patients receive the water for free; location of people with CKDu (red dots) and water patches (blue) are collected and mapped
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In the Office of Public Health, research initiatives have been established to understand the geographical distribution of CKDu patients. Epidemiologists and medical care teams carry out their field work in remote rural areas and one of their studies relies on GPS to map newly diagnosed patients. Despite the limited resources available, an enormous amount of data has been generated, which is invaluable to healthcare policy makers. 

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Scenes from the clinics: a simply furnished consultation room (left), and an improvised wheelchair in the clinic (right)

We also visited local healthcare facilities and were impressed how they made full use of their limited resources to provide quality care, such as improvised wheelchairs for patients too ill to walk. 

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A community health advocate explaining how she keeps track of teenage marriage and pregnancy using a hand-drawn map of the village (left); a student from Rajarata University explaining some of the tools they use in health promotion to Joseph and Leon (right)

One of the highlights of the trip was the visit to the Health Promotion Faculty of Rajarata University. We were introduced to the concept of health promotion, as a bottom up approach to health awareness. As Singaporeans, we are familiar with the top-down approach in health education. It was therefore heartening to see the level of community ownership in health promotion. The villagers take responsibility for their own health and come up with solutions to problems such as alcohol addiction and smoking, with the help of the students of the university. We joined community leaders in the villages and observed their initiatives to improve the health and education of the locals, with special focus on their children.

It was an extremely fruitful trip and an enriching experience for our team, with so many unforgettable moments and encounters. We are very grateful to the people of Anuradhapura for their hospitality and willingness to share with us their passion and commitment to healthcare improvements. We are very excited to work with them in the near future.