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Otwarte obiekty wykresu powinny być obecne w stronie internetowej (więcej informacji na temat protokołu OpenGraph: http://ogp.me/)

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H1
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surgeon with style – angola day 20
compassion in action – angola day 18
life after life – angola day 16
pyopericarditis – angola day 14
inadequate fuel for healthcare – angola day 12
recovery with a smile – angola day 10
digital health records – angola day 8
dr. alberto serving his people – angola day 6
multiplying healthcare capacity – angola day 4
aberrant abscesses – angola day 2
recent posts
current inmed students
inmed in action
inmed staff
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Pozycji używać znaczników (h1, h2, h3, ...), aby określić temat sekcji lub ustępów na stronie, ale zwykle, użyj mniej niż 6 dla każdego tagu pozycje zachować swoją stronę zwięzły.
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surgeon with style – angola day 20

http://inmedblogs.us/blog/2017/07/20/surgeon-with-style-angola-day-20/
inmed training sites in action http://inmedblogs.us/blog/category/inmed-training-sites-in-action/
- http://inmedblogs.us/nicholascomninellis/wp-content/uploads/sites/2/2017/07/annelise-e1500549806833.jpg
ceml http://ceml.org
samaritan’s purse https://www.samaritanspurse.org/

compassion in action – angola day 18

http://inmedblogs.us/blog/2017/07/18/compassion-in-action-angola-day-18/
inmed training sites in action http://inmedblogs.us/blog/category/inmed-training-sites-in-action/
- http://inmedblogs.us/nicholascomninellis/wp-content/uploads/sites/2/2017/07/patient.jpg
ceml hospital http://ceml.org

life after life – angola day 16

http://inmedblogs.us/blog/2017/07/16/life-after-life-angola-day-16/
inmed training sites in action http://inmedblogs.us/blog/category/inmed-training-sites-in-action/
- http://inmedblogs.us/nicholascomninellis/wp-content/uploads/sites/2/2017/07/singing.jpg
ceml hospital http://www.inmed.us/service-learning/training-sites/ceml-hospital-angola/
- http://inmedblogs.us/nicholascomninellis/wp-content/uploads/sites/2/2017/07/bible-men.jpg

pyopericarditis – angola day 14

http://inmedblogs.us/blog/2017/07/14/pyopericarditis-angola-day-14/
inmed training sites in action http://inmedblogs.us/blog/category/inmed-training-sites-in-action/
- http://inmedblogs.us/nicholascomninellis/wp-content/uploads/sites/2/2017/07/echo-e1500043481417.jpg
aberrant abscesses – angola day 2 http://inmedblogs.us/nicholascomninellis/2017/07/02/aberrant-abscesses-angola-day-2/
- http://inmedblogs.us/nicholascomninellis/wp-content/uploads/sites/2/2017/07/pus-1.jpg
- http://inmedblogs.us/nicholascomninellis/wp-content/uploads/sites/2/2017/07/lobito.jpg

inadequate fuel for healthcare – angola day 12

http://inmedblogs.us/blog/2017/07/12/inadequate-fuel-for-healthcare-angola-day-12/
inmed training sites in action http://inmedblogs.us/blog/category/inmed-training-sites-in-action/
- http://inmedblogs.us/nicholascomninellis/wp-content/uploads/sites/2/2017/07/fuel.jpg
ceml hospital http://www.inmed.us/service-learning/training-sites/ceml-hospital-angola/

recovery with a smile – angola day 10

http://inmedblogs.us/blog/2017/07/10/recovery-with-a-smile-angola-day-10/
inmed training sites in action http://inmedblogs.us/blog/category/inmed-training-sites-in-action/
- http://inmedblogs.us/nicholascomninellis/wp-content/uploads/sites/2/2017/07/recovery-e1499715824802.jpg
ceml hospital http://www.ceml.org
ceml hospital http://www.ceml.org

digital health records – angola day 8

http://inmedblogs.us/blog/2017/07/08/digital-health-records-angola-day-8/
inmed training sites in action http://inmedblogs.us/blog/category/inmed-training-sites-in-action/
- http://inmedblogs.us/nicholascomninellis/wp-content/uploads/sites/2/2017/07/chart-ceml.jpg

dr. alberto serving his people – angola day 6

http://inmedblogs.us/blog/2017/07/06/dr-alberto-serving-his-people-angola-day-6/
inmed training sites in action http://inmedblogs.us/blog/category/inmed-training-sites-in-action/
- http://inmedblogs.us/nicholascomninellis/wp-content/uploads/sites/2/2017/07/img_7524-e1499370205435.jpg

multiplying healthcare capacity – angola day 4

http://inmedblogs.us/blog/2017/07/04/multiplying-healthcare-capacity-angola-day-4/
inmed training sites in action http://inmedblogs.us/blog/category/inmed-training-sites-in-action/
- http://inmedblogs.us/nicholascomninellis/wp-content/uploads/sites/2/2017/07/foster-teaching-e1499164188396.jpg

aberrant abscesses – angola day 2

http://inmedblogs.us/blog/2017/07/02/aberrant-abscesses-angola-day-2/
inmed training sites in action http://inmedblogs.us/blog/category/inmed-training-sites-in-action/
- http://inmedblogs.us/nicholascomninellis/wp-content/uploads/sites/2/2017/07/angola-day-2-e1499028315538.jpg
ceml hospital http://www.ceml.org/
« previous entries http://inmedblogs.us/page/2/
surgeon with style – angola day 20 http://inmedblogs.us/blog/2017/07/20/surgeon-with-style-angola-day-20/
compassion in action – angola day 18 http://inmedblogs.us/blog/2017/07/18/compassion-in-action-angola-day-18/
life after life – angola day 16 http://inmedblogs.us/blog/2017/07/16/life-after-life-angola-day-16/
pyopericarditis – angola day 14 http://inmedblogs.us/blog/2017/07/14/pyopericarditis-angola-day-14/
inadequate fuel for healthcare – angola day 12 http://inmedblogs.us/blog/2017/07/12/inadequate-fuel-for-healthcare-angola-day-12/
jason gulati – uganda http://inmedblogs.us/jasongulati/
isaac billings – uganda http://inmedblogs.us/isaacbillings
michelle chan – china http://inmedblogs.us/michellechan/
felicia bassey-akamune – honduras http://inmedblogs.us/feliciabassey-akamune/
honor klassen – india http://inmedblogs.us/honorklassen/
jennifer olmstead – india http://inmedblogs.us/jenniferolmstead/
mihiret belihu – ethiopia http://inmedblogs.us/mihiretbelihu/
global health news & inspiration http://inmedblogs.us/blog/category/global-health-news-and-inspiration/
inmed grads in action http://inmedblogs.us/blog/category/inmed-grads-in-action/
inmed training sites in action http://inmedblogs.us/blog/category/inmed-training-sites-in-action/
inmed action steps for you http://inmedblogs.us/blog/category/inmed-action-steps-for-you/
low-resource healthcare pearls http://inmedblogs.us/blog/category/low-resource-healthcare-pearls/
international public health http://inmedblogs.us/blog/category/international-public-health/
disaster management http://inmedblogs.us/blog/category/disaster-management/
cross-cultural healthcare pearls http://inmedblogs.us/blog/category/cross-cultural-healthcare-pearls/
healthcare education http://inmedblogs.us/blog/category/healthcare-education/
nicholas comninellis http://inmedblogs.us/nicholascomninellis
institute for international medicine http://www.inmed.us
angola – jessie standish http://inmedblogs.us/jessiestandish
angola – laureen knuteson http://inmedblogs.us/laureenknuteson
angola – nicholas comninellis http://inmedblogs.us/nicholascomninellis/category/2014-angola/
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inmedblogs about contact surgeon with style – angola day 20 july 20th, 2017 by inmed posted in inmed training sites in action| annelise olsen, ceml‘s youngest general surgeon, expresses an inspiring persona. she embraces style, whether in clothing, cooking or lively conversation. annelise embodies medical excellence, devoting her judgment and procedures to our patient’s best welfare. and she advocates for the global health virtue of sustainability: giving our willing learners ample opportunity to develop their own skills under her keen supervision. i speak from experience. it was she who taught me the procedure for suprapublic prostatectomy. i first met annelise a few years back when she came to ceml as a resident physician. like many considering a career serving disadvantaged people, this early experience was formative. annelise’s skill in portuguese and eager learning orientation were clear. later, she returned as a post-residency fellow with samaritan’s purse. and today, annelise is an essential part of our career staff. i enjoy being on call, knowing i can summon her for assistance. as dr. olson likes to say, “i’m on back up for hell.” compassion in action – angola day 18 july 18th, 2017 by inmed posted in inmed training sites in action| “our child became ill 6 months ago. so, we visited the traditional healer. we lost our money and our child was no better, so we went to the closest clinic. they did tests and gave medicine, but our he didn’t recover.” thus, begins an account we hear frequently. it continues like this: “next we went to the hospital, but were told they would do nothing more. finally, we traveled several hours or days to reach ceml hospital. can you help us?” photographed above are the kind of patients and families who most frequently recount such stories of health lost, assurance languishing, and hope of healing. ceml hospital is often their last reasonable hope of assistance, especially for those suffering from eye disorders, orthopedic injuries, maternal fistula complications, and more recently, cancers too. who is ceml? in short: a ministry of the angola association of evangelicals – a collation of hundreds of churches pooling their influence to create care that none could provide alone. it’s an active expression of compassion on behalf of humble country men and women like these. life after life – angola day 16 july 16th, 2017 by inmed posted in inmed training sites in action| life span in angola averages only thirty-eight – a fact painfully experienced by our patients and families. we at ceml hospital are diligent to help people better these odds. but all life has limits. as i pondered this truth, pastor moses phoned again, asking me to prepare a mediation for chapel today. pictured above are patients and family members gathered outside their cabins, with the hospital in the background, singing in harmony with leaders from moses’ church, below. for my message of hope, i selected philippians 3:20-21, “our citizenship is in heaven. and we eagerly await a savior from there, the lord jesus christ, who, by the power that enables him to bring everything under his control, will transform our lowly bodies so that they will be like his glorious body.” what a wonderful promise! whether we succumb to malaria in angola at age eight, or malignancy in american at age eighty, christ – the only person in history to return from death to life – assures his followers of life after life. pyopericarditis – angola day 14 july 14th, 2017 by inmed posted in inmed training sites in action| caution: this is a graphic description. in my post on july 2, aberrant abscesses – angola day 2, i described the plight of a seven-year old boy with pockets of pus erupting in his leg, shoulder and hip. let’s call him “lobito.” after drainage of the hip abscess on that date lobito’s fever and appetite gradually improved. but this progress was unfortunately short lived. over the weekend lobito became short of breath and his chest x-ray revealed a new finding: an abnormally round heart size. yesterday, ultrasound of his heart demonstrated the presence of thick pericardial fluid, represented by the blue line that measures 2 cm in depth where there should be no visible fluid at all. yesterday our esteemed surgeon, annelise olson, performed a pericardiocentesis – insertion of a needle into the pericardium. immediately, yellow-green colored pus erupted from the puncture. a large bore catheter we inserted where the needed has been, and in the image above i’m aspirating 300 ml of pus, accumulating in this blue bowl. almost immediately lobito’s oxygen requirement predictably decreased as heart, which had been compressed by the pus, began beating freely. but pyopericarditis is both a rare and a lethal infection. individuals often die from the overwhelming sepsis and cardiac failure that accompanies the disease. this morning i approached lobito’s bedside with trepidation. what did i discover? please judge for yourself from the photo above. inadequate fuel for healthcare – angola day 12 july 12th, 2017 by inmed posted in inmed training sites in action| ceml hospital‘s home city, lubango, is facing a shortage of gasoline and diesel fuel. with a population of one million and some five thousand autos, the society seems to have literally come to a stop. this photo is illustrative. a line of car fifty cars is parked leading into a gas station, and the drivers mill around the pump awaiting the uncertain arrival of a fuel truck. what does this have to do with healthcare? all social institutions are connected with one another. without fuel, ceml employees cannot find transport to work. without fuel, patients often cannot work their jobs and thus earn income to pay for healthcare. without fuel, the often-needed backup electricity generators necessary for ceml surgeries and laboratory cannot function. and in cases of emergency transport, how can an ambulance running on empty deliver an injured person in time? economic health is essential to life as a whole. just ask these motorists. recovery with a smile – angola day 10 july 10th, 2017 by inmed posted in inmed training sites in action| elias is an eight-year old boy whom i met 10 days ago in the ceml hospital emergency department. he was febrile, vomiting and complaining of marked abdominal pain. fortunately, our laboratory capabilities are growing more mature, and elias’ results documented malaria, hepatitis, pneumonia and profound anemia. ill children in angola often do not recover, so we were especially prudent in this boy’s care. he received malaria treatment, antibiotic and oxygen for lung infection, and attentive monitoring of the liver dysfunction. through it all, his parents were constantly present. the boy remained febrile and coughing for 3 days. but then his malaria test converted to negative, need for supplemental oxygen decreased, and elias began to ask for food. on the 8th day, i gave him a discharge to the “patient village” next to ceml hospital, where our non-critical patients often finish out their treatments close to assist should a relapse occur. today, i fully cleared elias to return home – and we all are smiling! digital health records – angola day 8 july 8th, 2017 by inmed posted in inmed training sites in action| how can we best coordinate health records over multiple consultations and by multiple providers? this essential and complex question is relevant the world over, whether in north america or angola. in both locations, digital health information is priority – though the definitions are entirely different. digital in angola means the health record is literally created with one’s own fingers. above is a representative sample. i cared for a patient today suffering from new onset epilepsy associated with malaria infection. a small yellow notebook was given to her at registration, and here in each provider documents a brief record of each consult, including vital signs, history, examination, lab and imaging, diagnoses and treatments. and at the end of the consult, the patients themselves store their records digitally – guarding the notebook in their own fingers. dr. alberto serving his people – angola day 6 july 6th, 2017 by inmed posted in inmed training sites in action| healthcare professional in angola face a plethora of obstacles that would bewilder and derail most north americans. let me introduce you to my angolan physician colleague, dr. alberto alfredo. raised in the interior of this nation, he took advantage of the rare opportunity to study junior college level nursing at the famed kalukembe hospital about the same time i served there in the 1990s. dr. alberto’s pursuit of higher training launched him on a ten-year journey through medical education, interrupted by civil war and economic catastrophe. for most of his study, books were not available. during clinical hospital experiences, both medications and faculty were frequently absent. being from the interior, he faced racism and bigotry throughout the university. and all the while, alberto was working as a teacher to support his wife and nine children. when you come to ceml hospital today, you’ll meet a man whose character has been tested in most every conceivable way; one who has continued developing excellent patient care skills; and a man who year-after-year continues serving the most disadvantaged of his people. multiplying healthcare capacity – angola day 4 july 4th, 2017 by inmed posted in inmed training sites in action| this gentleman on the left suffers from gangrene of his left lower leg. note how the skin, subcutaneous tissue and even muscle has been killed by this ‘flesh eating’ bacteria, leaving behind only exposed bone and tendons. pictured center is my colleague, steve foster, expounding on the management of this lethal disease to a cadre of eager learners from the uk. dr. foster is passionate about multiplying his skills among future healthcare personnel. this capacity-building attitude is widely appreciated today. but it was not always so. when i first ventured into international medicine the popular emphasis was on provision of services, with much less attention to future service sustainability. but thirty years ago, dr. foster was already pioneering the equipping of both angolans and westerners with the vision of multiplying healthcare capacity. and he continues in this inspiring tract today. aberrant abscesses – angola day 2 july 2nd, 2017 by inmed posted in inmed training sites in action| this seven-year old child arrived with an account of a fall and pain in his right leg. steve foster, ceml medical director and my esteemed mentor, discovered a deep pus-filled abscess that occupied most of his shin. this abscess foster drained readily enough. but close examination revealed similar abscess on other locations on the boy’s arms and legs. x-ray of the pelvis suggested an abscess of the hip joint – another potential life-threatening complication – which i’m further probing with the aid of a portable ultrasound. a deeper question worthy of probing is why a seven-year old child would develop abscesses throughout the body. this phenomenon is rather common in angola, while almost unknown in north america. could it be related to malnutrition, especially protein deficiency which is common in this region? perhaps these abscesses are from salmonella typhi, a bacteria frequently present in contaminated water? does poor health literacy among the parents play a role, who unknowingly fail to recognize early signs of disease? honestly, such questions are often more abundant than answers at ceml hospital and throughout healthcare in this nation. « previous entries recent posts surgeon with style – angola day 20 compassion in action – angola day 18 life after life – angola day 16 pyopericarditis – angola day 14 inadequate fuel for healthcare – angola day 12 current inmed students jason gulati – uganda isaac billings – uganda michelle chan – china felicia bassey-akamune – honduras honor klassen – india jennifer olmstead – india mihiret belihu – ethiopia inmed in action global health news & inspiration inmed grads in action inmed training sites in action inmed action steps for you low-resource healthcare pearls international public health disaster management cross-cultural healthcare pearls healthcare education inmed staff nicholas comninellis inmed website institute for international medicine selected inmed alumni angola – jessie standish angola – laureen knuteson angola – nicholas comninellis bangladesh – brittni mclam cameroon – racquel stucky china – candice allen-jara dominican republic – amy fish ghana – kristen allcorn-killen ghana – crystal north ghana – dennis salter ghana – asdis wagner ghana – carmella caldwell ghana – shormeh yeboah guatemala – anthony petruso haiti – eileen westhues honduras – arthi chawla honduras – cheryl dalton honduras – garrett hooker honduras – james norman honduras – maggie higgins honduras – sean mark honduras – andrew peltier honduras – tara rognan india – beth grubb india – jennifer hicks india – kirsten mcnamara india – emily smith india – ashley sweeney kenya – ryna hansen kenya – meghan hofto papua new guinea – christine hoover papua new guinea – kelly hankins south africa – laura prewett tanzania – robert lane thailand – taylor veh uganda – scott biggerstaff uganda – stephanie peace uganda – amanda schmidt uganda – jeffrey walden zambia – hannah bolar zambia – taisei suzuki zambia – robert tung archives july 2017 june 2017 may 2017 april 2017 march 2017 february 2017 january 2017 december 2016 november 2016 october 2016 september 2016 august 2016 july 2016 june 2016 may 2016 april 2016 march 2016 february 2016 january 2016 december 2015 november 2015 october 2015 september 2015 august 2015 july 2015 june 2015 may 2015 april 2015 march 2015 february 2015 january 2015 december 2014 november 2014 october 2014 september 2014 august 2014 july 2014 june 2014 may 2014 april 2014 march 2014 february 2014 january 2014 december 2013 november 2013 october 2013 september 2013 august 2013 july 2013 june 2013 may 2013 april 2013 march 2013 february 2013 january 2013 december 2012 november 2012 october 2012 september 2012 august 2012 july 2012 june 2012 may 2012 april 2012 march 2012 february 2012 january 2012 december 2011 november 2011 october 2011 september 2011 august 2011 july 2011 june 2011 may 2011 april 2011 march 2011 february 2011 january 2011 december 2010 november 2010 october 2010 september 2010 august 2010 july 2010 june 2010 may 2010 april 2010 march 2010 february 2010 january 2010 december 2009 november 2009 october 2009 september 2009 august 2009 july 2009 june 2009 may 2009 april 2009 march 2009 february 2009 january 2009 november 2008 october 2008 september 2008 august 2008 july 2008 june 2008 may 2008 april 2008 march 2008 february 2008 january 2008 december 2007 september 2007 august 2007 june 2007 may 2007 april 2007 february 2007 january 2007 december 2006 november 2006 october 2006 september 2006 august 2006 july 2006 june 2006 may 2006 april 2006 january 2006 december 2005 november 2005 october 2005 august 2005 july 2005 june 2005 may 2005 april 2005 march 2005 february 2005 january 2005 inmed - institute for international medicine 2340 e. meyer blvd., building 1, suite #338-a kansas city, mo 64132 usa phone: 816-444-6400 | fax: 816-444-6400 © all inmed content is copyrighted. all rights reserved. inmed and dim&ph are registered trademarks of the institute for international medicine. institute for international medicine is a missouri registered, 501c(3) recognized, non-profit corporation. read our privacy policy read our frequently asked questions read our student blogs


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