“Isee MEDEX Northwest being a collaborator with countries that want to start the physician assistant model in their country,” says Alicia Quella, Ph.D., PA-C. Quella, the former site director for MEDEX Northwest in Spokane, Wash., believes that physician assistants are an effective solution in addressing the primary-care needs of low-resource nations across the world.

MEDEX student Ellie Andrews displays ultrasound techniques in Laos.
Photo courtesy of MEDEX Northwest

Other leaders at MEDEX agree. In November 2015, Quella and MEDEX global health faculty Reba McIntyre, Ph.D., were awarded a Robert K. Pederson Global Outreach grant from the American Academy of Physician Assistants. With the grant, they took a group of students to Laos to test a pilot project: an elective rotation. One that would provide a valuable experience to the growing number of MEDEX students with an interest in global health, and, more importantly, an additional resource for medical education in Laos.

Investing in Laos

The Vietnam War took an enormous toll on this Southeast Asian country. An estimated 2 million tons of bombs were dropped on Laos, and the land remains so contaminated with cluster bombs that it has delayed the development of roads, schools and major industry. Moving forward requires clearing these legacy armaments, a significant task for a resource-constrained nation. Consequently, it’s been difficult for Laos to move forward in areas such as technology and healthcare.

MEDEX Northwest decided to address part of this issue with the Pederson grant, as well as cooperation with Health Leadership International, a Seattle-based NGO (non-governmental organization) that has worked closely with the Laotian Ministry of Health since 2008 — and whose president is MEDEX graduate Khampho Ohno, PA-C (Seattle
Class 43), a Laotian-American.

“We have our direction from the ministry,” says McIntyre, the founder and executive director of Health
Leadership International (HLI). “In our memorandum of understanding, we’ve been asked to do skill-based work.”

Students teaching students

And that’s precisely what the visiting MEDEX students did. Paired with Laotian physicians, the students also helped teach a component of the primary-care curriculum for PA students in Laos. And each of them was required to do intensive research on an assigned health topic as part of their master’s degree capstone project. Students took care to develop approaches tailored for a low-resource environment, presenting the materials in ways that were sustainable and culturally appropriate.

Justin Shobe, a former critical-care paramedic in the Spokane class, researched and delivered hands-on modules on hypertension and diabetes, growing and significant health concerns in Laos and throughout Southeast Asia. Ellie Andrews, Seattle class, a diagnostic sonographer prior to entering the MEDEX program, helped teach an ultrasound training course and women’s health topics, including miscarriage mismanagement and contraceptives.

Spokane student Portia Kamps focused on the diagnosis and treatment of parasitic infections endemic to the region, and Sarah Kopke, also of Spokane, taught best practices concerning the prevention of diarrhea. In all, MEDEX’s students helped teach 95 Laotian PA students, alongside local physicians and interpreters, at the College of Health Sciences in Luang Prabang.

For McIntyre, the value to the MEDEX students and to Laos is clear. “PA students go into a low-resource country and see firsthand the actual needs of providers. What is appropriate? And what can be low-cost?” she asks. “The takeaway is how important medical education is — basically, improving skill levels.”

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