Considering Social Detriments, Privilege As a Future Public Health Pharmacist

I recently went on a medical mission to Panajachel, Guatemala, as part of a patient care elective for Advanced Pharmacy Practice Experiences at Philadelphia College of Pharmacy at University of the Sciences in Philadelphia, Pennsylvania. Before this journey I had known that this population has limited access to health care and resources to lead a healthy lifestyle by modern standards.

There are 16.5 million people in Guatemala. Nearly 60% live below the poverty line, with 23% living in extreme poverty.1 The majority of those living in poverty are indigenous people. In this community, 8 of 10 children suffer from chronic malnutrition.¹

Most people in Panajachel have very little access to clean water. This affects their health in several ways. The drinking water is contaminated, but there is no way to eliminate its consumption. As a result, this population is at high risk for waterborne diseases, like cholera, dysentery, intestinal worms and parasites, and hepatitis E.²

Boiling water makes it safer but less palatable. This leads to overconsumption of coffee, which tastes better but causes headaches, diarrhea, and dehydration. These symptoms are not easily managed in developing countries, which lack basic medical resources.

This medical mission helped me recognize some of the privilege we American health care providers have.

Pharmacists in the United States are privileged with access to clean water, medication, education, and skilled providers. We can recommend drinking more water and eating more nutritious foods, which are readily available here. Pharmacists volunteering for medical missions find that solutions aren’t easily given in developing countries.

Before my medical mission, I worked alongside pharmacists and other providers at Miriam Medical Clinics in Philadelphia, Pennsylvania. This helped me understand the different levels of access to care in the same city. Philadelphia has an abundance of world-class culture and universities, but many of its residents do not have the means to treat their chronic conditions. For example, Philadelphians have enough education to know what HIV is and how to avoid it, but some do not have the financial support to afford treatment if they contract it.

To provide effective care, all pharmacists must recognize the privilege we have. It is not enough to simply give patients a plan to improve their care. It must be sound and culturally sensitive for it to have a positive effect. This requires us to understand the social determinants of health to provide effective treatment. For example, if a patient has a gastrointestinal infection, we might prescribe an antibiotic. But if the patient can’t afford an antibiotic, we must offer a less expensive alternative. And an antibiotic won’t help if the infection was caused by a lack of clean water.

My medical mission to Guatemala helped me understand the importance of health care privileges. As a result, I feel more capable providing comprehensive care to patients in the United States.

But pharmacists can become more sympathetic and aware from the work they do in their own communities. Providing comprehensive care to an underprivileged population in the United States can be just as illuminating.

Helping patients in need makes a difference in their lives and in yours.

References

• Project B. Current Poverty Rate in Guatemala [Internet]. The Borgen Project. Borgen Project; 2017 [cited 2019Aug5]. Available from: https://borgenproject.org/exploring-poverty-rate-in-guatemala/. Published August 8, 2017. Accessed September 17, 2019.
• Vestergaard. Drinking contaminated water can lead to waterborne diseases. Vestergaard website. Available from: https://www.vestergaard.com/global-challenges/waterborne-diseases. Published 2014. Accessed September 17, 2019.
• Cambridge Dictionary. PRIVILEGE: definition in the Cambridge English Dictionary. Cambridge University Press; 2019. https://dictionary.cambridge.org/us/dictionary/english/privilege. Accessed September 17, 2019.