Lessons learned half a world away

Lessons learned half a world away

Family Practice Resident Trains in Papua New Guinea

Traveling from South Bend, Ind., to Papua New Guinea (PNG), Isaac Hatton, MD, took 40 hours and four flights, and covered 8,500 miles to reach the tropical island just north of Australia. Despite the distance, the third-year Memorial Family Medicine resident says the journey to PNG was a little like coming home again. After all, he had lived most of his childhood in PNG, while his parents did missionary work there.

During a two-month international elective in winter 2017, Dr. Hatton worked at the Kudjip Nazarene Hospital in the highlands of PNG.

He says all the familiar sights and smells came back to him: “The lush jungle and muddy rivers. The sound of rain every night on the tin roof [during the rainy season]. The people who are so friendly and warm. The horrendous potholes on the drive from Hagen. All those bird songs in the morning that I had forgotten about.”

He also notes the primitive living conditions and insufficient medical resources.

“People live in grass huts with mud floors. They are gardeners and farmers, so they have enough food and water but not many luxuries. And we see diarrhea and infection due to poor hygiene and unclean drinking water. In Papua New Guinea, there are only five doctors for every 100,000 people, and many of those are concentrated together in bigger cities.”

Dr. Hatton says he chose Kudjip because it’s known for providing a great learning environment for residents, with preceptor support and plenty of opportunities to perform procedures. In addition, he was able to visit his brother and his brother’s family, who are missionaries in a remote area of PNG.

Originally from Northern Ireland, Dr. Hatton’s family spent a couple of decades cycling through four years in PNG then one year in Ireland, and back again. He completed high school in PNG and then came to the U.S. to attend College of the Ozarks in Missouri. His art major soon expanded to encompass the sciences, and he attended the Medical School for International Health in Israel.

Dr. Hatton was thrilled to enter the Memorial Family Medicine Residency Program, which offers great flexibility to practice international medicine.

He was doing great when I discharged him, and his mom named him Isaac after me, which was really sweet.
– Isaac Hatton, MD

International Medicine Up Close

“One valuable lesson I learned in Kudjip is that your differential diagnosis has to adapt to the place where you are,” says Dr. Hatton. “A fever in a 30-year-old male doesn’t mean the same thing there versus here. I saw a lot of things we don’t see in the States.”

Bush knife injuries are commonplace, he says. One night, he saw a man lying on his belly groaning in the ER with a stab wound in his back. “Next, I heard a sucking sound, and I slapped a gloved hand over his wound. He had a big hemothorax, but we got a chest tube in him just in time.”

Dr. Hatton delivered dozens of babies on his own and performed several C-sections. One birth he remembers quite vividly: A woman had been pushing for six hours before she arrived at the hospital. She delivered the baby pretty quickly, but he was completely unresponsive. Dr. Hatton and a nurse did resuscitation for about 15 minutes.

“I felt sure the baby wasn’t going to make it,” Dr. Hatton recounts, “but he started crying, and he survived. He was doing great when I discharged him, and his mom named him Isaac after me, which was really sweet.”

HIV, pleural TB and Potts disease all have a strong foothold in PNG. Patients came in with such advanced cancer that some died during their clinic visit.

“People with cancer pain are being treated with Tylenol®,” he says. “The hospital had ultrasound and X-ray but no CT or MRI. Medicines — many donated from the U.S. — could run out, so we had to adapt and figure out alternatives.”

A Future in Global Medicine

“The situation in Kudjip helps me appreciate what we have here in the States, but it also gives me the desire to serve people who don’t have the kind of access we have,” Dr. Hatton says.

When he finishes his residency training with Beacon in June, he’ll start an international fellowship in July at a mission hospital in Africa, most likely Rwanda.

“My long-term plan is to practice overseas full time,” he says. Dr. Hatton is grateful for his experience in PNG and recommends it highly to other residents and fellows. He notes, “This was a really good place for residents. It has structure and preceptors, but you get to do a lot and do what you’re comfortable with. It exposes you to a lot of things you don’t see in South Bend. It informs your perspective and helps you learn to adapt.”

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