Rotation, research brings student to distant Vanuatu

A medical student recently traveled to a remote island nation in the South Pacific for a research project and clinical observation.

Student Juan Caceres uses a slit lamp to check a patient’s eyes at the clinic in Santo on the island of Vanuatu.

M2 Juan Caceres visited Vanuatu to help launch a study on beta thalassemia, a hemoglobin-reducing blood disorder that is prevalent there. The six-week experience also included ample time for clinical observation in a hospital in Luganville, where foreign medical students from Australia and the UK are regular visitors but American students are less frequent; Caceres was the first UMMS student to visit there.

“I felt really welcomed. I went in thinking this was strictly going to be a research project, so being able to spend so much time in the clinical wards was a surprise and a really valuable aspect of the experience,” he said. “I was able to grow both educationally and culturally.”

Caceres will be talking about his visit as part of the upcoming Kellogg Eye Center (KEC) International Night event Oct. 23. His experience was sponsored by the Kellogg International Center; because of current and former faculty connections to Vanuatu, KEC has been considering it as a site for sustained collaborations. KEC Genetic Counselor Dana Schlegel is leading the project which aims to evaluate how much the local population knows about the comparatively rare disease that requires blood transfusions and, in resource scarce settings like Vanuatu, can too often be fatal.

“The carrier rate for the genetic mutations that cause beta thalassemia are far higher there than in other parts of the world. At the same time, people don’t really know what this condition is,” said Schlegel, MS, MPH. “The idea is to learn what the population knows and what they don’t know, and then go back and provide some education.”

Caceres is one of the presenters slated for KEC's upcoming International Night Event. Registration is now open. Click here for details.

The condition arises from a pair of genetic mutations in a gene with autosomal recessive inheritance. Carriers of a single gene mutation do not display symptoms but can pass the mutation on. When two parents who are both single mutation carriers have a baby, there is a 25% chance that the child could receive both mutations, and, thereby, have the disease. Teaching the populace about the condition can help them better understand these risks, which may affect reproductive decisions and/or improve their preparation for a disease their child may have.

Caceres’ role was to pilot test the knowledge survey for cultural context ahead of Schlegel’s planned visit this month to administer it across a broader section of the populace.

“Juan helped us learn more about how the survey is functioning before I go to begin gathering the data in earnest. Because I only have three weeks there, laying that groundwork was important,” said Schlegel. “He also made a really good first impression. The physician I’m working with there was impressed, which is important in any new partnership.”

Caceres piloted the survey to a few dozen participants, working with Schlegel and the local physician to make modifications along the way. He also enjoyed observational rotations in the hospital’s various wards, including the ophthalmology, maternity, emergency, and pediatric units.

“I think I learned way more than I was able to give to them, especially at this point in my training,” he said. “I came away with insights about using clinical judgement to problem-solve without an overreliance on technology. I learned how to be humble and to understand people in a way that the doctors there seemed to understand their patients. I know those insights are going to make me a better doctor in the future.”

Caceres (right) with a local nurse, a visiting physician from China and a visiting student from Australia following rounds.