Meet Sandy and Tatiana, our 2011 Scholars

Posted At : November 30, 2011 12:52 PM | Posted By : IAMAT
Related Categories: Programs and Projects

We recently had the chance to skype with Tian Lingling (Sandy) and Tian Rui (Tatiana). Our 2011 scholars just completed a six-week intensive training course in travel medicine at the Kaiser Permanente Honolulu Travel Health Center. This scholarship program is sponsored by IAMAT, thanks to the generous support from our members.

Currently, our scholarship program focuses on training Chinese scholars since China is one of the major travel destinations in the world. We are grateful to Dr. Vernon Ansdell, Dr. Johnnie Yates, and their colleagues at the Honolulu clinic for their invaluable mentorship.

Some background...
Tatiana is a general practitioner from Beijing and has 3 year old twins. Her work at the Beijing International Travel Healthcare Center involves doing physical checkups for travellers coming to China. Her clients are mostly travellers, expatriates, and students from the USA, United Kingdom, Australia, Korea, and Japan. Tatiana likes travel medicine because it's an interdisciplinary field; travel health providers need to have a working knowledge of geography, epidemiology, international medicine, tropical medicine, just to name a few.

Sandy is also a general practitioner and works at the Jiangsu International Travel Healthcare Center in Nanjing.

From left to right: Tatiana, Dr. Vernon Ansdell,
Dr. Johnnie Yates, and Sandy.

She performs physical examinations for Chinese workers going abroad as well as for Chinese travellers and students mostly headed to the USA and Europe. The most interesting aspect of travel medicine for her is immunology – how vaccines are developed, the mechanics of protection, and understanding possible side effects.

What the scholarship means to them
Sandy says that the scholarship has given her the confidence to deal with different clinical situations, "It is a good opportunity for me to learn more about travel medicine and turn my knowledge acquired from books into practical skills to protect travellers. I was not sure how to approach cases before the training, now I have a sense of how to handle it and what I should pay attention to when a traveller comes to see me. The training is very helpful to us."

For Tatiana, the scholarship gives her the skills to improve her travel health consultations and an opportunity to advance her professional goals. "It really has helped me a lot. It has given me the chance to be trained by experts in the USA, leaders in travel medicine. It has broadened my view of travel medicine practice and given me a lot of information to take back to my clinic in China," she says. Sandy adds, "When I go back to China I can use this information to give consultations and give much better services for my patients who will travel all over the world. It is very important for my career."

How they plan to help travellers
Both scholars emphasize how the training has changed their approach to travel health practice. One key lesson learned is the need to provide detailed and thorough travel health consultations. "In China, we generally do not provide detailed consultations. Doctors administer travel vaccinations while providing the traveller with little advice and information on how to protect themselves," says Sandy.

Back home, they will teach their colleagues consultation best practices to ensure that the traveller can make informed choices. They learned that a successful visit involves giving advice tailored to the traveller's health needs and paying attention to the client's destination, trip itinerary, current health status, vaccination history, type and length of travel. Says Tatiana, "The goal is about enjoying travel, but getting the right information to ensure a healthy trip." Sandy agrees. She learned that many travellers feel that there is very little risk abroad, but if they do get sick, there are big consequences. "I want to prevent them from getting sick and protect them better, to make travel much safer so that they can enjoy it with minimal risk."

Learning about common infections like malaria in returning travellers was also part of the scholars' training. Tatiana is looking forward to developing protocols in her clinic to detect post-travel related infections. "When I return to China, I want to do research and write an article to raise awareness among doctors, who are not travel medicine specialists, on how to deal with post-travel infections. I want to break down the barriers between general medicine and travel medicine."

A typical day at the clinic
Everyday Tatiana and Sandy interacted with people travelling all over the world. Starting at 8am with consultations, they saw travellers from different backgrounds and health conditions. Finding solutions to ensure a healthy trip for a traveller with environmental allergies or a senior with mobility challenges taught them the dynamics of travel health. Considering the risk of yellow fever, malaria, travellers' diarrhea, jet lag, altitude sickness, food poisoning, mental health concerns, culture shock, air pollution, adverse reactions to medications, and understanding travel medical insurance are all part of the training. They also participated in rounds at the Kaiser Permanente Ambulatory Treatment Centre, including the HIV clinic and Hepatitis clinic.

Part of the day was also dedicated to individual study and case study research, as well as making weekly lunchtime presentations to their colleagues on various aspects of travel medicine, including travellers' diarrhea, Hansen's Disease (also known as leprosy), leptospirosis, and risks affecting immuno-compromised travellers.

Benefiting from experiential learning
Their training also took them to a travel medicine conference in San Diego to learn about the latest developments in the field and to network with experts. Sandy and Tatiana also had the opportunity to visit Houston to explore research possibilities on travellers' diarrhea.

They also went to Tijuana, Mexico where they learned about the risk or rabies, Hepatitis B (due to many tattoo shops in the area), road injuries, and travellers' diarrhea, common risks in Mexico. It was an eye opener for both of them. Being away from home has made Tatiana pay more attention to food and water safety, living conditions, cultural differences, and how these affect travellers. Hands on training also occurred on Molokai Island, in Kalaupapa, a former leprosy colony. The scholars learned about Hansen's Disease and made comparisons with the situation in China.

On their days off, Sandy and Tatiana enjoyed sightseeing, going to Pearl Harbour, Kilauea volcano, exploring the parks and beaches, eating Hawaiian specialties, as well as snorkeling. An eighteen hour difference separated the scholars from their families, but keeping in touch by internet made it easier. "It's hard to be away, but it's worth it! This is really a fascinating, challenging but rewarding training experience." says Tatiana.

Says Sandy, "I really appreciate the chance that you provide for us to train at the Kaiser Permanente clinic. The doctors here are very nice, taking good care of us, and teaching us the vocation. It's a wonderful experience for us that we will never forget."

To learn more about our scholarship program, go to: International Travel Medicine Education Program.

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IAMAT Scholarships Benefit Scholars and Travellers

Posted At : November 29, 2010 3:08 PM | Posted By : IAMAT
Related Categories: Programs and Projects

We recently caught up with our 2010 IAMAT Scholars, Li YunFeng (Aaron) and Dou YongYing (Colin), who just finished an intensive six-week training course at the Kaiser Permanente Honolulu Clinic. The two students were each awarded a scholarship last September through IAMAT's International Travel Medicine Education Program.

The initiative, which is solely funded through the generosity of IAMAT members, has supported 15 medical practitioners to train in travel medicine since 2002. This unique program provides an opportunity for doctors and nurses from developing countries to study in North America and return home to teach their colleagues. In turn, they help IAMAT expand its international Medical Directory.

Both Aaron and Colin live in northern China. Colin is a doctor at the Tianjin International Healthcare Center and Aaron is a doctor and medical researcher at the Liaoning International Travel Healthcare Center in Dalian. We talked about their work back home, their training experience in Hawaii, and what they hope to accomplish with their new knowledge in travel medicine.

Left photo: Li YungFeng (Aaron) doing one of his favourite activities, hiking in China. Top photo: Dou YongYing (Colin) taking a break at the Kaiser Permanente Honolulu Clinic.


Travel medicine's reach
Discussing Aaron's and Colin's work in China drives home the message of how important travel medicine is to global health objectives and its link to economic and political realities facing us today.

Colin experiences first hand China's foreign policy and international trade objectives – sending unemployed or under-employed workers from rural areas in China to African countries to build major infrastructure projects such as roads, buildings, mines, and dams. Prior to leaving, migrant workers, mainly merchant sailors and labourers, need to have a clean bill of health (physical exam, ECG, X-rays, blood tests), get vaccinated and informed on how to prevent infectious diseases like malaria, yellow fever, and schistosomiasis. Everyday, Colin sees between 50 to 100 workers heading for Africa, mainly Egypt, Tanzania, and the Democratic Republic of Congo. He tells us that his clinic's efforts to prepare migrant workers against possible health risks abroad is paying off – the majority come back healthy.

Aaron's work as a lab researcher – he's currently working on Hepatitis C – gives him an important insight into the links between epidemiology (the study of diseases and health patterns) and travel medicine. His interest in the mechanics of infectious diseases – how and why outbreaks occur – and analyzing the latest information on the spread of diseases allows him to enhance his delivery of travel health care to patients.

Problem solving and patient-centered care
Both Colin and Aaron emphasize the need for more travel medicine expertise in China. The field is still in its infancy and mostly unknown among the general population. As more and more Chinese are starting to travel internationally, pressure mounts to train more medical practitioners and reach more travellers before their trip.

Colin believes that the knowledge exchange component of the IAMAT scholarship program is important. Chinese practitioners look to North America and Europe for expertise and says that "being an IAMAT scholar will help me develop an authoritative and systematic knowledge of travel medicine." In return, the scholars educate their Hawaiian colleagues about developments in China, presenting on the occurrence of schistosomiasis (freshwater snail-borne infection) and the challenges of travelling with a disability in their home country.

For both Aaron and Colin, the training opportunity is an eye-opener. Under the guidance of Dr. Vernon Ansdell and Dr. Johnnie Yates at the Honolulu Clinic, they are discovering the problem-solving nature of travel medicine. Colin says that the most interesting aspect for him is balancing health recommendations and the needs of travellers. "For example," he notes, "if elderly people or pregnant women travel abroad and expose themselves to malaria or yellow fever, we must weigh the side-effects and benefits" before prescribing preventive medication. For him travel medicine is a process of thinking through a problem to provide the best advice and care possible.

The preventive, or pre-clinical, aspects of travel medicine is what interests Aaron most. To provide appropriate recommendations, practitioners need to consider the traveller's health status, destination, itinerary, and assess the health risks of their trip. At the clinic in Honolulu, they see all types of travellers planning trips around the world. They are immersed in the day-to-day aspects of running a clinic and interact with travellers providing input on health advice given by their mentors. Their training also involves reading up on the latest developments in the field and learning travel medicine case studies. Interesting cases they've seen so far at the Honolulu clinic: Senior travellers going to Iguaçu Falls and evaluating the risk of providing the yellow fever vaccine to persons over 75 years of age, and a suspected case of leishmaniasis in a soldier returning from Iraq.

"I think the most important thing for a travel medicine doctor is to travel," says Aaron. He's particularly inspired by Drs. Yates and Ansdell who are international travellers themselves. "They often share their personal experiences with travellers which is informative and a way to make travellers understand the importance of protecting themselves more easily," he adds. Since it's their first time travelling internationally, both Aaron and Colin laughed when they mentioned their experience with jet lag coming over to Hawaii. Now they know what the effects are and they can inform travellers on how to cope with it.

The benefits for practitioners and travellers
Both scholars are keen to share their new knowledge and training with their colleagues back home. Aaron will be looking at ways to improve his clinic's travel health care delivery – making it more patient-focused, something he learned at the Honolulu clinic. He's also thinking of setting up internal training sessions for his colleagues, discussion forums, a phone hotline for travellers, translating travel health resources to Chinese, and improving their website to advertise the clinic's services.

Colin too, will train his colleagues to give them a more comprehensive understanding of travel medicine. He also wants to introduce new vaccines to his clinic to benefit travellers (new Japanese Encephalitis, quadrivalent meningitis, polio, Hepatitis A) and look for collaborative research opportunities with other travel medicine institutes around the world. In addition, he plans to "develop travel consultations based on the travellers' destination so that we can provide better services to fit the needs of travellers." During the training, he learned the importance of giving travellers country and region-specific advice which is currently not the case at his clinic in Tianjin.

Part of the IAMAT scholarship is to promote cultural exchanges between the scholars and the host clinic. Colin and Aaron are learning about local Hawaiian customs, visiting cultural sites, and they experienced their first Hallowe'en which is not celebrated in China. Aaron takes the time to meet locals and practice his English speaking and listening skills. Colin has taken up beach volleyball and has had the pleasure of skydiving which he finds thrilling.

Asked about the effects of being away from home for a long time, both say that Skype helps them to communicate with friends and family. Both their families are supportive of their training opportunity. Says Colin, "I believe when you gain something, you must lose something. My family and friends support me to study travel medicine in Hawaii." Aaron adds, "It's a little hard, but it is a good opportunity and a lucky opportunity for me to improve my skills and knowledge".

See Colin's blog about his experience in Honolulu.

To learn more about our International Travel Medicine Education Program and to support the scholarship fund, please go to: Scholarships & Grants.

Thank you to Li YungFeng and Dou YongYing for the photos.

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Meet Angeline and Winona, IAMAT's 2009 Scholars

Posted At : September 30, 2009 2:06 PM | Posted By : IAMAT
Related Categories: Programs and Projects

Angeline (right) and Winona (left).

We recently met up with Dr. Ye Wei (Winona) and Dr. Meng Jing (Angeline) to talk about their two-month internship at Kaiser Permanente's Koolau Clinic and Honolulu Clinic in Hawaii. The two medical practitioners from China were each awarded a scholarship through our International Travel Medicine Education Program. The fund, which is solely supported by the generous donations of IAMAT members, has given 13 scholarships since 2002.

Chosen for their leadership skills, the two doctors will return home to teach their colleagues the skills they have learned in Hawaii, improving travel medicine practices in their workplace for the benefit of ill travellers.

The art and science of travel medicine
During the two-month intensive training program, Angeline and Winona are immersed in all aspects of pre-travel advice, travel medicine diagnosis, and post-travel consultation.

When asked what interests them most about travel medicine, their enthusiasm is inspiring. At the heart of their work is cultivating the relationship between caregiver and patient, ensuring that travellers are well informed to prevent the spread of infectious diseases and ultimately having a safe and healthy trip.

For Winona, who works at the Shanghai International Travel Healthcare Center, travel medicine is a multi-disciplinary subject. "Not only does it deal with medical and diagnostic aspects, but I have to be knowledgeable in world and regional geography, local climate, cultural and societal differences, legal requirements regarding medication and vaccination for the patient's destination. Providing comprehensive travel health advice to travellers is an art."

"No two consultations are exactly the same," adds Angeline who likes the diversity of her work. The challenge is to provide individualized recommendations for each traveller and keeping up with the latest in the constantly evolving field. "It's really important to keep up with up-to-date concepts and practices if you want to improve yourself in this field," she notes.

Getting the scholarship gives her the chance to kick-start her professional career in the field. A doctor at the Sichuan International Travel Healthcare Center, Angeline hopes to expand her scope of knowledge and share it with her colleagues and as many travellers as possible. "Since I am a novice in the field, the IAMAT scholarship has promised me a good beginning and I think that I'll have a bright future in travel medicine. I am so lucky to have IAMAT as a guide from the very beginning of my training. People always say that having a good beginning is already half the battle."

Winona says that for her, the internship is an opportunity to expand her qualifications and further promote travel health in China. "I have worked at my Clinic for almost eight years as a doctor and becoming a IAMAT scholar gives me the chance to go outside of China to increase my understanding of travel medicine." She tells us that through her background in immunology, she's interested in vaccine recommendation principles, specifically how they apply to different age groups and a patient's past and current health status.

Helping international travellers
Travel medicine is a relatively new discipline in China and is coming to prominence in large part to the economic reforms that have drastically increased the country's incoming and outbound international travel. Since 1995, IAMAT has been instrumental in advising the country's travel medicine and health network, the Chinese International Travel Healthcare Association (CITHA), develop and improve travel medicine practices among their clinics.

Says Angeline, "One of the first things I will do after I return is to share my experience with my colleagues and make as many people aware about the importance of travel medicine. The majority of Chinese people have not heard about travel medicine, so going for a pre-travel consultation to protect themselves is obviously not on their list." Her clinic will also start offering post-travel evaluations to Chinese nationals returning home after long-term working assignments in countries like Zimbabwe or the Democratic Republic of Congo where they are at high risk of contracting infectious diseases such as malaria or yellow fever.

A key component of IAMAT's scholarship program is to promote cross-cultural exchanges of medical knowledge and practices. It offers a chance for our scholars and their Hawaiian colleagues to exchange ideas and developments in the field practiced in their respective countries.

Training in Hawaii is a good opportunity to brush-up on their English speaking and writing skills. Says Angeline, "Having good communication skills, especially with someone of different education and cultural backgrounds is important."

A typical day at the clinic
The two interns have a busy schedule. Training takes them to the Koolau Clinic three times a week and to the Honolulu Clinic twice a week. Their day starts at 8:00am and usually ends at 5:00pm, in addition to studying in the evenings. Their supervisors, Dr. Vernon Ansdell and Dr. Johnnie Yates provide them with information about the patient's travel destination and health status the day before the client comes to the clinic, that way they have time to prepare their cases.

They also participate in the actual patient visit and provide advice based on their prior research and discussions with their colleagues. They are also given hypothetical cases to study and present the best approaches based on the patient's needs. "Through self-directed learning, discussion and problem-solving I can understand and master the key points of a specific case," says Angeline.

For her part, Winona enjoys the face-to-face consultations with patients, especially meeting new people and learning about their destinations and reasons for travel. Seeing how their colleagues interact with their patients is refreshing. "They are so warm-hearted and sincere with their patients, like old friends," notes Winona. The professionalism and physician-patient interaction is one aspect of her training that she'll take back to China to teach her colleagues. Adds Angeline, "The consultation part is neat, because face-to-face communication is direct and flexible. You don't know what patients will ask you or tell you, but you are the one leading the conversation."

The internship, however, is not all about studying. Both Winona and Angeline take the time to learn about Hawaiian culture and do sightseeing on weekends. They recently visited Diamond Head volcano and are planning to do some snorkeling soon. Being away from home for a long time can be hard, but both women keep in touch with their family and friends through online video-chatting. Winona, who has a five year-old son, Wang Ye Da, also writes about her overseas experiences on her Blog (in Chinese). "The people at the Clinic are so nice, so friendly, and they help me a lot, such as picking me up to go sight-seeing and going to restaurants to eat local specialties. I'm not lonely."

Photo credit: Vernon Ansdell

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