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Public Health School - Essay
The encounter with Mr. SN was one fundamental event in my path toward became an AIDS specialist and to be interested in Public Health.
I first met Mr. SN in 1996, during my second year of Internal Medicine Residence Program. He was a 27 years old male, born in the same city I was (1,700 km away from the hospital where we were), recently married, with a 2 month baby. He had been involved in drugs and alcohol when he just arrived to the big city to live in a very poor and marginalized neighborhood some years before. He felt in love with a girl, looked for a job, converted to the church, and became a great father and husband. After few months of this new life, he was admitted because a suspected tuberculosis (which is high prevalent in our city). Unfortunately, tuberculosis was ruled out and pulmonary Kaposi's Sarcoma (a malignant disease in HIV positive individuals) was diagnosed.
At those days there were very few knowledge about HIV, few options for HIV infected patients, and even less for patients with disseminated Kaposi sarcoma. He started antiretrovirals and chemotherapy and died 9 months after I meet.
I used to spend several evening talking with him. He was very upset because why he was ill, just now when he reorganized his life. We had long conversation along those months, and some professors were very worried about I was involved much with him. However, I do not think I was. My relationships with him allow me to discuss clearly about his possibilities, his outcome and his expectancies, and reply him all question he had. After he died his psychologist, that fully supported me caring Mr SN, borrow me the clinical notes she took during her sessions with him. Although I was very upset because he died, I was alleviated because I read he felt very contained and quiet by me.
The next year I started my Residence Program in Infectious Diseases at the Hospital Fernández, and since then I am hardily working caring HIV patients. I had a quite successfully career, with the opportunity to study and work in very qualified centers in my country and abroad. I spent 4 years in Barcelona where I completed a Master Program in Integral HIV/AIDS Care at the University of Barcelona and obtained the "Diploma de Estudios Avanzados" with high grades. I wrote several articles, participated in several conferences and gained a good reputation between my colleagues.
However, I continued feeling the need to do more. My experiences working at the Agencia de Salut Publica de Barcelona, the opportunity to travel to Tanzania for a short-time appointment at the HIV prevention program from Doctors of the World, and my current work at Fundación Huésped show me that any medical intervention is not enough if it is not integrated into a good Public Health System. Moreover, I learnt that public health interventions are much more effective and equitative, but frequently forgotten by the providers.
My country is a large nation, with big gaps in the health care system between providers and locations. My province is one of the most affected by HIV and TB. If Mr. SN in these days I would have many other options to save his life. We have highly active antiretroviral therapy and effective and less toxic chemotherapy for Kaposi's Sarcoma. However, many of the situations that lead to Mr.SN to became infected, and to suffer continue being significant. After my conversations with Mr.SN I understood that he represented an example of several weak links in the chain. He had never received any counseling in his city. When he arrived to Buenos Aires, he could no found any financial aid or social support. When he was arrested two years before the admission he was not offered to be tested for HIV. He was several months ill and saw several patients until he was admitted. He was discriminated by his community and his only support was his wife.
Currently, I am working in HIV and tuberculosis. The more involved I get in the care of those infectious diseases, the more deeply I feel the need to expand the prevention interventions and the access to good healthcare to the most affected regions. Good interventions must to be evidence based, and targeting local priorities, where resources can be obtained through the participation of international clinical research consortium. These reasons support my application for a Master in Public Health. A MPH master will broaden my vision and will enable me to expand the possibility of building a regional multilateral network to address HIV and TB care in poor areas of Argentina in order to increase the breadth of opportunities for international collaborative health research, as way to increase the quality of delivered care. I am looking for a MPH designed to develop leaders in health and medical care and to train to meet the challenges of the community and society at large.
After I got the Master I plan to continue working at Fundación Huésped in the design of integral programs directed to prevent and provide quality care in particular in HIV and TB. Ideally, I would like to provide monitoring & evaluation and research support to local TB programs in the most affected areas of the country, as North of Argentina. This will lead to increase the quality of care, which will allow us to apply as collaborative center for international TB research projects (as Tuberculosis Trial Consortium from CDC, etc). Also, I expect to continue collaborating as consultant with international Health Agencies, such as PAHO, as lecturer in local Universities, and with local organizations providing expert advice in public health.
Public Health School - Essay
The encounter with Mr. SN was one fundamental event in my path toward became an AIDS specialist and to be interested in Public Health.
I first met Mr. SN in 1996, during my second year of Internal Medicine Residence Program. He was a 27 years old male, born in the same city I was (1,700 km away from the hospital where we were), recently married, with a 2 month baby. He had been involved in drugs and alcohol when he just arrived to the big city to live in a very poor and marginalized neighborhood some years before. He felt in love with a girl, looked for a job, converted to the church, and became a great father and husband. After few months of this new life, he was admitted because a suspected tuberculosis (which is high prevalent in our city). Unfortunately, tuberculosis was ruled out and pulmonary Kaposi's Sarcoma (a malignant disease in HIV positive individuals) was diagnosed.
At those days there were very few knowledge about HIV, few options for HIV infected patients, and even less for patients with disseminated Kaposi sarcoma. He started antiretrovirals and chemotherapy and died 9 months after I meet.
I used to spend several evening talking with him. He was very upset because why he was ill, just now when he reorganized his life. We had long conversation along those months, and some professors were very worried about I was involved much with him. However, I do not think I was. My relationships with him allow me to discuss clearly about his possibilities, his outcome and his expectancies, and reply him all question he had. After he died his psychologist, that fully supported me caring Mr SN, borrow me the clinical notes she took during her sessions with him. Although I was very upset because he died, I was alleviated because I read he felt very contained and quiet by me.
The next year I started my Residence Program in Infectious Diseases at the Hospital Fernández, and since then I am hardily working caring HIV patients. I had a quite successfully career, with the opportunity to study and work in very qualified centers in my country and abroad. I spent 4 years in Barcelona where I completed a Master Program in Integral HIV/AIDS Care at the University of Barcelona and obtained the "Diploma de Estudios Avanzados" with high grades. I wrote several articles, participated in several conferences and gained a good reputation between my colleagues.
However, I continued feeling the need to do more. My experiences working at the Agencia de Salut Publica de Barcelona, the opportunity to travel to Tanzania for a short-time appointment at the HIV prevention program from Doctors of the World, and my current work at Fundación Huésped show me that any medical intervention is not enough if it is not integrated into a good Public Health System. Moreover, I learnt that public health interventions are much more effective and equitative, but frequently forgotten by the providers.
My country is a large nation, with big gaps in the health care system between providers and locations. My province is one of the most affected by HIV and TB. If Mr. SN in these days I would have many other options to save his life. We have highly active antiretroviral therapy and effective and less toxic chemotherapy for Kaposi's Sarcoma. However, many of the situations that lead to Mr.SN to became infected, and to suffer continue being significant. After my conversations with Mr.SN I understood that he represented an example of several weak links in the chain. He had never received any counseling in his city. When he arrived to Buenos Aires, he could no found any financial aid or social support. When he was arrested two years before the admission he was not offered to be tested for HIV. He was several months ill and saw several patients until he was admitted. He was discriminated by his community and his only support was his wife.
Currently, I am working in HIV and tuberculosis. The more involved I get in the care of those infectious diseases, the more deeply I feel the need to expand the prevention interventions and the access to good healthcare to the most affected regions. Good interventions must to be evidence based, and targeting local priorities, where resources can be obtained through the participation of international clinical research consortium. These reasons support my application for a Master in Public Health. A MPH master will broaden my vision and will enable me to expand the possibility of building a regional multilateral network to address HIV and TB care in poor areas of Argentina in order to increase the breadth of opportunities for international collaborative health research, as way to increase the quality of delivered care. I am looking for a MPH designed to develop leaders in health and medical care and to train to meet the challenges of the community and society at large.
After I got the Master I plan to continue working at Fundación Huésped in the design of integral programs directed to prevent and provide quality care in particular in HIV and TB. Ideally, I would like to provide monitoring & evaluation and research support to local TB programs in the most affected areas of the country, as North of Argentina. This will lead to increase the quality of care, which will allow us to apply as collaborative center for international TB research projects (as Tuberculosis Trial Consortium from CDC, etc). Also, I expect to continue collaborating as consultant with international Health Agencies, such as PAHO, as lecturer in local Universities, and with local organizations providing expert advice in public health.
