Background

Since 2005, physicians from the Bruyère Family Medicine Centre have volunteered in remote areas of Panama as part of a medical and humanitarian mission. The Bruyère-Panama project is a grassroots initiative linking physicians and other health care staff from the Bruyère Family Medicine Centre with indigenous communities in Panama.

The Bruyère-Panama Project aims to forge long-term links between the Departments of Family Medicine at the University of Ottawa and the University of Panama. A team of several faculty and residents in family medicine travel to Panama twice a year to partake in scholarly exchange and direct patient care at a remote location on the Ngöbe-Bugle reservation, one of the few remaining indigenous areas in Central America.

During each visit to Panama, more than 1,000 patients are cared for at a host clinic for surrounding communities. The team typically visits areas without access to basic amenities such as electricity or plumbing, where people subsist on less than a dollar a day. Time is reserved during every trip for interaction and education with local health staff.

By Dr. Steven Ballou

Last February, a medical team that included Dr. Charles Czarnowski, Dr. Steven Ballou and Dr. David Ponka, traveled to the remote village of Kankintu, in northwest Panama. There had recently been severe flooding in the area, and health care, medication, food and clean water were desperately needed.

The team was invited by Nutre Hogar, a Panamanian NGO, to bring medication and medical expertise to the community. The village of Kankintu has a small clinic staffed by a part-time local doctor and a permanent group of nurse practitioners. This remote site can be reached only after a lengthy ride through the mountains, followed by a three hour trip by boat. Travel was made even more difficult by the recent flooding.  

In Kankintu the team examined and treated nearly 1,000 patients over a twelve-day period. Members of the team completed a cumulative patient profile for each patient, with demographic and medical data that will be used for research purposes, as well as to guide them in future missions.

The most common medical problems encountered were intestinal infections by parasites, malnutrition, skin disease, pulmonary infections, pregnancy and its complications, and the musculoskeletal diseases associated with a physically demanding lifestyle. The recent flooding caused even greater health problems with the chronic lack of clean water and adequate food.

They worked side by side with their Panamanian hosts with great success and mutual appreciation. In particular, the directors of Nutre Hogar were very pleased with their intervention and are eager to sponsor them again. This group was founded 18 years ago by Panamanian volunteers, and specifically works to prevent and treat malnutrition among Panama’s children.

Nutre Hogar receives no funding from the government of Panama. Though the fundraising and volunteer work of its members, it has built and maintained seven treatment centre for severely malnourished children throughout the country, as well as an even larger number of remote clinics in places such as Kankintu. The local indigenous people of Panamaare their main target population.

The family practice residents, who traveled to Panama, found the experience enlightening from both a social and a medical point of view. By the end of the trip, all were functioning at a basic level in Spanish, and most had learned a few words in Ngobe, the local language.

The team also met with the representatives of the University of Panama, whom they know from previous trips to the country. As always, they are committed to continuing cooperation with the University of Ottawa, both in terms of resident participation in the mission itself, as well as continuing the resident exchange program that has been so successful in the past.

They met with the ambassador and chief secretary of the Canadian Embassy in Panama. The purpose was to discuss how we can work together to develop our program, in addition to ensuring the safety and comfort of our Canadian residents in Panama. They are very supportive of the project, and see an obvious link to the efforts of the Canadian government in developmental programs in Panama.

The team intends to return to Kankintu later this year and would like to develop a long-term project in association with Nutre Hogar and the local medical establishment. There is a unique opportunity at that site to create an educational experience with great research and humanitarian potential. They intend to meet with the department of Family Medicine in the near future to describe their experience and to promote interest and support in the project.

Fundraising

Proceeds from an art show at the Bruyère Art Gallery that included paintings by Dr. Ballou and his son, helped raise funds for the mission to Panama. Other fundraising activities included selling Christmas cards to patients and visitors at the family medicine centre and pharmacy.