The Global Partners volunteer team returned to La Crosse last Friday, Oct 30. Dr. Chuck Schauberger, MD, Ob/Gyn, shares some of his thoughts about his experience volunteering at Wanblee Health Center on Pine Ridge Reservation in this blog entry.
I’m back from a week at Pine Ridge, the Wanblee Clinic, and it is time to reflect on the week and what we accomplished. Several perspectives:
The people with whom we worked were very friendly. Everyone appreciated our presence and the efforts we made on their behalf. The patients also demonstrated comfort with our presence and our advice. We really felt welcomed and appreciated.
I like the mix of people who traveled to Pine Ridge. It wasn’t just a medical group, but also a group of students in a counseling master’s program at Viterbo working on counseling high schoolers. A group of Central High School students working on a health science academy project with local high schoolers. And of course, Jerry Burns, master networker, connecting with educational leaders throughout the region. Taking our evening meals together and sharing our experiences was really enjoyable.
There was enthusiastic agreement by everyone on our team that the healthcare provided was much better than we anticipated. The doctors, nurse practitioner, and midwife I met could practice anywhere in this country and I would be proud to call any of them my partner. They are doing much more than putting bandaids on serious disorders. They have long-term patient needs assessed and are working on preventive care goals. They measure their diabetes quality indicators (everyone seems to have diabetes). They also have long-term relationships with their patients and they understand the cultural limits of what they can do and what they cannot do. They are frustrated with the bureaucracy, but I would guess that they also know that the further out their orbit, the more flexibility they may have. Medical care at Wanblee is mostly limited by a small volume of providers (doctors, NPs, CNMs, nurses), tight spaces, and absence of resources. However, there is no limit to their caring and their enthusiasm for doing the right thing.
Self-reliance is the key to practicing at such a distance. The closest hospital, Pine Ridge, is 80+ miles in one direction and the closest tertiary level care facility, Rapid City Regional, is 90 miles in the other direction. I arranged one semi-emergent transfer to Rapid City and referred another patient for non-emergent evaluation and treatment. I’m told, and I experienced, that the obstetricians in Rapid City are very responsive to phone calls for consultations and transfers. I think they appreciate the mission of the providers in the regional sites and want to respect and honor their efforts.
I didn’t do any deliveries as that wasn’t the purpose of this trip. However, over the years, a number of births occur before or during transfer. Being able to take care of the emergencies that arise requires preparation and eternal readiness. (They really could use a resuscitation table for newborns.)
Their medical record system is clunky, but it doesn’t take long to figure it out. In several days, you can navigate your way around successfully. I miss my templates and smartphrases in Epic.
Does Wanblee need an obstetrician? I think a full-time midwife would be more useful. My greatest value was in being able to perform ultrasounds on a new ultrasound machine (I actually was the first to use it). As someone with a health system perspective, I think we need to consider how we could best aid the entire region. More about this issue in a future post.