In cities and developed areas of the world, it can be easy to take access to quality medical care for granted. People in the United States, for example, typically don’t have to trek over unpaved mountain trails barefoot, spend hours traveling by small boats, or purchase kits with basic medical supplies before being seen by a medical provider.
Have a migraine? Take some aspirin.
Respiratory infection? The doctor will write you a prescription for a round of amoxicillin.
Broken arm? Go to the emergency room for an X-ray and get a cast and some pain meds — come back in a few weeks to have it removed.
Pregnant? Plenty of vitamins, ultrasounds, and follow up appointments before a hospital birth with a team of medical providers.
That is unless you live in a place so remote that road signs warn about jaguar crossings rather than deer, or medical resources are so limited you have to provide your own scalpel, gloves, and trash bag to give birth.
This is the reality PAs in Lynchburg’s Doctor of Medical Science Emergency Management and Global Health concentration faced during medical humanitarian mission trips to Belize, Panama, and Uganda.
These global health missions allow DMSc students in the EMGH concentration to fulfill their practicum requirements, while also making a meaningful impact. Previously, students completed a seven-day, in-person disaster and wilderness medicine intensive at Claytor Nature Center in Bedford, Virginia, to meet this requirement. Now, students may choose between the wilderness intensive, a mission trip, or even both.
In March, two students, Dr. Sheila Bilica ʼ25 DMSc and Dr. Sonia Okolo ʼ25 DMSc, and one adjunct faculty member, Dr. Megan Hudson ʼ20 DMSc, traveled to Belize on a global health mission trip.
They went in partnership with Global Health ImPAct, an organization Hudson founded after completing her Doctor of Medical Science at Lynchburg. On its website, GHI is described as a “not-for-profit organization dedicated to creating clinical rotation sites and global health experiences for the next generation of healthcare professionals.”
In Belize, Bilica, Okolo, and PA students from Midwestern University participated in GHI’s EmpowerHer and Adaptive Hope programs.
Through EmpowerHer, the students provided sanitary and hygiene products and women’s health education.
With Adaptive Hope, the students provided prosthetic arms for patients with traumatic amputations or malformations.
“The students were actually able to take the patient from start to finish,” Hudson said. “So the moment they come into the clinic without an arm, [the students] assess the need, measure the limb — all those types of things — and then actually fit them for the device.”
The students also taught patients the basics of how to use the devices, as well as occupational and physical therapy exercises to improve their functionality.
“The devices are very basic, but they help with [activities of daily living] and improve function and allow patients to be able to continue to make an impact in their community and maybe make money or hold a job,” Hudson explained.
Bilica talked about a patient they ran into the day before the Adaptive Hope clinic. The man, who had amputations of all four limbs, was selling popcorn.
He excitedly told them, “I’m coming tomorrow to see you guys!”
Once fitted for his new prostheses, the man immediately focused on teaching himself how to use them.
“He was trying to teach himself how to do it and he was [very] into it,” Bilica said. “His wife was there supporting him. His children were there too. Everyone was just into helping him [as] he was trying to learn the process and [he] even taught us a few things.
“We all were putting our heads together to learn how to make [the prostheses] work for him.”
The trip also provided an opportunity for Hudson to visit the ministry of health and advocate for the PA profession, which is not currently recognized in Belize. Originally, the group was supposed to do some work in a local hospital but were denied because of their licensure.
“The schedule we had in place was a beautiful goal, [but] when you show up, sometimes things just don’t go as planned,” Hudson said. “So you stay flexible and you stay willing and you serve where you’re needed.
“Talking to [the ministry of health] about [a PA’s] role in healthcare and how we can improve access and care was really empowering.”
In May, a large group of DMSc students and faculty set out for a remote area of Panama to provide healthcare to the Ngäbe-Buglé people in partnership with Floating Doctors.
According to its website, the mission of Floating Doctors is to “reduce the present and future burden of disease in the developing world, and to improve healthcare delivery worldwide.” Floating Doctors has been providing “permanent” and “sustainable” healthcare in rural Panama since 2011.
“I really love this partnership,” said Dr. Travis Kaufman ʼ20 DMSc, lead faculty for the emergency management and global health concentration. “You never want to just show up and do a global health humanitarian mission and then leave.
“[If] you do a lot of great things and leave you probably made things worse.”
Kaufman explained that the permanent setup managed by Floating Doctors allows for outside providers to give care and provide supplies without leaving the local people without a source of care when the mission ends.
“With Floating Doctors, we don’t get anything from the community,” Kaufman said. “And that’s something you have to remember when you’re planning. You never want to show up and be a burden on the community.”
Villages in the area, like Playa Verde and Playa Lorenzo, rely heavily on Floating Doctors coming every three months to meet much of their healthcare needs.
“The nearest hospital is a 40-minute boat ride away, which many villagers cannot afford or choose not to spend their limited resources on, making outreach care critical,” Dr. Nathan Cameron ʼ25 DMSc said.
A boat to the hospital costs $30 one way.
The group established mobile clinics to provide general and trauma care to the local population. They saw everything from parasitic infections, skin irritations, urinary tract infections, pregnancies, and a latent tuberculosis infection. They also assisted in treating chronic conditions, like hypertension.
“One of the most difficult aspects of providing care in this area was the lack of internet access,” Dr. Monica Rocha ʼ25 DMSc said. “Without the ability to quickly look things up or reference clinical resources, we had to rely heavily on our training, clinical judgment, and teamwork.
“Despite the challenges, the team delivered high-quality, patient-centered care with compassion and precision. It was inspiring to see what’s possible with commitment and creativity.”
In addition to working with Floating Doctors, the team also spent time with the Manchichi midwife program. The program, which began in Guatemala, works to reduce infant and maternal mortality among the indigenous population and empowers indigenous women by providing training and resources for the care of pregnant women and infants.
“The thing that really touched me about [the Manchichi program] was just watching these people go about doing hard things — like legitimately up the side of a mountain [in] pouring rain,” said Dr. Hayley Brown ʼ25 DMSc. “They do it with no fanfare, no complaint. I think they have a great ability to just accept how things are and just do it.”
Those with Manchichi training equip other women, allowing the program to spread throughout the remote region. While there, the Lynchburg group helped celebrate the “graduation” of new Manchichi midwives.
“It’s spreading like wildfire from village to village,” Cameron said. “It’s going to be spreading throughout Panama as long as the funding can keep up, which is one of their biggest struggles.”
A common need across many rural and austere environments is quality women’s reproductive care. Access to birth control, sanitary products, pregnancy and birth care, and even accurate education is often limited.
This was the focus of the DMSc and Global Health Impact trip to Uganda in May.
The trip was led by Hudson, who was joined by Dr. Natalie Asbach ʼ25 DMSc and students from another GHI university partner. Similar to the Belize trip, the initiative they focused on was EmpowerHer.
They also worked with Save the Street Children, or SASCU, which has been described as a “Christ-centered, non-profit organization committed to transforming the lives of street children, unaccompanied refugee children, and vulnerable young women in Uganda.”
Hudson and Asbach talked to adolescents at SASCU’s facility about women’s health issues and period poverty. Each girl also received sanitary napkins, a bar of soap, and clean pairs of underwear.
For three days, the group provided prenatal care at rural health centers located on Lake Victoria. While there, they provided prenatal assessments and fetal doppler scans to 217 women.
“A lot of those moms got to listen to their baby’s heartbeat for the first time ever,” Hudson said. “Every [woman] who’s ever been a mom, who’s heard her baby’s heartbeat, it’s just this really special moment.
“To be able to be a part of that with those patients in those rural communities was just really rewarding.”
The group also provided health centers with Mama Kits containing items such as a trash bag, scalpel, receiving blanket, gloves, and umbilical clamp.
Typically, these kits are purchased by an expectant mother from a local pharmacy before she gives birth. If a mother is unable to provide these items, she may be turned away when it is time to give birth.
By providing the Mama Kits and connecting women to kit-equipped health centers, the students helped ensure the women would receive quality medical care.
“Uganda is a place that I serve regularly, and I will always say that Uganda changed me more than I will ever change Uganda,” Hudson said, adding that opportunities like those provided in the DMSc and through Global Health Impact empower participants to become better healthcare providers.
“The opportunity to meet people on the other side of the earth who are different from you in so many ways[is] so wonderful, and [to] become a student of them and create these relationships, it really empowers students to do critical thinking, complex problem solving, [and] adaptive medicine.”
