Winter break is typically a time for students to relax, take a break from their studies, and spend time with their families, but for 24 University of Lynchburg PA students, it was the perfect opportunity to bring medical care to those in need.

Students Without Borders, or SWOB, is a student-led organization that provides medical care to underserved communities outside of the U.S. Each year, the Lynchburg PA SWOB board plans a medical mission trip to accomplish this goal. Over the past three years, students have traveled to Oaxaca, Mexico, and the Dominican Republic. 

Upon arrival in San Andrés Huayapam, Oaxaca, students and faculty members were surprised to learn they would not be working in an established clinic as expected. Instead, their first task was to transform an elementary school that was closed for the holidays into a functional clinic. 

They covered windows with paper and used twine, shower curtains, and large road signs to divide classrooms into patient rooms. Existing bookshelves were repurposed to store medications and supplies brought from the U.S.

Over five days, students provided care to 196 patients across 225 visits, including follow-ups. They worked in pairs — a first-year student with a second-year student — to examine patients before consulting with a licensed faculty member on diagnosis and treatment plans.

“I had an idea of how well it was going to go, but I never would’ve realized how much of a difference we could make,” said Demet Saygili ʼ25 MPAM, the immediate past treasurer of the Lynchburg PA SWOB board.

“I’ve seen patients who come from really tough, hard backgrounds show trust, which brought tears to my eyes.”  

To overcome the language barrier, students worked with 12 translators, several of whom were college students who had volunteered the year before.

“The translators we had were awesome,” Saygili said. “I don’t remember hearing, or experiencing any barrier with an interpreter.”

Students learned to address patients directly, rather than focusing on the interpreter, and to build rapport with translators to improve communication.

“Because we had the opportunity to have the same translators for four days in a row, and they were also the same translators as last year, we really got to build a more personal relationship,” explained Camille Ervalez ʼ25 MPAM, immediate past president of the Lynchburg PA SWOB board. 

“Through that we are able to provide better patient care.” 

While the translator experience was overwhelmingly positive for both students and patients, it was a lengthy process, providing extra lessons in patience and choosing your words carefully.

“It will lengthen the time with the patient, since you are essentially having the conversation doubled,” Ervalez said. “You have to really pick what you say appropriately so you don’t have to backtrack through something that you said incorrectly.”

Another valuable skill learned by the students was how to adapt when there are limited resources. Dr. Travis Kaufman ’20 DMSc, who leads the Emergency Management and Global Health concentration for Lynchburg’s Doctor of Medical Science program, was on hand to impart those lessons. 

“It was my first time working with Lynchburg PA students and it was a great experience,” he said. “I got the chance to teach them some of that wilderness, knees-in-the-dirt medicine —different techniques they can use when they don’t have an X-ray or … lab capabilities.”

The only equipment and medications available to the students were the contents of their luggage — two 50-pound bags per person. 

“It all goes back to the austere medicine mindset: ‘What do you [have] in your bag or right here that you can work out of,’” Kaufman explained. “It’s fun to teach them those techniques — the things I love to do.”

It was a valuable lesson for the students. “It’s a lot of ingenuity and creativity that you have to have,” Ervalez said. “We’re used to working in such structured environments. … It’s an expectation of American health care that they’re going to have that equipment in the room.”

Ervalez added that sometimes equipment seemed to grow legs and walk off into another exam room, and sometimes “things wouldn’t work out the way we were expecting and we had to use something else. 

“We didn’t have everything you could possibly want. So you had to make do with what you had.”

Without advanced diagnostic equipment, the students had to rely on their history taking, asking the patient about their past and ongoing health conditions, and physical exam skills to diagnose patients and determine treatment options. 

“There’s the art of medicine, where you’ve got to talk to a patient and see exactly what they need, and you’ve got to be creative,” Kaufman said. “If you do a good physical exam and get a good history with the patient, nine times out of 10 you can get a good diagnosis and treatment for that patient and it will be correct.”

While these pop-up clinics are a valuable resource, sometimes they can only be a stepping stone toward the care someone needs. 

“The biggest thing for us is that if someone comes in, we have to know what we can and can’t do,” said Penelope Moore ʼ25 MPAM, immediate past vice president of the Lynchburg PA SWOB board. 

“As a health care provider in general, it’s important to know your resources and know your limitations — know when to ask for help and when to send someone to a specialist or get other portions of a health care team involved.”

Even with these limitations, the students provided an abundance of primary and women’s health care. They treated common infections, provided medication for chronic conditions like high blood pressure, performed pelvic exams, educated patients on women’s and sexual health, and provided much-needed public health items. 

The students also had the opportunity to perform a home health care visit for an elderly patient who had recently suffered a stroke. 

Medications and supplies needed for the trip were gathered through yearlong fundraising efforts, including car washes, selling snacks to fellow students, collecting donations outside storefronts, partnering with local businesses like Joe Beans, and hosting the SWOB Gala and silent auction. 

Local nonprofit, Gleaning for the World also contributed by donating Wings Feminine Hygiene kits. 

“Thanks to our Lynchburg community, we have gotten so many donations, whether it was cash or items,” Saygili said. “Thanks to them, this trip was possible.” 

Faculty and students found immense value in the experience. 

Dr. Stephen Lewia Jr. ’18 MPAM, ’20 DMSc, a faculty member who went on a SWOB trip as a student and continues to go when possible, emphasized the trip’s impact.

“If you’ve never been outside of your American bubble, you just don’t know what you’re missing,” Lewia said. “I can guarantee you’ll get something positive out of it. I can guarantee it will have a positive impact on how you treat patients in the future — with the good possibility it’ll be life changing for you.

“For them to have the ability to do this early in the program is something I’m really proud that Lynchburg does.”

Saygili described the trip as “definitely an unreal experience,” adding, “Not only serving the community, but also creating the bond, seeing the culture and history, hearing the stories, and seeing how much of a difference we could make in the community.

“The feeling Oaxaca left me with is forever going to be in my heart and I want to live it again — not because it made me feel good, but because I saw what we can do and I want to do it again.”