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Opening Doors : A Veil Lifted

I know, but finding and organizing a volunteer experience can be an overwhelming task; an effective organizational network would tap a substantial resource.

During my time in Dar, I was exposed to a variety of international organizations and their volunteers: religious groups, such as the Catholic church, which runs clinics and hospitals; foreign academic institutions, which conduct research and provide services; foreign governments, which fund patient care and run public- health projects; and nongovernmental organizations, which focus on a variety of specific issues. One of the most significant learning experiences was to realize how many different approaches to international health exist. My eyes were opened to the possibilities, and my mind is constantly churning. In addition to my plan to start a hospital, I also expect to be involved with other international projects.

I am considering specializing in gynecological oncology and am interested in doing research during my residency that's related to reproductive cancers in developing countries. Not surprisingly, there is no Pap-smear screening program for cervical cancer in Tanzania. The organizational effort required to start such a program would be huge, and the cost of the labwork and interpretations prohibitive. Although cervical cancer is common and deadly for otherwise healthy young women, even most female physicians there have never had an annual gynecological exam. What would a feasible screening program in such a setting look like?

Dr. Lillian Mtei, above, is the clinical coordinator for the DarDar study. Photographer Patrick Saine describes her as "upbeat" and "enthusiastic." In fact, Dartmouth visitors come away impressed by all the Tanzanian staff on the project. "Day in, day out," says Daniel Kaser, a DMS student who spent the summer of 2005 there, "I was impressed with . . . how welcoming people were."

Above, an HIV-positive patient discusses with her doctor whether she's eligible for antiretroviral treatment; an array of antiretrovirals is displayed in a CD case on the desk. Unfortunately, her T-cell count is too high for that treatment option. At right, Amelda Urasa draws a blood sample from a patient. Next, the patient will get a TB test.

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