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Northampton doctor learns a lot in Ethiopia trip

By Chad Cain
Daily Hampshire Gazette / August 18, 2012
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NORTHAMPTON, Mass.—When she landed a Fulbright Program assignment to teach medical students in Ethiopia, Dr. Marty Nathan could not have predicted the many ways she would become the trainee during her stay in the impoverished African country.

"It really was a two-way street," Nathan said. "It's hard to measure whether I gave or took more."

The Northampton resident and her husband, Elliot Fratkin, recently returned after nearly nine months in Hawassa, Ethiopia. Nathan worked at a government-run facility, the Hawassa University Referral Hospital, and taught students at the University of Hawassa School of Medicine. Fratkin, a cultural anthropologist at Smith College, taught at the University of Hawassa, also under the Fulbright Program.

Nathan, a family practitioner for 35 years, said her time in Ethiopia gave her a new perspective on the field of medicine and the discrepancies between the modern world and a resource-starved country.

"Medicine is so technological that the lack of technology just slams you in the face," she said.

Nathan discovered that fact early on as she collaborated with general practitioners who were diagnosing diseases that she doesn't encounter in her work at Baystate Brightwood Health Center in Springfield. Patients in Hawassa were dying every day from tuberculosis, malaria, HIV, meningitis, unusual parasites and more.

"I grew to respect my colleagues so much because their lives were just so overwhelmed by the illness of the people that they were dealing with, day and night," Nathan said.

It took her awhile to fit in on Referral Hospital's internal medicine ward, where she spent most of her time. Doctors didn't have time for a "ferengi," or foreigner, she said.

At first, Nathan simply followed physicians on their patient rounds. These visits were difficult, she said, because of the language barrier and her penchant for asking questions. She grilled the doctors about tuberculosis and other diseases she had little experience with, so she could take that knowledge back to the students she was training.

"I experienced many new cases while I was there, cases that were diagnosed right there in the ER," Nathan said. "My poor general practitioners who were having to put up with me were absolutely right. I was a burden, and I laughed with them later that I was a real pain in the neck."

But knowing that she would be there for months, Nathan began to search for ways to help. She focused on two areas: using technology as a diagnostic tool and treating diseases of the affluent such as weight gain, diabetes, hypertension and asthma.

Nathan said general practitioners at Referral had good clinical skills and could diagnose bacterial and other diseases on the spot. There was no functioning laboratory, however, to confirm those diagnoses, so she helped them advocate for the needed resources.

"That became a campaign," she said.

Nathan also set up a clinic to treat street people and beggars. When patients with no money to pay for their prescription medication visited, Nathan started paying for the medicine herself. Then she started seeing people who couldn't afford any medical care at all.

She eventually helped negotiate an arrangement in which Hawassa's private hospital allowed the public facility to use its medical equipment at a reduced rate. Nathan and her husband helped establish a fund to pay for care for those who can't afford it.

While in Hawassa, she said, she discovered a love for teaching.

"I really found myself trying to be in their shoes and face those difficult situations with them," Nathan said, "and also talk about the future in which perhaps they were going to have access to more - so they needed to know it."

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