Michele Langowski leads an interdisciplinary mission to El Salvador
Michele Langowski, MA, JD, is the newest member of the Department of Health Care Ethics faculty, filling the recently created position of Assistant Department Chair. She is also Assistant Professor and teaches ethics courses for the School of Nursing and the Doisy College of Health Sciences in addition to seminars for the Department's PhD program. Langowski came to the Department after working as a Health Care Ethics and Legal Bioethics Consultant in St. Louis and Washington DC, and teaching undergraduate and graduate courses in the Department of Theological Studies at Saint Louis University.
In addition to her departmental duties, Langowski is also serving as Academic Leader for the 2nd Annual SLU IPE (Interprofessional) El Salvador Medical Service Mission, which is sponsored by the Doisy College of Health Sciences, the School of Nursing and Campus Ministry at Saint Louis University.
The mission to El Salvador is in its second year. Robert Murphy, SJ planned and led the original two-week January 2008 trip. “Everyone called Robert our ‘fearless leader,’ during our last trip” Langowski says. “I have massive shoes to fill.”
The ongoing project targets El Salvadoran health care providers. It’s a unique interdisciplinary health care outreach program, in which the primary mission is educational, though some direct patient care is provided. The goal is to provide members of the Salvadoran health care community education and training that is current, evidence based, and relevant to their self identified needs. An additional goal is to provide lasting opportunities for further training.
“Medical delegations come and go in El Salvador, bringing valuable services to the people, but not offering much to the health care providers,” says Langowski. “During last year’s inaugural trip I helped assess future needs and sustainability with an eye toward setting up an ongoing continuing education program for health professionals through SLU’s Center for Interprofessional Education and Research.”
Langowski is quick to point out that she learned just as much as did the people they went to help.
“I know this sounds trite, but last year’s trip was life-changing for both the students and faculty. It’s difficult to distill into meaningful sound bites the various experiences—from the rural mountain villages to the urban shanty communities to the national public hospital—the extreme poverty coupled with boundless hope,” she says.
“We spent 4 days at Nacional Hospital Rosales, the ‘Cook County Hospital’ of San Salvador,” continues Langowski. “It’s a 530-bed public teaching hospital that serves primarily the poor and unemployed on a shoe-string budget with limited supplies. Sections of the hospital remain damaged from an earthquake in 2001.”
In addition to structural hindrances to providing quality care, it quickly became apparent how badly the providers needed the group’s education mission.
“We noticed the nurses in the ER were not wearing gloves or using standard precautions for infection control and watched as blood dripped from the arm of a patient onto a nurse’s hand eventually drying on her skin,” says Langowski. “The same cotton swab was used to ‘clean and disinfect’ more than one patient before blood draws and injections. On the burn unit, we saw a severely burned teenage girl who had not received any PT or rehab. She was seated in a chair and did not have a hospital gown, so she tried to keep her breasts covered by holding a sheet and folding her arms around herself, worsening the contractures of her limbs. We jimmy rigged her sheet like a large bib around her neck, so she was less self conscious, thus enabling her to start some basic rehab exercises with our PT faculty.”
“What haunted me, as a health care ethicist, was the number of patients who were not informed of their diagnoses and prognoses,” she continues. “These were not circumstances in which the families were given information, while the patients were left wondering what was happening. Instead, a collision of factors seemed to contribute—for instance, lack of hospital resources and limited time, poverty-stricken patients and the socio-economic class structure, as well the predominance of medical hierarchy and paternalism.”
This year’s expedition will last 8 days this coming January. Five faculty, a campus minister, and 8 students from Saint Louis University will be making the trip, which will again visit the Nacional Hospital Rosales. La Chacra Clinic, another provider for disadvantaged populations in San Salvador, is also on the itinerary.
“I have been a member of the Jesuit university community for over 20 years, first as an undergraduate then graduate student, law student, teacher and now assistant chair,” says Langowski. “It is central to our Jesuit identity to educate the whole person and to form persons ‘for others.’ This endeavor exposes students and faculty alike to the demands, challenges, and rewards of using their interdisciplinary skills in new ways to benefit others, providing education and health care to underserved populations in a developing nation.”