Dermatology Outreach With Passion to Heal

The volunteer dermatologists and assistants helped more than 2300 people in 5 days in North India.  

Julie Neville

In the remote Rajasthan desert of Northern India, doctors are scarce, and dermatologists are practically unheard of. That is why 12 dermatology professionals from across the United States have come here: to see if their diagnostic skills and bedside manner will transfer to patients who would never have heard of skin doctors, but desperately need to see one.

Figure 1. Julie Neville, MD, specializes in Mohs surgery at a clinic in Cheyenne, Wyoming. This was her first time in India.

Mamta Kantilal, a Mohs technician from Denver, Colorado, said the goal is to “make even a 1% of difference. People here don’t have access to care.” 

It might be the least likely place you would expect to find a group of specialists—outside of climate-controlled offices, stripped of LED lighting, lab technicians, cultures, tissue slides, and even electricity. Granted, dermatology is a visual field, but this is back-to-basics medicine. This is empirical evidence and gut instinct. 

Part of a program called Passion to Heal, 5 dermatologists and 7 assistants braced themselves for everything: advanced cases of common bacterial infections and rare cases only studied in textbooks—tropical dermatoses or leprosy.

Outreach

Many patients walked for hours to reach the clinic. No one has an appointment; hundreds are expected over the 5-day mission. Every patient exam is performed through a translator.

The health camp is run by WE Charity, an international development organization with a permanent presence in the region and a local team. Every day, health mobilizers meet villagers who endure severely cracked heels, itchy rashes, lice, strange plaques, and unexplained bald spots. WE Charity has worked in the country since 2008. The first Passion to Heal volunteers started in 2012. This year marks the sixth trip. 

India could induce a kind of professional culture shock for American clinicians. The climate is dry, the culture is foreign, and the health care system lacks resources. Julie Neville, MD, specializes in Mohs surgery at a clinic in Cheyenne, Wyoming. Her typical patients are ranchers who bring her homemade elk jerky. This is her first time in India (Figure 1). 

“I am excited to see the variety of conditions, perhaps some without prior treatment or diagnosis, given the rural location,” said Dr Neville. “Possibly even conditions not normally seen in my practice.” 

Erik Gilbertson, MD, is the director of a satellite leprosy clinic in San Diego, California, which is one of only a dozen or so such clinics in the United States where the disease is rare. India has one of the highest rates in the world. In the months before Dr Gilbertson and the others arrived in Delhi, WE Charity spread the word. 

For the mostly illiterate population, ambassadors make rounds, grassroots-campaign style, driving through each hamlet in a van equipped with loudspeakers. They announce the dates of the free clinic weeks in advance on the tinny sound system. No one will be turned away. It has not rained in Rajasthan in 6 months and the skies will not open again for another 3 months. Summer temperatures hit 102°F. 

On the first day, the doctors saw 309 patients.

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