USC Dana and David Dornsife College of Letters, Arts & Sciences

By Divya Ayyala

For someone who is pursing medicine, I sadly have to admit that my personal life has not been speckled with illness leaving me with little to no personal experience with medications. That is, until I got my wisdom teeth removed. Between the pain meds, anxiety pills, anesthesia, and saline mouthwashes, the array of antibiotics and anti-inflammatory pills that I was prescribed, my daily schedule revolved around pill popping. Throughout the experience, I began to realize not only how taxing keeping track of my pill regimen was, but also how many side effects the medication actually caused. Besides physical tiredness, extreme nausea, and digestive discomfort plagued me for weeks after the surgery discouraging me from eating a full meal. For the first time, I could empathize with the patients I had seen in my clinical shadowing rotations that chose not to adhere to their medication regimens despite knowing full well the repercussions.

Before I came to Oxford for this three-week course, I thought that patients just had to deal with these side effects, no matter how uncomfortable, and take their pills. However, when this type of philosophy is extended to medications that deal with chronic diseases, this discomfort can prevent people from living their life and performing to their full economic potential. Such issues can be especially detrimental to low-income families that rely on day-to-day wages to survive. For this reason, the current healthcare systems and interventions should explore other treatment options that don’t rely primarily on synthetically manufactured drugs.

Divya Ayyala and Jeremy Huang in Oxford’s Botanical Garden. Photo by Gabby Yee.

A day in the Royal Botanical Gardens in Oxford, England with herbalist Merlin Wilcox revealed such an alternative. Thousands of plants such as foxglove, rosemary, and thyme, lined picturesque ponds, paths, and hothouses, all holding medicinal uses. I was amazed how many of the herbs and flowers that were growing in my backyard at home could actually serve as substitutes for several pills that filled our family medicine cabinet. Besides the obvious accessibility of herbal remedies, other benefits of this treatment option were highlighted by two of our lectures, Dr. Ryan and Dr. Wilcox.

Both of these professors highlighted the importance of implementing alternative medical practices in conjunction with modern medicine to achieve sustainable treatment options in low income countries. Dr. Ryan’s work in rural Indian villages primarily with elephantiasis showed how yoga and locally grown herbal remedies can prove to be far more effective treatment options rather than modern medical approaches. Additionally, Dr. Wilcox discussed the effectiveness of the artemisinin plant in curing malaria in several endemic regions since it provides a level of innate immunity after treatment preventing recurring infections. Furthermore, these treatment options often have fewer side effects compared to taking the more potent and concentrated forms of the active ingredients of these plants.

Most importantly though is the fact that these alternatives are much more cost effective and therefore more sustainable. Instead of patients relying on imported medicines to sustain their treatment options, it is much more beneficial for communities to actually begin to grow these medicinal plants and learn how to manufacture already known treatments in a low cost manner. This will eliminate dependence on NGOs and other aid organizations that rely heavily on independent donations to fund medication supply and delivery thus making them reliant on economic fluctuations thereby creating an unreliable and spotty supply chain for these low-income communities.

Without these lectures, I would have begun my medical career without appreciating the strength and power of plants and ancient wisdom. Who would have thought learning to eat your greens might be the key to actually delivering effective healthcare to low-income countries?

Divya will be a senior this fall pursuing a double major in Biology and Global Health.  She is from New Orleans, Louisiana.

Photo:  Divya Ayyala and Jeremy Huang in Oxford’s Botanical Garden.  Photo by Gabby Yee.

By Sandy Lee

Global map made from mosquitos used in malarial research. From Wellcome Collection. Photo taken by Sandy Lee.

On Wednesday, July 25, we went to London and visited the Wellcome Collection Museum. I found the it to be extremely intriguing. We visited two of the museums famous collections. First was Henry Wellcome’s collection of unique artifacts and the second was a collection of scientific breakthroughs that happened after Wellcome’s death in 1936.

Henry Wellcome was an entrepreneur who sold medical tools for a living. On the side, he was extremely interested in collecting strange and interesting artifacts. He was able to compile a large array of extraordinary and extremely fascinating objects ranging from surgical tools to Chinese and Japanese sex aids and dolls. Wellcome’s collection also included Napoleon’s toothbrush and a lock of George III’s hair. Wellcome even amassed a large collection of remarkable caricatures and interesting paintings.

I thought the paintings to be the most interesting of the collection. One painting particularly caught my eye. One of the paintings that I thought was quite interesting was this picture of a woman giving birth to a baby and surrounding the woman were babies, dead and alive.

Statue "I Can't Help the Way I Feel" by John Isaacs. From Wellcome Collection. Photo taken by Sandy Lee.

In contrast to Wellcome’s collection was the Medicine Now exhibit which presented many of the scientific breakthroughs that occurred after Wellcome’s death in 1936. There were three main sections in this exhibit. In The Body exhibit, the body was presented in two different ways. One model was a 3-D model of the human body and each individual organ of the body lit up when a button associated with that specific organ was pressed. Another body model was a frontal cut of a plastinated body of a real donor body. To prepare the plastinated body, the body was drained of its liquids and a vacuum process was used to replace the organs with plastics that decay slowly.  The sight of the plastinated body was quite remarkable and colorful.

In the Genomes section, there were many books that had the whole genome printed in them. It was very clever of the museum to print out the genome into the large numbers of books as these books really exemplify the complexity of the DNA.

I found the malaria and the obesity section to be the most interesting of them all. In the malaria section, there was a map of the world and upon a closer look at the map you will be able to see tiny mosquitoes making up the borders of the countries. In the description of the map, the artist actually took dead mosquitoes from Robert Sindan, who used the mosquitoes to conduct his research on malaria, to construct the map to show that malaria is not just a third world country problem but a global problem that we have to try and find a solution to.

Photo of author, Sandy Lee at the British Museum. Photo taken by Gabby Yee.

In front of the mosquitoes map of the world is a giant obese human being model with no arms and head. The figure was quite life-like disregarding the fact that it had no head and arms. The model represents the problems often associated with obesity such as diabetes, hypertension, and heart problems. The two displays, the map and the obese figure are positioned right next to each other to show the disparity between the developed and developing world and how even though developed countries are well advanced, we still have our share of problems that continues to threaten our lives such as obesity.

Sandy Lee is from Walnut, California and is going to be a senior majoring in biological sciences. She is going to pursue her master’s degree in global medicine from the Keck School of Medicine next semester and hopes to finish by Spring 2013. She also hopes to pursue a career in medicine after obtaining her M.S. in global medicine.

By Ashwin Malynur

After spending over a month in a southern Indian metropolitan city, the view of the English country side from my train window was a nice change.  I was on my way to Oxford for the first time and the train was fairly crowded. Though I was sitting next to some of my fellow classmates there were still many strangers that were right next to me.  As the train started a couple of my fellow classmates and I were discussing about what the next three weeks had in hold for us.

As pre-med students we were discussing about med-school and different types of doctors. While we were talking about different stereotypes associated with different types of doctors, one of my classmates made a joke about becoming a general practitioner and how people do it as a last resort. This reflects the general mentality that being a general practitioner in the U.S is not as sought out as other types of doctors. Right as my classmate made this joke, the person sitting right across from us started talking. We were all astounded when she said that she was a general practitioner from Australia. She then went on to tell us how being a general practitioner in Australia is a very sought out job and how the majority of doctors in Australia are general practitioners. She then described how in the Australian healthcare system people go to general practitioners more often because they can diagnose and treat them on a larger range of diseases rather than referring them to a specialist. This got me thinking about our own healthcare system and what we can do to improve it.

Ashwin Malyner, fourth from the right, with other USC students in front of Blenheim Palace. Photo by Dr. Erin Quinn.

Right now in America’s healthcare system the majority of doctors are specialists. In our current system general practitioners act more as people who give recommendations to other people rather than treating the patients themselves- at least more so compared to other countries.  As the discussion on the train continued we talked about how it would be a lot more cost effective if general practitioners treated patients more often rather than referring them to specialist.

Our cost per capita for healthcare is one of the highest in the world. There is a reason why other countries are paying less per person for healthcare. In some cases the quality of care may decrease but I truly believe that we can cut healthcare cost in the U.S and still maintain a high quality of care.  General practitioners often charge much less than specialist so if we have more patients seeing general practitioners it would be a very effective cost cutting technique. It would also be easier for general practitioners to encourage a patient to practice preventive care.  More often than not by the time a patient see’s a specialist the disease or infection is already in the beginning stages of progression. So overall if there were more general practitioners that could treat and diagnose patients more frequently, rather than referring them to specialist, our healthcare system would improve.  The number of general practitioners in the U.S is already increasing and our healthcare system is in the process of changing. We are taking a step in the right direction and we just need to continue this change.

England is truly an international destination and it was great meeting new people on the train like the general practitioner from Australia. Travelling abroad has really expanded my perspective even though it was just the first day of our trip. As Americans it is important that we look at different cultures and countries perspectives so that we that we can take the best out of each one to improve our own.

Ashwin is a sophomore majoring in Neuroscience from Beaverton, Oregon.