Dr. Maryam M. Asgari spent her summer vacation improving community health in a Ghana village.
A paper plate hanging in the office of Maryam M. Asgari, MD, MPH, features a hand-crayoned image of Dr. Martin Luther King, Jr., above the words, “I have a dream … that my mom will find a cure for skin cancer.”
Dr. Asgari’s oldest son, Arman, made the plate when he was 8 years old. Two years later, Dr. Asgari took Arman with her to Yamoransa, Ghana, on a two-week mission sponsored by the Yale Alumni Service Corps. The mission provided basic services in education, medicine, construction, and business consulting to a poor West African community of 4,700 people.
In addition to her appointment with the Kaiser Permanente Division of Research, Dr. Asgari is an associate physician in dermatology at KP Walnut Creek and a clinical assistant professor at the University of California, San Francisco. The majority of her time is spent doing clinical research with a focus on preventing skin cancer, primarily funded by the National Institutes of Health.
Yamoransa has no medical facilities. How did you provide care?
The town took three very, very small rooms where they housed primary school teachers and made them into a clinic for us. They painted the rooms and hung pieces of fabric from rope and made dividers, so there was some privacy to see patients. But there were many more physicians than there were rooms—about 30 people on the medical team, the majority physicians. Two of the doctors were emergency room physicians, so they formed a triage team, and we devised a questionnaire to divide people into urgent and non-urgent care. We saw over 800 people during our 6 days of providing medical care.
What types of skin conditions did you see, and how did you help treat them?
The majority of what I saw were common things like bacterial and viral infections, eczema, and warts. I saw rare things that I don’t ordinarily see in this country, including several cases of leprosy and filariasis, a parasite that invades through the feet and causes swelling in the legs. By contrast, I didn’t see any skin cancer. The average life expectancy in Ghana is late 50s to early 60s, plus people’s skin tones are quite dark. With this combination, people are not at very great risk of skin cancer, which tends to be a disease mostly of elderly Caucasian people.
Was it a challenge to leave these patients?
Yes, especially that last day when there were people waiting, some of whom were kids—it was heartbreaking to know that you just couldn’t meet the demand. We came equipped with a basic assortment of medicines, but there were still things that we could diagnose but not treat, and others that we could not diagnose given our limited equipment and time. So that was frustrating. And also knowing that if you worked for 200 days, there would still be people coming.
What did you learn from working with the other doctors?
We were fortunate to have two other KP Northern California docs, Tien-An Yang, MD, and Ellen Kolarik, MD, both in ophthalmology, on the medical team. I think that says volumes about KP docs and our willingness to spend our vacation time doing public service—we were by far the most heavily represented of any medical group. One thing that KP docs are really good at doing is integrating with the team. We’re well-trained as team players to walk in, figure out what needs to get done, and do it. All 3 of us floated and did a bit of triage, a bit of vital signs, and whenever there was a backlog we saw to it that people were taken care of.
What did your 10-year-old son, Arman, do while you were with patients?
He chose to teach science—which is his favorite subject in school—to primary school kids during the day, and to engage in field sports with them in the afternoon. That was a great fit for him, because it allowed him to spend the whole day interacting with kids and getting a sense for what it’s like to be a child in that community. He said, ‘The people who live in Yamoransa don’t have very much, but they’re always smiling.’ He understood that you don’t have to have material possessions in order to have happiness.