Sarah Andiman, MD'13

GHI Spotlight Interview Questions: Sarah Andiman, MD '13

Sarah Andiman, MD '13Sarah Andiman, MD '13Sarah Andiman received a BFA from Rhode Island School of Design in 2003. After graduating, she spent a few years teaching photography, assisting documentary photographers and conducting various freelance projects before deciding to become a physician. While at Alpert Medical School, in addition to her international work, she especially enjoyed working with Providence’s immigrant and refugee community and was involved with projects assessing how physicians can better serve these groups. She will begin her residency in obstetrics and gynecology at Albert Einstein College of Medicine/Montefiore Medical Center this July.

What is your current status at Brown?
I just graduated from the medical school and I am starting my obstetrics and gynecology residency at Albert Einstein College of Medicine/Montefiore Medical Center in July.

How did you first get interested in global health?
I studied photography in college and was exposed to the brilliant work of Robert Capa, Sebastiao Salgado, Robert Frank and Bill Burke.  Their photos of war, famine and other hardships were the catalyst that eventually led me to medicine. I realized that I wanted to be part of a profession in which I could help the people who need it the most. 

How did you become involved with your project?
I connected with an American working at Sihanouk Hospital Center of HOPE (SHCH), in Phnom Penh, the year before starting medical school. I traveled to Cambodia to work with her and helped with a project analyzing hospital demographics, but I was also able to shadow physicians on the wards. After starting at Brown, I sought out Dr. Susan Cu-Uvin, who I knew had done research in Cambodia. She, along with Dr. Herb Harwell at Brown and Dr. Kruy Lim at SHCH helped me design my project. We wanted a project that would not only be educational for me but that would directly benefit the hospital. The hospital sees patients with unique manifestations of common diseases, as well as unusual ones, on a daily basis but because they are so busy clinically they are rarely documented extensively. The book we have created really shows how they diagnose and treat what are often very advanced diseases with limited resources.

What is most difficult about your global health work? Most rewarding?
What has been difficult for me has to accept that in some situations you face barriers that are out of your control. For example, you may have a patient that needs a surgical procedure or medication that is absolutely unavailable in the country. The Cambodian patients and physicians respond to this with equanimity. I have had to remind myself that change happens over time, that healthcare in Cambodia is far better now than it was ten years ago, and as education and infrastructure improve, it will continue to get still better.

 When I provide hope, or assurance to a patient who is distressed, I am thrilled. During my summer at SHCH, I sat down with patients and their family members and had long conversations with them and their family members (with an interpreter’s assistance) about their illness as well as their family history and daily life. I really valued having the time that allowed them to tell their stories and ask questions of me. Recently, while at Angkor Hospital for Children (AHC) on a clinical elective, I left the operating theater after a five year old’s heart surgery. Her mother sat on the bench outside. She looked at me with a face filled with anxiety—she knew I had been in the operating room with her daughter. I cannot begin to imagine how scary it must be for someone with no understanding of hospitals or surgery to relinquish her child to gowned and masked strangers.  I was able to tell her in Khmer, “she’s ok, there’s no problem,” She and the women next to her smiled and laughed, repeating “no problem.” They probably thought my speaking Khmer was funny, but clearly they were also relieved that the child was safe. I love being able to connect with patients and their families, and am excited to be providing more and more of the actual medical care myself.

How does your global health work fit in with your career plans?
I have been inspired by my mentors at Brown, Dr. Cu-Uvin and Dr. Star Hampton, who does pelvic reconstructive surgery in Africa. From my experiences in Cambodia, I very much believe that physician education, and clinical training in particular, is of the utmost importance in improving healthcare in developing countries. Right now I am interested in pursing a fellowship in urogynecology and pelvic reconstructive surgery after my residency. After that, I would like to conduct research and teach abroad.

What has your experience been with global health at Brown (Framework, GHI, etc.)?
I received funding for my scholarly concentration project from the Framework in Global Health.  Being part of the Global Health Concentration also meant I was also able to hear about the many fascinating projects being carried out by other medical and public health students at Brown. The medical school also offers a wide variety of clinical electives abroad. I spent a month this past winter at Tokyo Women’s Medical University, where I researched Japan’s unique healthcare system. Then I returned to Cambodia where I spent a month at AHC and also returned to SHCH to visit and deliver copies of my book.

Any other thoughts/comments you’d like to add?
I am so grateful for the international health opportunities at Brown. They have provided me with perspective and experience that will allow me to better care for all my patients during residency and beyond.