Texas Tech University

CISER Medical Missions Enable Undergraduates to Make a Difference

Glenys Young

June 19, 2019

Since 2014, these annual trips have given students a new, more global perspective.

It all began with a simple, "So, what are you doing this summer?"

It was the spring of 2014. Dr. Gary Fish, a Dallas ophthalmologist and Texas Tech University alumnus, was in Lubbock as a judge for the annual Undergraduate Research Conference, hosted in part by the Center for the Integration of STEM Education & Research (CISER). Chatting with some student presenters, he asked that question.

Nafees, Fish and DeLeon

When they said they were planning to stay in town to conduct research and perhaps take classes, he invited them to go to Guatemala instead.

Fish had an established medical mission trip – he took off a few weeks each year from his practice at Texas Retina Associates and traveled to either Guatemala or Haiti to provide vision care for people who otherwise wouldn't have any. Since he was already headed to Central America that summer, he figured it wouldn't be a big deal to take along some promising students.

The two he asked, Saba Nafees and Stephanie DeLeon, jumped at the opportunity. In doing so, they laid the groundwork for a program that changed their lives, the lives of Texas Tech students yet to come and the lives of complete strangers thousands of miles away.


In the summer of 2016, then-undergraduate student Helen Scott was teetering on the edge of a life-altering decision – should she go to medical school to become a doctor or choose graduate school and focus her efforts on research?

Already a member of CISER, Scott heard firsthand about the wonders of Fish's medical mission trips, so she applied and was accepted. She and the other two students on the trip took turns rotating through the ophthalmologist clinic, dentistry clinic and primary care clinic set up near their lodging.

"There also were teams that would go out to the smaller villages and set up in a school, a church, just kind of anywhere they would let you set up," Scott said. "That's what we typically would do. People would line up and tell us what was wrong. We would try to give them anything we could, so we had kind of a traveling pharmacy."

But working in such a remote part of Central America came with its own challenges. Their home base was in the mountains of Guatemala, near Lake Atitlán, but to get to their neediest patients, they had to boat across the lake and hike to the villages, carrying all their supplies with them on what could easily be an hourslong journey.

Villagers line up for medical care.

"You get up in the mountains and, for a lot of the people who came to our clinic, it was the first time they'd ever seen a doctor," Scott recalled. "It was crazy that we could be the only doctor they'd seen in their entire life. So, we had some heartbreaking cases and some very simple things, too. One boy came in complaining that his feet always hurt, and we realized, 'Oh, he needs bigger shoes.' It ranged from totally crazy medical cases to just kind of humanitarian problems."

One humanitarian problem she witnessed was a shortage of dental care.

"When I was in the dentistry clinic, we had a 1-year-old boy who had to get almost all of his baby teeth pulled because they were completely rotten," Scott said. "Even though they're around this massive lake, it's horribly contaminated so the only safe water to drink is bottled water. Most of the people there will drink soda instead because it's cheaper and more plentiful in stores.

"We had huge problems with obesity and just poor dental hygiene, so we actually did a drive collecting toothpaste and toothbrushes just to give out to all the kids and teach them how to brush their teeth properly. There are just those systemic problems of not having resources or the education of how to take care of yourself properly."

The communication between the doctors and patients also proved problematic.

"The national language is Spanish, but in the region we were in, it's mostly just really remote villages," she explained. "So we had translators who could speak all the local Mayan dialects, or one of the local dialects, and Spanish. Sometimes we would have a line of translators trying to get down to the local dialect, which got crazy."

Hundreds of people each day visit the clinics.

Fish headed the ophthalmology clinic, giving patients glasses with the closest prescriptions they had available and performing cataract surgeries. That's where the difference between Guatemala and the United States became painfully obvious to Scott.

"It was really fascinating, learning that what you expect there wouldn't necessarily be what you expect here," she said. "When they came to the ophthalmology clinic, each patient would get sunglasses, just to prevent cataracts, and eye drops, because with the way the traditional stoves were in that town, they typically just cooked over fire, and so they got a lot of smoke in their eyes. The most common thing people came in with was, 'My eyes are red, and they itch, and they hurt.' We had to say, 'Well, the good news is, nothing's wrong. The bad news is I can't do anything.'

"It was simple things we'd see a lot of the time, and we had to learn not to see things as we would here in the U.S. If someone comes in complaining about that kind of stuff here, you think very differently. Here in Lubbock, you wouldn't even think of needing to give people sunglasses to prevent damage."

During Scott's time there, her primary job was to check in the patients and take their blood pressure, find out their complaints and direct them to a physician based on her initial assessment of what might be wrong with them. She saw more than 300 patients a day.

"Here, you maybe shadow a doctor for five or six hours and go home, and then do it maybe once or twice a week, and you think, 'OK, this is new, this is fun,'" Scott said.
"The mission trip is exhausting every day, but it definitely gets you into the swing of things. It made me really excited about the hands-on, immediate gratification work a physician has. So, definitely, it can get you excited or give you a reality check, depending on what you need."

It also gave her perspective on how to make the biggest difference in the world.

A former CISER scholar poses with patients.

"We got into a debate about the master of public health (M.P.H.) viewpoint versus the doctor of medicine (M.D.) viewpoint," Scott said. "An M.D. would come into this town and see one person and say, 'OK, I want to help them every way I can, spend all my money and all my resources on this one person and get them the best care I can give them.' An M.P.H. would say, 'OK, or we can give a little bit to everybody.' I think that was one of those moments where I really had to grapple with that.

"You realize, 'OK, I can only give this person enough Tylenol for a week or one pair of glasses or this one tiny thing of eye drops, and they're going to need way more than that.' How do you deal with that?"

That realization helped Scott in her decision to attend graduate school rather than medical school – even after being accepted to study medicine.

"That's something I definitely was thinking about: should I spend all my time trying to make a very few number of patients or people as healthy as I can, or do I want to go into research or policy, something kind of higher level that effects change, maybe in smaller increments, but over a longer course of time?"

Scott went on to earn her bachelor's degree in biology in 2017 and her master's degree in biotechnology last month through the Center for Biotechnology & Genomics.

She said the experience helped her to focus on her purpose in life.

"Undergraduates can get very caught up in grade-point average and the Medical College Admission Test (MCAT), and everything they do just kind of becomes, 'Oh, I'm doing this to check off the box,'" Scott said. "When you shadow a doctor, anywhere, you get taken out of that. You confront the reality of being a doctor and what it actually means to be involved in someone's life in such a significant way.

"But when you can take it even further and get to a different country where you're completely removed from this idea of competition and 'I need to be the best student and have the highest MCAT score,' I think it can be very informative. This can really take you out of that mindset and refocus you: 'Why do I want to be here?'"

Julie Isom, associate director of research for CISER, said that's exactly why these medical mission trips are so important.

"When you turn students loose, you teach them real things: In the mission work, it's life and death; it's not just important research," she said.

DeLeon and Nafees pose in Guatemala.

"They are stressed, and it's hard, but instead of falling on the sword because, 'This is so hard,' they're happier. I think getting outside yourself and helping others, especially when you go to another country and you see how lucky we are here, there's less of that. And then, moving forward in that mindset, they feel more gratified about the work they do, even if it's a lot and it's stressful."

For Nafees, now a doctoral candidate in mathematical biology and a CISER graduate research scholar, the opportunity for service-based learning these trips present is the perfect pairing for a traditional education.

"The global leadership and educational experience that I, along with countless CISER scholars, have gained is unmatched, and if it weren't for CISER, I am unsure if it would be possible," Nafees said. "There's no better way for a Red Raider to complement their wonderful time at our university than to grow in unparalleled ways through such international educational opportunities."