patients upon arrival, assisting during
the procedure, monitoring patients after the procedure, cleaning the instruments, and setting up the room for the
My experience in Zambia strengthened
my interest in pursuing a career in global
health, focused on teaching and providing patient care in sub-Saharan Africa.
With the increase in noncommunicable
diseases (NCDs) such as cancers, there is
a need for subspecialists such as a gastroenterologist with advanced endoscopic skills. This increase in NCDs has been
attributed to heightened rates of physical
inactivity, urbanization, and unhealthy
dietary habits. Practitioners in our field
have to understand and look beyond
communicable diseases as the predominant cause of mortality and morbidity
in Africa as well as accept the necessary
role of gastroenterologists and endoscopy in patient care.
I chose Zambia as a site for research because it is my home and my
career intentions are to have a joint
appointment both in the United States
and Zambia that allows me to remain
engaged in gastroenterology. I have
maintained contact with some of my
collaborators and plan more joint work
in the future. I also plan to return to
Zambia to conduct research analyzing
pancreatic cancer by using the Cancer
Disease Hospital database.
My recommendation to medical students, residents, and fellows interested
in global health is to take the opportunity while in training. Opportunities
do not end as a trainee but carry on
throughout one’s career. But perhaps
most importantly, I was finally home
with my family and making a positive
impact on patient care.
I thank my mentors and supervi-
sors for their guidance and support in
making this an exciting and productive
experience: Fogarty (Dr. Sten Vermund,
Dr. Douglas Heimberger), Washington
University in St. Louis (Dr. Nicholas
Davidson, Dr. Prakash Gyawali, and
Dr. Deborah Rubin), and Dr. Paul Kelly.
I thank the Zambian physicians with
whom I worked on this project and
look forward to continued collaborative opportunities. n
1. Asombang A. W., et al. Med. J. Zambia
2. Asombang A. W., et al. Gastrointest. Endosc.
3. Kayamba V., et al. S. Afr. Med. J. 2013;103:255-9.
4. Asombang A., et al. Am. J. Clin. Nutr.
5. Asombang A., et al. Am. J. Gastroenterol.
6. Asombang A. W., et al. World J. Gastroenterol.
ANSWERS // From page 21
QI: ANSWER: B
Constipation occurs in up to 39% of patients who undergo
gastric banding. Diarrhea occurs in 46% of patients after
Roux-en-Y gastric bypass and in 55% of patients after biliopancreatic diversion. Neither vertical-banded gastroplasty nor sleeve gastrectomy is associated with a significant
change in bowel habits.
1. Potoczna N., et al. Obes. Surg. 2008;18:1287.
Q2: ANSWER: B
Zinc deficiency can occur with short gut syndrome due to
malabsorption. It is characterized by alopecia, loss of taste,
poor wound healing, and scaly rash similar to acroderma-titis enteropathica, which can be seen among patients who
have an autosomal recessive disorder of zinc metabolism.
1. Buchman A.L., et al. Gastroenterology 2003;124:1111-34.