February 02, 2017
By Joe Stumpe
|Drs. Oliver Schmidt and Robert Freelove, during a visit to the Smoky Hill Family Medicine Clinic.|
He's a member of the first family of family medicine in Paraguay, but Dr. Oliver Schmidt has roots in Kansas, too.
Schmidt's grandfather, Dr. John Schmidt, practiced in Newton before moving to Paraguay in the 1950s as a missionary doctor treating leprosy. Oliver's father, Dr. Wes Schmidt, who spent his first five years in Newton, was Paraguay's first residency-trained family physician and later established the country's first residency in that specialty.
And before Oliver entered medical school in Paraguay, his parents sent him to Newton to work on a relative's farm for a year, raising pigs and wheat.
"That was a neat experience," he said, smiling at the memory.
Today, the 38-year-old Schmidt is forging his own path, as one of the few family physicians in Paraguay's sparsely populated western half, a region called Chaco. He visited the KU School of Medicine-Wichita's Department of Family and Community Medicine in December as part of the long-running Kansas Paraguay Partners Physician Faculty Exchange Program. Schmidt teaches part-time at a nursing school in the Chaco region, and he hopes someday to start a family medicine residency at the Yalve Sango Hospital, where he is the only full-time physician.
Schmidt said there's still a huge need for family physicians in Paraguay, despite the growth of the specialty in recent years. Currently, he said, there are about 200 family physicians in the country, most working in government clinics. Ideally, those clinics would be staffed by a physician, two nurses, and two or three medical technicians. However, there are another 550 or so clinics without full-time physicians, and the nation's population of 6.8 million means there should be at least a couple thousand more clinics.
The 12-bed hospital where Schmidt works serves a population of about 12,000 people, he said. Schmidt described Chaco as a hot and windy place without good supplies of safe water, which contributes to gastrointestinal diseases that are probably the region's biggest health issue. The region is known for its cattle industry, developed by European and American immigrants, including several large colonies of Mennonites totaling about 30,000 people. Many of the native men work in the cattle business. Only a few decades removed from life as hunter-gatherers, many of the natives do not use last names, know their age or have the same concept of time as the immigrants, Schmidt said.
Tuberculosis, chagas and sexually transmitted diseases - though not AIDS - are other common problems among the natives that Schmidt's hospital serves. The hospital also has a five-bed delivery area.
"If there's something we can't do, we send them to the Mennonites' two hospitals," which are larger and primarily serve residents of the colonies.
Schmidt said he grew up dreaming of practicing medicine in a place where he'd need a four-wheel drive vehicle to get around. "That's exactly what I'm doing now," he said.
But he knows that Chaco is a tough sell for many residents and physicians, joking that the chief diversion is the practice - by both natives of immigrants - of sharing a cold tea-like drink called Terere.
"Chaco is one of those places you either love or hate," he said.
After several days observing KUSM-W's residency program, rural rotations and other programs, Schmidt said he was impressed by the "very different" style used here compared to Paraguay. "Here, it's more problem-based, more interactive" while in Paraguay medical students and residents tend to "sit in class and listen to a teacher."
"I see faculty as committed here," he said, shown by things as simple as knowing residents by their first names.
Schmidt has already had a varied career. After completing his medical degree, residency and internship in Asunción, Paraguay's capitol, he worked for hospitals and clinics serving natives for several years. From 2014-15, he lived in Portland, Oregon, with his wife, Anna, an environmental engineer, while she studied on a Fulbright Scholarship. While there he worked as a youth care worker for juvenile detainees from Central and South America who'd been caught trying to bring drugs into the United States.
The Schmidts returned to Paraguay in the fall of 2015. They have a daughter, Melissa, who's 13 months old. He and his siblings purchased adjacent lots in the same colony. "It's a very Latin arrangement," he said.
His father works for Paraguay's Ministry of Health, while his mother, Esther Martinez, who's also a physician, still practices at a public hospital, focusing on the care of diabetes.
Schmidt noted that the KU School of Medicine-Wichita has played a significant role in the development of family medicine in Paraguay, with KU faculty and students visiting on a regular basis as part of the exchange program, which dates to the Kennedy administration.
"It's just covering their needs," Schmidt said of caring for native Paraguayans. His goal is to "feel useful."KU School of Medicine-Wichita