“That was one of the things that drew me to Quillen – knowing the school was excelling at reaching unreached areas and at training doctors in primary care fields,” says Pfister, who went through the rural primary care track at Quillen. “As a student, I was in Mountain City and those experiences were very helpful in training me and giving me independence early on.”
Through the rural track, Pfister also spent two months in Kenya before completing her pediatrics and internal medicine residency in Birmingham, Alabama. In 2009, after her residency, Pfister returned to Kenya for two years to work at a hospital there, an experience she lovingly calls her “international fellowship.”
“Even though there were limited resources and I was seeing patients die, I really enjoyed the work and it affirmed that God had given me a passion to serve others and to teach,” she says. “Our team really developed a vision for medical education in the underserved setting, for training competent and compassionate physicians who will really transform their communities.”pfister
Pfister and her colleagues set their sights on an even more underserved area – Burundi, a country in sub-Saharan Africa that is often referred to as the hungriest and poorest country in the world. Sandwiched between Congo and Tanzania, it is a country of 12 million people with just three doctors per 100,000 Burundians.
“That is one of the lowest ratios in the world. That’s why education is a huge part of what myself and my team are doing over there,” Pfister says. “We’re training Burundian doctors and other African physicians from the region because they’re going to be the ones to really make a difference. African students who understand the culture and language so much better than us will always do much more than we ever could.”
After first spending a year in France to learn to speak French (Burundi is a French-speaking country) and studying tropical medicine, Pfister and five colleagues arrived in Burundi in 2013. For the past four years, Pfister has served alongside her team – now three times its original size – as the director of pediatrics at Kibuye, a rural teaching hospital for Hope Africa University.
“We are the only center that has a pediatrician outside of the capital city and we are about three hours from the capital so any complicated patient is going to come to us,” Pfister says. “The most common diseases we see are malaria and then malnutrition. Often times, those two are combined. We also see sickle cell disease, meningitis, pneumonia, bronchiolitis and a lot of pre-term babies.”pfister
In addition to treating patients, Pfister and her colleagues train African medical students who, she hopes, will transform their nation through the education they receive not only throughout medical school but after as well.
“Right now there are no residency programs in Burundi, so if a doctor finishes medical school and wants to go on for more training, he or she has to go elsewhere. And most of the time, if they go elsewhere, they are not going to come back to Burundi,” Pfister says. “But when we bring specialist doctors to Burundi to do training programs, then the new doctors are trained using the resources available to them in a setting they are familiar with and can really do a lot of good.”
Resources available to them are extremely limited.
“We may have one medication for a given illness versus the 10 or 12 you’d have in the United States. For our incubators for our tiny preemies, we’ve had to make them ourselves with wood and Plexiglas, lightbulbs and other local materials,” Pfister explains. “We have huge infrastructure challenges as well. We have as little as two hours of grid power a day so keeping babies warm, keeping oxygen concentrators running, getting lab results, getting surgeries done, all of that is made complicated by the challenges with power. And when we don’t have power, the pump can’t get water from the well either so we end up with water limitations, too.”
Still, she says, it is amazing how much can be done for patients with so little. Pfister and her team have developed a 20-year master plan for the hospital in hopes of improving infrastructure to some degree.pfister
“The hardest thing for me is when patients die from what I see as a preventable illness even in Burundi. I recently had one of my favorite little patients with sickle cell disease die. He was four years old and I’d been treating him for several years,” Pfister says. “He was taking all of his medications he needed to help prevent illnesses and infections but he came in with acute chest syndrome, which happens with sickle cell. He really just needed two, three days with oxygen, antibiotics and fluids, and then he was going to be on his way. But that night, the power went out again and he died because he wasn’t getting the oxygen he needed.
“Those are the hard cases, the ones where you know just a little bit of infrastructure would have made a difference.”
Despite witnessing such disparities, or perhaps because of them, Pfister says she is thankful to get to do this kind of work.
“I really enjoy my work. It is meaningful and fulfilling,” she says. “I get to see lightbulbs go off in students as they catch on to a concept for the first time. I see kids who are at death’s door from malaria or meningitis recover within a day or two, running around the room, happy and playing with a future ahead of them.”