In the fourth edition in our “Faces Behind LUMC Global” series, Dr. Jogchum Beltman, a gynecologist-oncologist at LUMC brings us back to the early days of his career as a tropical doctor in Malawi and his current work as a medical specialist. A story about his experiences and the challenges he faced in this exciting field.
Initially trained as a tropical doctor, nowadays called ‘doctor of international health and tropical medicine’, Jogchum Beltman worked in Malawi, one of the poorest countries in the world. What he saw in hospitals there would leave lots of people in awe. A situation different from what we are used to here: an overcrowded hospital, with too many patients and not enough medical staff, leading to people not having access to care, being underserved and, ultimately, deaths. To be able to work under these difficult circumstances it is crucial to be flexible. As Jogchum mentions: “You must have a large dose of flexibility, especially when working in a place like Malawi.” With his wife, who is also a medical doctor, he was responsible for a 400-bed hospital with no other doctors around. Confronting language barriers, learning local health care politics, and getting used to all the different impressions took time. Therefore, it was crucial to remain humble and learn as much as possible from local staff. Paramount in those situations is avoiding the so-called ‘white savior complex’ Jogchum states. Earning people’s trust was their first goal.
Mothers as the cornerstones of society
What struck him most during his time there was the number of mothers who died, often with grave consequences for their families as a result. The role mothers play often is a crucial one, since most of the time all children depend on them. The absence of a mother often leaves the kids to fetch for themselves, making the mother “the cornerstone of society”, Jogchum says. Curious to learn the cause of these high numbers of maternal deaths, he realized mothers needed more than only improved clinical care. Often, transportation to hospitals was lacking or women did not realize they needed help in time. As a medical doctor, tackling those causes that have their origin outside of the hospital is extremely complicated. One of the best tools he had, however, was education. It was their hope, through teaching and creating awareness, to have a lasting structural impact. After all, at some point, you are bound to leave and return home.
For him and his wife this moment came after about two years. Here, he continued his training as a gynecologist in Leiden. He enjoys his time in academia since it provides him with the chance to spend time teaching and conducting research in addition to being a clinician. Even though his time as a tropical doctor is now behind him, internationalization still plays a key role in his current work. As being away from home for longer periods of time gets more complicated once one gets a family, his attention shifted to conducting research. Nowadays, he mostly supervises international Ph.D. students and colleagues who live in low and middle-income countries like Uganda or Bangladesh. Together with his colleague Thomas van den Akker, who was interviewed in this series before, he is also responsible for lecturing in the half-minor Global Health.
Idealism, adventurism, and professionalism
Growing up in Indonesia has made him feel comfortable in an international environment. Also, during his time studying medicine in Belgium, he realized: working abroad was the right fit. When asked what in the end brought him all the way to Malawi, he firmly answers: “Idealism, adventurism, and professionalism – those were the three things that led me to Malawi.” Talking about LUMCs’ help in internationalization, he admits there are some aspects that can be improved. There is a need to connect all departments within LUMC in a more efficient manner, to bundle all knowledge available collectively to share, but also to make sure that LUMC can benefit more from experiences and research done in LMICs. Luckily, this is exactly where LUMC Global comes in: by combining all in-house and external expertise, the creation of multidisciplinary teams can be created, ultimately improving maternal care, research, and education.
