Improving Access to Dermatologic Care in Costa Rica

For Karen Stolman, MD the motivation to complete her first global health volunteer assignment came from falling in love.

“It started with falling in love with the country of Costa Rica, and having already visited and being fluent in Spanish,” she recalled during a recent interview.

Dr. Stolman, a practicing dermatologist since 2001, recognized the need to improve the quality and availability of specialty health care services in Costa Rica over the course of several family vacations spent in the country.

“After visiting the country for many years just on vacation, I looked into volunteer medical opportunities, and that is how I found HVO.”

Dr. Stolman learned about HVO while searching on the American Academy of Dermatology (AAD) website for volunteer opportunities in Spanish-speaking countries. AAD is a sponsor of HVO’s dermatology program, and supports project sites in Cambodia, Costa Rica, Nepal, Uganda and Vietnam. Dr. Stolman completed her first volunteer assignment in 2016, teaching in the Department of Dermatology at the University of Costa Rica. She returned the following year to assist with a pop-up clinic in an underserved rural community, where access to care was largely limited to primary health services.

The opportunity to participate in the pop-up clinic, which was organized through the country’s public health care system, arose as a result of the sustained relationships Dr. Stolman built with her Costa Rican colleagues during her first assignment. After completing this initial assignment, Dr. Stolman remained in touch with Benjamin Hidalgo-Matlock, MD—the on-site coordinator for HVO’s dermatology training project at the University of Costa Rica.

“He is still a friend of mine who I talk to regularly, and we keep in touch so I can continue my volunteer work.”

She also keeps in touch with many of the residents she trained while volunteering at the University of Costa Rica. It is through these connections that she learned of the pop-up clinics and was able to participate in a clinic in September 2017. During the clinic, Dr. Stolman worked closely with a team of Costa Rican dermatologists, residents, nurses and assistants to provide care to more than 1,450 dermatology patients. In addition to treating patients, Dr. Stolman helped teach the accompanying residents by discussing patient symptoms and diagnoses with them.

Dr. Stolman also benefitted from the opportunity to improve her medical Spanish, and observe how her colleagues treated various skin conditions with limited access to resources.

“I learned what their limitations were, what medications they could and couldn’t provide, and what tests they could do in that situation.”

Dr. Stolman added that her increased proficiency in medical Spanish as a result of her 2017 assignment enhanced her ability to serve as a resource to Spanish-speaking patients at the University of Utah—where she practices and teaches. She now sees the majority of Spanish-speaking patients there. She also serves a resource to colleagues interested in volunteering internationally to improve global health.

“As I get the word out that I did this, and this opportunity is there, and how fulfilling it is, I have become a resource for this opportunity.”

Dr. Stolman encourages any interested colleague to consider completing an assignment in Costa Rica, regardless of whether they speak Spanish fluently. While her Spanish skills were necessary to assist with the pop-up clinic, lectures at the University of Costa Rica are conducted in English.
“The younger generation of Costa Ricans all learn English in school, so a lot of the younger generation of doctors are fluent in English,” she explained.

And there is a tremendous need for volunteer educators at the University, particularly for individuals specializing in Mohs surgery, who can build on the dermatopathology program already in place. Dr. Stolman learned of this need through conversations with her Costa Rican colleagues, and is working to identify a Mohs surgeon at the University of Utah who can travel to San Jose to teach for a week or more.

By teaching residents and supporting the staff at the University of Costa Rica, volunteers help build the capacity of the local dermatology workforce. This benefits patients, not only in the capital city of San Jose, but in the rural communities served by pop-up clinics and through the country’s burgeoning telemedicine program. Volunteers like Dr. Stolman contribute to a legacy of care that leads to more patients served and more lives transformed through access to needed dermatologic services.

“It is hard to explain why you get that urge to volunteer,” Dr. Stolman reflected. “You just know in your heart it is the right thing to do when you see that need and feel that push … I think some of the most important things in life are to interact with other people, and help other people, and put a smile on someone else’s face.”

Want to join Dr. Stolman and others in their efforts to improve the quality and availability of dermatologic care across the globe? View our current volunteer opportunities in dermatology.

Not a dermatologist? Use our project finder to identify the volunteer opportunity that is right for you, or make a gift to support our mission to transform lives and empower health workers through education and professional development opportunities.

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