My great-great-grandfather, Dr. José María Lombana Barreneche, is considered to be the father of Colombian internal medicine because he pioneered research and treatment methods in his field (D’Achiardi 43). Graduating from medical school at the age of twenty, Dr. José María Lombana Barreneche was an internal medicine physician and researcher (D’Achiardi 44). Before the time that infectious disease was deemed a subspecialty of internal medicine, my great-great-grandfather conducted research on the infectious disease known as typhoid fever and founded methods of preventing it (D’Achiardi 44). I aspire to become an infectious disease physician because microbiology fascinates me, and it would be an honor to carry on my great-great-grandfather’s legacy. I never was able to meet my great-great-grandfather, as I was born years after he died, but I feel that I will become closer to him through my studies and endeavors and I intend to carry on the legacy of great physicians with the last name “Lombana.”
“Infectious disease” is a medical specialty that studies pathogens such as viruses and other microorganisms that cause disease by infection. Through the advancement of research on infectious viruses, Colombian physicians could better treat and prevent the diseases caused by these viruses. One way Colombian physician scientists could advance their research is by seeking opportunities to do collaborative research with developed countries, such as the United States and France. The Colombian government should assist their physician scientists in virus prevention by providing more accessible methods of using molecular diagnostics and research to detect infection. In addition to decreasing the frequency of viral infections in Colombia, the advancement of medical research would help the healthcare of Colombia as a whole.
D’Achiardi states that around 1950, after a period of contemporary medicine, there was progressive change from Colombia’s medical knowledge and methods to ones similar to medical schools in the United States and France (43-44). This means that Colombia caught up with the United States and France in terms of the prevention and management of internal diseases that are not necessarily infectious. The nature of infectious disease prevention is that the specialists will study certain types of disease-causing viruses or pathogens, and then develop ways they can help prevent infection (D’Achiardi 43). The specialists in a particular region study pathogens that are in their respective regions, meaning that the pathogens that cause disease in Colombia do not necessarily prevail in the United States and France. Colombia’s earlier period of medicine was beneficial for the broad field of internal medicine, but the narrower subspecialty of infectious disease was left behind (D’Achiardi 44).
Ignoring infectious disease has been detrimental, and Colombia needs to adopt methods of early detection. According to Jorge Enrique Gomez Marin, “outbreaks of coronavirus, H7N9, enterovirus and whooping cough urge their field to have time for analysis, reflection and joint proposal of academic, government and providers of health services sectors, on the subject of epidemiological surveillance for infectious diseases” (1). Marin also states that Colombia must train their physicians, researchers, and lab technicians on how to use efficient monitoring systems and methods of detection, such as molecular tests, in order to prevent viral infection. Control of infectious viruses must be addressed as a public health priority over financial and administrative matters. Molecular tests, used to diagnose and identify viruses, are necessary tools for researchers because smear microscopy cannot detect viruses due to their submicroscopic size. The frequency of certain viral infections is contingent upon how well the disease is prevented and treated. If physicians are able to detect contagious viral pathogens earlier, then the patient can be quarantined sooner in order to prevent the spread of the virus. Virology is not solely focused on the pathology of viruses, but also the public health and epidemiology of them (Marin 1). To decrease the frequency of a viral infection, researchers must develop methods to prevent the spread of the virus. Molecular tests can be used to detect where a virus is at a particular time and, with that information, researchers will be able to understand how the virus spreads. Once the method in which a virus spreads is understood, researchers can develop methods of inhibiting them (Marin 1).
Once these methods are developed, the discoveries must be shared. According to Julian Ruiz-Saenz and Marlen Martinez-Gutierrez, medical education is a life-long process, as new discoveries are made regularly. In order for physicians to improve upon their ability to diagnose and treat ailments, they must remain up to date on the current trends in their field of specialty. Medical journals are an integral part of the process of relaying information discovered to other healthcare providers throughout the world. When physician scientists conduct research, they make careful notes of what they observe, and upon concluding their experiments, they publish an article in a medical journal outlining their research and findings. Medical journals benefit physicians and researchers around the world through the spread of research (Ruiz-Saenz and Martinez-Gutierrez 1226-1227).
There is an uneven balance in the output of virology research publications throughout the world. Julian Ruiz-Saenz and Marlen Martinez-Gutierrez conducted a bibliometric analysis in which they analyzed the output of indexed journals on virology in Colombia from the years 2000-2013. They discovered that the amount of research on virology in Colombia has increased from 2000-2013. The uneven balance in the world’s virology research can be seen in the “past bibliometric analyses that have shown that research in microbiology and virology are concentrated in developed areas (United States and Western Europe), which have produced the majority of the world’s virology research in terms of both quantity and quality of information” (Ruiz-Saenz and Martinez-Gutierrez 1226). Ruiz-Saenz and Martinez-Gutierrez further observed that most of the publications with an elevated quality index from Colombia were made in collaboration with developed countries. Collaboration between countries is necessary because it helps all of the countries involved gain knowledge about their topic of research (Ruiz-Saenz and Martinez-Gutierrez 1227).
The quality of research is crucial to the advanced treatment of viral infections. Ruiz-Saenz and Martinez-Gutierrez suggest that Colombian scientists could obtain better publicity from publishing their articles in collaboration with scientists from developed countries such as the United States and France since the research would then be considered more credible. As a result, when in collaboration with other countries, the articles may become published in more well-known journals such as the New England Journal of Medicine (Ruiz-Saenz and Martinez-Gutierrez 1235). Because developed countries have increased sharing their virology journals over the last decade, Colombia has benefitted in terms of reducing costs of technology transfer, communication, and quality of research (Ruiz-Saenz and Martinez-Gutierrez 1227). I agree with Ruiz-Saenz and Martinez-Gutierrez: in order for Colombia’s healthcare to improve as a whole, Colombia needs to emphasize doing research in collaboration with developed countries. In order for the physicians and scientists to conduct collaborative research, the government needs to understand the priority of healthcare research and assist with the necessary funding (Ruiz-Saenz and Martinez-Gutierrez 1235-1236).
Currently, Colombia’s government is standing in the way of development. Infectious disease specialist and malaria researcher, Dr. Manuel Elkin Patarroyo, discussing the future of combatting infectious disease in Colombia, says that “the problem is a war of interests” (Patarroyo 2014). Dr. Patarroyo faces “great opposition to his studies” because the government would prefer not to spend money on research that is already heavily invested in other parts of the world (Patarroyo 2014). For example, he would like to receive a federal grant for his research because he is able to synthesize chemical vaccines which can be produced at a low cost and very high efficacy (Patarroyo 2014). The World Health Organization says that the number of deaths resulting from vaccinable diseases is nearly 17,000,000 per year (Patarroyo 2014). This data demonstrates that the benefits of vaccines far outweigh the costs, and the Colombian government should acknowledge this and support the associated research.
Colombia is located in a region where many viral infections are prevalent. For this reason, advancing their virology research would provide a tremendous opportunity for Colombia to become heavily involved with the world leaders in epidemiology and virology research. With that in mind, Colombia could use the virology research as an investment in order to improve their healthcare as a whole. The gap in the quality of care experienced in Colombia, as discussed by Garcia-Subirats, et al., could be improved by advancing their virology research.
Collaboration with developed countries has provided Colombia with the opportunity to advance their medical education and research. Healthcare in Colombia is challenged by the prevalence of these viral infections, and the steps they need to take to prevent them will also provide the opportunity to improve their healthcare as a whole. The Colombian Association of Internal Medicine’s goal has always been to encourage the transfer of knowledge through the presentation of scientific papers and publications in research journals (D’Achiardi 47). According to Zea, Dr. José María Lombana Barreneche’s research on typhoid fever was crucial because, for the first time, physicians were able to diagnose typhoid fever through seriodiagnosis and blood cultures (Zea 2011). The research conducted by Dr. Lombana Barreneche should serve as a roadmap for the future of virology research in Colombia, with intentions of reforming their healthcare system to include virology research as a priority. I hope to one day travel to Colombia so that I can work with infectious disease specialists in Colombia to do collaborative research on topics similar to those of my great-great-grandfather.
D’Achiardi, Roberto. “Internal Medicine in Colombia Relevance of the Colombian Association of Internal Medicine.” Acta Medica Colombiana 34.1 (2009): 42-47. Web. 14 November 2016.
Garcia-Subirats, Irene, et al. “Barriers In Access to Healthcare in Countries with Different Health Systems: A Cross-Sectional Study in Municipalities of Central Colombia and North-Eastern Brazil.” Social Science & Medicine 106 (2014): 204-213. Web. 21 November 2016.
Gomez Marin, Jorge Enrique. “On the Need to Modernize the Epidemiological Surveillance and to Expand the Use of Molecular Diagnostics for Infectious Diseases in Colombia.” Colombian Association of Infectology 18.3 (2014): 77-78. Web. 14 November 2016.
Patarroyo, Dr. Manuel Elkin. “An interview with Colombian malaria researcher Manuel E. Patarroyo.” LatinAmericanScience.org, June 2014. Web. 18 November 2016.
Ruiz-Saenz, Julian and Marlen Martinez-Gutierrez. “Virology Research in a Latin American Developing Country: a Bibliometric Analysis of Virology in Colombia (2000–2013).” Journal of Infection in Developing Countries 9.11 (2015): 1226-1238. Web. 14 November 2016.
Zea, Francisco Adolfo. “Doctor José María Lombana Barreneche.” Encolombia (2011): Web. 28 November 2016.