Grant Wandling had never left the U.S. before an April trip that had him sleeping in hammocks, making due with no running water and providing medical care to the indigenous Ngabe people of Panama.

He was one of 20 first-year medical students at Penn State College of Medicine who completed their primary care preceptorship on the remote islands of Panama’s Bocas del Toro province. Drs. Bill and Eileen Hennrikus, both professors at the College of Medicine, led the 10-day trip with eight other professors.

“It really reminds you that there are people outside of the United States who are in great need of treatment,” Wandling said. “We not only saw a lot of medical problems, we also saw another culture.”

The Hennrikus couple began leading the Panama trips seven years ago when students requested it so they could gain experience in international health without committing to Penn State College of Medicine’s four-year global health curriculum. It has grown into an accredited medical school course.

Eileen Hennrikus said the preceptorship is one of the first times medical students can get out of the classroom and practice what they have been learning for the past year.

“It’s very hands-on,” she said. “We really need the medical students to help manage the patients because we don’t have nurses and medical assistants. The students are involved from beginning to end: taking histories and blood pressures, performing physical exams and lab studies, and finally discussing diagnoses and care plan. They then help in pharmacy and in patient education.”

This year, the group traveled with the Floating Doctors organization, which uses motor boats to reach remote regions and provide care. Each morning, groups of the students would ride to different islands and set up free clinics near schools.

“We go way out where health care isn’t available,” Eileen Hennrikus said. “The country has an excellent medical system and medical care, but there are isolated places with small populations where it’s geographically difficult to provide access.”

Wandling saw firsthand how the lack of a working sewer system or running water can cause medical conditions such as pinworm infestations and dehydration. “The people are living in 95-degree heat and high humidity with limited water supply,” he said. “Many of the patients we saw had low blood pressure and high heart rates because of it.”