The Call to Serve and Heart to Teach

Cure Hospital is fortunate to have Josette McMichael, MD, MPH, a dermatologist from Virginia on their teaching team.  Following is an interview with this amazing woman who shares her knowledge and insights to help improve the health of the people of Afghanistan.

How do you know about Cure Hospital and what was the driving force that brought you to Kabul?

In early 2001, my husband and I were called to international service and moved to Kabul. At that time, the Afghan government requested expatriate female physicians to provide medical care and training due to the limited female healthcare workforce. My husband, a pilot, worked for an aviation organization providing flight services to remote areas of Afghanistan, while I served as a family medicine doctor. From 2010 to 2013, we returned to the U.S. for my second residency in dermatology. Though dermatology is now my specialty, my heart remains with family medicine, which is why I am drawn to Cure Hospital’s family medicine program.

In 2012, we founded DermAlive (https://dermalive.org/), a non-profit dedicated to developing dermatologic care through strategic training opportunities and resources for healthcare professionals in underserved communities. Our mission is to educate healthcare workers in Afghanistan in basic clinical dermatology, aiming to increase access to quality dermatologic care and skin health education in the country.

Upon our return to Kabul from 2013 to 2017, I volunteered as faculty in the dermatology training program at Maiwand Teaching Hospital. I also worked with Cure Hospital once or twice a month, teaching a dermatology curriculum to the family medicine department and seeing challenging dermatology patients with their faculty and trainees. Given the high prevalence of skin diseases in primary care, Cure Hospital’s physicians have always been eager to advance their dermatologic knowledge, and they have kindly welcomed my participation in their training over the years. We’ve also fostered a collaboration between dermatologists at Maiwand and the pathology department at Cure Hospital who have provided expert interpretation of skin biopsies from complex cases.

Since leaving Kabul in 2017, we have continued to collaborate with Cure Hospital physicians via teledermatology for challenging cases.

You continue to return to the Cure Hospital.  What keeps bringing you back?

People!  The faculty, trainees, staff, and patients. I have interacted primarily with physicians, but it is also other staff who draw me back including lab techs, nurses, and security staff who have been friendly, kind, hospitable, and professional in all my observations and interactions with everyone.

What were the topics you taught in your most recent visit to Afghanistan? 

The topics covered included:

• Infectious Skin Diseases (a two-part lecture on bacterial, fungal, viral, and parasitic skin infections in Afghanistan)
• Top 10 Dermatology Diagnoses (a two-part lecture on the most common non-infectious skin diseases encountered by primary care providers in Afghanistan)
• Cutaneous Manifestations of Nutritional Deficiencies
• How to Use the Hyfrecator (an electrocautery device), including a demonstration
• An introduction to accessing dermatology education resources such as VisualDx and our new “Clinical Guidelines for Skin Diseases and Skin Health in Afghanistan: For primary healthcare professionals,” available on our website, DermAlive.org., in English, Dari, and Pashto.