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Responding to Typhoon Haiyan

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A rural health unit damaged by typhoon Yolanda.

 

By Shawn D’Andrea, MD
Attending Physician, BWH Emergency Medicine

The week before Thanksgiving, the disaster medicine section of the American College of Emergency Physicians(ACEP) circulated a request for physicians to participate in ongoing humanitarian relief operations in the Philippines in response to  typhoon Haiyan, also known as typhoon Yolanda. On Nov. 27, I arrived at Roxas City on the island of Panay, Philippines, to join a small group of physicians and nurses with a non-government organization engaged in relief efforts.

The group that had sent the request through ACEP, Remote Area Medical (RAM) is a small, all volunteer U.S. medical non-government organization which has functioned in several disaster settings and defines itself as an organization able to access and function in difficult-to-reach and austere settings.  Following typhoon Yolanda, the group partnered with the Philippine Red Cross and later a regional health department on Panay island to support medical needs in the relief effort.  When I arrived shortly before Thanksgiving, RAM, coordinating with the regional health department and other relief organizations, was performing daily missions to the rural areas of Panay island to provide direct medical care to patients in areas affected by the storm. While the regional health department has an extensive network of local health offices and clinics, the storm left the health infrastructure severely damaged.  The role of medical relief organizations, under the direction of the regional health authority, was to assess the health needs of communities following the disaster,  provide direct patient care during relief and recover phases of the disaster, and to provide ongoing disease surveillance. Continue reading “Responding to Typhoon Haiyan”

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Global Health Summit Offers Insight, Inspiration

BRIGHAM AND WOMEN'S HOSPITAL AND HARVARD MEDICAL SCHOOL HOST THE GLOBAL HEALTH SUMMIT MONDAY AFTERNOON
From left, Paul Farmer, Atul Gawande and Nawal Nour share a laugh during the keynote panel at the Global Health Summit.

Through the stories and insights shared during the Nov. 25 Global Health Summit, attendees were transported to war-torn Somalia, the mountains of Rwanda and back home again.

Throughout the afternoon, they heard Andrew Ellner, MD, MSc, of BWH’s Division of Global Health Equity, demonstrate the need for an overhaul of the American health care system and Michael VanRooyen, MD, MPH, FACEP, of BWH’s Department of Emergency Medicine, share his personal insights into training the next generation of humanitarian workers.

Attendees listened intently as BWH associate physician Ashish Jha, MD, MPH, asked the poignant question about preventable health care costs: “How is it safe to fly a 30-year-old plane but not use a 6-year-old CT scanner?”

Hosted by BWH, Harvard Medical School (HMS) and Harvard School of Public Health (HSPH), the Global Health Summit—a BluePrint-themed event—provided a thought-provoking inside look at the important work being done in the global health arena. Special guests and BWH, HMS and HSPH leaders and staff came together in the Joseph B. Martin Conference Center at HMS to learn lessons straight from the field from expert physicians, patients and donors in three panels.

“What makes global health work successful is partnership,” said BWH President Betsy Nabel, MD, who provided an introduction and closing for the event’s last panel. “The ability to connect and work together is essential.”

Robert Riviello, MD, MPH, and Daniel Ponton discuss stories from the field in Rwanda.
Robert Riviello, MD, MPH, and Daniel Ponton discuss stories from the field in Rwanda.

In one panel, BWH surgeon Robert Riviello, MD, MPH, of the Division of Trauma, Burns and Surgical Critical Care, shared his inspiration for getting involved in global health work: his Christian faith and growing up reading stories of saints and missionaries.

“That dedication, resilience and effectiveness struck me as, ‘This is ‘good with a capital G’ work – work you would want to spend your life doing,’” he said.

Joining Riviello on the panel was philanthropist and former BWH patient Dan Ponton, who spoke about his partnership with Riviello to build much-needed housing for doctors in Rwanda. Ponton, who was successfully treated at BWH for a life-threatening brain tumor, saw how the housing shortage made it difficult to attract and retain qualified medical staff. His foundation—the Daniel E. Ponton Fund at Brigham and Women’s Hospital—subsequently funded and built the Butaro Doctors’ Housing project.

During the panel, Ponton shared the inspiring message that “it doesn’t always take a doctor to solve a health care problem.”

In the event’s final panel, WBUR “Here & Now” co-host Robin Young spoke with global health luminaries Paul Farmer, MD, PhD, Atul Gawande, MD, MPH, and Nawal Nour, MD, MPH, in what resembled a personal living room conversation among friends.

After providing introductions of each other, the three panelists answered Young’s thoughtful questions, sharing everything from their inspirations to formative moments in their lives and careers—including Farmer’s admission that working in Haiti was his “Plan B.” Plan A was working in West Africa.

Gawande, a self-described “professional dilettante,” or dabbler, said that he has always been interested in change and why it seems so hard. He sees his research and writing as ways to “work through the puzzles and try to solve problems.”

He later summed up the spirit of BWH by saying: “If you’re not leading by making a difference, then you’re not fulfilling the mission of this place.”

Nour discussed her work with the African Women’s Health Center at BWH, which she founded in 1999, and the nuances and complexities of the beliefs held by her patients, many of whom have experienced female genital cutting.

Of the media’s flashing interest and coverage of women’s and children’s health issues, Nour said: “If we could sustain that interest and funding, we could make changes systematically. If more people looked at health issues through a gender-based lens, we could make great improvements.”

View a photo gallery from the event.

Watch webcasts of the panel discussions:
“The Global Health Experience: What We Can Learn”
Introduction and moderation: Jeffrey Flier, MD
Panelists: Andrew Ellner, MD, MSc, Ashish K. Jha, MD, MPH, Michael VanRooyen, MD, MPH, FACEP

“Making Global Health Happen”
Introduction and moderation: Julio Frenk, MD, PhD, MPH
Panelists: J. Christopher Flowers, Dyann Wirth, PhD, Daniel E. Ponton, Robert Riviello, MD, MPH

“To Alleviate Human Suffering: Our Work to Strengthen Global Healthcare”
Introduction: Elizabeth G. Nabel, MD
Moderation: Robin Young
Panelists: Paul Farmer, MD, PhD, Atul Gawande, MD, MPH, Nawal Nour, MD, MPH
Closing: Elizabeth G. Nabel, MD

 

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How Rwanda is Redefining HIV Care

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Neil Gupta, MD, MPH, during his graduation from BWH’s Division of Global Health Equity Doris and Howard Hiatt Global Health Residency Program. Photo by Justin Knight.

In recognition of Dec. 1 as World AIDS Day, BWH physician Neil Gupta, MD, MPH, contributed a compelling op-ed piece to The Atlantic on HIV treatment in Rwanda. Gupta, the deputy clinical director for Partners In Health in Rwanda, has witnessed the success of Rwanda’s approach to HIV care and treatment, and the impact it has had on the lives of Rwandans.

He writes: “In Rwanda, where just 20 years ago a genocide claimed approximately 1 million lives, the government has transformed HIV care for the poor by redefining the standards for successful treatment. More than three decades into the epidemic, many national and international agencies are still counting the basics—how many people get infected, how many people receive medication, how many patients die. Success in Rwanda, meanwhile, is measured not in the number remaining alive, but rather in how many are actually able to take their medications as directed and suppress the virus in their bodies to a level where it is essentially non-existent. In Rwanda, success is achieved when people living with HIV can earn a living, support their family, raise their children, and care for their community no differently than their peers.”

Read the complete op-ed here.