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Hot Coffee

Patrick Elliot, MD, MPH, of BWH’s Division of Global Health Equity, contributes this post about his work with Compañeros en Salud México.

Patrick Elliott
Dr. Patrick Elliott, left, and Dr. Enrique Valdespino perform a prenatal ultrasound for a patient in Valdespino's clinic in Reforma. Photo by Balam-ha' Carrillo, Shoot4Change Mexico

A hot cup of coffee is an almost universal invitation to friendship and conversation, and it’s never truer than in the Sierra Madre de Chiapas.  On Mexico’s southern border, Compañeros en Salud México (CES), a sister project of Partners In Health, has been working in several rural, coffee-growing communities to strengthen the healthcare system alongside the state government of Chiapas.  In six rural pueblos in the mountains of Chiapas, the physicians of CES live and work alongside the people of the community.  The lived reality of the community is shared by both patients and our doctors and opens new paths to discoveries, conversations and quite a few hot cups of coffee.

I began work with CES in February 2012, shortly after it officially began operations.  At first, my work largely consisted of assisting in public sector community clinics that CES helps administer, seeing patients alongside the social service physicians who operate the clinics and are the heart of the organization.  The social service physicians (pasantes) are recently-graduated medical students who must complete a year of required service before gaining eligibility for independent practice or entrance into residency.  The pasantes and I would see patients together in the clinic, discuss cases and management options and in the evenings make house calls to patients who were too sick, infirm or who had simply failed to come to clinic during the day.  As night fell across the town, we’d sometimes sit on the clinic roof and watch the stars.  Continue reading “Hot Coffee”

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Opportunities for Health Scientists in Disease-Endemic Countries

Sungano Mharakurwa’s dream is to eliminate malaria one day.

Sungano Mharakurwa
Sungano Mharakurwa

“I had this preventable disease when I was a kid, lost some relatives to it and saw it ravage communities. That’s why I became a health scientist. I want to find novel strategies for strengthening malaria control and elimination.”

This week, Mharakurwa is moderating a GHDonline expert panel to discuss the current and future state of career opportunities for health scientists in disease-endemic countries.

Learn more about Mharakurwa and join the GHDonline panel.

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Motivational Interviewing Overseas

The older members of our group (Jamie, Whit and me) have taken several days to adjust to the time difference and the altitude. The teens of course look like they don’t have any idea what we are talking about when we complain of feeling tired, light headed and short of breath at times. We are at a similar altitude as Denver, it being ‘the mile high city’.  We are all well on this fifth day.

I’m feeling the comfort of coming back to Guatemala having visited in April 2012. Familiar faces, expected changes in the pace, climate, walking conditions (rough cobblestones everywhere), etc. Of course it didn’t keep me from feeling anxious all over again about the talks I had planned for the social workers and psychologists of Common Hope. The first talk was on Resiliency and Positive Psychology. The second talk was on Motivational Interviewing. My major challenge was wondering how it was going to be to have me speaking English while my slides had been translated in to Spanish and then to have an interpreter playing go between. Thankfully, I had gotten excellent advise from Joji Suzuki, MD, from the addiction psychiatry department after practicing at our Motivational Interviewing practice group. He had suggested I try to speak more like a Ted Talk and less like a lecturer. Good advice for a talk in any country!

Continue reading “Motivational Interviewing Overseas”

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First Week in Guatemala

group

I have been in Guatemala for about a week with Susan and Emma, this being their second and my third occasion to visit this very interesting country.

Guatemala is the only predominantly Mayan country. These native American people have a very diverse culture with numerous languages and are united by the national language of the Spanish conquerors. Although the culture of the native people in the United States seems to have been nearly decimated, their cousins here in Guatemala have maintained a vibrant culture. Continue reading “First Week in Guatemala”

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Pericardial Tuberculosis in the “Last Mile”

Nyaya
Nirajan

Duncan Maru, MD, PhD, a resident in BWH’s Division of Global Health Equity, is a co-founder of the organization, Nyaya Health. Nyaya’s mission is to realize the right to health by delivering transparent, data-driven health care for Nepal’s rural poor.

In a recent blog post for Nyaya, Maru writes about a patient named Nirajan.

“Nirajan is a nine-year-old boy who had been seen by our clinicians two weeks prior and diagnosed via ultrasound with a massive pericardial effusion. The diagnosis was not hard to make, and the etiology was almost certainly to be tuberculosis. Over 12 hours away from an intensive care unit or a cardiologist, our clinicians at that time made the decision that most rural doctors would make; they prescribed Nirajan anti-tuberculosis therapy and steroids.”

Read Nirajan’s story and learn more about the work of Nyaya Health.

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Clintons Visit HRH Program Faculty, Patients in Rwanda

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Minister of Health of Rwanda and HMS senior lecturer in the Department of Global Health and Social Medicine Agnès Binagwaho (center), President Clinton and Chelsea Clinton visit the Centre Hospitalier Universitaire de Kigali. Image: HRH Program

On Aug. 5, the Ministry of Health of Rwanda welcomed President Clinton and Chelsea Clinton to visit the Human Resources for Health (HRH) Program. The program, which was launched by His Excellency President Paul Kagame of Rwanda and President Clinton, is celebrating the completion of its first year and the beginning of its second year.

The program operates through an innovative model to address critical gaps in the quantity and quality of health professionals in Rwanda. Each year, HRH deploys nearly 100 faculty–doctors, nurses, midwives, dentists and global health management experts –for one-year periods to “twin,” or partner, with Rwandan colleagues. Faculty mentor and support their Rwandan colleagues in the areas of curriculum development, didactic teaching, clinical teaching and management and administration.

In the first year of the program, 91 faculty from U.S. institutions, including Brigham and Women’s Hospital, partnered with 90 Rwandan colleagues across four referral hospitals, seven district hospitals and eight schools of medicine, nursing and midwifery and public health. Continue reading “Clintons Visit HRH Program Faculty, Patients in Rwanda”

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North Korea's Other Crisis

KJ Seung
K.J. Seung

“There's a crisis brewing in North Korea that has nothing to do with nuclear weapons or six-party talks. Tuberculosis has long been recognized as one of the biggest public health problems in North Korea, but there is a disturbing new development: much of the TB in North Korea is resistant to regular antibiotics.”

This is the introduction to a compelling new piece in The Atlantic by K.J. Seung, MD, a physician in BWH's Division of Global Health Equity and deputy director for the Partners In Health project in Lesotho, who regularly travels to North Korea.

Read the article to learn why he believes that multi-drug resistant TB is basically a death sentence for patients in North Korea.

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Ready for take off!

Tomorrow morning bright and early we take off for Guatemala! We are two families travelling together; Nora and Emma are sophomores in high school. Anna is a sophomore in college. Jamie Redgrave, MD is an endocrinologist in the Jen Center at Brigham and Women’s Hospital and also does diabetes care at Harvard University Health Services. My husband (Whit) and me round us off at six. For all but Anna, this is our second trip to Antigua. We became part of a volunteer team at Common Hope (www.commonhope.org) in April of 2012 and fell in love with the warm and welcoming people, the culture, language and landscape of the area.

Common Hope is a unique organization as the backbone of it’s workforce are it’s 25 social workers. Through home visits they support families in sending their children to school (instead of bringing them to the farms) as well as giving them opportunities to improve their housing (we built a house last year), health care (that’s where Jamie will come in as she provides continuing education to the medical providers) and mental health. Although my work at BWH is very different from theirs, our clients are challenged by many of the same psychosocial issues including domestic violence, substance use, poverty, etc. So we find much common ground.

Since the recession, Common Hope has been forced to make tough economic choices. This has resulted in the social workers and psychologists losing all funding for in-service education. While at Common Hope over the next two weeks I’ll be providing several in-service trainings on topics which include Motivational Interviewing,  Positive Psychology and Resiliency in Care Providers. Each of these will be done in such a way as to promote conversation among all of us so that I am sure to learn as much from them as I bring to the sessions.

Better change the message on my work phone and head home to pack. Adios!

Guatemalan market
Guatemalan market