Global Health News and First-Hand Accounts from Brigham and Women's Hospital staff
Author: Brigham and Women's Hospital
Brigham and Women’s Hospital is world-renowned in virtually every area of adult medicine. As a teaching hospital of Harvard Medical School, our leadership in patient quality and safety, development of state-of-the-art treatments and technologies, and robust research programs have improved the health of people around the world. BWH’s mission of advancing the health of the world’s underserved is exemplified by the Division of Global Health Equity, which works closely with Partners In Health. The Division, with its Global Health Residency Program, supports the education of residents who train in some of the world’s most impoverished areas, such as Haiti, Rwanda, and Losotho, as they learn to deliver medical care in challenging circumstances.
From BWH Bulletin 8/26/16 by Jessica Zimmerman Traumatized by years of civil war and a devastating act of genocide in the early 1990s, Rwanda used to be a place where hope was in short supply.
Over time, however, the country came back stronger than ever—investing in education, infrastructure and regional trade—and Rwanda’s economy enjoyed one of the largest growth rates in the world last year. Still, one critical resource remained scarce: health care.
For BWH International Emergency Medicine fellow Nirma D. Bustamante, MD, having the opportunity to travel to Greece to care for refugees is an experience she will always cherish.
“I had the privilege of caring for, and most importantly, getting to know the most incredible human beings,” said Bustamante, of the Division International Emergency Medicine and Humanitarian Programs in the Department of Emergency Medicine at BWH, which prepares leaders in global health and humanitarian response.
Earlier this month, Bustamante spent more than two weeks at a refugee camp in northern Greece, along with volunteers from Team Rubicon, which recruits, trains and deploys U.S. military veterans and health professionals to aid in disaster-response operations around the world. Bustamante provided primary and urgent care to Syrian and Iraqi refugees, developed care plans and helped patients access specialty care in the local community.
Building capacity in specialty care is key to BWH partnership with Human Resources for Health Rwanda From BWH Bulletin 8/25/16 by Jessica Zimmerman
Training residents in anesthesiology is not only about teaching them the medicine behind the specialty, says Jill Lanahan, MD, of the BWH Department of Anesthesiology, Perioperative and Pain Medicine. It’s also about sharing a passion for the profession to inspire them to join the field.
Lanahan has done exactly that at the Brigham since March 2014, and for the next year she will share that same expertise and enthusiasm for anesthesiology with the next generation of physicians in Rwanda as part of the Human Resources for Health (HRH) Program, a collaborative, seven-year project between the Rwandan government, BWH, Harvard Medical School and more than 20 other academic institutions in the U.S. The program recently began its fifth year.
Lanahan—who relocated with her family to the Rwandan capital, Kigali, on Aug. 2—will spend one day each week doing didactic training with her new crop of residents. The other four days will consist of clinical training in the operating room. During her year-long position, she will offer three months of training in cardiac anesthesia, her primary area of clinical interest. Continue reading “BWH physician serves as anesthesiology faculty in Rwanda”→
Hanni Marie Stoklosa, MD, MPH’s background as a BWH emergency physician has inspired her work in addressing human trafficking. She founded an organization focused on combating human trafficking. Health Education Advocacy Linkage (HEAL) Trafficking (www.healtrafficking.org) focuses on addressing the health-related problems that trafficked victims face from a public health standpoint. In her role as researcher, advocate, and nationally and internationally recognized expert, she has years of experience in addressing this global problem. Dr. Stoklosa has done extensive research in all areas of trafficking including sex trafficking and labor trafficking. She is a leading force in addressing the myriad of health issues which are often overlooked by health professionals, as well as a force in advocating for human trafficking legislation before the US Congress. Dr. Stoklosa has advised the US Department of Health and Human Services and was recently named an American Board of Emergency Medicine fellow (2015-2017) of the National Academy of Medicine (formerly the Institute of Medicine). She holds appointments at Harvard Medical School, the Harvard T. H. Chan School of Public Health and the Harvard Humanitarian Initiative. She has extensive international experience in many countries. “I conducted qualitative interviews to further understand the anti-trafficking landscape and the gaps in response.” Her work has affected populations in India, Nepal, Thailand, and Kazakhstan, as well as Australia, China, Egypt, Guatemala, Liberia, the Philippines, South Sudan, and Taiwan. Most recently, Dr. Stoklosa has written a text (forthcoming, Springer Publishing in 2017) Human Trafficking Is a Public Health Issue: A Paradigm Expansion in the United States.Continue reading “Combating Human Trafficking: An Interview With Hanni Marie Stoklosa, MD, MPH”→
A year had passed since a young man came to the clinic with severe joint disease in his hips that left him unable to stand up straight, his torso pitched forward about 45 degrees as he steadied himself on a crutch.
But thanks in part to a group of volunteer clinicians from the Brigham, he was now running laps up and down a hallway at a hospital in the Dominican Republic, where he had received bilateral hip-joint replacement surgery through Operation Walk Boston—an orthopedic medical mission founded by Thomas S. Thornhill, MD, former chair of the BWH Department of Orthopaedic Surgery.
In this blog post from the Partners Center of Expertise in Global and Humanitarian Health, Kristin Dwyer, MD, MPH, a BWH fellow in Emergency Ultrasound, writes about working with emergency medicine residents for her rotation at University Central Hospital of Kigali (CHUK) in Rwanda.
“As I wrap up my time here, I must say I found it to be a valuable experience,” she writes. “While it is difficult to effect change in a short amount of time, I think having smaller goals is useful. I am not necessarily going to get patients to come to the hospital earlier in their disease course, but I can arm physicians there with ultrasound skills to more accurately diagnosis them when they arrive looking for help.” Read more.
Senegal has long been one of the most stable democracies in Africa. However, compared to the United States, physicians there lack many resources. Recently, a team of Brigham physicians traveled to the country’s capital city of Dakar to teach a course in collaboration with the African Center of Excellence for Mother and Child at Cheikh Anta Diop University (also known as the University of Dakar) on minimally invasive techniques for gynecological surgery. Through a series of lectures and live surgeries, physicians taught these techniques, helping the local physicians understand how they might perform them safely with their limited resources.
Many questions remain about Zika and its current impact on the Haitian population. Until more answers surface, BWH and Partners In Health(PIH) staff strive to find the best solutions for women, men, and children who may be adversely affected by the virus.
Louise Ivers, MD, MPH, of the BWH Division of Global Health Equity and senior health and policy advisor for PIH, answers questions about the mosquito’s resiliency, efforts to control it in Haiti and how PIH is working to prevent Zika infections and treat those who might be suffering from complications.
When Indian regulators implemented a series of new clinical trial regulations in 2013, clinical trials in India ground to a halt. Under the new regulations, clinical trial sponsors would be responsible for compensating participants who were injured or died during the trial, even if the death or injury was unrelated to the trial itself. Virtually all clinical trials sponsors, including the National Institutes of Health, stopped initiating any new trials. Less than two percent of the world’s clinical trials were unfolding in a country that is home to one-seventh of the world’s population. Barbara Bierer, MD, co-director of the Multi-Regional Clinical Trials (MRCT) Center, had been following the dilemma in India closely.
Bierer and Mark Barnes, then at Harvard University, had launched the MRCT Center in 2011 to define and address emerging issues in global clinical trials. By bringing together a variety of stakeholders, the center aims to find solutions to improve the integrity, safety and rigor of trials around the world.
After the new regulations were announced, Bierer and her colleagues reached out to government officials and industry and academic stakeholders in India, organized roundtable discussions and, over the course of more than 14 visits to the country, worked closely with Indian leaders to help to develop fair amendments to the earlier legislation and address the issues resulting from regulatory reform. The MRCT Center has been involved in training, and in developing scalable tools that will assist the appropriate application of the regulations such as a tool to assess causality to determine whether a death or injury is directly linked to a clinical trial. Their efforts continue today.
Haiti has just one neurologist for 10 million citizens, but the burden of neurological disease there is enormous, say BWH’s Aaron Berkowitz, MD, PhD, and Louine Martineau, MD, of the University Hospital in Mirebalais, Haiti.
Since BWH helped the University Hospital open in 2013, Martineau has been regularly consulting on his neurologic patients with Berkowitz, who leads BWH’s Global Neurology Program. “By opening an outpatient clinic in communication with Dr. Berkowitz, we have created a way to manage patients with neurologic problems,” says Martineau.
To address the larger problem, Berkowitz and colleagues are launching Haiti’s first neurology training program. Initial seed funding will allow them to train two neurologists over the next two years.
“With further investment in the fellowship, we hope to train a few neurologists every year,” says Berkowitz. “These neurologists will serve different regions of the country so patients can get the care they need from local providers.”