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The Zika Virus in Haiti

Dr. Louise Ivers

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.

Read the Q&A on the PIH blog.

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Training the First Generation of Neurologists in Haiti

Aaron Berkowitz teaches a neurology course to residents in Haiti.

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.”

Read the full story in the Brigham and Women’s magazine (pages 24 and 25).

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Slowing the Spread of Cholera

The Crisis in Haiti
Louise Ivers leading earthquake relief efforts in Haiti in 2010; at right, caring for a young patient at a clinic in Haiti.

Louise C. Ivers, MD, MPH, and colleagues published a paper that shows exactly how much the vaccine Shanchol slowed the spread of cholera in villages north of St. Marc, Haiti, in 2012.

Writing in The Lancet Global Health online, Ivers, the senior health and policy adviser at Partners In Health, finds that Shanchol was widely effective when administered to thousands of adults and children in the region. “We found that there were about 65 percent fewer cholera cases among people that were vaccinated than there were in those

that were unvaccinated,” says Ivers, who is a member of BWH’s Division of Global Health Equity in the Department of Medicine.

It’s fantastic news, and not just for the obvious reason that fewer cholera cases means fewer cholera fatalities. Read the original story on the Partners In Health website.

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Haiti’s First Emergency Medicine Residency Program

 

HaitiEMfellows
Haiti’s first Emergency Medicine residents

Recognized as the best teaching hospital in Haiti, the 200-bed Hopital Universitaire de Mirebalais (HUM) plays a major role in training future generations of health care providers and is home to residency programs in general surgery, internal medicine, obstetrics and pediatrics.

With the leadership of BWH Emergency Medicine attendings Regan Marsh, MD, MPH, and Shada Rouhani, MD, MPH, HUM recently added a fifth program to the roster: the country’s first Emergency Medicine residency.

“The need for emergency medicine in Haiti was apparent after the earthquake and continues to be an area of priority for the Haitian government and the Haitian branch of Partners In Health.”

Read more in BWH Bulletin.

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Supporting Medical Education in Haiti

Berkowitz FDB 2012-2 (2)
Dr. Aaron Berkowitz joins Haitian physicians on rounds to assess a patient at Saint Boniface Hospital.

On Jan. 13, 2010, just one day after a devastating earthquake struck the island nation of Haiti, a group of BWH physicians huddled in the Department of Medicine’s Eppinger Conference Room to ask: What can we do to help?

One of them, Michelle Morse, MD, MPH, went to Haiti during her residency in Global Health Equity at BWH. After the earthquake, she met Zadok Sacks, MD, a resident at BWH and Boston Children’s Hospital.

“There was just an incredible energy among people here about doing something and making a contribution together,” said Sacks, who now runs the young adult consult service at Children’s.

Together, Sacks and Morse founded an organization called Physicians for Haiti, which supports the work being done around medical education in Haiti.

“Haiti is full of amazing health care professionals, and they deliver care without access to any of the resources that we have here-the network of colleagues, technology and equipment,” Sacks said. Continue reading “Supporting Medical Education in Haiti”

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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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BWFH Physician Provides Urologic Care in Haiti

On recent trips to Jacmel, Haiti, to provide urologic care, Dr. Robert Eyre faced obstacles, like loss of electricity, that made performing surgery quite challenging.

“We had to carry in every piece of equipment–IV bag, suture, drape, gown, etc,” said Eyre, a Brigham and Women's Faulkner Hospital urologist. “The power frequently went off, and we had only one OR light that occasionally worked, so I wore a battery-powered headlamp to do all the surgeries.”

Read more about Eyre's work in Haiti on the Brigham and Women's Faulkner Hospital website.Eyre

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Celebrating Haiti’s New Teaching Hospital

I was honored to speak at the opening of Haiti’s national teaching hospital on April 28. The Haitian flag bears a phrase meaning “strength through unity,” and the Hôpital Universitaire de Mirebalais – also known as HUM –  is a shining example of the power of unity. Many of our committed staff at BWH have worked tirelessly in Haiti to design, build and outfit the facility, including Dr. David Walton from the Division of Global Health Equity, who played an instrumental role in shepherding HUM from ideas to reality. I admire and commend David as well as the countless others whose collaboration and guidance helped transform a rice field in the Haitian countryside into a world-class teaching hospital.   Continue reading “Celebrating Haiti’s New Teaching Hospital”