The Equity Imperative

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“There is no correlation between money and what you can offer your people,” said Rwandan Minister of Health Agnes Binagwaho. “Money is not the obstacle; your vision is the obstacle.”

Paul Farmer, MD, PhD, Chief of the Division of Global Health Equity at BWH, introduced Binagwaho to the audience gathered on July 23 at Harvard School of Public Health. Binagwaho was a guest speaker at Harvard’s Global Health Effectiveness Program, which is co-directed by Joseph Rhatigan, MD and Rebecca Weintraub, MD, both Associate Physicians in BWH’s Division of Global Health Equity.

Over the next two hours, Binagwaho shared how reforms in Rwanda’s health care sector had produced stunning results: Despite a GDP of less than $1000 per capita, life expectancy in Rwanda has doubled since 2004. Continue reading “The Equity Imperative”

It’s a Marathon, not a Sprint, in Health Innovation

By Marie Connelly, Global Health Delivery Project

With millions of Americans gaining access to health care through the Affordable Care Act, the need for innovative solutions that lower costs, increase quality, and improve patient outcomes, has never been greater.

Four core lessons have emerged so far from last week’s virtual expert panel with leaders from around the country and during the Google hangout on air discussion led by GHDonline moderator and Health for America co-founder, Kapil Parakh, MD.

Continue reading “It’s a Marathon, not a Sprint, in Health Innovation”

Born Too Soon

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Did you know that pre-term birth complications are the leading cause of neonatal mortality worldwide?

15 million babies are born preterm (at less than 37 weeks gestation) each year, and 5 million of those are born outside of hospital facilities in low-income countries. Led by Dr. Anne CC Lee, a group of researchers  in the BWH Department of Newborn Medicine is working to improve early recognition of pre-term infants in rural Bangladesh, where 90 percent of births take place at home. The group is part of the Projahnmo team–a collaboration with Johns Hopkins University, International Center for Diarrheal Disease Research-Bangladesh, Shimantik NGO, and the Bangladeshi Ministry of Health and Family Welfare.

Our researchers will develop methods to train lay community health workers on how to accurately identify pre-term infants and to link these high-risk babies with effective interventions to reduce neonatal morbidity and mortality.

Recently, the project, called “Linking Pre-term Infants with Special Care in rural Bangladesh: Improving Identification and Management of Babies Born Too Soon,” was selected as a finalist in the Saving Lives at Birth Grand Challenge. To learn more about it, and to vote for The Brigham and Women’s project to receive a People’s Choice Award, please visit http://savinglivesatbirth.net/innovation/2013/innovators/all

“Every Rwandan Ought to Be Proud”

Paul Farmer, in a photo taken by The New Times during a recent interview.
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Paul Farmer, MD, PhD, chief of BWH's Division of Global Health Equity and Partners In Health co-founder, recently told “The New Times” that Rwanda is on track with its work addressing disparities in health care.

He spoke of the progress the country has made so far in health care provision: “There is remarkable progress made, especially if you look at fertility rates, mortality rates or life expectancy. If you look at only six indicators such as death due to Aids, malaria, tuberculosis and during child birth and from vaccine preventable illnesses and under five, significant progress has been made. Rwanda is the only country in sub-Saharan Africa on track to meet all the health-related Millennium Development Goals.

If you look at those six indicators, you see that Rwanda has the steepest decline in mortality ever documented anywhere at any time, so that means even more than Europe after the war. It’s very striking. Every Rwandan ought to be proud of that.”

Read the full interview in “The New Times,” a daily newspaper in Rwanda.

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BWH and COPE: Global Health Here at Home

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Margo Hudson, MD, and Jamie Redgrave, MD, are among several BWH physicians who volunteer at Gallup Indian Medical Center and the Indian Health Service hospital in Shiprock through the Brigham and Women’s Outreach Program (BWOP) with Indian Health Service.  This centralized volunteer program is dedicated to providing specialty expertise in direct patient care and staff training in the Navajo Nation, where about 37 percent of people live in poverty.

Homes are isolated, with no running water and often no refrigeration. Heat is produced by a wood-burning stove in the kitchen. Landline phones are a rarity.  Access to preventive health services, such as cancer screening and immunizations, is often limited, and patients travel long distances to obtain medical care.

Despite these incredible barriers faced by the American Indian communities in New Mexico, physicians volunteering with the Brigham and Women’s Outreach Program and COPE are able to provide services and perform activities that positively impact the health and wellness of the Navajo people. Continue reading “BWH and COPE: Global Health Here at Home”

COPE Brings Cross-Pollination to Navajo Nation

COPEOn one of her first visits to Navajo Nation as a resident in the Division of Global Health Equity, Sara Selig, MD, went to the home of a man in his late 20s with uncontrolled diabetes. A young father, one of his legs had already been amputated due to the disease, and Selig was concerned he was developing even more complications.

The Community Outreach & Patient Empowerment Program, or COPE for short, was started five years ago to help high-risk people with diabetes living in two areas of Navajo Nation, which is the largest tribe in the U.S. Today, COPE has expanded to cover the entire Navajo Nation and works across the spectrum of   chronic diseases. Continue reading “COPE Brings Cross-Pollination to Navajo Nation”

Born Too Small

Every year, 20 million babies around the world are born with a low birth weight of less than 2500g (5.5 pounds). BWH’s Anne Lee, MD, of Newborn Medicine worked with colleagues in the  Child Health Epidemiology Reference Group to create the first-ever national estimates of small-for-gestational-age (SGA) and its co-occurrence with preterm birth in low- and middle-income countries, which was published in the inaugural issue of Lancet Global Health last month. Growth restricted infants in low- and middle-income countries are 1.8 times more likely to die in the first month of life, compared to non-growth restricted infants. If you’d like to learn more, the full article is available here.

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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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Virtual Communities Link Health Care Professionals


Thousands of health care professionals across the country have a new opportunity to share resources, ideas and information thanks to an innovative concept in medicine – the virtual community.  The first virtual community that is part of a federal grant awarded to Brigham and Women’s Hospital’s Global Health Delivery Project (GHD) went public in June.

“The US Communities Initiative will enrich GHD’s online platform through a continued exchange of ideas between new and seasoned professionals across geographies,” said Rebecca Weintraub, MD, an associate physician in the Division of Global Health Equity and faculty director of the GHD.  “The virtual communities will facilitate an important cross-pollination of ideas, as well as the dissemination of new, translatable knowledge, for health care professionals working in the United States and around the world.”

The grant from the Agency for Healthcare Research and Quality at the U.S. Department of Health and Human Services will enable GHD to host six professional virtual communities and 36 virtual expert panels on www.GHDonline.org over the next three years.  Topics will range from the Affordable Care Act to mental health integration with a goal of sharing innovative ways to deliver evidence-based health care to underserved communities in the United States. Interested health care professionals are invited to join GHDonline and shape the US Communities Initiative by suggesting future discussions.