First Week in Guatemala

Posted on by Amanda

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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” →

Pericardial Tuberculosis in the “Last Mile”

Posted on by Amanda
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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.

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” →

North Korea’s Other Crisis

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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!

Posted on by Amanda

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

A Guide for Global Health Workers

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building partnerships in the americasThe recently published book, “Building Partnerships in the Americas: A Guide for Global Health Workers,” is an important resource for those working in global health.

According to BWH Chief of Global Health Equity Paul Farmer, MD, PhD: “This book answers a great, and until now unmet, need. For all those who ask what to read before going to work in these settings, ‘Building Partnerships in the Americas’ is the answer. It’s sure to become the go-to volume for those deeply engaged in such work.”

BWH’s Dan Palazuelos, MD, MPH, of the Division of Global Health Equity, is a co-author of the book’s first chapter about Mexico. You can learn more about the global health experiences of Dr. Palazuelos and his fellow authors  during “An Evening with the Authors” on Sept. 7, 7:30 – 9 p.m., at the AIC Center, 38 Newbury St., seventh floor, Boston.

The event is free and open to the public. Refreshments will be served. Please register in advance.

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

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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”

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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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