Partnership in Belize structured through Global Health Program
The number of patients Medical College of Wisconsin providers see in a year exceeds the entire population of the nation of Belize, but health care leaders from both sites are discovering they have much to learn from one another.
A collaboration that began when faculty of the College’s Global Health Program were invited to present at the Belize Medical and Dental Congress annual meeting in October 2010 was formalized this summer. A delegation from Karl Heusner Memorial Hospital in Belize visited the Milwaukee campus in June and created the framework for a reciprocal partnership designed to improve medical care in Belize while deepening opportunities for learning and information sharing.
“We want to build sustainable partnerships with entities, whether they be schools of medicine, hospital partners or health ministries, to help each other learn about various disparities and challenges in our respective communities,” said Stephen Hargarten, MD ’75, MPH, Associate Dean for Global Health and Professor and Chairman of Emergency Medicine at the Medical College. “Our emerging Global Health Program is predicated on the sustainable and respectful exchange of ideas, information and experiences over years.”
Stephen Hargarten, MD ’75, MPH (right), describes the use of simulators in medical education during the Belize delegation’s June tour of the Standardized Teaching Assessment Research (STAR) Center at the Medical College. Counter-clockwise from center are Dr. Francis Longsworth, CEO of Karl Heusner Memorial Hospital, Shirlee Samuels, Dr. Marta Habet, Kereen Birch and Dr. Egbert Grinage.
The College’s Global Health Program was established in January 2010 to develop a sustainable platform of local and global health partnerships to support and grow education, research, clinical, public and community health activities of its faculty and trainees. It does so through institutional partnerships that address local and global health inequities across neighborhoods and nations. Nearly 200 faculty participate in global health activities across 80 countries, including the United States.
The affiliation between the College and the Heusner Hospital supports a platform for global health student and physician exchanges to advance education, research, clinical care and public and community health training. The representatives from Belize enter the partnership with several priorities: addressing injury prevention, strengthening emergency care and disaster preparedness, improving pediatric acute and critical care, and enhancing the education of medical providers in Belize. These are areas of excellence for the Medical College.
Participating in a tour of Children's Hospital of Wisconsin were (front row, L-R): Shirlee Samuels, Dr. Marta Habet, and Jacquelyn Nohl, MD, GME '08; (back row, L-R): Robyn Saxe, RN, from Children's, Dr. Egbert Grinage, Kereen Birch, Dr. Francis Longsworth, and Dr. Nicole St. Clair, pediatric hospitalist at Children's and Director of the Pediatric Global Health Program.
The Belize delegation included two physicians, two nursing leaders and the hospital’s CEO. The group spent four days on campus, participating in tours and observations of the emergency departments and pediatric critical care wards of the Medical College’s affiliate hospitals; in educational, state-of-the-art simulation activities; in information exchanges with medical leadership in these fields; and in meetings with local and global collaborators.
Karl Heusner Memorial Hospital is a referral hospital, and the staff faces many challenges that begin at the primary level with deficiencies in standards of care in rural areas of Belize, said Dr. Francis Longsworth, the hospital’s CEO.
“At the hospital, we have a shortage of human resources and a lack of equipment and supplies,” he said. “The distance patients must travel to get to the hospital delays care. A lot of education needs to take place at the local level.”
Improvements in pediatrics and emergency medicine should have a large impact for the people of Belize. The infant mortality rate there is high – 10.6 per 1,000 live births. The under-5 mortality rate is 22.6 per 1,000, with most of these deaths attributable to motor vehicle crashes, drowning, respiratory infection, sepsis and diarrhea. Belize also has a high rate of injury and death from trauma in both adults and children.
The delegation is interested in developing a pediatric intensive care unit for the Heusner Hospital and improving care delivery across priority areas. They are drawing on the Medical College’s expertise in using a team approach for managing patients of all ages and to advance the skills of their health care providers to better meet the challenges of their population.
“At our hospital, we need to formalize training. It’s really the main reason we are here,” said Dr. Longsworth, who has been with the hospital for three years. “The first two years were spent emphasizing infrastructure and equipment and facility needs. But if you fix the building but not the problems, it will not matter. This year, the emphasis is on quality of care and service delivery.”
The partnership dovetails with a longtime affiliation the Medical College has had with Hillside Healthcare International, a clinic in Belize that offers global health experience to medical students through an elective. Jacquelyn Nohl, MD, GME ’08, Assistant Professor of Pediatrics and a hospitalist at Children’s Hospital of Wisconsin, serves on the Hillside Board and was a key participant in the summer delegation visit as a member of Children’s Hospital’s and the Medical College’s global health programs.
“I had the opportunity to work at Hillside during every level of my training, including residency,” Dr. Nohl said. “I was also fortunate to be involved in the original site visit that led to the creation of this partnership. Both projects strive to address disparity and improve population health. Through a united goal, the unique programs continue to evolve in a symbiotic partnership that has strengthened health care in Belize.”
The next steps, Dr. Hargarten said, are to continue planning the details of the affiliation, secure financing (a small grant from the Wagner Foundation has already helped facilitate the partnership), and identify additional faculty leaders to implement the plan beginning in 2012.
Senior Chinese officials create partnership with Medical College
Senior representatives from Shanghai's Xin Hua Hospital visited the campus on Wednesday, Sept. 7, to formalize a trilateral global collaborative partnership involving The Medical College of Wisconsin and the Center for International Health. The partnership will develop a sustainable platform for global health student and faculty exchanges to support the education, research, clinical care and public and community health training of both academic institutions and their hospital affiliates.
Dr. Pan Shumming with alumnus Dr. Stephen Hargarten, both heads of emergency medicine at their respective institutions.
As part of the exchange program, The Medical College of Wisconsin and Xin Hua Hospital will host each other's trainees and faculty to introduce them to academic medicine and health care delivery systems in their respective countries, initially starting in Emergency Medicine, but with expansion to other disciplines such as Surgery and Urology.
The Medical College of Wisconsin's Global Health Program, led by Associate Dean Stephen Hargarten, MD ’75, MPH, and established in January 2010 to provide a means for physicians-in-training to learn important lessons about health disparities and cultural diversity both in Milwaukee and abroad, will facilitate these reciprocal exchanges.
Xin Hua Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, was established in 1958 after the founding of New China in 1949 and is a modern comprehensive teaching hospital, integrating functions of medical care, education and research. The College's Department of Emergency Medicine has been hosting trainees from Xin Hua since 2006 including their now director of emergency medicine, Dr. Pan Shumming, who was part of the delegation. Xu Weiguo, President of Xin Hua Hospital; John R. Raymond, Sr., MD, President and CEO of the Medical College of Wisconsin; and Mark Anderson, President of the Center for International Health, met to sign an affiliation agreement formalizing the partnership and exchange program.
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