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Echeverry-López ME, Marín-Uribe A, Garcés-Palacio IC, Borrero-Ramírez Y, Hernández-Holguin DM, Pacheco-Sánchez CI, Haar RJ. Impacts of attacks to female health care workers in three territories of Colombia. Confl Health 2024; 18:25. [PMID: 38566196 PMCID: PMC10988842 DOI: 10.1186/s13031-024-00582-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND This study explores the impacts of attacks perpetrated in the context of armed conflict, to female health workers in three Colombian territories. METHODS We conducted a document review of the reports and databases of the Colombian Truth Commission, 17 in-depth semi-structured interviews with experts on the national and regional armed conflict and the medical mission, and 26 female health workers who were victims of attacks. RESULTS Experts and female health workers reported attacks to health activities, facilities, equipment, and personnel, including attacks to traditional doctors belonging to indigenous communities. The most frequent attacks were threats and retention of health personnel; theft of supplies and medicines; damage and use of infrastructure and means of transport for purposes other than health care; and hinderance of health service provision. The attacks occurred in a framework of structural violence that intersects with poverty, racism, and gender bias. The impacts of these attacks include gender-based violence, significant disruption of the lives of health workers, and physical, emotional, psychological, social, and economic effects on the victims and their families. The government response to protect victims and populations has been absent or insufficient. CONCLUSIONS Attacks to health care were reported in all the studied territories obstructing adequate health care. Impacts of these attacks affect negatively the professional and personal life of the workers and are aggravated by structural violence and absent or little institutional response.
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Affiliation(s)
| | - Alejandra Marín-Uribe
- Health Management and Policies Research Group, School of Public Health, Universidad de Antioquia UdeA, Medellín, Colombia
| | - Isabel C Garcés-Palacio
- Epidemiology Group, School of Public Health, Universidad de Antioquia UdeA, Medellín, Colombia.
| | - Yadira Borrero-Ramírez
- Health Management and Policies Research Group, School of Public Health, Universidad de Antioquia UdeA, Medellín, Colombia
| | | | - Carlos Iván Pacheco-Sánchez
- Health Policy Research Group, Department of Sociology, Universidad Nacional de Colombia -Sede Bogotá, Bogotá, Colombia
| | - Rohini J Haar
- Berkeley. School of Public Health, Division of Epidemiology, University of California, Berkeley, CA, USA
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Anderson H, Sweeney C, Perry R, Vaquero J, Ison H. Patient-Centered Team-Based Learning in Pre-Clinical Curriculum Supporting the Application of Knowledge to Real-World Clinical Experience. Med Sci Educ 2020; 30:65-68. [PMID: 34457639 PMCID: PMC8368343 DOI: 10.1007/s40670-019-00872-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
We report an active learning session which effectively supported 1st year medical students applying their learning experience in a clinical setting. A team-based learning (TBL) on familial hypercholesterolemia (FH) with a live patient was given to deliver basic genetics knowledge in a clinically relevant context. Subsequently, two participating students applied their learning experience by presenting a differential diagnosis of homozygous FH in a patient at a medical mission in Central America. We propose that combining active learning with clinically relevant scenarios effectively fosters student's clinical reasoning skills and can bridge the perceived gap between basic science and clinical education.
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Affiliation(s)
- Hana Anderson
- Department of Internal Medicine, Department of Cell Biology and Human Anatomy, University of California, Davis, Davis, CA USA
| | - Colleen Sweeney
- Department of Biochemistry and Molecular Medicine, University of California, Davis, Sacramento, CA USA
| | - Ross Perry
- University of California, Davis, School of Medicine, Sacramento, CA USA
| | - Jorge Vaquero
- University of California, Davis, School of Medicine, Sacramento, CA USA
| | - Hannah Ison
- Stanford Center for Inherited Cardiovascular Disease, Stanford, CA USA
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Ghersin ZJ, Yager P, Cummings BM, Hersh M C, Cayer M, Callans KM, Zablah EJ, Gallagher T, Abrego S, Bonilla J, Vela OS, Guzman L, Aguilar A, Hartnick CJ. A multidisciplinary, video-based, curriculum for management of the intubated and surgical airway patient for a pediatric hospital in El Salvador. Int J Pediatr Otorhinolaryngol 2020; 128:109732. [PMID: 31644996 DOI: 10.1016/j.ijporl.2019.109732] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/13/2019] [Accepted: 10/13/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Primary objective is to determine the rate of intubation with inappropriately sized endotracheal tubes (ETTs) in a pediatric intensive care unit (PICU) in El Salvador. Secondary objective is to determine effectiveness of a video-based curriculum to teach local providers on pediatric advanced airway management and surgical approach to patients requiring airway reconstruction. METHODS Data for 296 intubated pediatric patients was collected over a six month period in a 16-bed PICU in El Salvador. Results of a learning behavior assessment survey completed by local healthcare workers informed a curriculum to complement on-site education during annual surgical airway mission trips. The video-based curriculum addressed proper sizing and use of cuffed endotracheal tubes, care of the intubated child and perioperative considerations of the surgical airway patient. Providers completed pre and post-curriculum quizzes to measure knowledge acquisition. RESULTS Over 6-months, 281 patients were intubated. Sixty-three percent had improperly sized ETTs. Thirty-one percent had a failed or accidental extubation. All-cause mortality was 24%. One hundred and fifty-nine Salvadorian providers completed a learning behavior survey informing a video-based curriculum. Sixty-four providers completed the curriculum. Post-curriculum quiz scores increased by 18.7%. Surgeons, anesthesiologist, intensivists and speech pathologists demonstrated significant improvement (p < 0.05). CONCLUSION Nearly two-thirds of intubated patients in a PICU in El Salvador have improperly sized ETTs and one-third require reintubation following planned or accidental extubation. The development of this first of its kind video-based curriculum for critical care and surgical training regarding how to properly care for the intubated child is coupled with the development of a longitudinal database to record pediatric airway related morbidity and mortality in the largest pediatric hospital in El Salvador. This model and system can be used to track the reduction in airway related morbidity and mortality directly related to a systems based intervention both in El Salvador and then elsewhere.
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Affiliation(s)
- Zelda J Ghersin
- Massachusetts General Hospital for Children, Boston, MA, USA.
| | - Phoebe Yager
- Massachusetts General Hospital for Children, Boston, MA, USA.
| | | | - Cheryl Hersh M
- Massachusetts General Hospital for Children, Boston, MA, USA.
| | | | | | | | | | - Susana Abrego
- Hospital de Niños Benjamin Bloom, San Salvador, El Salvador.
| | - Jose Bonilla
- Hospital de Niños Benjamin Bloom, San Salvador, El Salvador.
| | | | - Luis Guzman
- Hospital de Niños Benjamin Bloom, San Salvador, El Salvador.
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Merkey RJ, Palombi LC. Student-reported value of a short-term service-learning trip to Nicaragua. Curr Pharm Teach Learn 2020; 12:49-57. [PMID: 31843164 DOI: 10.1016/j.cptl.2019.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 07/10/2019] [Accepted: 10/15/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The purpose of this qualitative study was to assess the student-reported professional and personal value of a one-week service-learning trip to a Nicaraguan community. METHODS Five pharmacy students who participated in a one-week service-learning trip to Jinotepe, Nicaragua were invited to participate in this study. Individual, semi-structured interviews were conducted following the trip. RESULTS A variety of themes and subthemes surfaced, demonstrating the student-reported professional and personal value of the short-term service-learning experience. While each pharmacy student was impacted differently, common themes demonstrated transformative pharmacy student learning. These themes included recognition that every individual has a unique story that is essential to understanding how to care properly for that individual; the benefit of establishing a relationship with a community to more effectively and compassionately serve them; the importance of determining community-specific needs to ensure that service provided is beneficial; and recognition that those who are served have wisdom to offer healthcare providers. CONCLUSIONS Short-term service-learning opportunities can provide impactful learning for pharmacy students. Established service-learning visits with a consistent host site allow for deeper and more trusting relationships, resulting in the ability to respond to the needs and requests of the partner organization in developing communities and not impose agendas. Organizers of service-learning trips must cater to the needs of the developing community to ensure that the trip is effective in providing value to the host site rather than creating unnecessary burdens and unanticipated hardship.
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Affiliation(s)
- Rebecca J Merkey
- University of Minnesota College of Pharmacy, 1110 Kirby Drive, 232 Life Science, Duluth, MN 55812, United States.
| | - Laura C Palombi
- University of Minnesota College of Pharmacy, 1110 Kirby Drive, 232 Life Science, Duluth, MN 55812, United States.
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Jennings WC, Lou-Meda R, Mushtaq N, Mallios A, Méndez-Soveranis S, Sosa Tejada RE, Lucas JF, Gradman WS. Creating arteriovenous fistulas for children in Guatemala. J Vasc Surg 2019; 70:1635-1641. [PMID: 31126771 DOI: 10.1016/j.jvs.2019.02.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 02/05/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The Guatemalan Foundation for Children with Kidney Diseases was established in 2003 as the first and only comprehensive pediatric nephrology program and hemodialysis unit in Guatemala. Bridge of Life (BOL) is a not-for-profit charitable organization focused on chronic kidney disease and supplied equipment, training and support during formation of the hemodialysis unit. Pediatric permanent vascular access (VA) expertise had not been established and noncuffed dialysis catheters provided almost all VA, many through subclavian vein access sites. BOL assistance was requested for establishing a VA surgical program, resulting in recurring BOL surgical missions to create arteriovenous fistulas (AVF) in these children. This study analyzes the BOL pediatric VA missions to Guatemala. METHODS Three surgical pediatric VA missions were conducted in Guatemala from 2015 to 2017. Each mission was led by two or three surgeons. All supplies and equipment (including ultrasound units) were taken as part of each mission. The BOL surgical VA mission teams work with local pediatric surgeons, pediatric nephrologists, and dialysis nurses to establish collegial relationships and foster teaching interactions. We retrospectively reviewed the patient demographic data, procedures, and outcomes for these missions. RESULTS AVFs were created in 54 new pediatric patients. Ages were 8 to 19 years (13.4 ± 2.8 years) and 29 patients (54%) were male. Patient weights were 28 to 50 kg (30.8 ± 8.3 kg) with body mass indexes of 12 to 25 kg/m2 (17.9 ± 2.9 kg/m2). Radiocephalic AVFs were created in 21 children (39%), proximal radial artery AVFs in 12 (22%). and brachial artery inflow AVFs in 5 (9%). Sixteen patients (30%) required transpositions and one a translocation; two of these were femoral procedures. Primary and cumulative patency rates were 83% and 85% at 12 months and 62% and 85% at 36 months, respectively. The median follow-up was 17 months. Interventions with fistulagram and balloon angioplasty options were not available for AVF dysfunction or access salvage during the study period. However, six patients underwent an AVF revision and salvage during subsequent missions or by one of the Guatemalan surgeons (R.S.). Four individuals underwent successful transplantation during the study period. There were no operative deaths or major complications. CONCLUSIONS Pediatric VA missions to Guatemala created safe and functional AVFs in concert with local pediatric surgeons and pediatric nephrologists. Three surgical missions included access operations in 54 new patients. Cumulative AVF patency was 85% at 36 months.
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Affiliation(s)
- William C Jennings
- Department of Surgery, The University of Oklahoma, College of Medicine, Tulsa, Okla.
| | - Randall Lou-Meda
- Servicio de Nefrología, Hipertensión, Diálisis y Trasplante, Departamento de Pediatría, Hospital Roosevelt/FUNDANIER, Guatemala City, Guatemala
| | - Nasir Mushtaq
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Tulsa, Okla
| | - Alexandros Mallios
- Vascular Surgery Department, Institut Mutualiste Montsouris, Paris, France
| | - Sindy Méndez-Soveranis
- Servicio de Nefrología, Hipertensión, Diálisis y Trasplante, Departamento de Pediatría, Hospital Roosevelt/FUNDANIER, Guatemala City, Guatemala
| | - Raúl Ernesto Sosa Tejada
- Department of Pediatric Surgery, Roosevelt Hospital, Mariano Galvez University, Guatemala City, Guatemala
| | - John F Lucas
- Department of Surgery, Greenwood Leflore Hospital, Greenwood, Miss
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Shah S, Lin HC, Loh LC. A Comprehensive Framework to Optimize Short-Term Experiences in Global Health (STEGH). Global Health 2019; 15:27. [PMID: 30940155 PMCID: PMC6444847 DOI: 10.1186/s12992-019-0469-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 03/14/2019] [Indexed: 11/18/2022] Open
Abstract
Increasing demand for Short-term Experiences in Global Health (STEGH), particularly among medical trainees, has seen a growth in programming that brings participants from high-income countries to low and middle-income settings in order to engage in service, teaching or research activities. Historically the domain of faith-based organizations conducting “missions”, STEGH are now offered by diverse groups including academic institutions, non-profit organizations, and the private sector, either as dedicated for-profits or through corporate social responsibility arms. The growing popularity of STEGH has resulted in concerns about their negative impacts on host communities. Traditional STEGH are often crafted with little or no input from host community leaders, and this results in activities that do not address locally identified priorities. Other concerns include culturally incongruent programming and the creation of parallel systems that disrupt established local services and redirect scarce local resources, which fosters dependency instead of building capacity. One concern specific to trainees also includes trainee provision of services beyond their scope and training level. To address these concerns, this paper presents a comprehensive framework that aims to categorize promising interventions that might promote greater responsibility in STEGH. Based on the micro-meso-macro framework, this paper proposes various interventions as incentives and disincentives to be deployed at the individual, program, and societal levels to promote greater responsibility in STEGH. Deployed altogether, the interventions contemplated by this framework would foster the optimal context required to encourage responsibility, minimize harms, and optimize host community outcomes for STEGH.
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Affiliation(s)
- Shivani Shah
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Henry C Lin
- Oregon Health Sciences University, Portland, Ore, Canada.,, Brooklyn, NY, USA
| | - Lawrence C Loh
- , Brooklyn, NY, USA. .,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7, Canada.
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Smith JN, Phan Y, Johnson M, Emmerson K, West BO, Adams J, McGiness T, Otsuka S. Describing pharmacy student participation in an international, interprofessional medical mission trip as part of an advanced pharmacy practice experience (APPE). Curr Pharm Teach Learn 2018; 10:940-945. [PMID: 30236432 DOI: 10.1016/j.cptl.2018.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 01/22/2018] [Accepted: 04/02/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND PURPOSE Several schools of pharmacy across the United States have taken steps to incorporate international medical mission trips into the doctor of pharmacy (PharmD) curriculum. This study aims to describe the impact of advanced pharmacy practice experience (APPE)-level student pharmacists on an interprofessional team during an international medical mission trip to Jamaica. EDUCATIONAL ACTIVITY AND SETTING The Jamaica Medical Mission (JMM) trip is an annual event involving healthcare professionals from several disciplines across multiple universities and healthcare systems. At this institution, the JMM trip is included as part of a rural health elective APPE rotation. Students electing to participate in this rotation are provided with the opportunity to serve as active participants on an interprofessional healthcare team in underserved and under-resourced communities throughout Jamaica. The JMM trip that took place during June 2016 included healthcare professionals and students in the fields of medicine, dentistry, optometry, nursing, and pharmacy. A total of five pharmacist preceptors and 10 pharmacy students attended the JMM trip in June 2016. Approximately three to five clinic sites per day were conducted simultaneously on each of the seven clinic days at various locations throughout Jamaica. The interprofessional healthcare teams provided free medical care, including physical exams and access to prescription and non-prescription medications. FINDINGS The interprofessional healthcare team saw a total of 1014 patients and dispensed 1879 prescriptions during the seven clinic days. A total of 811 clinical recommendations were made by student pharmacists and/or pharmacy preceptors. Of these recommendations, 561 (69%) were made by student pharmacists without pharmacy preceptor prompting, 103 (13%) were made by the student pharmacist with preceptor prompting, and 147 (18%) were made by pharmacy preceptors. Over 70% of recommendations made by student pharmacists without pharmacy preceptor prompting were accepted by prescribers. DISCUSSION AND SUMMARY This study sought to describe the impact of APPE-level student pharmacists on an interprofessional team during an international medical mission trip. Our findings demonstrate that APPE-level student pharmacists were capable of making a substantial number of clinical recommendations without preceptor prompting. The number of recommendations made by students without preceptor prompting were consistently greater than the number of recommendations made with preceptor prompting throughout the trip. Future studies should address student competence in achieving learning objectives associated with international, interprofessional APPE rotations.
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Affiliation(s)
- Jennifer N Smith
- Philadelphia College of Pharmacy at University of the Sciences, 600 S. 43rd St, Box 34, Philadelphia, PA 19104, United States.
| | - Yvonne Phan
- Philadelphia College of Pharmacy at University of the Sciences, 600 S. 43rd St, Box 34, Philadelphia, PA 19104, United States.
| | - Mikala Johnson
- Philadelphia College of Pharmacy at University of the Sciences, 600 S. 43rd St, Box 34, Philadelphia, PA 19104, United States.
| | - Kaitlin Emmerson
- Philadelphia College of Pharmacy at University of the Sciences, 600 S. 43rd St, Box 34, Philadelphia, PA 19104, United States.
| | - Bre-Oscha West
- Philadelphia College of Pharmacy at University of the Sciences, 600 S. 43rd St, Box 34, Philadelphia, PA 19104, United States.
| | - Jessica Adams
- Philadelphia College of Pharmacy at University of the Sciences, 600 S. 43rd St, Box 34, Philadelphia, PA 19104, United States.
| | - Thaddeus McGiness
- Philadelphia College of Pharmacy at University of the Sciences, 600 S. 43rd St, Box 34, Philadelphia, PA 19104, United States.
| | - Shelley Otsuka
- Philadelphia College of Pharmacy at University of the Sciences, 600 S. 43rd St, Box 34, Philadelphia, PA 19104, United States.
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Andrews RJ, Johnson W, Park KB, Roy N. Medical Missions: Mission Accomplished or Mission Impossible? World Neurosurg 2017; 103:911-3. [PMID: 28347896 DOI: 10.1016/j.wneu.2017.03.078] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 03/16/2017] [Indexed: 11/20/2022]
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Haranhalli N, Gelfand Y, Abramowicz AE, Siyez A, Elahi E, Yassari R. Surgical and Teaching Mission to Mongolia: Experience and Lessons. World Neurosurg 2017; 102:191-199. [PMID: 28254543 DOI: 10.1016/j.wneu.2017.02.059] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 02/09/2017] [Accepted: 02/11/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND For decades, the disparity in medical care across the world along with the fundamental essence of medicine as service has laid the foundation for the global medical mission. Mongolia, a country often overlooked as an area in need of medical aid, harbors a fertile environment for long-term change. In the last 15-20 years, after the fall of the Union of Soviet Socialist Republics, Mongolia has turned to a free-market healthcare model and has been struggling with the transition from the formally state-run system. These changes have slowed the original progress noted among surgical specialties, namely neurosurgery, in Mongolia. A lack of resources, a desire for international interaction, and a need for technical mentorship remain a real struggle for local neurosurgeons. METHODS Under the auspices of the Virtue Foundation (www.virtuefoundation.org), we report on our 3-year experiences during our surgical and teaching mission to Mongolia and look towards long-term improvements in Mongolian neurosurgery. RESULTS A total of 15 operations were performed and more than 50 patients seen in clinic during the 3-year experience. Patients ranged from 1 to 77 years of age. No patients encountered any significant peri- or postoperative complications. CONCLUSIONS In our experience with the surgical and teaching mission to Mongolia, when directed appropriately, medical missions can serve as the perfect medium in fostering that environment, providing local healthcare professionals with the knowledge, skills, and motivation to create self-sustaining improvement in their own country, hence promoting intellectual and technological advancement and raising the standard of care.
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Affiliation(s)
- Neil Haranhalli
- Department of Neurosurgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Yaroslav Gelfand
- Department of Neurosurgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Abai Siyez
- Department of Neurological Surgery, Shastin Central Hospital, Ulaanbaatar, Mongolia
| | - Ebby Elahi
- Departments of Ophthalmic, Oculofacial Surgery and Global Health, Mount Sinai School of Medicine, New York, New York, USA
| | - Reza Yassari
- Department of Neurosurgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
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Abstract
Responding to disparities in health, thousands of health care providers volunteer annually for short-term medical service trips (MSTs) to serve communities in need as a result of environmental, geographic, historical, or sociopolitical factors. Although well intentioned, short-term MSTs have the potential to benefit and harm those involved, including participants and communities being served. The contexts, resource and time limitations, and language and cultural barriers present ethical challenges. There have been increasing requests for standardized global guidelines, transparency, and open review of MSTs and their outcomes. Principles of mission, partnership, preparation, reflection, support, sustainability, and evaluation inform and equip those engaging in medical volunteerism.
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Affiliation(s)
- Geren S Stone
- Department of Medicine, MGH Center for Global Health, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
| | - Kristian R Olson
- Department of Medicine, MGH Center for Global Health, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
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Abstract
Disparity still exists in the surgical care between sub-Saharan Africa and developed countries. Several international initiatives have been undertaken in the past decades to address the disparity. This study looks at the impact of these programs in child surgery in Sub-Saharan Africa. Review of electronic databases Medline and African Index Medicus on international partnerships for child surgery in Sub-Saharan Africa was undertaken. Four types of international initiatives were identified and consist of periodic medical missions; partnerships between foreign medical institutions or charities and local institutions; international health electives by surgical residents; and training of individual surgeons from developing countries in foreign institutions. The results of these efforts were variable, but sustainability and self-reliance of host nations were limited. Sociocultural factors, dearth of facilities, and lack of local governments' commitment were main impediments to effective local development or transfer of modern protocols of surgical management and improvement of pediatric surgical care at the host community level. Current initiatives may need improvements with better understanding of the sociocultural dynamics and local politics of the host nation, and improved host nation involvement and commitment. This may engender development of locally controlled viable services and sustainable high level of care.
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Abstract
BACKGROUND: The escalating political and humanitarian crisis in Syria has left thousands detained, killed or displaced in neighboring countries. Given the permission and co-operation of the Turkish health authorities, a short-term medical mission to the Syrian refugee camps in the Hatay province was arranged. MATERIALS AND METHODS: To assess this mission's impact and potential expansion to serve other more emergently inflicted areas both inside and outside the Syrian borders, an evaluation was conducted via survey questionnaire of participating physicians. RESULTS: While almost all respondents found the experience worthwhile and fulfilling, medical, social and educational challenges as well as possible solutions were outlined. CONCLUSION: The use of several specified principles to further guide efforts towards providing service, education, relief, and awareness would result in greater effect, sustainability and growth of the mission.
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Affiliation(s)
- Nora Alghothani
- The Ohio State University, College of Public Health, Division of Endocrinology, Columbus, OH, USA
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