Ideas Worth Sharing

Six Easy Steps to Become a Global Health Practitioner

Mori Morikawa, MD, MPH, FAAFP

The most frequently asked questions from residents and students about global health are the ‘how to’ ones: how to get involved, how to engage, and how to build a career. The purpose of my talk is to break down the process to become a global health practitioner into six steps and discuss each step to help designing careers in global health. There is no single path to become a global health practitioner, but family physicians have tremendous advantage to become one due to our comprehensive scope of our practice. A step-by-step approach in this presentation will guide the audience as to what questions to ask and what advice to seek.

Do Short-term Medical Trips Make a Difference?

Mark Ryan, MD, FAAFP; Marwah Khalid, MD; Camille Hochheimer; Dien Tu; Goldie Chang; and Michelle Vy

There has been a significant increase in global health experiences among health professions students, clinicians, and health professional schools. Many of these experiences are in the form of short-term medical trips (STMTs), lasting at most a few weeks. Prior research has indicated that one way to enhance the impact of STMTs is to return to one community regularly, so as to become familiar with the community’s residents, resources, and needs. With increasing global attention on non-communicable diseases (NCDs), such as hypertension and diabetes, STMTs that establish a regular presence in a community will need to address NCDs and determine the most-appropriate approach for treatment. There is little systematic investigation into whether STMTs are correlated with improvement in the status of NCDs. This presentation will assess the impact of a twice-yearly STMT to Santo Domingo, Dominican Republic on hypertension and other cardiovascular disease risk factors based on medical visit records from 2011 to 2016.

What are the Costs of Global Health Rotations? Lessons Learned from the WWAMI Partnership in Malawi

Elizabeth Hutchinson, MD; Esther Johnston, MD, MPH; Anna McDonald, MD; David Kennedy; and Akira Kobayashi, MD

Knowledge and passion for global health is growing. Over the past 20 years, students have increasingly entered programs in order to participate in global health. Family medicine training views a global health curriculum as integral to addressing globalization of disease and health equity challenges. Subsequently, medical schools and residencies are implementing more global health rotations. Using the University of Washington/University of Malawi College of Medicine/Global Health Service Partnership model as an example, it is imperative that global health rotations be designed, implemented, and monitored with several features in mind, including burdens placed on host systems must be recuperated (time to orient and supervise, transportation, housing etc); the host institutions must benefit from the partnership (support with grant writing, research, teaching, administrative duties, etc.); the need for flexibility and open communication designed for problem solving and strategic planning; and rotations that continue only with permission of the host instituition leadership.

Using Narratives as a Teaching Tool to Increase Skills and Competencies in Interprofessional Provider Learner Groups

Nidhi Lal, MD

Stories reflect experiences. As physicians we have stories that tell us about our patients and their lives and serve as examples and teaching tools. Our experiences teach us not to repeat mistakes, but if captured and shared they can also teach others not to make them. We have used narratives from our clinical practices to develop a teaching tool to increase competencies in various levels of interprofessional provider learner groups. This knowledge allows learners to understand, interpret, and empathize with human actions. Our initial “wave” of collecting narratives used a prompt, focusing on “new immigrants.” We analyzed them with a medical anthropology lens to determine hidden biases, use of certain culturally-appropriate words, and understanding of cultural practices. These results, insights into some experiences, and how this powerful approach can be translated to both improved patient satisfaction and care, and more informed, culturally-sensitive interprofessional providers will be presented.

Food Security: Collaboration Between University and Community

Karen Lin, MD, FAAFP

Food insecurity is a global issue. It exists in New Brunswick, New Jersey, where only 38 percent of the population reported to be food secure during a 2009 survey. The clients of the Elijah’s Promise Soup Kitchen often suffer from illnesses due to lack of accessibility, affordability, and availability of quality foods. The small seed grants from Rutgers University supported community-based research. One of them is a stipend-based community garden program for vulnerable population, including the homeless, immigrants, veterans, and migrated workers. The participants obtained gardening skills and fresh produce knowledge, completed own sketching, and reflection at the end of each session. Presenter will share the positive outcomes of participants; the richness of their sketching and reflection; the benefits of interdisciplinary education; the inspiration of future university-community partnerships; and the empowerment of peer leaders and networks. At the same time, we will discuss the challenge of institutional review board and implementation, as well as the gaps in sustainable funding supports.

Local Global Health: Truths and Myths about Obstetrical Care Along the U.S.-Mexico Border

Myles Stone, MD; and Zoe Cappe, MD

Family physicians that provide obstetrics care around the world often manage patients with minimal prenatal care, transient housing in migrant shelters, and increased exposure to Zika virus and tuberculosis. But this isn’t just the practice of physicians abroad, this is family medicine in southern Arizona along the U.S.-Mexico border. The border region is a complex and interesting environment, and it poses some very unique public health questions. The stereotypes may not always match the reality. For instance, pregnant teens living in Mexico are more likely to receive early prenatal care than those in the U.S. The C-section rate is much higher along the border than it is throughout the rest of either country. This presentation will review the current border health literature and present several cases of pregnant women living along the U.S.-Mexico border and share the lessons of global health being applied at a local level.