Teaching Global Health Lecture Series

Learn from colleagues who have expertise and passion in certain global health topic areas. These sessions are perfect for those looking to expand their knowledge base in core and contemporary global health issues. This lecture series can model didactic approaches for faculty and trainees who are developing curriculum within their institutions.

Workshop Topics

Workshop sessions that focus on clinical issues are denoted with an asterisk (*).

Thursday, September 8, 2016, 9-10 a.m.

Pre-Travel Consultations

Jeffrey Hall, MD, FAAFP

International travel continues to increase. Patients are traveling farther, faster, and more frequently than ever. Also, patients with health conditions that might previously have kept them from traveling internationally often want to continue planning trips for business, service, or recreation. Family physicians are often the clinicians best suited to evaluate the patient’s medical needs and risks associated with travel. They can provide or recommend the appropriate vaccinations, medications, or emergency plans for unanticipated events that can occur while patients travel to areas remote from care.
Room Location: Piedmont

Parasitology I: Malaria*

Mark Huntington, MD, PhD, FAAFP

Although global health involves more than exotic infections, infectious diseases remain common in much of the world. Malaria is arguably the most important infectious disease in the world today and throughout history. Pathophysiology, clinical presentations, diagnosis, transmission, treatment, and prevention—for both locals and expatriates—will be covered during our time together.
Room Location: International Ballroom

Thursday, September 8, 2016, 10:15–11:15 a.m.

Developing A Global Health Initiative at a New Medical School: Challenges and Opportunities

Rachel Yoskowitz, MPH

A growing body of literature about global health (GH) ethics and practice accompanies the fields’ evolution from independent parachute practitioners to a field of medical specialization. Developing a corps of physicians educated to practice globally presents challenges. Developing a GH curriculum within a new school of medicine presents even greater challenges, ranging from compliance with Association of American Medical Colleges guidelines, Liaison Committee on Medical Education standards, and student expectations within the reality of a full course of study. Students’ prior experiences with “voluntourism” and their perceptions of global practice are inconsistent with best practices in resource poor settings. Students’ desire for autonomy and unsupervised clinical experiences present additional barriers. Understanding and addressing these barriers has enabled the Oakland University William Beaumont School of Medicine to implement a GH program that integrates core issues in global practice across multiple longitudinal courses and offers clinical opportunities through partnerships with medical schools abroad, global health learning opportunities participation, Child Family Health International affiliation, summer internships, and mentored experiences with clinical faculty.
Room location: Inman

Thursday, September 8, 2016, 2:15-3 p.m.

Human Trafficking: An Overview

Ranit Mishori, MD, MHS, FAAFP; and Katherine Stolarz, DO

Human trafficking is a widespread problem with estimates ranging from 14,000 to 50,000 individuals trafficked into the U.S. annually. This hidden population involves the commercial sex industry, agriculture, factories, hotels, restaurants, domestic workers, marriage brokers, and some adoption firms. Health care professionals may be one of the few professions likely to interact with victims while enslaved. About 30 percent of trafficked individuals will be exposed to the health care system at some point during their captivity, yet they are seldom recognized as victims. Lack of awareness due to sub-optimal educational opportunities plays a key role in why clinicians are not equipped to screen, identify, or care for victims of trafficking. We will review statistics; identify the types of trafficking and their related health consequences; and efforts to train clinicians to screen for, identify, and manage trafficking victims and survivors.
Room location: Piedmont

Care of Sick Children in Low Resource Settings*

Martha Carlough, MD, MPH

Young children in low- and middle-income countries are susceptible to significant infectious and trauma-related risks that may be different and more acute than competent U.S.-based clinicians may be familiar with. Often treatment options are limited, but national guidelines and protocols define appropriate care. Rapid initiation of treatment is important to save children’s lives. It is essential that family physicians and other providers working with pediatric patients in low- and middle-income countries have the knowledge and skills necessary.
Room location: International Ballroom

Thursday, September 8, 2016, 4–5 p.m.

The ABCs of FGM/FGC:  Female Genital Cutting/Mutilation: What Clinicians Need to Know*

Ranit Mishori, MD, MHS, FAAFP and Katherine Stolarz, DO

Female genital mutilation/female genital cutting/ (FGM/FGC) is a practice that involves partial or total removal of the external female genitalia or other injury to the female genital organs for non-therapeutic reasons. It is common in several regions worldwide and more than 100 million women and girls are estimated to have had FGM/FGC. The practice has serious, life-threatening health risks for children and women, manifesting acutely or chronically. Negative obstetric outcomes have also been reported. U.S.-based physicians may encounter FGM/FGC in their immigrant and refugee populations, and should have a basic understanding of the practice, its clinical management, cultural ramifications, and communication strategies. In addition, physicians should understand the legal and ethical implications surrounding deinfibulation and reinfibulation and their own beliefs regarding these practices. This presentation will draw on a variety of published sources and expert experience and opinion to present best practice in the management of girls and women with FGM/FGC. The presentation will provide some case-based examples to promote discussion and problem solving within the group.
Room location: Inman

Advocating for Ethical Best Practices of Pre-Health Students Internationally: An Interactive Session to Organize Around Influencing Medical School Admission Policies to Promote Ethical and Appropriate International Health Experiences

Ben Pederson, MD; and Jessica Evert, MD

The expansion of pre-health student interest and involvement in international experiences puts communities and participants at risk for unethical health-related activities by untrained students abroad that overstep ethical and professional boundaries. The majority of medical schools do not have policies defining what constitutes appropriate pre-health activities for applicants and value hands-on patient care experience prior to formal training. There is growing national advocacy to promote the awareness of this issue with the goal to influence medical school admissions policies to address this issue. This interactive workshop session is designed to bring together students, residents, and physicians in family medicine to discuss how we can unite and organize to promote best practices of pre-health students and motivate medical schools to adopt admission policies that specify desirable, acceptable, and ethical experiences for pre-health students participating in global health experiences.
Room location: International Ballroom

Friday, September 9, 2016, 9-10 a.m.

Human Rights–Why is it a Doctor’s Business?

Ranit Mishori, MD, MHS, FAAFP

Why should doctors care about human rights? What are major human rights crises in the world today and how can doctors get involved? Whether they work abroad or in the U.S., students, residents, and doctors will encounter individuals whose health and well-being are deeply affected by human rights violations, such as torture, female genital mutilation, violence, human trafficking, sub-standard prison conditions, child labor, or illegal working conditions. Health professionals have a unique role to play, not only in caring for these individuals, but in responding to human rights violations, and in mobilizing others to try to stop these violations. Doctors have a special responsibility to speak out based on their ethics and broader advocacy for their patients and in support of global health issues.
Room location: Techwood

Cross-Cultural Health Care Skills

Nicholas Comninellis, MD

One’s culture, health, and approaches to health care are all closely connected. Better cross-cultural skill holds promise for improving health outcomes and reducing disparities. Culturally competent health care is attained through a process that includes awareness of differences and biases, attitudes of respect, increasing knowledge of cultures, and applying the skills of observing, understanding, and adjusting. This presentation includes case studies and interactive use of role-play to enhance the learning experience.
Room location: International Ballroom

Friday, September 9, 2016, 10:15–11:15 a.m.

Post-Partum Hemorrhage in the Tropics*

Jeffrey Perry, MD

Post-partum hemorrhage (PPH) is the leading cause of maternal mortality in sub-Saharan Africa. Common causes include uterine atony, retained tissue, and lacerations, and can be severe, especially if the patient presents late. In the tropics, such cases may be complicated by coagulopathy and thrombocytopenia. Contributing factors may be recurrent malaria, chronic anemia due to nutritional factors or hemoglobinopathies, and reactive hypersplenism (tropical splenomegaly). Treatment is complicated by limited blood products, late presentation due to poor infrastructure and transportation, and cultural factors. Even if PPH occurs in a health facility, these factors make treatment challenging. Despite surviving the initial hemorrhage, complications such as renal failure can lead to mortality seven to eight days postpartum in settings where limited laboratory and no dialysis exists. Several cases of complicated PPH are presented, highlighting the key factors that can lead to successful management—a team approach involving prompt medical treatment, ultrasound evaluation, transfusion, curettage, and surgical management.
Room location: Piedmont

Parasitology II: Gastrointestinal Parasites*

Mark Huntington, MD, PhD, FAAFP

Although global health involves more than exotic infections, infectious diseases remain common in much of the world. Gastrointestinal parasites are among the most common infections worldwide. Recognizing that memories of your parasitology course in medical school may be distant, this session is the second part of a concise overview of the field of parasitology. Focusing on important worms and germs that infest the gut, this session will dust off those neurons used to describe the clinical symptoms, transmission and prevention, and treatment of parasites of the digestive track. In addition to a significant yuck-factor, these parasites are responsible for significant morbidity. Simplified and amply illustrated with plenty of graphic images that will spoil the appetite of even the most stoic, you’ll walk away from this presentation remembering far more about parasites than you probably desired.
Room location: International Ballroom

Friday, September 9, 2016, 3:15–4:15 p.m.

Medical Care for Undocumented Immigrants*

Thien-Kim Le, MD; Teresa Beck, MD, FAAFP; and Megha Shah, MD

The number of undocumented immigrants (UI) varies worldwide and the majority resides in the U.S. With over 12 million UIs in the U.S., addressing the health care needs of this population presents unique challenges and opportunities. The majority of immigrants to the U.S. are from Mexico, and although private insurance plans are available, most UIs are uninsured, relying on the safety-net health system for care. In general, due to younger age, this population is considered to be healthier than the overall U.S. population. However, they have specific health conditions and risks. Knowledge of this nature is imperative for health care systems and providers. While several provisions allow some services for this population in the U.S., coverage is lacking. However, there are examples both nationally and internationally to better address the health needs of UIs.
Room location: Piedmont

Duct Tape and Extra Fuses: Repairing Medical Devices Abroad

Myles Stone, MD

The digital divide is closing for many patients around the world. Cell phones are ubiquitous, and more and more field clinics are being outfitted with electrocardiogram machines and other devices. However, these devices are often secondhand, and are rarely sent with spare parts or people who know how to fix them. World Health Organization guidelines and current global health literature will be presented to help participants choose which medical devices are appropriate for various global health settings, and which are best left at home. Most importantly, participants will learn how to keep their equipment running in resource-limited settings. With just a few dollars worth of spare parts, many devices can be repaired safely and quickly. This session will be led by a former medical device engineer and current family medicine resident. It is suitable for people of all technical skill levels.
Room location: International Ballroom

Saturday, September 10, 2016, 9–10 a.m.

Parasitology III: Vector-Borne Parasites*

Mark Huntington, MD, PhD, FAAFP

This is part three of a concise overview of the field of parasitology. Zika virus has captured the news lately, but what of other insect-borne infections? In part one of this series, we reviewed malaria. This part will examine the rest of vector-borne parasites (but leaving the bacteria and viruses for another time). The majority of these worms and germs infest the body outside of the digestive system, and tend to be more malignant than the gut-dwelling ones. Don’t worry if your memory of prior parasitology courses is rusty. Simplified and amply illustrated with plenty of images that will make even the most stoic cringe, you’ll walk away from this presentation with a recharged knowledge base, along with a remarkably persistent creeping sensation.
Room location: International Ballroom

Saturday, September 10, 2016, 10:15-11:15 a.m.

Evaluating Returned Travelers

Jeffrey Hall, MD, FAAFP

The expansion of international travel throughout the globe allows for the possibility of exotic diseases to be imported to our doorstep. Family physicians are often the first to examine these returned travelers and must be able to recognize emergencies and the most frequent causes of common complaints. The differential diagnosis should include the usual etiologies, as well as those more unique to the region from where the traveler is returning. The workshop will discuss the evaluation of returned travelers with complaints such as fever, diarrhea, or respiratory symptoms. Recognition of emergency situations and a plan for management will also be discussed.
Room location: Piedmont

Zika Virus, a Literature Review: Are We Prepared for the Zika Pandemic?*

Naushad Amin, MD; Michelle LaBrunda; Mena Ramos, MD; and Neil Jayasekera, MD

The Zika virus, first discovered in 1947, gained little attention until recently. In 2015, a Zika pandemic emergered in Brazil and by 2016 spread to U.S., bringing attention to the Zika virus among both the medical communities and the general public. The authors present a unique case of the Zika virus infection, acquired during a mission trip to Haiti and complicated by the development of Guillain-Barré syndrome. The following includes the review of the currently available literature on the Zika virus infection, including history and epidemiology of the disease, clinical presentation, differential diagnosis, available diagnostic tools, and potential complications. Also, the role of bedside ultrasonography in identification of microcephaly and the Centers for Disease Control and Prevention guidelines for prevention of spreading the Zika virus will be discussed.
Room location: International Ballroom

Saturday, September 10, 2016, 11:20 a.m.-12 p.m.

A Student-Run Asylum Program: Service, Capacity Building, and Refugee Health

Ranit Mishori, MD, MHS, FAAFP

According to U.S. government statistics, in 2013 (most recent data available), 25,199 persons were granted asylum status in the U.S. In order to obtain asylum status in the U.S., seekers must undergo a full medical and psychological evaluation as means of providing evidence of ill treatment, abuse, and torture. Some health care professionals are trained to document forensic evidence of various forms of harm, including torture. The process of conducting an asylum evaluation and writing a medicolegal affidavit can be quite lengthy and requires specialized clinical skills. Despite training and recruitment efforts, there is a reported shortage of providers who can expertly and adequately participate in the asylum process and respond to the increasing demand. We report on efforts by a group of Georgetown University medical students working with a faculty advisor and with Physicians for Human Rights to create a program to train health care professionals, residents, and students to perform medical evaluations for individuals seeking asylum in the U.S. An associated curriculum was developed and focuses on refugee and asylee health topics, including torture, female genital mutilation, trauma-informed care, and other topics.
Room location: Roswell