Celebrating the 7th Annual Traditional Midwife Training

by Lyndsey Brahm, Program Coordinator

You could feel the afternoon heat of Puerto Escondido’s tropical sun blazing through the open-air patio that overlooks a precious slice of Oaxaca’s coastline. The fans provided little relief from the thick air, nor did the ocean breeze coming off of Puerto’s infamous Playa Zicatela. But the heat and subsequent lethargy were no match for 37 practicing midwives (parteras tradicionales), 6 medical students from Northwestern University Feinberg School of Medicine, CFHI participants and staff, and clinical and public health officials from the Oaxaca Ministry of Health who joined forces for the 7th Annual Traditional Midwife Training in Puerto Escondido, Oaxaca, Mexico.

IMG_2956This CFHI community health project is a shining example of the value of reinvesting in host communities and the importance of collaboration, welcoming diversity in our interactions, and connection amongst people of different cultures; all of which represent values CFHI has long held in high regard. The curriculum for the training is prepared by the coastal region branch of the Oaxaca Ministry of Health and addresses safe birth techniques, detection of warning signs, knowing when to refer to a physician, appropriate care for a newborn, etc. The training is then delivered by Northwestern University medical students entirely in Spanish. Even though the midwives are receiving the training they are also very enthusiastic about sharing their expertise and the traditions that have maintained their virtue across generations.

It is an extraordinary opportunity for each midwife to take part in the 4-day training in Puerto Escondido, especially those traveling from remote villages of Oaxaca’s coastal region. This year 37 midwives attended, several of whom returned from previous years and quickly showed leadership within the group. The midwives are selected according to location, the goal being to invite those spanning a large geographic area, and the number of births they attend to, a statistic reported to the Ministry of Health by a practicing physician within each community. The midwives are often leaders within their communities and held in high esteem. They return to their villages and share knowledge and resources gained during the training.

DSC00107Two of the midwives braved the Oaxacan sun and traveled on foot for 4 hours to reach Puerto Escondido after catching a bus from their villages. You could see the determination on their faces to make the most of this professional development opportunity.

It is programs such as this that CFHI takes pride in supporting year after year. One that impacts the community by giving them the tools to take ownership of their own future.

CFHI Student Spotlight: Ross – Reproductive Health, Quito Ecuador

CFHI student spotlight showcases students who have been and are working in one of our many programs . This is a feature where we highlight the students’ experience, if you would like to be featured please contact CFHI’s outreach director Keaton Andreas via email Keaton@cfhi.org. 

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Ross is involved in Pace University’s Physician Assistant program. He is interested in Women’s Health, Primary care/preventative medicine, and pediatrics. He selected the Reproductive Health rotation in Quito, Ecuador, because he is around spanish speaking patients back at home and wants to be able to speak to his patients in whatever language that makes them most comfortable.

 

 

 

  1. What school did/do you go to?  Pace University’s Physician Assistant Program
  2. How did you hear about CFHI? It’s the international rotation provider my school works with.
  3. What areas are you interested in regarding medicine? Women’s Health, primary care/preventative medicine, pediatrics
  4. What program are you in and how did you determine that was the right one for you? Reproductive Health rotation in Quito Ecuador;  I selected this program based on my interest in reproductive health and my desire to improve my medical Spanish.  I live in NYC, where many patients only speak Spanish, and I want to be able to speak to my patients in whatever language makes them most comfortable.
  5. What were your expectations for the trip and how have those matched up with reality? My expectations were that the rotations would be largely observation with the opportunity to take histories and present patients in order to practice discussing patients in Spanish.  My expectations have been surpassed.  I have rotated through very different locations in OB/GYN, emergency medicine, and primary care, giving me exposure to a diversity of medical situations.  
  6. What has been the best part of your experience so far? The best part is definitely the cultural immersion, which also happens to be the most difficult part.  The discomfort of being in a totally new place is what forces you to adapt.  It is absolutely the reason my Spanish has improved so much.
  7. Who are you working with? Depending on the location, I have mostly worked with the attendings.  At one of the sites, I was matched with a resident, which was a nice opportunity, as they usually do more procedures.
  8. What is the overall goal of your program? My overall goal was to improve my medical Spanish.
  9. What is your overall goal? What do you want to accomplish through your program? Same ^ [Same answer as the previous question]
  10. What are some cultural things you have learned? The primary cultural difference I have noticed, at least medically, is that family is prioritized by patients over everything, including privacy.  This is definitely different in the U.S.  We learn that in order to get an honest history it is best to talk to the patient alone.  That is often not an option here.  It is interesting that people have such a level of comfort regarding their personal medical details, definitely surprising at times.

Photo of the Week FAQ

thumbnail_1 CFHI wants to help you share your one of a kind moments from your program! We are excited to be starting a ‘Photo of the Week’ contest where we will select a winning photo every Friday of the week. Entering your photo is simple, just tag us on Facebook and or Instagram @CFHIglobalhealth and use our hashtag #LetTheWorldChangeYou. Just take a quick look at our Social Media Ethics and our Photo Contest guidelines.

ATTENTION ALL ALUMNI: We also want you to share your past experiences with us, you are encouraged to post any past photos! Just use the hashtag #LetTheWorldChangeYou, #TBT, and tag us @CFHIglobalhealth, your photo could be featured in a Throwback Thursday post!

FAQ

How long does the POTW contest last?

The Photo of the Week contest is a summer event that CFHI is running for 8 weeks over July and August  of 2016. Individuals can tag their photos they take/took while partaking in one of CFHI’s 30+ programs. Every Friday starting July 1 – August 26, we will announce a ‘Photo of the Week’, or a photo we felt best represented CFHI’s motto of ‘Let The World Change You’!

How do I enter?

This is an online social media contest therefore you are automatically entered by posting a photo and tagging us in it instagram @CFHIglobalheath or by tagging ‘Child Family Health International’ on Facebook. You should also use the hashtag #LetTheWorldChangeYou!

Where can I post?

We will choose the POTW winner based on Instagram and Facebook posts. However, you are free to post on any social media site (Twitter, LinkedIn, etc.), just remember to tag us!

What are you looking for in a winning photo?

We want to show what it is like to be a participant in CFHI’s worldwide programs! We are looking for photos that best represent you and your program, the work you are doing, and the experience you are having. We know that there will be many interpretations of this and we are so excited to see what you come up with!

What can’t I post?

Please refer to our guidelines below for instructions on how to be a conscious photographer. You cannot post any photo that exploits or misinterprets people, places, and situations you are in. For greater detail, please refer to our Social Media Ethical guidelines here

Can I win more than once?

With over hundreds in our summer programs and 8,000+ alumni, we want to be as fair as possible and see different people from different programs each week! However, it is possible to win more than once, just not in a row. So share as many photos as you would like!

What if I want to share old pictures?

We absolutely want to see and feature alumni photos too! Just post on instagram, tag us in the photo (@CFHIglobalheath), and use the hashtags #LetTheWorldChangeYou and #TBT so we can select your photo for a throwback Thursday special mention!

Do I get a prize?

Gloating rights and a sweet congratulations card from CFHI, what more could you want! 😉 All winning photos will be used throughout our social media channels and maybe even in our future promotional material, you famous photographer, you!

Where will you feature my photo?

We will feature your photo on Instagram, Facebook, and might use it for other promotional purposes throughout the year. Each time we do, we will tag you or make sure to credit you and your great photographic skills!

  

CFHI Bolsters Staff With Advocacy Expertise

Child Family Health International is pleased to welcome Keaton Andreas as Director of Outreach.  Keaton brings to CFHI a passion for advocacy and community organizing having honed his skills as Campus Campaigns Organizer for Universities Allied for Essential Medicines. CFHI Board Chairman, Gunjan Sinha, reflects “it’s exciting to hire someone with a community-building approach to our outreach position.  Keaton’s unique point of view will allow CFHI to expand the thought leadership community that CFHI has been nurturing for nearly 25 years.”  

keaton_bio_picKeaton will expand CFHI’s advocacy training for CFHI scholars and alumni in order to meet CFHI’s mission of creating changemakers through programs that emphasize the strengths in communities abroad often noted for what they are lacking. Keaton received his Master’s in Intercultural Studies from Fuller Seminary in 2011.  Fuller Theological Seminary is one of the United States most influential institutions of its kind with over 4,000 students representing 90 different countries.

Ethical Dilemmas in Global Internships: Lessons from the GIC 2016

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by Robin Young
Assistant Director, Africa and Asia

“The first year that the Northeastern Students came to the Tunaweza Children’s Centre in Uganda, it was wonderful!” shares Titi Pamela Kakonge, founder of the Centre, which offers a range of therapies for children with disabilities. “But then they left, and all the local parents withdrew their children from our school. They thought that since the Mzungus (white people) had gone, the program was over.”

The vacuum left by the departing students was gaping, despite the fact that the Centre was led and staffed by a robust local team. After that, Ms. Kakonge and Northeastern University worked together to find ways to ensure that the community saw the local staff as the leaders and the teachers, not vice versa. Today the Centre runs year-round, successfully receiving interns from Northeastern and other institutions, with clear local leadership and well-defined job descriptions for the physical and speech therapy interns.

I heard Ms. Kakonge speak at the Global Internship Conference in Boston earlier in June, at a session titled “Tunaweza Children’s Centre- We Can: An Interprofessional, International Partnership with Northeastern University’s Bouvé College of Health Sciences.”  Ms. Kakonge founded the Centre while searching for adequate care and services for her daughter who was born with disabilities. The challenge that she highlighted above has been well documented.

Pamela Roy, Farzana Karim-Haji, and Robert Gough call this the ‘revolving door’ nature of exchange between students and hosts, and propose several ideas for host communities to address this ethical dilemma, all of which Northeastern is now utilizing. They suggest making certain that students are sufficiently prepared for the experience, taking steps to ensure that host community needs are truly being met through the internship, and equipping students to listen, observe, and learn from the host community.

During their session at the GIC, Roy, Kaim-Haji, and Gough, drawing on their experiences at Aga Khan University, Western University, and the Consultancy for Global Higher Education, highlighted a new, open-access resource they have developed, titled “Building Ethical Global Engagement with Host Communities: North-South Collaborations for Mutual Learning and Benefit.” In it, they compile recent findings and summarize the ethical dilemmas that challenge all of us who engage in North-South Global Internships, including mobility inequality (in which students from the north have more access to the south in terms of professional development and career opportunities than vice versa); exploitation of the host community as research participants; and unethical marketingand advertisement to promote global internships, to name a few. The resource offers definitions of these dilemmas and offers a series of recommendations that can help all of us in the field to improve our global internship offerings.

At CFHI, we’re always thinking about how to offer internships that, to quote a recent publication on short-term global health experiences, “Optimize community benefit and learner experience.” From where we stand, an internship should only take place if we can ensure that it benefits, within an ethical framework, our partners around the world, as well as the intern.  We do this by engaging in fair trade learning practices, ensuring that our partners are fairly compensated for their work and have substantial leadership and input into all internships and programming; by requiring our participants and interns to complete the Global Ambassadors for Patient Safety modules, preparing them to engage in ethical medical practice that prioritizes patient safety at all times; and by inserting interns into existing healthcare and social service systems, with local leaders who focus on assets rather than deficits in their communities. I had the opportunity to share some of these resources during a session at the GIC alongside Moira Mannix Votel, Associate Co-op Coordinator & Director of Cooperative Education at Northeastern University’s Bouve College Cooperative Education.

At CFHI, we strive to close the ‘revolving door’ referred to earlier.  It is important to us to create leaders for the future who understand a larger view of the world beyond their own.  We are continuously pushed and encouraged by the input of our colleagues in this field and look forward to moving this conversation forward at any opportunity.


Rorobinyoungphotobin joined the CFHI team in 2015. As Assistant Director, Africa and Asia, she provides program management and support for CFHI’s programs, helping to ensure program safety and quality, best practices in international education, and strong institutional and global partnerships. Robin’s professional background includes extensive work in international education, global health, and asset-based development. Robin holds an MBA from Florida International University and a BA in Sociology/Anthropology with a minor in Ethnic Studies from Lewis and Clark College. She completed a course at the Summer Institute for Intercultural Communication, helping to inform her interest in increasing intercultural competency in global work and education, and subsequently co-authored the Cultural Detective Dominican Republic series. Robin received a Fulbright Fellowship grant in 2007 and spent a year researching gender-based violence in the Dominican Republic, where she ended up living for nearly 5 years. Robin is passionate about supporting thoughtful, ethical and asset-based strategies to address health disparities and support underserved communities. She lives in the Bay Area and loves backpacking, riding her bike, and spending time with family and friends.

 

A Recap of CFHI’s Time at PEGASUS 2016

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CFHI was proud to send their Program Coordinator, Lyndsey Brahm, to the 2016 PEGASUS Conference that took place in Toronto over May 13th to 15th.  PEGASUS is an acronym derived from the conference’s three main themes of peace, global health and sustainability. Leaders, change-makers, professionals and students from multiple disciplines convened to share their expertise in research, education, field experiences, advocacy and policy in order to address unacceptable levels of poor health nationally and internationally.

CFHI hosted a workshop on asset-based community development (ABCD) and introduced our vision into how recognizing assets within a community as opposed to what is lacking can prove to be a successful global engagement approach and can lead to communities feeling more empowered. CFHI has numerous partnerships throughout ten different countries and prides itself on fostering sustainable relationships and not being “fair weather friends.” We want the communities we work with to take ownership of their own development and to be enthusiastic about sharing their expertise with our global health scholars who come seeking new perspectives in health and medicine, outside of their own system.

Program Coordinator, Lyndsey Brahm asserts, “We want people to challenge their way of thinking and to see past what may initially appear as image2chaos and devastation; to lend time towards learning about innovative ideas already in place and community strengths that are critical to overcoming health challenges that persist within their community.”

A buzz was in the air as this thought-stimulating conference carried on throughout the weekend. One presentation that stood out from our perspective belonged to Matt DeCamp, Assistant Professor at the Johns Hopkins Berman Institute of Bioethics and in the Johns Hopkins Division of General Internal Medicine. He spoke on the subject of global health ethics, encouraging students and trainees to go abroad for longer, and the development of appropriate pre-departure materials. He shared his experience about a global health trip he undertook as a medical student at Duke University, where he faced challenges cultural differences and was exposed to human rights. He remembers feeling unequipped and under prepared to deal with such circumstances. He now contributes to the development of adequate pre-departure materials for those seeking an international health experience and runs focus groups for returnees at Johns Hopkins University.  CFHI recently gave a webinar on this very subject.  Which is available by clicking here.

CFHI was excited to be a sponsor for this year’s PEGASUS conference.. It is a valuable space for CFHI and others within the field to challenge one another and generate new ideas, actions and policies to improve the health and well being of the world’s citizens, whether on a small or large scale. The commitment is fierce.

The Joys of Motherhood: Sharing CFHI’s Impacts with my Children

Mother’s Day post by Jessica Evert, MD, CFHI Executive Director

It’s been said that “having kids- the responsibility of rearing good, kind, ethical, responsible human beings- is the biggest job anyone can embark on” (Maria Shriver). The challenge of mothering is monumental, yet there are precious pieces of this world that aid us in the journey. For me, one of those pieces is Child Family Health International (CFHI). IMG_7937 Jess & the kids

Through my involvement with and support of CFHI, my daughter has come to learn about a world beyond her imagination and comfort zone. I have been able to support mothers in 10 countries; community leaders who are passionate about making those struggling in their midst better off; and young people who are embarking on a transformative experience abroad that will raise their consciousness of global citizenship and make them feel a “a little softer about places that are not as economically well off,” as one CFHI Medical Director put it.

The day in and day out of mothering is a frequently overwhelming cacophony of whining, laughter, hugs, and shrugs. There are moments that intersperse our daily routine and allow us to expand our children’s worldview. These moments make us feel like super mamas. Through CFHI I am able to be the mother I want to be for my children and the children of the world.

Although my financial support of CFHI is modest, it is steady. Through this steady giving to CFHI, I am confident I am contributing to a better world. Through modeling generosity for my children, I am confident I am shaping the kind, ethical, responsible humans that I hope they will become.

International Women’s Day 2016: Celebrating CFHI’s Inspirational Women in Global Health

CFHI is proud to have worked with many talented and empowered women in global heath, who are inspiring change in their local communities. Please join us in celebrating some of these truly remarkable women.

Isabel SaucedoDr. Isabel Saucedo
CFHI Medical Director Puerto Escondido, Mexico
Dr. Isabel Saucedo has been a vociferous champion of women’s reproductive health throughout her medical career. A consummate health professional and mother of two, Dr. Saucedo manages domestic violence training programs for women, as well as maternal care. She was also the catalyst for kick starting the Traditional Midwives Training program in Oaxaca, set up in collaboration with the local Ministry of Health. We are grateful to have her as a partner and friend and wish to see her continue her work in the local community.

Hema PandeyHema Pandey
CFHI India Director
Hema recently celebrated her 10-year anniversary with CFHI, and what a journey it has been. She has been instrumental in expanding CFHI’s programs across India, and today she manages 8 thriving programs that address health topics such as maternal and child health, traditional medicine, chronic disease, and palliative care. She has worked tirelessly to gain the respect of her peers and excel in what is a highly male-dominated profession. We are very fortunate to have worked with Hema throughout the years – and here’s to ten more years to come.

Cecila UribeDr. Cecilia Uribe
CFHI Medical Director La Paz, Bolivia
A dedicated pediatrician, Dr. Cecilia Uribe has been committed to serving the underserved women and children in her local community. Observing an unfortunate trend in La Paz for single mothers to fall into a vicious cycle of poverty, Dr. Uribe responded by creating a safe haven for young mothers. The Young Mother’s Empowerment Center (EMJ) is a place of hope where these women can get back on their feet through easy access to education, vocational training, and child-care. Dr. Uribe has left an indelible mark on the well being of her community and we are so proud of her achievements.

Susana AlvearDr. Susana Alvear
CFHI Medical Director Quito, Ecuador
Dr. Susana Alvear is a family physician from Quito who has dedicated her life to improving the local healthcare system in Ecuador and creating equitable access to healthcare, especially in poor, underserved communities. As a CFHI partner, she has been a staunch advocate of empowering local medical professionals, and giving them the training and resources they need to better serve their people. We are truly inspired by Dr. Alvear’s passion for helping those who suffer extreme poverty, discrimination, hunger, and illness and we hope that you are too.

Avril Whate 2 (1)Avril Whate
CFHI Medical Director Cape Town, South Africa
Avril Whate is a Nurse Practitioner who supervises one of CFHI’s most popular programs in Cape Town, South Africa. She has been with CFHI since 2004, has worked with the Provincial Health Department for over 20 years, and remains a strong advocate of public health programs. Avril makes a tremendous effort to ensure that our students have a fulfilling experience during their time in Cape Town, and enjoys learning about global health concerns and their impacts on the community. We have really enjoyed working with Avril, and her commitment to our students and health programs is truly admirable.

Magaly ChavezDr. Magaly Chavez
CFHI Medical Director Oaxaca City, Mexico
Raised in a small rural town in Oaxaca, Mexico, Magaly cherished the seemingly impossible dream of one day becoming a female physician. However, through hard work and perseverance, she went on to become the first doctor in her family, as well as the first female doctor in her hometown. Today, Dr. Magaly Chavez manages CFHI’s Health Access and Inequities program in Oaxaca. Dr. Magaly’s strength and determination serve as an inspiration to so many women so are striving to achieve gender parity in male dominated societies and professions.

 

Hasta pronto, Córdoba

Sophia Alvarado is a pre-medical student at Diablo Valley College and a member of the American Medical Student Association (AMSA). Sophia received a scholarship to participate in CFHI’s Global Health Intensive Program, Hospital Medicine in Latin America, in January 2016. The following is an excerpt from her blog. This post was originally published on January 15, 2016.

IMG_8938Everyday in the hospital was a new and fun experience for me and I am so happy that I decided to come to Córdoba and participate in the Hospital Medicine program through CFHI. I have had the opportunity to see and learn things now that back home I might not have seen until the end of medical school or even until residency. All the people I got to meet and talk to have been so great and helpful. Overall, my time in the hospital surpassed all my expectations and I hope that I can come back soon.

I want to say thank you to everyone at CFHI in California and everyone at ICC and the Hospital de Urgencies here in Córdoba. This experience was so amazing and I will cherish the time that I have had here for the rest of my life. Leaving Argentina is really bittersweet but this is definitely not the last time that I will travel to this amazing place. Again, thank you to everyone involved in this program – words cannot fully express how much I have enjoyed my time here and how truly sad I am to go.

Read more from Sophia’s blog at http://californiatocordoba.blogspot.com/.

 

Traditional Healer

Courtney James is a Senior Resident in Baton Rouge, LA and a member of the American Medical Women’s Association (AMWA). Courtney received a scholarship to participate in CFHI’s program Exploring HIV & Maternal/Child Health in Kabale, Uganda in November 2015. The following is an excerpt from her blog “CFHI Uganda Experience.” This post was originally published on December 29, 2015. 

I visited the Traditional Healer during my stay. You can’t fully understand health in Kabale without discussing the Traditional Healer’s role. I believe they quoted a percentage of about 90% of Ugandan natives have utilized the traditional healer at some point in their lifetime. The healer is sought for a multitude of ailments such as malnutrition, allergies, arthritis, GI issues, sexual dysfunction (hahaha). He has so many different herbal remedies that he prescribes for each issue.

img_42551KIHEFO has respectfully bridged a partnership with the healer in hopes that the two entities can coexist without disregarding the other. KIHEFO has provided education to the healer regarding complex cases that should be referred for medical intervention, especially Malnutrition. So many people believe that malnutrition is due to a curse and therefore they seek the healer’s herbal remedies in hopes of curing the child. This is very dangerous and unfortunately some families seek medical treatment when things are severe. Since KIFEHO has started communicating with him the healer does sometimes refuse to treat complex cases and KIHEFO has seen a reduction in the severe cases that present to the Nutrition center.

Read more from Courtney’s blog at https://cjglobalhealth.wordpress.com/.

Young Leaders of Global Health Ask for a Seat at the Table if They are to be the Ones to Usher in the Sustainable Development Goals (SDGS)

This blog was written by Caity Jackson, Co-Founder & Communications, Women in Global Health and Director of European Engagement, CFHI. It summarizes Panel 4 from the GHLS 2015 Symposium titled Young Global Leaders Reflect – How Will I Shape the SDGs? It was originally published on Global Health Council’s Young Global Leaders Blog on November 23, 2015.

The 2015 Global Health Landscape Symposium’s final panel, ‘Young Global Leaders Reflect: How will I shape the SDGs,’ challenged today’s leaders to institutionalize young peoples’ involvement in the Sustainable Development Goals (SDGs).  Three themes guided the discussion, including recognizing the important role the enormous population of youth have in ushering in these goals, ensuring young voices are heard in these discussions and invited to the decision-making tables, and encouraging true collaboration at all levels, with a focus on capacity-building and training in this skill for young leaders.

Moderated by Kyle Peterson of FSG, the stage was alive with ideas and energy as all the panelists considered on their own experiences as young leaders and what they see as the role they can play in the SDGs. Sahil Angelo from the Center for Strategic and International Studies (CSIS) started out the discussion focusing on the immense number of young people in the world – almost 2 billion between the ages of 10 and 24. This is in-part due to the successes of past global health efforts, but as a community, we have not really considered or planned for the implications of these strides. What does 2 million young people (and rising) mean in the context of the SDGs? Nowhere in the “Means of Implementation” section of the SDGs’ text does it mention that youth would be the ones to usher them in.

Many panelists commented on the comprehensiveness of the goals and saw them as tangible objectives that address the root causes of inequity in health outcomes, even as a chance to do it ‘right this time’, referring to the previous Millennium Development Goals (MDGs). Yet in terms of young leader involvement, Oliver Anene of the New York City Department of Health commented that young leaders need to be invited to the decision-making table and their voices need to be heard – especially since they are currently on the receiving side of the policies created by today’s leaders. Anne Heerdegen of the Global Health Fellows program echoed this thought, commenting on how young leaders should be invited to speak at conferences and events alongside their experienced colleagues.

Read the complete blog post here.

Celebrating a Decade of Growth and Positivity

Hema Pandey 2CFHI would like to thank Hema Pandey for her 10 years of outstanding service with CFHI! Since joining as India Coordinator in July 2005, Hema has grown into the role of India Director while leading CFHI’s growing presence in India. Today, there are 8 thriving programs in India, located throughout the country and offering a variety of health topics to meet participant interests. Hema has played an integral role in program development by establishing and maintaining strong partnerships with a wide and diverse network of health professionals and NGOs in India. Her professional interests include rural and urban healthcare, water and sanitation, gender, and social development. She holds a Bachelors in Business and Commerce from Kurukshera University and a PG Diploma in Fashion Design from the International Institute of Fashion Technology.

Hema explains that her work with CFHI is always exciting, and that she learns something new from every student she encounters. Working with CFHI has been a learning process, and every student adds to her understanding of different cultures and worldviews, including perspectives on health and health care systems. Since working with CFHI, she shares that “instead of looking straight, I’ve started to look in all directions for answers. I am still learning with every student, so it’s as enjoyable as it was on day one.”

Hema represented CFHI at the Forum on the Empowerment of Women at the United Nations in New York in September 2010, and experience that she says was “The highlight of (my) 10 years at CFHI.” At the conference, she spoke alongside CFHI’s Executive Director, Dr. Jessica Evert, on a panel that highlighted their experiences working and leading in male dominated professions. Hema spoke about her successes using a collaborative approach to get the work done. Hema also represented CFHI at the 5th International Symposium on Service-Learning at Stellenbosch University in Cape Town, South Africa in 2013.

Landour Community Hospital, MussoorieHema is very appreciative of the years she has spent with CFHI, giving her the opportunity to improve herself while improving the communities around her. She reflects that her role as India Director allows her a path to help so many people. Hema is very supportive of her local staff and as an individual, she receives immense satisfaction when connecting grassroot organizations with aspiring students. She explains that this is her way of giving something back to society at large.

Robin Young, Assistant Director Africa & India, shares, “Hema is a force of energy and vision for CFHI’s programs in India. She has built our engagement in India into what it is today- 8 strong programs with 2 more coming very soon- each offering a unique perspective on health and public health, from maternal and child health, to traditional medicine, to chronic disease and palliative care. Here’s to ten more years!”

CFHI’s programs in India: What does the future hold?

robin & hemaBy Robin Young, CFHI Assistant Director, Africa and Asia

I just returned from a month-long site visit to India, where I delved deep into CFHI’s 8 programs in that most captivating of countries. It was a whirlwind journey that took me from a small village clinic in the foothills of the Himalayas, to a bustling OB/GYN unit in a hospital in Pune, to the home of an 80 year-old woman receiving palliative care from a team of nurses and doctors in the Southern state of Kerala.

India is a dazzling, intense place. With a population of 1.25 billion people, the scale of its cities; the ease with which so many people co-exist, struggle, and thrive; and the fascinating public health challenges, triumphs, and pitfalls, are enough to make any visitor want to stay much longer than a month.

But one month in India is enough to take in plenty of new information about health and medicine in a country that has so much to teach us. CFHI’s India programs offer an array of topic areas, clinical rotations, and geographical settings to choose from—there is truly something for everyone. Each of our programs is grounded in deep and longstanding local partnerships and a commitment to ethical practice—two key components that guarantee a rich and unique experience for CFHI scholars.

Under the leadership of CFHI’s India Director, Hema Pandey, we are finalizing exciting new partnerships and integrating program enhancements that will make our programs in India even stronger and more impactful. Here’s a sneak peek at a few of the exciting developments you can expect from CFHI’s programs in India:

  • In Delhi, we are finalizing a new research program that will welcome students with an interest in completing research in India on a variety of topics in global health, biomedicine, and beyond.
  • In Mumbai, we are opening a new program that offers students an up-close look into hospital medicine and infectious disease in this glittering, world-class city. Observe hospital medicine in urban and rural settings and learn about infectious diseases in a variety of locations, from outpatient clinics to small, family-run practices, to non-governmental organizations.
  • IMG_0312Also in Delhi, our “Public Health Delivery Innovations and Community Medicine” program will have an increased focus on three themes, around which all rotations and non-governmental organizations will center: water and sanitation, social services safety net, and programs for marginalized populations. As always, this program will provide an inspiring and eye-opening look into public and community health efforts in Delhi, working with populations ranging from young children who are addicted to drugs to women formerly considered “untouchable” who now prepare crafts and food for their communities.
  • All India participants can expect expanded pre-departure training and orientation in the form of webinars, question and answer sessions, and more. A recent addition to CFHI’s pre-departure training is Aperian Global’s online cultural intelligence tool, GlobeSmart, which provides detailed information on how to engage effectively with people from India and around the world. Competencies based on the new roadmap for global health training will frame each program and articulate the learning outcomes that you can expect to come away with after participation in our programs.

For a complete list of India’s programs in India, review our website. Learn about the wide offering of programs—from traditional and alternative medicine and Rural/Urban Himalayan Rotation in and around Dehradun, to Maternal and Child Health in Pune; and from End-of-Life and Palliative Care in Thiruvananthapuram (Trivandrum) to Ophthalmology in Delhi.

CFHI’s programs in India are the best way to come and experience the magic of India while immersing yourself in the intricacies of the health system and the social determinants of health in this fascinating country. Having just visited these programs myself, I am already excited for my next visit!

WEEK 3: CAPE COAST ADVENTURES!

image20Julia Tanguay is a 4th year medical student at Rocky Vista University College of Osteopathic Medicine and a two-time CFHI alumna piloting CFHI’s new Global Health Education Programs in Ghana, Child Health and Social Determinants and Hospital Medicine in Coastal Ghana. The following is an excerpt from her blog “My Trip to Ghana.” This post was originally published on November 2, 2015.

Hello everyone! I have thoroughly enjoyed my first week in Cape Coast and my third week in Ghana. Since I last wrote, I spent all of last week in the Pediatric department, except on Friday, when I worked in the Emergency Department. I have seen children with various conditions, like type I diabetes, bronchopneumonia, cerebral palsy, among others. The pace in Cape Coast is quite different than that of Accra, but I am enjoying more teaching and time spent with house officers and medical students. I also met some others from other NGO organizations that are volunteering in the hospital, and we ended up all going to Kakum this weekend, which I will discuss later.

On Tuesday, there was a morning talk about the management of preterm and low birth-weight infants. It was very interesting to get this lecture and then later in the week a lecture on the morbidity and mortality in the NICU. It is crucial to review those cases and reflect upon management to see if there is anything to improve upon in the future. Of note, there is a rate of 14.5% preterm births in Ghana in 2012, versus a 10% rate in the United States for comparison. Of the 111,500 preterm births in Ghana, the mortality rate was 7800. Often, in low-income countries, those born at 32 weeks or earlier often die, whereas they survive in more developed countries. The two themes that stuck out in prevention of mortality and management of very ill neonates is the need for infection control, including cord care, as well as close preterm follow up.

On Wednesday, I spent time going over the High Dependency Unit charts and then got a tour of the NICU with Dr. Bukarie. It was very interesting and eye-opening to see how they treat tiny babies without ventilator support or CPAP. They have the machines, but lack compressed air and continuous oxygen built into the walls, therefore, they treat the children with oxygen by nasal cannula. Also, there are 3 working incubators and otherwise used a heat lamp. We discussed how there might be potential with this sleeping bag looking device that is like an incubator. I am going to look into it further and see if I can get some donated or funded for Cape Coast’s teaching hospital. It is the simple things that make a huge difference in the outcome of neonates, especially preventing hypothermia in premature infants. I also have spare glucometers from diabetes camp this summer, so I will make sure at least two meters and strips go to Cape Coast and two to the Malnutrition ward at Princess Marie Louise in Accra.

Read more from Julia’s blog at https://ghana939.wordpress.com.

Reflecting on the 2015 Family Medicine Global Health Workshop

By Dr. Andy Baldwin, CFHI Alumni Advisory Board (AAB) Member

Greetings from Denver! My mind is racing with excitement and ideas after spending the past three days with fellow family physicians passionate about global health at the American Academy of Family Physicians (AAFP) Global Health Workshop at the Grand Hyatt in Denver, Colorado. The organizers did a fantastic job establishing several tracks and special sessions that ran throughout the conference—General Plenary Sessions, Global Expansion of Family Medicine, Reflections in Global Health, Global Health Lecture Series, Focus on Research, Case Studies in Program CQb34BLU8AAWMjCDesign, Ideas Worth Sharing and Facilitated Discussions. I had the opportunity to present at the Ideas Worth Sharing session, condensing two years of work in El Salvador into a 7-minute presentation. It was rapid fire. There were also two poster presentation sessions, of which I was fortunate enough to have my shipboard influenza outbreak case featured. The best part about the workshop was the intimate size of the group, allowing for collaborative discussions, mentor-mentee interactions, and sharing of stories. This is what the future of Global Health depends on—relationships. The opening plenary speaker, William Ventres, MD spoke about the work of global family medicine being one of creating, developing, and sustaining relationships. The other plenary speaker whose words resonated for me was Lynn Eckhert, MD who encouraged all of us to “tell the story” of global family medicine. Our lives are full of stories around the globe, and by sharing it defines us, and allows others to learn and gain appreciation. As faculty in charge of developing a global health track at Fort Belvoir Community Hospital Family Medicine residency, I found it incredibly helpful to go to CQaQw6xU8AA-6rUsessions focusing on global health curriculum development. The number of medical schools and family medicine residency programs with “global health” tracks is growing substantially. We also learned how to do journal clubs more effectively, as well as ethical approaches to Global Health engagements. One of the challenges in global health education is that competencies have not been standardized yet, making it difficult to determine a learners level of proficiency with global health. It was exciting to see the work that Jessica Evert, MD, Executive Director of CFHI, is doing to achieve this. She referenced her recent publication in the Annals of Global Health with the Consortium of Universities for Global Health (CUGH) that proposes four levels of Global Health competency. Global Family Medicine is a relatively young field, and it was an honor to be in the midst of those forging its path. As stewards of global health we are making progress toward a more connected and healthier world. I’m already looking forward to next year!

The International Classroom

by Caity Jackson, CFHI Director of European Engagement

The European Association for International Education (EAIE) conference held in Glasgow last week was a great start to CFHI’s Autumn European activities. It was also my first time attending an international education conference of that size and scope and it was exciting to be amongst the hustle and bustle of hundreds of institutions, partners and participants that had flocked together from all corners of the world.

IMG_7329The EAIE is a non-profit, member-led organization serving individuals actively involved in the internationalization of their institutions through a combination of training, conferences and knowledge acquisition and sharing. Their annual conferences welcome over 5,000 international higher education professionals and this year saw these participants coming from over 90 different countries.

There was an excellent opening speech by the dynamic
Baroness Helena Kennedy, QC, which struck a chord with me about the movement education sees these days. Not only are there students who are completing their full degrees abroad, but there is constant movement between regions for short courses, specialized training and immersion education. It is becoming the norm and I think it speaks to how the world has become a community and how our aims and objectives align no matter where in the world we live.

That being said, disparities still exist in stark contrasts and for us to truly be educated in a subject in our globalized world, we have to experience these contrasts first hand. There is nothing like having your hands deep (literally or metaphorically) in the complexities of what you have studied in textbooks to drive home a message and increase knowledge retention. I left the auditorium after Baroness Helena Kennedy’s speech mulling over her message about being enablers for education and allowing students to have mobility to obtain the knowledge they desire. The classroom truly is global now more than ever and students should be encouraged to broaden their horizons and reach out to the knowledge they know will enhance their education. I think that if we are to be true global citizens, we must all strive to include a little ‘international’ to our classroom.

Child Family Health International (CFHI) provides community-based Global Health Education Programs for students and institutions. Our unique model fosters reciprocal partnerships and empowerment in local communities, transforming perspectives about self, healing and global citizenship.

Alumni Spotlight: Q&A with Olivia Low

Q.  Tell us about the CFHI program you participated in.

I participated in Sexual Health as a Human Right: Ecuador’s Unique Model. I spent one month in Quito and was placed with Fundación Equidad, a LGBTQ health and human rights organization. This program stood out to me because it was not clinical, but rather community-based. Though I’m Processed with VSCOcam with hb2 presetin medical school already, I chose this program because I believe that practicing socially just medicine requires an understanding of the social, political, and economic forces that underpin communities. Volunteering with Equidad was a great way to gain insight into the activism and health-related challenges that LGBTQ people face in Quito. As a volunteer, I helped them organize their database of people who had received their services, such as HIV counseling and testing, human rights training, and safe sex education. I also participated in their staff meetings, helped them prepare for Orgullo (Pride), and was the photographer for one of their events.

Q.  What were your goals going in to the program? How did CFHI help you in achieving those?

Because I will serve Spanish-speaking populations as a physician, one of my main goals was to learn Spanish. Being able to speak Spanish is not only a practical skill, but in my opinion reflects a greater gesture of respect and solidarity with patients. CFHI helped me do this in part by setting me up with a wonderful host family. My abuela had hosted students for 18 years, and every night she would cook us a delicious meal. We would chat about everything from Caso Cerrado, a hilarious TV show, to current events and politics. I was grateful for her desire to teach and to take good care of us. In the process, I realized that a lot of communication is about confidence. You can’t be afraid to speak, to fail, and to be present in the room.

Q.  Who was the most inspiring person you met on the program?

Efrain Soria is the Director of Equidad, and it was great to be able to work with him so closely. He was not only approachable, kind, and welcoming, but also clearly an effective leader. I was able to gain a glimpse into his leadership style during meetings in both informal and formal settings. By doing some research for Equidad, I learned that his voice matters in Ecuador–popular newspapers often quote him, for example. In doing so, he advocates for his work and amplifies the voice of the LGBTQ community. It was beautiful to see Efrain lead with such fearless calm and grace.

Q.  Did the CFHI program influence your career path? If so, how?

Because I’m already in medical school, I have stopped debating my career path and have instead begun to think about how to be the best doctor I can be. For me, part of that involves sustaining my passion for human rights, and fighting for marginalized and underrepresented people. One requirement of being a physician ally is learning how to honor the way my patients wish to identify themselves in terms of their gender and sexuality. When Equidad counsels people on HIV, for example, they complete a very thorough interview that honors the language that the LGBTQ community in Quito prefers to use to describe themselves. Seeing how this works was valuable for me. As a medical student, I am learning how to communicate in a way that allows my patients to feel safe, discuss their medical problems freely with me, and define their own identities.

DSC_0267-4Q.  What are you doing now?

I’m about to begin my second year of medical school at Albert Einstein College of Medicine in the Bronx. For the rest of the summer, I’m working on a very interesting research project with Dr. Johanna Daily in her lab at Einstein. It’s a longitudinal study that examines the immunological and clinical dynamics of mild malaria in a rural population in Malawi. Other than that, I’m reading lots of books, working on my photography, and loving summer in New York.

Q. Do you have any advice for students who are thinking about applying or about to go on a program?

Before you go, look at your motivations for going on this program with honesty and ask yourself lots of questions. What do you hope to learn? What can you realistically learn? What might you be able to contribute? What is the space that you’re taking up by entering this country and what are the implications of your presence? Doing global work is ethically complex and can be problematic. But it can also further collaborative movements for social justice when done with critical mindfulness.

In a practical sense, define specific goals and have clear conversations with your supervisors from the very beginning. This will help you achieve tangible, shared goals. Lastly, be open-minded, respectful, and spontaneous. Do your best to connect with local people in addition to your host family, whether it be your barista or your taxi driver. They are secret reservoirs of some of the best stories.

Special thanks to CFHI alumna Olivia Low to authoring this guest post.

Bridging the Healthcare Divide: 6th Annual Midwife Training

By Lyndsey Brahm, CFHI Program Coordinator

Sounds of interaction, excitement, cultural exchange, and a mix of English and Spanish could be heard from Hotel 55’s top floor balcony in Puerto Escondido, a lively coastal town in southern
Mexico that lures surf enthusiasts from every corner of the world. However, Hotel 55 was bustling the final week of July not for those seeking the thrill of Playa Zicatela’s ferocious waves, but for an annual midwifery training that provides essential continuing education for parteras tradicionales or traditional midwives serving their communities throughout the state of Oaxaca.

The project, now in its 6th year, is critical to the health and well being of pregnant women and their families throughout Oaxaca. Over the course of 4 activity-packed and eventful days, a training DSC00169mandated by the Oaxacan Ministry of Health is carried out in collaboration with Child Family Health International (CFHI), a group of ambitious medical students from Northwestern University Feinberg School of Medicine who are members of the institution’s Alliance for International Development (NUAID), and local health professionals, including Dra. Isabel Saucedo, an employee of the Reproductive Health Office of Jurisdicción 4 and CFHI’s Medical Director in Puerto Escondido. Dra. Saucedo is a local champion for bridging the gap between the local healthcare system and traditional midwives, and has shown great perseverance and commitment to ensuring this project takes place year after year.

Themes covered were safe birth techniques, recognition of obstetric emergencies, and addressing newborn distress. The Oaxacan Ministry of Health builds upon each year’s training and seeks quality improvement to establish consistency and correctness with prenatal guidance, fertility advice, family planning, and birth attendance.

This year’s training incorporated an interesting component that complimented the materials provided throughout the project. Hesperian Foundation’s award-winning Safe Birth App was introduced to a select group of midwives using low-cost computer tablets. This app was created for low literacy audiences and has been piloted in several midwife cohorts in Latin America with great success. Working in tandem, CFHI and Hesperian will continue to track the response and impact of the application and the use of the tablets on the health of local communities.

Due to limited public funding, CFHI and NUAID have joined forces to provide generous donations to breathe life into the project for the past several years. The joining of hands is what makes this project unique and generates an impact that is far reaching. Traditional midwives are highly respected members of their communities and women often seek out their services at least twice DSC00172during their pregnancy. Therefore, the reproductive health of Oaxacan communities, especially those in dangerously remote locations, is vastly improved. The opportunity for the midwives to sharpen their skills, foster relationships with members of the formal healthcare system, and engage with foreign medical students is invaluable to their careers and their livelihoods. Lastly, the medical students from Northwestern University thrive off of the cultural exchange and the opportunity to contribute to a meaningful grassroots project and greatly improve their Spanish language skills. First year medical student Kyle Yoo explains, “Overall, I felt like I was really doing something. I was fully engaged. Without CFHI, I don’t believe I would have this opportunity otherwise to interact with the community and learn in the way I did.”

Puerto Escondido’s intense heat presented no match for the enthusiasm of the 30 midwives who traveled from various parts of Oaxaca, many of whom were eager to join the training for another consecutive year and to proudly represent their communities.

Learn more about the Traditional Midwives Training at: https://www.cfhi.org/traditional-midwives-training

CFHI as my stepping stone: New MCAT embraces age-old tenets of humanism and society

maniaBy Mania Kupershtok, CFHI Alumni Advisory Board (AAB) Chair

Each year, thousands of pre-med students around the country will begin to stress and pore over their medical school applications, writing and re-writing personal statements, reaching out to mentors for letters of recommendation, logging endless hour of community service and shadowing experience, and burying their noses in textbook after textbook studying for the dreaded Medical College Admission Test (MCAT). If you haven’t heard already, things have changed for the MCAT, which now is 3 hours longer and includes sections on sociology and psychology. “Being a good doctor is about more than scientific knowledge. It also requires an understanding of people,” observes Darrel G. Kirch, M.D., President and CEO of the Association of American Medical Colleges (AAMC). “By balancing the MCAT exam’s focus on the natural sciences with a new section on the psychological, social, and biological foundations of behavior, the new exam will better prepare students to build strong knowledge of the socio-cultural and behavioral determinants of health.” It’s about time that the MCAT caught up with what is truly vital in medicine today. Our doctors today need to understand these aspects just as much as they need the basic sciences, and finally, it’s beginning to hit them at the pre-med level.

As a pre-med student, I remember loving the sciences, but that’s not why I became a doctor. I wanted to understand suffering, to really get to the bottom of why patients of different backgrounds and social status were having such drastic difference in health outcomes. Not only that, I wanted to know why this was happening all around the world. When I got the opportunity to work with Child Family Health International, a non-profit organization that partners with international healthcare providers, it changed the direction my future took. I participated in CFHI’s program, Tropical Medicine and Community-Based Care on the Coast of Mexico, based in the southern state of Oaxaca. Oaxaca is one of the poorest states in Mexico with the largest concentration of indigenous populations. Working with 10 other medical students, we worked parteras thursday 039closely with the local midwives, physicians, and women in the community to understand their experiences and needs with regard to family planning, sexual health, and maternal health. Using this information, we assisted the local health team in developing and delivering a four-day training for roughly forty traditional midwives from across the state of Oaxaca. I will never forget what it was like to sit down and listen to the midwives’ experiences of providing maternal and child health care in this setting, and the opportunity we had to work with them in their efforts to improve the health of their community. What struck me most about CFHI’s approach was that they work to empower local communities and really take “service-learning” and “partnership” to heart. The focus was not providing a service, but partnering with local organizations and offering the skills and training in an ethical way. After this experience, I continued to have multiple global experiences throughout Central America. By the time I finished medical school, I would not have taken back any of these experiences for anything. I had a better knowledge about communication barriers between physicians and patients, cost burden of disease, importance of relying on physical exam over technological tests, and treating patients as a whole, not just their illness.

Now, as a shiny new family medicine intern, currently working at a hospital where nearly 100% of the population is underserved, I’ve made a pledge to myself to never lose that empathetic side of medicine. I challenge the pre-meds and medical students of today to do the same: Get out there! Yes, learn the basics, but don’t overdo it. Be a real person, spend time outside medicine, get out into the community and the rest of the world and really, truly try to understand where disease comes from and how your patients live their everyday lives outside your clinic. Even the new MCAT wants you to.

Learn more about the recent changes to the MCAT here: https://www.aamc.org/newsroom/newsreleases/273712/120216.html