Category Archives: Rotations

Interview with CFHI’s Medical Director –Audio Post

I had the chance to sit down with CFHI’s Medical Director, Dr. Jessica Evert, at our offices in San Francisco,  just before she was honored with an award from the Global Heath Education Consortium (GHEC) at their annual conference in Cuernavaca, Mexico.  Dr. Evert began her role as CFHI Medical Director in January.  Her education career includes studies at Emory University, The Ohio State University College of Medicine, and the University of California at San Francisco, where she continues to serve as a clinical faculty member of the Department of Family and Community Medicine.

Jessica Evert MD

We spoke about her introduction to Global Health, how she integrates her work as a physician in the San Francisco Bay Area with her Global Health Activities, and what attracted her to CFHI.  She talks about how CFHI’s model is one that changes the dynamic by empowering local communities through actively building on their strengths in ways that lead to sustainable solutions.

Please click on the links to listen to our conversation and you are invited to join the conversation through adding your comments below.

Dr. Jessica Evert 1

Dr. Jessica Evert 2

Dr. Jessica Evert 3

Dr. Jessica Evert 4

A Dental Program for International Students

One of CFHI’s newest programs is a Dental Program set in Quito, Ecuador.

CFHI Global Health Dental Program

CFHI Global Health Dental Program

CFHI is happy to partner with the Sonrie Ecuador Clinics to provide an outstanding program for pre-dental and dental students who want to understand how oral health is approached in a different culture and a different healthcare system.

The “Sonrie Ecuador Clinics” provide dental care and promote oral health in Quito and its surrounding neighborhoods.  The clinics have been operating for over twelve years and continually strive to better the services offered to their patients give attention to the dental health.  In general, the main dental problem seen by Ecuadorian dentists is cavities.  Ecuadorians are considered to be concerned about their dental health, although adequate oral hygiene is not, in reality, reported amongst the majority of the population.

This program will provide a rich and diverse experience for pre-dentistry and dentistry students, allowing them  to  view  local oral  health   practitioners  providing  close to  world class care in a developing country while at the same time improving their cultural competency and broadening their public health knowledge.  Ecuadorian dental professionals who work  in a country are interesting and thought provoking as they give context to the real challenges of  providing the best possible dental care to the different socioeconomic classes of Ecuador.

From Untouchable to Breadwinner, From a Human Waste Disposal Problem to Useable Fertilizer: A Sanitation and Public Health Success Story

Human waste is always a strange topic to talk about but it is clear that sanitation is one of the biggest public health challenges.  The idea of a Toilet Museum may bring a laugh but I was introduced to an organization that, while understanding the lighter side of the issue, has taken this subject very seriously.  “This is nothing short of amazing work,” reports CFHI India Coordinator, Hema Pandey, as she has made it an important part of CFHI’s Public Health and Community Medicine Program in New Delhi.  Students also report that this experience is very enlightening to them.   It is all the great work of an organization called Sulabh International, an NGO based here in New Delhi, that has for all practical purposes, solved a problem as old as the human race: how to effectively manage human waste.  Moreover, they have done it in one of the poorest and most populated countries in the world.  At the heart of it, was the desire to free the Scavengers, a caste of Indian society who, for as long as anyone can remember, were relegated to cleaning the excrement of others and carrying it in buckets on their heads, therefore being considered untouchable.

CFHI Students Visiting Sulabh International in New Delhi

CFHI Students Visiting Sulabh International in New Delhi

Sulabh is nothing short of a movement, started by Dr. Bindeshwar Pathak.  Dr. Pathak’s outstanding accomplishments can be summed up in two areas, a new technology for waste management and a social revolution for more than a million people to whom society gave no hope for self-determination.

The technology is alarmingly simple.  Sulabh’s design of a two-pit, pour flush toilet is an appropriate, affordable, environmentally sound, and culturally acceptable technology.  Many United Nations groups including WHO and UNDP have recommended this technology for more than 2.6 billion people in the world.  Essentially the pits are constructed in such a way that one side can be used and filled over about a three-year period.  Once it is filled, you switch to the second pit.  Over the next three years, the pit design allows for the natural breakdown of the waste in the first pit so that after the three year period, the pit can be opened revealing a dried substance with no harmful bacteria, that is 100% recyclable as a high qulaity fertilizer.  This design is perfect for rural areas but Dr. Pathak has taken it to the next step by designing a process of dealing with large-scale public toilets.  In this process, bio gas is generated in significant portions to power lighting, heating, cooking, and electricity.

CFHI Students visiting Sulabh International

Receiving Instruction on 2-Pit Toilet System at Sulabh

Dr. Pathak is credited with changing the mindset of the Indian people about sanitation and the persons who were required to do the sanitation work.  He has done this by example. He went to live among Scavengers learning the affects of the life they were considered destined to and thereby designing a social movement to raise them out of poverty and their unacceptable destiny.  Sulabh has schools, training centers and successful assistance programs that are training former Scavengers for everything from light industry, to culinary and food service jobs, and all aspects of computer technology.

This is a terrific success story, making great progress for health as well as a wonderful human story, and one that definitely gets the attention of our students.

CFHI Expands Rural Program in Himalayan Region of India

CFHI’s program in rural areas of Northern India will expand in 2010 and our student programs will support a local doctor’s dream of increasing access to healthcare in this region.  Dr. U.S. Paul has been working in the surrounding areas for many years and he knows well the needs of the people in rural villages.  We are happy to help him in this new effort to serve thousands more people in the foothills of the Himalayas who have little or no access to healthcare.  The effort is being conducted by a local nonprofit, the Indian Global Health and Education Forum.  The village of Sirasu will be one of the areas served.  The villages are accessible on foot after crossing the great river.  This photo shows the crossing point at Gullar on the River Ganges, about 45 minutes drive north of Rishikesh.

Ganges Crossingpoint at Gullar

Ganges Crossing Point at Gullar

As we made the drive along mountain roads tracing the edge of the gorge, with sheer drop-offs right next to you that are not for the faint of heart, Dr. Paul spoke of his excitement at being able to operate regular health camps for this remote population.  The area around Sirasu is one of several village groupings that will be served  Sirasu and its grouping have a population of about 1,500 people.  Each village has its own identity and Dr. Paul is an expert at providing care that is respectful of the cultural differences that may exist even from village to village.

Crossing to the East side of the river Ganges in a simple rowboat, I looked over and saw Dr. Paul beaming with joy because he knows how important these services are to the people.

Crossing Ganges

Crossing The River Ganges --Mr. Mayank Vats, CFHI Local Coordinator, and Dr. U.S. Paul board a boat to cross to the East side of the Ganges river

Once across the river, it is a 20-30 minute hike up the East side of the gorge to Sirasu.  Dr. Paul meets with village leaders to discuss recent developments.  An initial camp was held in November during which Dr. Paul saw more than 150 people in one day.  The people ask Dr. Paul to schedule the camps as often as possible.  With many other villages to cover, Dr. Paul says he will plan to make monthly visits.  While they would wish for more, the people are very happy and express their gratitude.

Local School that serves as a site for the health camp

Local School that serves as a site for the health camp

The camps are conducted at the few local schools as these are natural gathering points and are the largest structures around.

Everything is built on relationships.  The local formalities of introductions and meetings to discuss the different aspects are a time  to build trust and gain the valuable support of village leaders.  These meetings over cups of tea are important times to size everyone up and get a feel for each other.  It is the oral culture’s way of completing an application form.

Every meeting has to have tea

Every meeting has to have tea

We look forward to these additions to our program and to developing these new relationships.

After meeting with local leaders of Sirasu to discuss health camps

After meeting with local leaders of Sirasu to discuss health camps

CFHI South Africa Alum in the News

David Liskey (in a photo by Jan Sonnenmair), was a 2008 CFHI South Africa participant that came to us through our Oregon partner IE3.

David Liskey photo by Jan Sonnenmair

David Liskey photo by Jan Sonnenmair

David was featured recently in the Oregon State University President’s report.  Read about his experience and “how race, culture and poverty affect health care in a country with one of the highest HIV infection rate in the world.”

David participated in an 11 week program with CFHI and received credit from his home institution.  From his first-hand experience, he wrote a University Honors College senior thesis.  David was perceptive and able to see how culture impacts health.

In the president’s report, he reflects, “The different experiences and topics I studied had an effect on how I see the world.”

Report from Kwazulu-Natal: Filling a Need for Forty Years –The Islamic Medical Association of South Africa

Dr. Ebrahim Khan is a family practitioner with a private practice in the Kwazulu-Natal  Province of South Africa and serves as Medical Director of the CFHI program based out of Durban. As with most doctors in South Africa, the demands on his time are great.  Dr. Khan’s daily schedule is easily enough for two or three men.  His long and distinguished career has earned him the respect and confidence of the local community, and even at this point in his career, his desire to be of service and give back is as vibrant as I have seen in twenty-year-old students, so he is a good match for the many CFHI students from around the world who choose the Durban program. I especially sensed a love for teaching medicine in a way that guides the students to make their own discoveries.

Among the many hats Dr. Khan wears is that of being the Vice President of the Islamic Medical Association of South Africa.  In the early 1970’s, a few Muslim Doctors, noting with concern the disparate health services under the Apartheid government of South Africa, embarked upon the establishment of a modest Sunday clinic on the south coast of Natal in Eastern South Africa, where there were virtually no services for the black rural community.  This was the birth of what would be called the Islamic Medical Association. With such a deeply personal mission, it did not fade away after the end of Apartheid.  Now almost 40 years later, IMA has set up various healthcare and crisis relief centers operating full time in various places in the country where there is dire need for such facilities; social work and counseling are happening for families and children as well.   The IMA mission challenges them as healthcare professionals to “establish and project a value system that is a living entity in our own lives, and in the practice of health care solely for the service and the pleasure of the Almighty. ” The health professionals who give their service are truly dedicated to improving primary care for the underserved.

Avril Whate, Vusi Ngcobo, Steve Schmidbauer

Avril Whate, Vusi Ngcobo, Steve Schmidbauer

One of the many programs that IMA provides here is a small community clinic in Marianhill outside of Durban, a favorite site for CFHI students.  One of the services that has been happening for some time now is voluntary counseling and testing (VCT) for HIV.  Vusi Ngcobo is the counselor who is responsible for the success of the VCT program here. In an area with such a high prevalence of HIV, it is important that voluntary testing happens so that the virus can be detected as early as possible.  For those found to be HIV-negative, they will still receive valuable information about HIV prevention.

The clinic here and the many other projects of IMA are the continuation of a very long tradition of providing healthcare and teaching medical students. I learned that in ancient times, medical education was flourishing in Islamic society as evidenced by written case studies for teaching that date to the seventh century!

New Technology Brings Efficiency and Increases Capacity for Department of Hospital Civil in Oaxaca, Mexico

Computer being received at Hospital Civil in Oaxaca, Mexico

Computer being received at Hospital Civil in Oaxaca, Mexico

CFHI is proud to announce the donation of a Macbook computer to one of our partner sites in Oaxaca, Mexico– the teaching department of Hospital Civil. The donation to the subdireccion de ensenanza department came after the hospital requested this equipment from CFHI as a useful tool in improving operations there. The replacement for the manual typewriter, also in the picture, is a welcome addition to this very busy facility.

The computer will serve in many capacities including logging various activities occurring within the department and in managing the coordination of medical residents working at Hospital Civil.  In the photo above from left to right: CFHI Oaxaca Medical Director Dr. Tenorio, Dr. Gabriel Augustin Velasco, the head of Hospital Civil’s teaching department, and CFHI Program Manager Nick Penco, alongside the new computer.  CFHI would like to thank the participants of our Global health Education programs as well as support from our donors in making such contributions possible.

Hospital Civil is an outstanding facility with a dedicated staff.  CFHI has enjoyed a long relationship with this excellent teaching hospital.  This municipal facility is an anchor of the community and has seen everything from the increase of chronic diseases, to the fallout of civil unrest.  And  Oaxaca was one of the initial detection points of the Novel H1N1 Virus this past year.  We commend them on their quick and professional response to what was an unknown crisis.  The quality of their work has helped to blaze the trail for everyone working to treat and stop this pandemic.

International Experiences and Medcial Education

The May-June issue of International Educator, the magazine of the Association of International Educators (NAFSA), contains an article by Karen Legget entitled: Teaching Medicine Without Borders.  Ms Legget traces the movement from “International Health” to “Global Health” and the impact this is having on medical education.

She looks at various programs from medical schools to organizations (including CFHI) and conducts interviews with students and administrators alike.  Her article can be found through the NAFSA website.

CFHI Program Spotlight: Sight for All

One of CFHI’s newest programs, Sight for All- Ophthalmology Rotation is unique in that it is based out of just one organization- a local NGO located in New Delhi, India. CFHI participants rotate through the various departments, learning how programs and treatment are implemented to reduce preventable visual handicaps. Participants are exposed to mobile eye care clinics, ophthalmic procedures in the operating theater, and take part in advanced level classes at the institute.

The Sight for All program recently had its first participant, Melanie Mamon, and she shares a report on her experiences.  To learn more about the program’s location, arrival dates, and clinical sites, click here.