February 19, 2010

Haiti puts hospital’s global outreach in the spotlight

After last month’s earthquake in Haiti, the University sent medical supplies and a small team of doctors and nurses to the crumbling capital and a field hospital near the Dominican border.

In the weeks after the quake, most returned to be replaced by a larger contingent. This Sunday, yet another group of doctors, nurses, and specialists are being sent to the island.

Responsible for coordinating this high-intensity effort is a developing program at the U of C, the Global Health Initiative (GHI). Although the GHI was created with long-term goals in mind—education, research, and clinical outreach—it reacted quickly when word of the earthquake hit Hyde Park.

“It’s been going about 500 miles per hour ever since,” GHI coordinator Jimin Kim said, referring to GHI’s role in providing for the safety and goings-on of the volunteers in Haiti, as well as communicating with schools in Chicago and Boston partnering in the relief effort.

The University has sent dozens of staffers to the country, working mostly in a hospital in Fond Parisien, where patients are flown after surgery on naval medical ships. Kim texts the medical workers every day, and speaks to some on the phone.

“It’s very hard work; people are exhausted. They’re eating maybe one, one-and-a-half meals a day. It’s extremely hot, humid there, but they’re doing great work and they’re in great spirits,” she said.

This is the first large-scale medical relief project the University of Chicago has coordinated, but GHI director and genetics professor Dr. Funmi Olopade said in a phone interview that, with the resources and faculty at its disposal, the U of C can make such missions a responsibility.

“A great university should be able to respond to such a tremendous tragedy… I think we had the ability to muster a really great response team, and that’s really in part because we had faculty who were trained to do it,” she said, referring to Fond Parisien team-leaders, Drs. Christian Theodosis and Chrissy Babcock.

Theodosis and Babcock both spent time in John F. Kennedy Hospital in Liberia. Ninety-five percent of health care facilities had been destroyed there, and only 20 physicians remained in the country by 2003, after a 15-year civil war, Kim said.

“We used our time [in Liberia] to help ‘redevelop’ the Emergency Department—helping with triage, doing nursing education courses, helping move a new pharmacy into the ER, and, of course, to help with patient care,” Dr. Janis P. Tupesis, formerly a resident at the UCMC, said in an e-mail. He worked in Liberia with Theodosis and Babcock and is now an associate professor of medicine at the University of Wisconsin.

“Conditions there were relatively primitive as compared to the U of C or UW (no CT scanner, poor radiology, labs), but they have a huge amount of smart and motivated people,” Tupesis said.

Theodosis, who was unavailable for comment, has been involved in the multi-institutional effort at JFK Hospital for a number of years, Kim said. Last year, 51 residents were placed on field assignments, serving for 640 days. American doctors are now concentrating on teaching, lecturing for 281 hours last year and training 41 nurses.

Founded in 2008, and launched more formally in 2009, GHI was conceived as a method for joining medical education, field research, and clinical outreach, and bringing together students interested in working abroad from across the University and Medical Center.

“You can think of it as what the University of Chicago can do for the rest of the world,” Kim said

Olopade, a breast cancer specialist and MacArthur fellow, said global health became a major concern in the 1980s, during increased awareness of the AIDS epidemic.

“It was clear that there are more ways a university can engage than talking about infectious diseases or the AIDS epidemic,” she said.

The GHI is part of a nationwide trend. “Across the country, universities have been starting global health initiatives and global health centers for a number of years, and the University of Chicago is a little behind,” Kim said.

Dr. Scott Stern, a professor of internal medicine and medical textbook author, is working on one of GHI’s programs, an effort to bring web-based teaching tools to underserved countries like China and Chile. “You can educate hundreds of thousands of doctors at almost no cost,” Stern said of the system, which hosts lectures and interactive diagnosis demonstrations.

Dr. Aisha Sethi, an assistant professor of medicine, runs an HIV/dermatology outpatient clinic one month for the past three years in Malawi. There are no dermatologists in the country, Sethi said, and while treating skin diseases, she helps train specialists.

“It’s just a wonderful experience to go and care for a community...and impart an education,” she said. Sethi credited a group of University grad students who went on the last trip for the Initiative.

“Before the GHI started, it was faculty and students doing their projects in a not very connected way. They were just doing their thing. This GHI brings everybody together and says, okay, what are we doing in what project that may be good for another project? Let’s open this up. There’s students in anthropology who might be interested in doing work on albinism in Malawi, which is what’s happening now.”

Doctors interviewed said working in other countries is rewarding, they agreed that triage work, especially in Haiti, presents a difficult situation.

“You can’t show up and say, we’re here to help. You have to have some ground connections, you have to have approval from local authorities,” Sethi said.

And not all people are suited for working in the field, said Stern, who worked in a poor, regional hospital in Kenya in 1995.

“Everybody has different personalities. The resident I was with really enjoyed it… I actually found the depth of human suffering so tremendous that it outweighed the other aspects,” he said.