Stories about: Global health

Boston Children’s role in the Global Health Delivery Partnership

By Kim Wilson, MD, MPH, associate director of the Global Pediatrics Program.

For most children in the United States, seeing a pediatrician is an annual event. For other children, especially those with more complex problems, visits to pediatric subspecialists are common. But in many parts of the world seeing any type of doctor, pediatric specialist or not, is simply impossible.

Ever year eight million children die in developing nations where there are few or no doctors and nurses trained in pediatric care. What’s worse, many of these deaths are preventable. Public health initiatives that increase access to clean water and improve nutrition have done much to contain these numbers, but more needs to be done to provide quality health care to children all over the world.

As Paul Farmer, MD, founder of Partners in Health (PIH) and Chair of Global Health and Social Medicine at Harvard Medical School, recently stated, the clinical expertise we have at Boston Children’s Hospital can have a profound affect in achieving this goal. And I’m proud to say that our physicians and nurses have taken on this challenge, with global health activities happening in over 160 different sites, including ongoing programs in Haiti, Rwanda, Liberia, Ghana and Uganda.

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Doctor from Boston Children’s documents difficulties of life in the Congo

Chris Carpenter and patient

Chris Carpenter, MD, of Boston Children’s Hospital’s Global Pediatrics Program (GPP), sees the world a little differently than most people. When faced with news stories about poverty and suffering in Africa, many of us see tragedy; Carpenter sees an opportunity to help.

Now he’s sharing his vision with the world, through the eyes of a camera. His documentary film, “Born in Goma” captures his time in the war-ravaged Democratic Republic of Congo, focusing on three special patients— Isaac, Gisele and Dieume—trying to survive in the midst of extreme poverty and violence.

Be aware, some of the following images are somewhat graphic in nature.

After finishing medical school and his pediatric residency, Carpenter was ready to embark on a personal mission to practice medicine in areas wracked by violence and lacking in resources. In October of 2009, he went to Goma, an eastern city in the Congo, where he worked with families whose daily life was a constant struggle. But despite the harsh conditions, most of these people had an unbelievable will to survive.

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Boston Children’s Nurses: Local care, global teaching

Boston Children's nurses demonstrate care techniques to an audience of thousands. Photo courtesy of Toni Imprescia, RN, CCRN

In a hospital in Guatemala—3,400 miles from Boston Children’s Hospital—a group of Boston Children’s nurses is teaching a class on how to use surgical safety checklists to improve safe perioperative practice.

Another group of nurses and physicians is sitting in on the same class, 10,000 miles away in Viet Nam. From Bangladesh to El Salvador, clinicians don’t need to leave their hospitals to benefit from the expertise of Boston Children’s staff—they just need a computer and an Internet connection.

The idea to have Boston Children’s nurses produce and broadcast educational webinars to hospitals in resource-limited countries started with Patricia Hickey, PhD, MBA, RN, FAAN, vice president of Cardiovascular/Critical Care Services, and Kathy Jenkins, MD, MPH, senior vice president and chief safety and quality officer. When the two attended the Global Forum on Humanitarian Medicine in Geneva in 2008, they discussed how the hospital could make a difference in the global health landscape. Although they encountered representatives from many countries who were interested in learning from Boston Children’s, the cost of traveling to each interested hospital was always going to be prohibitive—but the cost of broadcasting online to all of them at once was minimal.

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Reflecting on Haiti

By Dennis Rosen, MD

Photo: Dennis Rosen

This month marks the second anniversary of the January 2010 earthquake that devastated Port au Prince, killing more than a quarter million, injuring over 350,000, and leaving an estimated one million without shelter. Having gone there three times since then with groups from Children’s Hospital Boston to participate in the relief efforts, hardly a day goes by that I am not reminded of what I saw and lived during those weeks. Ranging from the truly horrible to inspiring and uplifting, many of the experiences were unlike any others I had had prior to setting foot in Haiti.

The first time I went was in May 2010 with a group that worked at the General Hospital along with Partners in Health. Conditions on the ground were utterly chaotic, and the disorganization made it difficult for foreign volunteers to work as we were accustomed to doing back home. This only added to our frustration at the discrepancy between the enormity of the challenges we faced and what we could (or could not do) to help. Many of those we cared for were suffering from the after-effects of injuries sustained in the earthquake, including chronic bone infections following amputations. A significant number of the children we saw were malnourished, their golden, frizzy hair and big bellies (often full of worms) helping us to make the diagnosis as soon as we saw them.

Others presented with routine medical and surgical problems which would have been straightforward in Boston but which were, in fact, very difficult to treat in Haiti because of the limited resources available and the lack of continuity of medical care. Perhaps the hardest of all was to repeatedly see children die from conditions and diseases which could have been prevented or treated back home, at little cost, and to be powerless to stop that from happening. On both the first and the second trips our teams cared for children who died from diphtheria. Previously widespread in the United States, it has not been reported here since 2003 thanks to widespread vaccination. However, diphtheria remains endemic in Haiti, and because most children do not have access to vaccinations, hundreds die from it there each year.

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