2018 FOR THE YEAR 2018 THE WESTERN CONNECTICUT HEALTH NETWORK AND

GLOBAL HEALTH PROGRAM HEALTH GLOBAL

THE UNIVERSITY VERMONT OF ANNUAL REPORT ANNUAL GLOBAL HEALTH PROGRAM

table of contents

Welcome 2 Global Health Leadership 3 Our People, Our Mission 4 Building Leaders in Global Health 6 Educating Physicians Around the World 8 Mentoring the Next Generation 10 12 Russia 16 Dominican Republic 18 Vietnam 19 Thailand 20 21 Awards and Recognition 22 Publications and Presentations 26 More pleasant than the sound of love’s Directory 28 speech, naught I heard: A great token, that, in this revolving dome remained.”

– HAFIZ

Cover photo: Majid Sadigh, M.D., with Emergency Medicine residents at University College of Health Sciences. (Left to right): Dr. Darlington Muhwezi, Dr. Umarashid Gulooba, Dr. Stella Magara Namirembe, Dr. Rose Nampeera, Dr. Peter Kavuma, Dr. Majid Sadigh, Dr. Jane Francesca Namugerwa, Dr. Doreen Okong, and Dr. Joseph Kalanzi

GLOBAL HEALTH ANNUAL REPORT 2018 1 GLOBAL HEALTH PROGRAM GLOBAL HEALTH LEADERSHIP

Now celebrating its seventh year, our Global global health scholars each year in a bidirec- Health Program at WCHN continues to exceed tional exchange offering a remarkable opportu- expectations as we expand our global footprint nity to physicians around the world who wish and secure a reputation as one of the nation’s to learn—and to educate—here in the United most respected global training initiatives. States. By sharing deep cultural knowledge and Under the extraordinary leadership of Dr. insights into diseases and conditions not often Majid Sadigh, the Christian J. Trefz Family encountered in the United States, these visiting welcome Endowed Chair in Global Health at WCHN, the global health scholars help our faculty, staff, program is making impressive strides in caring and students see patient care and professional for the world’s underserved populations while responsibility through a different lens. We are moved by the richness of our community, as well as by as the support—fiscal, offering clinical training experiences that are The Global Health Program continues to physical, and philosophical—that we receive each day from our members around the both profound and life-changing. expand through new clinical partnerships world. Each one of you helps us grow in scale, membership, outreach and aspiration. There is no better way to gain understanding with Walailak University School of Medicine in Together, we have built this program with a deep commitment to mutuality whereby of global issues involving healthcare delivery Thailand, Dalian Municipal Central Hospital in John Murphy, M.D. and access than by experiencing them first- the People’s Republic of China, and Datta Meghe we give our esteemed partners the respect and resources that they graciously give us. President and CEO, hand. The Global Health Program works collab- Institute of Medical Sciences in India. We are Though this mission will continue to evolve alongside us, we are humbled to have Western Connecticut come as far as we have, and we are optimistic about the distances yet to be traversed. Health Network oratively with our academic partners to offer also working to launch Global Health at Home, a We are proud to have over 110 medical students, residents, and faculty participate medical students, residents, nurses, and other new initiative aimed at serving underprivileged faculty members a range of experiences in other populations in the United States including each year, made possible with support from a diverse panoply of members, from healthcare systems to better understand public Native Americans, immigrants, and refugees, students to leadership, nurses to physician assistants, administrators to public health issues, cost-constrained care, and the im- through a potential partnership with Chiricahua relations personnel. pact of globalization on vulnerable populations. Community Health Centers (CCHCI) which The tremendous momentum we have amassed in fundraising and fiscal support Through robust capacity building, the serve under-resourced communities along the reinforces our commitments and propels us toward our ambitions. We have had the Global Health Program now hosts over 110 Mexican border in southern Arizona. privilege of contributing more meaningfully to partner-site development through medical students, residents and faculty each As we move forward into a new era of global donating computers and diagnostic machines to our collaborating institutions, year at international partner sites in the health, we are both justifiably proud of our supporting preschool education of ACCESS children via Grace’s Promise, providing Dominican Republic, Russia, Uganda, Vietnam accomplishments and deeply grateful for our communities with solar lights, and funding the education of women in pursuit of and Zimbabwe. Program participants learn national and international partners as well as higher education. We have raised over $22,000 to establish a lab in how to compassionately provide quality care our loyal donor community, whose commitment Naggalama through Climb for a Cause; $32,000 to upscale an outpatient clinic for without access to the medications, supplies, or and generosity have brought our dreams to life cancer patients in ; $27,000 to construct living quarters for participants in diagnostic equipment we often take for granted. as we advance medical education across borders Nakaseke; $7,200 to the Global Women’s Health collaboration with Nakaseke and True to its unique mission, the Global Health through meaningful opportunities to serve close to $6,000 dollars toward supporting education of the female orphan college Program also trains over twenty international humanity and learn from one another. students in Uganda. Let us celebrate the momentum garnered in our many reaches—from site development to new partnerships, resource centers to online platforms, community outreach to multi-partisan engagement—all of which allow us to nurture meaningful relationships with communities and our communities with one another. Ultimately The Larner College of Medicine global health exist beyond our borders. One of the key values partnership with the Western Connecticut of our Global Health Program is to weave founded in individual trust and connection, the emergent structure holds us up as we Health Network (WCHN) has been, for seven this knowledge into the education of future reach out, hand-in-hand, to the world around. Each of you strengthens the collective years, a collaboration based on our shared physicians through their experiences serving in breath. Thank you for standing with us, and letting us stand with you. missions of medical education, research, other countries. and the improvement of clinical care. Those Our students understand this connection. Sincerely, missions are inextricably linked in the work As Katherine Callahan from our Class of 2021 of our Global Health Program, just as they put it when describing her experience in are through the interaction of clinicians and Uganda last summer, “In these six weeks I have students at our branch campus at Danbury and begun my career as a physician and member of Norwalk Hospitals. the global community. My impact will not come Majid Sadigh, M.D. Our institutions exist first and foremost to in the next three weeks, or even next years, but Christian J. Trefz Family Endowed Chair in Global Health at Western Connecticut serve the patient, wherever that patient may be, eventually I hope to be a driver of change on the Health Network and Director of Global Health at the University of Vermont Larner and we guarantee the continuance of that work global level.” College of Medicine Richard L. Page, M.D. as we educate and train the next generation of I am delighted to express my appreciation to Dean, The Larner College of physicians. While there may be few boundaries Dr. Majid Sadigh, Dr. John Murphy, and all our Medicine at The University of Vermont when it comes to a physician’s commitment to collaborators who have made this program such serve their patients, we recognize the unique a success. We are honored to be a partner in this needs and limited access to resources that important work.

2 THE UNIVERSITY OF VERMONT AND THE WESTERN CONNECTICUT HEALTH NETWORK GLOBAL HEALTH ANNUAL REPORT 2018 3 GLOBAL HEALTH PROGRAM New Partner: Datta Meghe Institute of under the auspices of DMIMS. WCHN will support DMIMS in build- Medical Sciences (DMIMS), India ing local capacity through introducing various certificate courses and fellowships as well as exploring new areas for research. SWAPNIL PARVE, M.D., SITE DIRECTOR, Monitored by Dean of Interdisciplinary Health Sciences Dr. DATTA MEGHE INSTITUTE OF MEDICAL Lalitbhushan Waghmare, with mainstream and allied health courses SCIENCES (DMIMS), INDIA coordinated by Dr. Tripti Srivastava and Dr. Shweta Parwe, and a our people- We welcome our newest partner: Dat- director who will be announced soon, this program promises to ta Meghe Institute of Medical Sciences be a unique opportunity for cultural and clinical enrichment. An (DMIMS), a prestigious private university institutional member of the Consortium of Universities for Global in Sawangi (Meghe), a small town approx- Health (CUGH), DMIMS has worked with the National Institute of imately seventy kilometers from Nagpur. Health and other eminent global health institutions. The institution our mission Through this first-of-its-kind tripartite boasts faculty in a range of fields including general medicine, collaboration with DMIMS, WCHN Global dentistry, nursing, Ayurveda, and physiotherapy. It also has a large Health Scholars receive their conceptual international student body and a hospital with over 1,500 beds Why a Global Health Institute and simulation lab training at WCHN and their “hands-on” training serving 325,000 patients each year.

JONATHAN FINE, M.D., DIRECTOR OF expansion enables global health to mature administratively MEDICAL EDUCATION AT WESTERN while advancing new initiatives including research projects, The Global Health Family VOICES FROM OUR NETWORK CONNECTICUT HEALTH NETWORK interdisciplinary collaboration, a peer-reviewed journal, and Over its seven-year existence, the a Global Health Teaching Academy. With the coming creation In the intensive care unit at Norwalk who are participating in global health electives have University of Vermont Larner College of of another medical school partnership with Marist College, the Hospital, we have the opportunity to been overwhelmed by the generosity of their host country Medicine/Western Connecticut Health institute expands its key academic associations. host visiting global health scholars with physicians and are excited to reciprocate. This bond of Network Global Health Program has Our network’s global health activities are defining elements regularity, and many fellows and residents hospitality, sharing, and connection makes our program grown into an internationally-recognized for our academic mission. The humanity evoked, the medical complete global health rotations. Through Robyn Scatena, strong. We reach out and connect with physicians from network of partnerships that support knowledge gained by our students, professionals, and partners hosting experienced attending physicians m.d. across the world with a true sense of familiarity. This is the multidisciplinary, multi-school, and post- abroad, and the stimulus of selfless commitment to serving from other countries, our residents have global health family, of which I am honored to be part. graduate activities. In recognition of the patients anywhere together mold our participants into astute been challenged to share their medical knowledge at a – R obyn Scatena, M.D., Associate Director of Global Health fact that the Global Health Program services a broad array of healthcare professionals and compassionate human beings. higher level and to refine their teaching methods. Residents at Norwalk Hospital health professionals, it is fitting that it assumes the status of We realize in global health the aspirational purposes that draw institute within the network. healthcare professionals to their calling. By elevating global health As an institute, funding and faculty may derive from all to an institute, we acknowledge and support its essential place Momentum and Enthusiasm New Partnerships: healthcare disciplines that wish to participate. The resulting within our healthcare network. Sacred Heart My current role is to organize and coordinate global health electives for senior medical University By elevating global health to an institute, we acknowledge students from American University of We continue to strengthen and support its essential place within our healthcare network.” the Caribbean (AUC) and Ross University existing partnerships and (RUSM), two of our partner institutions. I Bulat Ziganshin, initiate new ones in our Patricia Christina am excited to start my new role as Director M.D. Walker, ed.d. Gunther, m.a. Global Health Program. Our of International Affairs whereby I will collaboration with MakCHS, work with our partner sites to establish a structured through which our nurse practitioner students undergo educational program for international visitors hosted in clinical training at St. Stephens Hospital and the OB/GYN the United States. We are proud of and excited about the College of Ward of Hospital, is going strong. Groundwork has momentum global health has garnered in our off-site The CGH is committed to building fruitful been set for a new partnership with Vietnam’s Cho Ray Health Sciences Launches Center institutions. Interest in global health has gained so much Hospital whereby our physician assistant students will join collaborations with institutions around traction that AUC has begun hosting its own Global Health for Global Health UVMLCOM/WCHN global health participants for rotations the world in order to foster genuine Annual Retreat, which was a huge success this year. Our beginning in 2019. Also underway is a collaboration between PROFESSOR ISAAC OKULLO, B.D.S., PH.D., interdisciplinary partnerships.” participant application and preparation processes have the College of Education of Sacred Heart University (SHU) DEPUTY PRINCIPAL been enhanced through a newly-designed selection tool, and MakCHS that allows for student and faculty exchanges The new Center for Global Health (CGH) and funded by university and development partners, the center and we are continuing to see participants returning from between the two institutions. We are working to expand at Makerere University College of Health will offer global health education and research opportunities their electives with meaningful insights and skills. My advice our partnerships to include the Department of Social Work for students pursuing global health is to be open-minded Sciences (MakCHS) aims to promote global to a new cadre of Global Health Scholars in Uganda. Makerere at Makerere University and eventually in Vietnam. Our next and respectful of differences in culture and traditions; to health through education, training, and University’s Schools of Medicine, Biomedical Sciences, Health step is to join the UVMLCOM/WCHN Global Health Program embrace challenges with a positive attitude; to be an active research, while leading global health Sciences, and Public Health, along with several other departments, at Kazan State Medical University in Russia. Thank you to all learner; and to strive towards achieving your goals. It is a advancement in Uganda. The center is will offer local expertise in respective areas. The CGH is committed members of the Global Health Program. We are grateful to be great privilege to be part of this unique, dynamic program committed to serving as an information to building fruitful collaborations with institutions around the part of the family. resource center for global health initiatives, world in order to foster genuine interdisciplinary partnerships. through which we can both support and witness the growth of our participants into global health leaders. – P atricia W. Walker, Ed.D., Dean, College of developing short global health courses of A member of the Consortium of Universities for Global Health Health Professionals and Christina Gunther, M.A., international interest and relevance, and conducting well-managed (CUGH), MakCHS has hosted over 380 students, residents, and – Bulat Ziganshin, M.D., Director of International Affairs Sacred Heart University transnational global health research projects. Semi-autonomous faculty for global health education programs. at Western Connecticut Health Network

4 THE UNIVERSITY OF VERMONT AND THE WESTERN CONNECTICUT HEALTH NETWORK GLOBAL HEALTH ANNUAL REPORT 2018 5 GLOBAL HEALTH PROGRAM

EDUCATIONAL ADVANCES building leaders in global health Expanding Global Mental Advocating for Women’s Advocating for Health Partnership Health in Rural Uganda Children’s Health Global Health Western Connecticut Health Network (WCHN) had the pleasure of hosting several Global Health Scholars from the Dominican Republic, Russia, Uganda, Vietnam, and Zimbabwe this year. They JUDITH LEWIS, M.D., DIRECTOR OF THE ANNE DOUGHERTY, M.D., DIRECTOR OF MOLLY MOORE, M.D., DIRECTOR OF Scholars as undergo months-long training at WCHN while contributing to medical education and patient care UVM RESIDENCY PROGRAM, THE UVM LARNER COLLEGE OF MEDICINE THE GLOBAL HEALTH PROGRAM FOR and actively participating in events such as local presentations and hospital conferences. UVM MEDICAL CENTER GLOBAL WOMEN’S HEALTH EDUCATION THE UVM LARNER COLLEGE OF MEDICINE Drivers of Change On returning to their home countries, these scholars are drivers of change in medical education The UVM Larner College of Medicine PROGRAM DEPARTMENT OF and patient care at their institutions. We are grateful for their participation in this unique program, Department of Psychiatry has initiated In one Ugandan hospital, I witnessed The Global Health Program in the and for their role in diversifying medical culture at our home institutions. While with us, they are its first global health elective in 10 maternal deaths in 10 days. At the Department of Pediatrics benefits from supported by our friends, colleagues, and global health community. Global Mental Health at Makerere University of Vermont Medical Center, the leadership of Department Chair University College of Health Sciences. there has been only 1 maternal death in Dr. Lewis First and Pediatric Residency Now approaching its third year, the 10 years. This stark contrast speaks to the Program Director Dr. Jerry Larrabee. partnership has been a huge success. fact that a Ugandan woman has a one in Department members present at global From encountering different cultural forty chance of dying during pregnancy or health conferences, author publications, interpretations of illness to learning to childbirth, a one-hundred-fold risk greater and participate in field activities locally, practice with limited pharmaceutical than her American counterpart. While nationally, and internationally. Our and treatment options, psychiatry rapid repeat pregnancy dramatically pediatric faculty also serve as teachers residents return to Vermont with a increases maternal, infant, and child of the Global Health Bridge for third-year new perspective on the U.S. healthcare mortality, access to family planning can medical students. I am committed to system. Their experience as a minority help modify this risk factor. Our innovative developing and directing global health in an unfamiliar place makes them more Vermont-based program has significantly courses for first-year students and attuned clinicians and compassionate increased the uptake and continuation mentoring global health participants in human beings. We plan to identify a of family planning while decreasing Uganda and Zimbabwe. Over the next faculty expert in Global Mental Health unintended pregnancy in opiate- year, we are working toward establishing to join the team, as well as apply for dependent women, a population that partnerships with pediatric hospitals grant support to help offset the cost of similarly struggles with limited access to in Arizona, the Dominican Republic, residency training for talented Ugandan healthcare, food security, and fertility and Vietnam. We look forward to our medical students, and to help fund the control. Over the last year, we have continued involvement with the Global Community Mental Health Outreach worked with the ACCESS team to adapt Health Program through which we can Program in . We are developing our intervention for use in Nakaseke, strengthen our advocacy for quality joint scholarly projects with Makerere Uganda. We are grateful for the beautiful healthcare delivery and access for University psychiatry residents, including partnership we have built, and look children everywhere. a comparative survey of the perception forward to continuing to promote the Thursday marked one of the most beautiful moments I have of the field of psychiatry by medical health of mothers, children, families, had so far in the U.S.—my first ever Thanksgiving celebration. students in Vermont and Uganda. and communities. Being in the presence of people from five different countries—the United States, Vietnam, Uganda, South Sudan, and Turkey—added more excitement to the event.” – EMMANUEL DENIS MORGAN, M.D., GLOBAL HEALTH SCHOLAR FROM UGANDA I am grateful for the opportunity to visit WCHN and UVMLCOM and learn about the Global Health Program. I also extend my gratitude to It is an honor to see our students’ deepening commitment to serving patients. I have no doubt that the experiences that they have opened themselves up the staff whose hospitality aided in a variety of meaningful experiences. We to will make them better doctors. I also see our roots growing and strengthening in had a meeting with the Dean of UZCHS to follow up on my recommendations our collective work as a global health program. Our relationships and commitment from the visit. He seemed to embrace the global health concept and suggested to service give us a strong foundation to work across disciplines, across institutions that it should be college-wide in undergraduate and postgraduate programs.” and across cultures.” – SHALOTE R. CHIPAMAUNGA, PH.D., M.ED., B.ED., DNE, SCM, SRN, – MARIAH MCNAMARA, M.D., ASSISTANT PROFESSOR OF AND SENIOR LECTURER, DEPARTMENT OF HEALTH PROFESSIONS EDUCATION GLOBAL HEALTH PROGRAM ASSOCIATE DIRECTOR, UVM LARNER COLLEGE OF MEDICINE AT UNIVERSITY OF ZIMBABWE COLLEGE OF HEALTH SCIENCES

6 THE UNIVERSITY OF VERMONT AND THE WESTERN CONNECTICUT HEALTH NETWORK GLOBAL HEALTH ANNUAL REPORT 2018 7 GLOBAL HEALTH PROGRAM educating physicians 22 149 BY THE Number of global health leaders Number of weeks that global health NUMBERS and scholars from international leaders and scholars from international around the world partner sites who trained at or partner sites were hosted by the Global visited WCHN/UVMLCOM. Health Program at WCHN/UVMLCOM.

Russia China $ Dominican 106 364 205,000 Republic India Number of WCHN/UVMLCOM Number of weeks that faculty, Investment in capacity building of faculty, fellows, residents, and fellows, residents, and medical human resources and site development Uganda medical students who participated students from the United States in international sites in 2018. United States in the Global Health Program at (WCHN/UVMLCOM) spent at international partner sites. international partner sites in the Global Health Program.

Thailand Vietnam

Our Partners: Global Health Alumni in Action Global Health Host Countries Zimbabwe Having established themselves as leaders in research and medical education in their respective institutions, many of our alumni have The global health elective provides medical continued their interest in global health. students with a unique opportunity to engage in global health work that Elena Belousova, M.D. (left), alumna from Kazan State Medical University OUR PARTNER SITES emphasizes sustainability and reciprocity. in Russia, has been chair of the Young Internist Group in the Russian The elective at WCHN/UVM Larner College China Uganda Society of since May 2018 and representative of Russia in the Young Internists in the European Federation of Internal Medicine of Medicine encourages students to • Dalian Municipal Central Hospital • ACCESS/Nakaseke Hospital reconnect with the true roots of medicine • Makerere College of Health Sciences section since August 2018. Her research on the prevalence of inflammatory and cultivate passion for empathy and Dominican Republic • St. Stephen’s Hospital back pain, spondyloarthritis, and ankylosing spondylitis among patients clinical advancement. Every international • Universidad Iberoamericana • St. Francis Hospital/Naggalama with inflammatory bowel disease was the winner of an oral presentation site exposes students to a wide array of • Hospital Universitario Maternidad • Mbarara University of Science and at the World Congress of Internal Medicine in Cape Town, South Africa. clinical cases while the supplementary • Nuestra Señora de a Altagracia Technology socio-cultural curriculum allows further • Instituto Dominicano de Cardiologia • Hospital Vinicio Calventi United States I want to thank the WCHN/UVMLCOM Global Health connection with the local culture. Students • UVM Larner College of Medicine Program for supporting my rotation in Cho Ray who experience the homestay model are India • Western Connecticut Health Network Hospital, Vietnam. Though a few years have passed, the able to delve even deeper into the cultural • Datta Meghe Institute of Medical • Sacred Heart University program’s influence has been ongoing. I finished my family underpinnings of the region and garner Sciences a better understanding of the landscape Vietnam medicine residency this past June, recently returned from of the country, people, and patients that Russia • Cho Ray Hospital a six-week medical trip in rural Guatemala, and sat for the they serve. Ultimately the global health • Kazan State Medical University American Society of Tropical Medicine & Hygiene exam in Zimbabwe elective is a chance to confront the October. My wife and I hope to continue our involvement Thailand • University of Zimbabwe College of pressing inequities of healthcare, release in sustainable medical trips in the future.” judgment, and redefine what it means to • Walailak University School of Medicine Health Sciences be a teacher and healer. – John Paul Kelada, M.D.’15, UVM Larner College of Medicine alumnus

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We must learn to commit ourselves to learning without fear, anxiety, mentoring the self-recrimination, or envy, and use these perspectives to help us walk gracefully through our more difficult moments.” next generation – MAHSHEED KHAJAVI, M.D.

The following essays showcase some of the best writing to come from participants in the Global Health Program over the past year. Their work illustrates the reflection and Allowing Ourselves Grace growth that students and faculty experience. BY MAHSHEED KHAJAVI, M.D., resources in one’s heart in order to truly know understanding, ASSOCIATE PROFESSOR OF CLINICAL acceptance, and tolerance. The irony is in the fact that so many of MEDICINE AT FLORIDA STATE UNIVERSITY The Sun is Particularly Harsh Today those who seek a deeper sense of unity and who genuinely believe that this world is good and worth the fight, and to whom tolerance I read a recent piece by Nikolas Moring and empathy come naturally, do not allow themselves this grace. BY CHRISTINA DAWSON ‘21, LARNER on Global Health Diaries and was moved. In the case of this young man, there is no place for condemnation. COLLEGE OF MEDICINE STUDENT I could sense that this young man was He went to care for others because he cares about others—neither disappointed, not in his trip but in his by virtue of blood ties or time spent in school nor by means of a The sun is particularly harsh today. The decision to return to the United States. cultural history, but simply because he knows that in the act of intermittent gush of wind usually provides I believe there is a difference between the caring comes a relationship and in the relationship, stories are temporary relief despite the swell of red clay words “trip” and “journey.” The former implies a start and end exchanged. These stories are what define us, inspire us, and make that stains my white coat, but today I feel it point, a series of expectations from others and oneself which one us more human. making a paste on the back of my neck. The must fulfill, and ultimately a return. Self-incrimination is antithetical to growth and prevents us day begins with our routine: waiting for Dr. Meanwhile, a journey is made of the stories one gathers, the love from leading authentic lives. We must learn to commit ourselves Cathy to greet us as she promptly does every and openness one offers, and the spirit of compassion and unity. It to learning without fear, anxiety, self-recrimination, or envy, and morning around 9. She is late today. I decide to make a quick dash also implies a look into one’s own being—who one is and who one use these perspectives to help us walk gracefully through our more for the restroom, and head towards the only clean one I know in the wants to become, and the distance between these two beings. An difficult moments. We make decisions, and sometimes in doing so maternity ward. investigation into what one has learned, how one has been changed disappoint ourselves or others. But we think and we learn and we I exit the restroom in synchrony with the opening of the labor by the experience, and how ultimately one dives into the deepest continue to move toward the life in which we believe. and delivery room door across the hallway. It’s Dr. Cathy gesturing me to come in. On the table is a young woman lying down naked with her feet propped on a plastic tarp that she surely brought from home. There is a partially blood-soaked wad of cotton between Humanity’s Transience her legs. On the edge of the table by her feet is a folded bundle of beautiful blue printed cloth with a characteristic pattern that one BY KATRIN SARA SADIGH, M.D. literally drop everything they are doing and drive long hours or often sees in shop windows around Kampala. Dr. Cathy begins canoe or fly out (often across many countries) in order to add the to open the cloth, I assume to get more supplies the mother Ever heard of the term “twitcher”? bird of their list of rare bird sightings. Some birdwatchers may take has brought for delivery. She opens up each corner slowly. “An with. I wish she had someone to stay with her in the room so she This word may conjure up eye or muscle offense to this term, and push to differentiate themselves from abortion,” she says. Lying there in the middle of the cloth is a isn’t alone. twitching. Or maybe something related to what they consider more of an adrenaline seeker/checkbox ticker baby. He isn’t alive. He is small and fully formed with just enough I had never seen a dead baby before. I’m not sure if it’s seizure activity, which is exactly how this without real appreciation or care for birds or the community of likeliness in his face to the young mother on the table to scare me. necessarily the baby that made me feel so upset or the way in which one birder describes this phenomenon: birdwatchers. They argue that once twitchers capture the bird on I don’t say anything. I don’t react. Dr. Cathy explains what I felt the young woman was left exposed in that room by herself. “The very mention of some exotic avian their lens, they do not consider the bird for another moment, even happened: she had come in with bleeding, the baby half out; a The day followed with me quickly putting my hands to work. I delight, a purple Peruvian rock thrush though these birds struggle with exhaustion and fear, and often partial abortion around five months. We wait for the placenta. She put in my first catheter, gave over a hundred immunizations at for example, sends them into paroxysms. ultimately die in the foreign setting. adds oxytocin to the IV, gives the mother a tablet of misoprostol, the vaccine clinic, and scrubbed in twice: one time to watch a They literally twitch; hence ‘twitchers.’” (Terrence Hollingworth, Others argue that even serious birdwatchers, those who can says a few words to the woman, and then looks at me and says, debridement, and a second to quickly help with an emergency Blagnac, France). spend hours watching even the most commonplace of birds, can “Okay, we will wait, and we can start rounds now.” She isn’t c-section that came into the operating theatre at the same time. I never knew this group existed until recently. During the still jump up at the chance of such a rare sighting. After all, poets uncaring or apathetic, but says all this with the calm tone of I ended the day with popcorn, chocolate, and avocados from the migration season, a small fraction of birds become disoriented and of all ages have written about all kinds of birds, from pigeons to someone who experiences this as a daily reality. We leave the stand down the street and watched a funny movie. I think it helped lose their way. Instead of flying north, they fly south, ending up skylarks, representing the most singular of human emotions, as mother in the small, cold room, naked, on her plastic tarp, with me decompress for the day. It wasn’t until later that night when I in unusual places. Their mistake becomes an opportunity for this in Emily Dickinson, “‘Hope’ is the thing with feathers,” even as an her dead child on the corner of that unsteady delivery table by her was relaying the events of the day to my mom over the phone that I specific group of people. Once sighted, the network of twitchers exploration of humanity’s transience and the inevitability of death, feet. Her face is expressionless. I wish I had something to cover her finally let myself cry. I’m looking forward to safari this weekend. lights up with posts and communications. These individuals will as Keats’ nightingale.

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Makerere College of Health Sciences

ACCESS Headquarters uganda in Nakaseke

St. Francis Naggalama Hospital, Naggalama, Uganda The African Community Center for Social Sustainability (ACCESS), Nakaseke, Uganda

ROBERT KALYESUBULA, M.D., FOUNDER to invigorate our community. Working to mitigate infant and SISTER JANE FRANCES NAKAFEERO, OF ACCESS, AND ESTHERLOY KATALI, DIRECTOR OF ST. FRANCIS NAGGALAMA maternal mortality by preventing unintended pregnancy during MANAGER OF ACCESS HOSPITAL the critical postpartum period, the team is studying the role of incentives in family planning access. A workshop on Digital From new community health and research proj- The second year of our partnership with the Modules for Palliative Care Education, led by Dr. Eison from ects to the greatest ever number of global health Global Health Program is coming to a close, WCHN and Lorien Menhennett, has refined the communication participants, this year has been fruitful for us at with plans solidified for the third. We are skills of nurses and clinical officers at Nakaseke Hospital and the African Community Center for Social Sus- proud to offer a learning environment that ACCESS, particularly in delivering difficult news to patients and tainability (ACCESS). The newly founded Inter- nurtures meaningful relationships, as well St. Francis Naggalama Hospital their families. The early childhood development program, Grace’s national Coordination Program now manages as clinically and culturally rich experiences. staff with the medical team Promise, founded by Grace Herrick last year, is flourishing with and members of the WCHN ACCESS research projects and collaborations, Moving from home to home alongside the Palliative Care Team, high parental engagement and a newly designed curriculum. Global Health Program at the arranges for international student exchanges, participants gain a vivid understanding of patients’ economic and new microbiology lab This year, we are working to establish small research grants and and oversees volunteer capacity building. Our social backgrounds while observing a way of life they have never scholarships to support bidirectional, co-mentored collaboration new Guest House is operational, thanks to the seen. As small red-mud houses with black-sooted cooking areas between our students and global health participants. We hope help of a donation from WCHN, and our online in the bush sharpen into focus, participants are welcomed with a to receive training through a placement at St. Francis to graduate greater numbers of nurses and midwives from our orientations are facilitating smooth transitions genuine smile and excitement for a visit by a “muzungu doctor.” Hospital in Kampala. Climb For a Cause, the fundraising event training school and upgrade the institution from diploma- to into our site elective. The construction of a Microbiology Unit at Naggalama Hospital that made this facility possible, not only provided international degree-awarding. Finally, we aim to continue our synergistic Supported by the generous fundraising is complete and infrastructure is in place for its laboratory staff recognition for our community but also deeply touched our hearts. mission of supporting the education of orphans and health of efforts of Dr. Weiner’s family, our collaboration with the UVM patients in our community. Larner College of Medicine’s Global Women’s Program continues Makerere University College of Health Sciences St. Stephens Hospital, Uganda SUSAN BYEKWASO, COORDINATOR OF MAKERERE UNIVERSITY COLLEGE OF CATHERINE NAKIBUULE, M.D., HEALTH SCIENCES INTERNATIONAL OFFICE DIRECTOR OF GLOBAL HEALTH AT ST. STEPHEN’S HOSPITAL The Global Health Program continues to expand at the Makerere University College It has been another productive year of Health Sciences. We are excited for our here at St. Stephens Hospital. The newly new global mental health partnership constructed WCHN Global Health cross-linking the psychiatry departments Information Center, funded by the of UVMLCOM and MakCHS, with the first Global Health Program, launched as an group of psychiatry residents having already rotated through. orientation and support site for participants The newly established Global Health Information Center (GHIC) as they adjust to life in Uganda. A new partnership with Sacred is in full function. The center will be a cornerstone for orientation, Heart University, through which physician assistant and nurse training, and supplementary sociocultural curriculum for global practitioner students spend a portion of their global health elective The leadership of St. Stephens Hospital health participants in Uganda. In continuing education, Dr. Dr. Majid Sadigh with MakCHS at St. Stephens Hospital, is blossoming. A community health needs Sahand Arfaie, pulmonary and critical care medicine specialist in emergency medicine residents assessment guides us in improving patient care services. Fargo, North Dakota, helped train pulmonary and intensive care We have engaged this year’s multidisciplinary group of global improvements in medical education and quality of care. We hope unit staff, while Dr. Anne Dougherty, director of the UVMLCOM Kalanzi’s site visit to UVMLCOM’s Emergency Medicine health participants in an array of clinical activities within the to continue enhancing our site by acquiring additional diagnostic Global Women’s Health Program, focused on training OB/GYN Department. Four of our Global Health Scholars who trained at hospital. Outreach visits provided insight into home-based equipment, engaging more actively in participant orientation, and providers and improving access to digital information. WCHN this year will join the group of pioneers at New Mulago— healthcare in a resource-limited setting. Participants teach creating a structured assessment tool to better support participants The coming year features the first group of global health which is soon to open and in need of trained specialists and community members about child safety, accident prevention, and and document their experiences. We are grateful for the many ways participants rotating through the new emergency residency subspecialists—where they will work in the intensive care unit as family planning; deliver presentations to our staff on an assortment our involvement with the Global Health Program enriches our program at Mulago Hospital, and program director Joseph well as pulmonary and divisions. of clinical topics; and initiate discussions that contribute to hospital and greater community.

12 THE UNIVERSITY OF VERMONT AND THE WESTERN CONNECTICUT HEALTH NETWORK GLOBAL HEALTH ANNUAL REPORT 2018 13 GLOBAL HEALTH PROGRAM

Makerere College GLOBAL HEALTH INFORMATION CENTERS of Health Sciences New Global Health Information Centers at three sites throughout Uganda provide resources to the community and steer Global South interest in global health. Our greater vision is of a resource center that encircles all individuals from anywhere in the world, a place where people can come to learn more about global health. These centers orient participants and compile sociocultural curriculum, as well as match participant needs with available resources and host institution needs with participant skills. While the classes held at the centers will be offered mainly to our own participants, uganda ] we hope they will eventually be open to international participants in other programs. ]

A True Understanding The biggest lesson I learned was, first REFLECTIONS FROM THE FIELD of Patients and foremost, humility. My time in Driver of Change RANDI R. DIAMOND, M.D., Uganda also taught me not to take things ASSISTANT PROFESSOR OF MEDICINE for granted, and that real wealth is not Every day we see a parade of people without adequate resources, AND DIRECTOR OF THE LIZ CLAIBORNE CENTER FOR HUMANISM IN MEDICINE about money or possessions, but people suffering from diseases and injuries that would otherwise be AT THE WEILL CORNELL MEDICAL COLLEGE, and relationships. This realization managed differently, or at a higher level. In my six weeks here, AND CO-SITE DIRECTOR AT ST. FRANCIS encouraged me to cherish my family and there is no way I will contribute to the structure of the Ugandan NAGGALAMA HOSPITAL friends more fully while also reinforcing healthcare system, or have any significant impact on the patients receiving healthcare. However, in these six weeks I have begun my During a recent reunion dinner held for my desire to work in healthcare.” career as a physician and member of the global community. My participants who were in Naggalama with – GRACE HERRICK, FOUNDER OF GRACE’S PROMISE, impact will not come in the next three weeks, or even next years, Katherine Callahan ‘21, at right, in Uganda with us, we all reminisced about our shared A CONNECTICUT-BASED NONPROFIT DEDICATED TO but eventually I hope to be a driver of change on the global level. classmate Christina Dawson ‘21 experience in Uganda. Participants commented that though PROVIDING PRESCHOOL EDUCATION IN IMPOVERISHED COMMUNITIES – Katherine Callahan ’21, UVM Larner College of Medicine student they did not have clear memories of all the patients they saw, they remembered the patients we saw together very well—those Establishing Our Roots who allowed us into their homes and lives; those who honored us by sharing their most personal concerns at such vulnerable We started off early Saturday morning at Reverend Luboga’s farm times. Hearing these students’ impressions of their experiences where we each planted a fruit tree as a symbol of establishing our in Naggalama—a year and a half later—I cannot help but think roots in Uganda and supporting its people. It was a humbling about what a fabulous medical education the Global Health Children experience. We were then invited to attend a Ugandan engagement Program provides. More than remembering textbook facts, we as watching an ceremony, a special event where families of the bride and groom medical educators want our students to carry into their futures educational meet for the first time. We all wore traditional Ugandan gomezis as physicians a true understanding of patients’ experiences with video at with beautiful bright colors and sashes. We did not know the bride or the ACCESS illness. I am grateful to be part of a program that supports such the groom, but Dr. Luboga was the reverend for the ceremony. What preschool meaningful and important work. he failed to mention was that the bride was a princess, and that the Dr. Lindo (second from right) with Reverend program Samuel Luboga and Global Health Program Ugandan Queen would be in attendance! – Amanda Lindo, M.D., participants at a Ugandan engagement ceremony internal medicine resident at Norwalk Hospital

Life Changing Opportunity HOMESTAY MODEL, , UGANDA

and accompany them to wedding I am grateful for the supportive learning Some of the highlights of my visit Our homestay model has continued ceremonies and other cultural activities. environment that the Global Health included the point of care ultrasound to be refined as it flourishes. We are We encourage them to participate Team and Department have course I attended at UCONN, the day I proud to provide a comfortable space in our family activities such as meal created. In exchange, I have shared my spent at the simulation lab in Danbury for participants to practice Luganda, preparation, and even invite them to knowledge in autopsy and pediatric and my day in the operating room doing share reflections about their day, inquire showcase their own home dishes. Our cancers with pathology residents. I will CT guided epidural steroid injections. about their encounters, and learn about new Leaving Your Roots Behind ceremony join Makerere University as a lecturer My experiences also included soaking Ugandan culture through storytelling at the family farm has become a as a way to give back to the leadership up the local culture and history with and observation. We offer them emotional tradition: As participants cover tree roots for providing me with the life-changing the Vietnamese global health fellows support for any difficulties they may face, with soil, they solidify their personal training opportunity at Danbury who were such a joy to be around. With the experience from help them navigate the city, and assist connection to our country and its people Hospital. My time as a Global Health Scholar is helping me build a this visit, I hope to transplant a few ideas such as an annual them in planning trips. We share patients Reverend Professor Samuel Luboga, while internalizing a symbol of growth strong foundation in hematopathology, the field that I love most. critical care ultrasound course for our residents. and faculty stories with them as part of M.D., and Christine Luboga and new perspectives to which they will – Emmanuel D. Morgan, M.D., Global Health Scholar – Peter Agaba, M.D., Global Health Scholar the global health cultural curriculum, someday return.

14 THE UNIVERSITY OF VERMONT AND THE WESTERN CONNECTICUT HEALTH NETWORK GLOBAL HEALTH ANNUAL REPORT 2018 15 GLOBAL HEALTH PROGRAM

Focusing on the education of the next generation of medical

Kazan students and instilling the principles of global health has State Medical the potential to positively impact the medical landscape.” University russia – JOHN ISA NGBEDE, M.D.

A Commitment to Health Equity NOTES FROM THE FIELD

ALEXEY SOZINOV, M.D., PH.D., D.SC., with a remarkable wealth of clinical, cultural, and personal RECTOR, KAZAN STATE MEDICAL UNIVERSITY insight. We are also proud to have hosted many students and Learning from Commonalities and Differences MARAT MUKHAMEDYAROV, M.D., PH.D., faculty from UVMLCOM/WCHN. Among our exciting updates, SITE DIRECTOR, KAZAN STATE MEDICAL Ms. Alsu Khairutdinova has been appointed as the new Improving communication skills and empathy reduces anxiety cultures and healthcare systems UNIVERSITY coordinator of the Global Health Office at KSMU. Tropical and positively affects patient well-being across cultures. Achiev- increases professionalism and cultural Medicine Modules 101 was published by University Press in both able at all levels of a healthcare workforce, tools for adequately awareness for all participants, and in 2018 was another successful year for global English and Russian, and is now available to students during responding to illness-related emotions can powerfully enhance turn allows us to provide better care health at Kazan State Medical University their rotation in infectious disease hospitals. Dr. Stephen Winter the landscape of compassionate healthcare delivery. to our patients. (KSMU). The number of participants spent a week with us during our Anniversary Day Celebration to The effort to share ever-evolving clinical knowledge across – Rafael Khalitov, M.D., Russia in our tripartite partnership has now join our festivities, deliver a series of talks, perform clinical work, reached thirty. These alumni return to and participate in distribution of certificates to Global Health KSMU where they share their sharpened Scholars selected for the elective in Uganda. Moving forward, we skills and insight, advocate for the global are excited to host an increased number of faculty and residents health philosophy, and drive change in from our partner sites and send even more Global Health Scholars our institutions and communities. Two of to WCHN for training and observership. We thank the Global our residents traveled to the Dominican Health Program, and look forward to another year of continued Republic and two to Uganda for global partnership and growth. health electives this year, and came back

NOTES FROM THE FIELD

Impacting the Medical Landscape

I knew little about the complications of AIDS (tuberculosis, cryptococcus meningitis, CMV, toxoplasmosis, candidiasis), or diseases like tetanus until I realized they were immersed in the daily routine at Kiruddu Hospital in Kampala, Uganda. Slim disease, as it was known when it was first discovered here, affects about 7.3 percent of the population and brings many with advanced complications to Kiruddu Hospital. Daria Artemeva, M.D. (third from left), Global Health Scholar from Russia Lack of diagnostic resources demands deep medical knowledge and clinical judgment from medical caregivers, as these are the only diagnostic tools in their hands. Interactive seminars and healthcare delivery as well as the significance of taking a good lectures given by a team of doctors, nurses, and pharmacists history, performing a meticulous physical examination, and Seeking Answers, Developing Confidence had the most educational value for me, and was a showcase for using scarce resources judiciously and thoughtfully. Focusing demonstration of amazing intellectual capacity, teamwork, and on the education of the next generation of medical students and [My experience in the Global Health Program] has given me headaches. At the same time, I have had the chance to meet up-to-date medical knowledge of caregivers at MakCHS. instilling the principles of global health has the potential to greater confidence treating patients with different types incredible and highly professional doctors and residents. Each The insight and medical knowledge I have acquired in Uganda positively impact the medical landscape. of strokes and preventing stroke in my patients at KSMU. teaching session with my supervisors inspired me to delve further will help me educate young medical students and peer residents – John Isa Ngbede, M.D., PGY1, Internal Medicine Department, I have learned new approaches to treating the most frequent into discussed topics and seek answers to important questions. at KSMU about the cultural and economical attributes of Kazan State Medical University neurological conditions such as epilepsy, Bell’s palsy, and – Daria Artemeva, M.D., Global Health Scholar from Russia

16 THE UNIVERSITY OF VERMONT AND THE WESTERN CONNECTICUT HEALTH NETWORK GLOBAL HEALTH ANNUAL REPORT 2018 17 GLOBAL HEALTH PROGRAM GLOBAL HEALTH PROGRAM

Cho Ray dominican Hospital Universidad republic Iberoamericana vietnam A Commitment to Health Equity The Development of Global Health Advocates

surgery departments hosted each other’s faculty for training, LAN PHUONG (left), M.D., HEAD OF meaningful insights in medical education, during which trainees shared their own unique perspectives. INTERNATIONAL AFFAIRS, AND TRAN cultural competence, and clinical skills, Thanks to these beautiful exchanges, as well as frequent lectures HANH UYEN (right), M.D., COORDINATOR, including up-to-date procedures and CHO RAY HOSPITAL given by the director of the Global Health Program, interest has techniques. In exchange, they familiarized grown so immensely among UNIBE medical students that a global WCHN members with the medical The Global Health Program at Cho Ray DEAN MARCOS health interest group has been formed. Meanwhile the success education and healthcare delivery systems NUNEZ, M.D., Hospital continues to expand in scope, of the homestay model at our site has led to an expansion to a in Vietnam through venues such as the AND JOMAR FLORENZAN, participation, and reach. In response to second household. We hope a rewarding collaboration can blossom Global Education and Health Systems M.D. this remarkable growth, we have launched between the OB/GYN departments of UVMLCOM and WCHN when lectures hosted by Sacred Heart University a new Training Center this year, led by renovations at UNIBE’s Maternity Hospital are complete. Sparked (SHU) College of Health Professions and We are grateful and proud to describe our partnerships as truly associate professor and deputy director by a visit from Danbury Hospital’s Cardiology Fellowship Program, Isabelle Farrington College of Education, mutual and bidirectional. Our many successes and innovations Tran Minh Truong, to serve as the home a future collaboration with U.S-based cardiovascular surgeons is where our scholars presented this year. this year are a result of faculty collaboration from both sides. of global health at our institution. We are also under discussion. We are excited for a new partnership To investigate the use of simulation in orienting participants to excited for this global health epicenter Our collaboration continues to provide our students, faculty, and through which SHU physician assistant global health competencies, the heads of the simulation lab at to stand as the connection point for all leadership with a wonderful experience. We are grateful for the students will join UVMLCOM/WCHN Danbury Hospital and UNIBE visited each other’s sites. To revamp our global health partnerships. Dr. Tran opportunity for growth and learning through our relationship with global health participants at our medical education at UNIBE, Dr. Nunez visited UVMLCOM and the Hanh Uyen and Dr. Hoang Lan Phuong the UVMLCOM/WCHN Global Health Program, and to uphold our institution. Over the next year, we hope to amp up pre-departure Teaching Academy while medical education leaders from Vermont will be directly responsible for coordination of the educational ongoing commitment to comprehensive medical education, strong orientations and develop midterm and final evaluation reports visited UNIBE to gain a clearer sense of the curriculum. To expand partnership between WCHN/UVMLCOM and Cho Ray Hospital. partnership, and health equity. to aid participants in their development as clinicians and global our global surgery partnership, UNIBE and Danbury Hospital’s We had a record number of Global Health Scholars this year. health advocates. We also plan to engage young physicians from a They truly enjoyed their training at WCHN where they were wider variety of departments to participate in global health. immersed in international hospital teams, and returned with NOTES FROM THE FIELD Focus on Mastering the Basics NOTES FROM THE FIELD Observing Cultural Differences One of the challenges during my The Doctor-Patient Relationship time in the Dominican Republic was Perhaps the most interesting realizing that their surgeons are Value in Providing for Others Two things especially impressed and inspired thing to me is that the entire great—really great—and that I likely me throughout the training. First was learning hospital staff at Nuestra Señora wouldn’t be contributing much in Having grown up in a diverse neighborhood about the doctor-patient relationship and de la Altagracia prays together the way of innovation, knowledge, in Queens, New York and traveled extensively communication. Doctors are aware not only every morning and during procedural expertise, or even throughout my upbringing, I had long been of disease, but also patient living conditions the evening shift change, with perspective. The surgical residents interested in global health when I finally had and environments. Second is the quality of hands held and eyes closed, and had immense operative experience, the opportunity in 2015 to participate in a comprehensive care and use of evidence-based the prayer is always explicitly great judgment, and the ability to global health rotation in Vietnam. During medicine in clinical practice, which together Christian. I was initially taken operate with true beauty without many meetings with the global health group, the allow chronic patients a higher quality of life. All the mentors, aback by this practice because it of the technologies we enjoy in the United States. While this was program director made a comment that hospital staff, and global health faculty provided me with a warm is so different from the thoroughly certainly humbling, it also served to remind me that technology has stuck with me: When we travel to someone else’s home welcome, caring atmosphere, and emotional support as I enriched secular medical culture I am accustomed to. However, I began doesn’t make me a better surgeon per se. It will always be the country, we must consider ourselves citizens of the world, and my clinical and cultural knowledge. This training has inspired me to appreciate and even look forward to these prayer sessions. fundamental surgical principles of knowing when to operate and as such have a global responsibility to provide them care. This to work toward providing a higher quality of care while helping Despite the fact that I am not Christian (I am Muslim), I feel that when not to, knowledge of and physiology, and the core idea transformed my view of global health from a hobby into a me realize that I can do so even with limited resources. these sessions bring a greater sense of togetherness, spirituality, technical skills of cut, expose, dissect, divide, and sew that make responsibility that we must continue to fulfill. – Nguyen Thanh Nam, M.D., Global Health Scholar from Vietnam and compassion to the group. a surgeon great. – Bilal Khan, M.D., Pulmonary/Critical Care Specialist and – Asaad Traina, M.D.’18, UVM Larner College of Medicine alumnus – Patrick Zimmerman, D.O., surgery resident at Danbury Hospital Fellow in Sleep Medicine, Norwalk Hospital

18 THE UNIVERSITY OF VERMONT AND THE WESTERN CONNECTICUT HEALTH NETWORK GLOBAL HEALTH ANNUAL REPORT 2018 19 GLOBAL HEALTH PROGRAM GLOBAL HEALTH PROGRAM University Walailak of Zimbabwe University College of Health thailand zimbabwe Sciences

DR. “MENN” Thailand: My Vision PRACHYAPAN Meaningful Collaboration and Friendship PETCHUAY, DEAN CHIRATIDZO ELLEN NDHLOVU, M.D., nominated for the Velji Global Health Education Award, which OF WALAILAK PRACHYAPAN PETCHUAY, M.D., PROFESSOR OF MEDICINE AT THE UNIVERSITY SCHOOL I was able to receive in person at the Consortium of Universities DEAN OF WALAILAK UNIVERSITY OF ZIMBABWE COLLEGE OF MEDICINE, for Global Health Conference in New York City thanks to support UNIVERSITY SCHOOL OF HEALTH SCIENCES OF MEDICINE AND DR. STEPHEN of the program. Another significant event was the fundraising SCHOLAND, GLOBAL effort of Dr. Stephen Scholand, along with his family and friends, HEALTH PROGRAM At UZCHS, we have continued to expand our I strive to nurture my students that raised $32,000 to improve the care of cancer patients at our SITE DIRECTOR networks and friendships as well as research into well-rounded physicians university, particularly in the Kaposi Sarcoma clinic. IN THAILAND, and publication opportunities this year. who approach their patients In the future, I hope our college will set up a global health office VIETNAM, AND Visitors have brought useful equipment for with astute clinical skills and ZIMBABWE to help accommodate the growing program. Currently, we are our university while exposing our students with heart. Undeniably difficult working on utilizing simulation for our medical education cur- to new cultures and ideas. Our faculty find to teach, empathy opens a riculum. After training at UVMLCOM/WCHN sites in September, supervising global health participants beautifully rewarding, window into a world deeper than the classroom where Our New Collaboration With UZCHS Senior Lecturer Dr. Shalote Chipamaunga took an interest and enjoy imparting to them not only clinical knowledge but care translates as truly listening to patients and seeing in advancing simulation experiences at our university where our Walailak University also insights into our way of life. It is this “hidden curriculum” the communities in which they live. In imparting this Clinical Skills Laboratory is largely underutilized. that makes global health education so valuable - the relaying way of being, we as teachers are reminded to reflect on We enthusiastically welcome Walailak University (WU), the The Global Health Program has given us a lot this year. The of information that cannot easily be found in a textbook. To the meaning of empathy and learn to practice it anew. newest member of our global health family. Situated in Nakhon unfortunate part of our story is the political unrest that has arisen adequately transmit these perspectives, we are dedicated to being In providing a scaffold on which different Si Thammarat, a city about an hour’s flight from Bangkok, the in our nation. We plan to continue sending our Global Health resourceful and knowledgeable about our country, its political perspectives, cultures, traditions, and beliefs can university sits on a large rural campus with ample educational Scholars to UVMLCOM/WCHN for training, but must take a hiatus landscape, and global health competencies. converge, the UVMLCOM/WCHN Global Health opportunities including rotations in two community hospitals as well from hosting global health participants until we regain economic There have been shifts in leadership this year, as we welcomed Program encourages a suspending of our own as an outpatient clinic experience on the university grounds. With a and political stability. We are honored to be part of this meaningful the new dean, Professor Rangarirai Masanganise, and Deputy worldviews toward better understanding those of seven-hundred-bed university hospital currently under construction collaboration and friendship. Dean Professor Jephat Chifamba. Tendai Machingaidze was others. With time, growth, and practice, empathy and projected to be completed next year, this site is rapidly growing. appointed the associate clinical site director. I was honored to be can embed itself in our beings in such a way that we Dean of the WU School of Medicine Dr. “Menn” Prachyapan can better care for each other and our communities. Petchuay welcomed our collaborative global health vision with open We are excited to be part of a network that advocates arms as the institution invests in capacity building, educational Frameworks for the Future not only for higher-quality healthcare, but for a more infrastructure, and engagement of junior faculty. We are delighted that the WU School of Medicine leadership espouses our philosophy deeply connected world. TENDAI MACHINGAIDZE, M.D., ASSOCIATE seas where they get better pay. Despite these unfortunate setbacks, of a holistic bidirectional partnership, a proverbial two-way street for SITE DIRECTOR FOR UNIVERSITY OF Zimbabwean healthcare workers have continued to strive to help, medical education. ZIMBABWE COLLEGE OF HEALTH SCIENCES heal, and comfort, and the Zimbabwean commitment to educating This new collaboration will offer our participants a unique experi- and training medical students is strong. Due to financial constraints ence to learn about the healthcare education and delivery systems in The impact of the University of Vermont and shortages of specialized equipment, an impressive emphasis southern Thailand where there are shortages in healthcare access. The Larner College of Medicine/Western is placed on history-taking and physical examination in diagnosis Thai healthcare system is very strong, however, and the emphasis on Connecticut Health Network Global making—a lost art in modern medicine. There are few places in the education will provide our participants with lessons in making the best Health Program in Zimbabwe goes far world where one is faced with the reality of both the art and the sci- of available resources. Meanwhile “The Land of Smiles,” known for its beyond what can be quantified in charts ence of medicine than in a country like Zimbabwe. Global healthcare friendly people, promises nurturing and supportive faculty mentor- and graphs. Rooted in mutual respect and goes far beyond lab tests and prescriptions. It encompasses the socio- ship. In fact, WU medical students highlight this trait as a strength of bidirectionality, it is a program that builds frameworks for the economic, postcolonial, racial, and religious realities that influence their program, as indicated by their use of the title Pee - which means future. It empowers Zimbabwean students, doctors, and patients if and how a patient will receive the appropriate treatment. “big brother” or “big sister” - to refer to their professors. In reciprocity, to tell their own stories, in their own voices, from their own As you engage with Zimbabwean students, doctors, and patients we look forward to hosting junior faculty from WU School of Medicine perspectives of healthcare in their country. In so doing, it helps to with cultural humility and a willingness to learn and not just to fix, at our WCHN training sites. Our new partnership with Walailak Uni- better chart a viable and sustainable course from where they are Zimbabweans are reassured that they too have a role to play on the versity School of Medicine promises to be a “crown jewel” of the Global into the uncertainties of the future. global health stage. They learn that they are not only the object, but Health Program. We thank their leadership for entrusting us with this In past decades, Zimbabwe was a leader in healthcare and educa- more importantly also the subject of a reciprocal relationship whose new collaboration, and we are excited to send our first group of global tion in Africa. Recent political and economic turmoil has resulted in heart is our shared humanity and a love of medicine. health participants. a “brain drain” of qualified doctors and nurses seeking jobs over-

20 THE UNIVERSITY OF VERMONT AND THE WESTERN CONNECTICUT HEALTH NETWORK GLOBAL HEALTH ANNUAL REPORT 2018 21 GLOBAL HEALTH PROGRAM awards and recognition Left to right: Dr. Molly Moore, Professor Chiratidzo Ndhlovu, and Dr. Mariah McNamara CELEBRATION 2018 Global Health Award Winners Consortium of Universities for Global Health Patricia O’Brien, M.D. Global Health Leadership & Humanitarian Award: The UVM Larner College of Medicine/Western Connecticut • UVM Professor of Surgery Bruce Leavitt, M.D. Health Network Global Health Program was well- represented at the ninth annual Consortium of Universities Beth Kirkpatrick, M.D. Citizen of the World Award: for Global Health (CUGH) conference, held in New York • Tampas Green and Gold Professor and Radiology Chair Kristen City from March 15-18, 2018. Several leadership team DeStigter, M.D. members and international partners participated in the event, including Dr. Isaac Okullo, Dr. Rose Nabirye, and Majid Sadigh Global Health Education Award: Susan Byekwaso from Makerere University College of • UVM Assistant Professor of , Gynecology and Health Sciences in Uganda. Reproductive Sciences Anne Dougherty, M.D. AWARDS 2018 Poster and Essay Competition Winners • Professor Chiratidzo Ellen Ndhlovu, M.D., Director of the Best Poster: Global Health Program at the University of Zimbabwe • Danielle Ehret, M.D., Assistant Professor of Pediatrics and College of Health Sciences, received the 2018 Drs. Anvar Neonatologist and Pari Velji Global Health Education Award. Best Reflection Essay: • A poster presentation from Alexandra Miller, M.D.‘18, was selected as a finalist for The Lancet Poster Presentation. • Julia Shatten, M.D. ‘18 for “Ethics of the Theater” (Uganda) The poster, titled “Cervical Cancer Screening in Rural Global Health Day Celebration Essay Honorable Mentions: : A Capacity Building Project,” was co-authored by • Amanda Kardys ’20 for “Impressions” (Zimbabwe), Stefan Miller, Kelley Collier, M.D.’18, Anne Dougherty, M.D., et al. The UVM Larner College of Medicine/Western Connecticut Health Wheat, M.D.’18 for “The Ghosts of Makerere Kikoni” (Uganda), PRESENTATIONS Network Global Health Program hosted a “Celebration of Global and Stephanie Brooks, M.D.’18 (Uganda). • Molly Moore, M.D., Director of Global Health for the UVM Health” April 17-18, 2018. International guests joined program leaders, 2018 Photo Winners Select photo winners below and left. Larner College of Medicine’s Department of Pediatrics, faculty, staff, and students for several events. During a special dinner, presented research titled “Use of Simulation for Global Health Program Director Majid Sadigh, M.D., presented Dean Preparation of Pre-Clinical Medical Students for Global Rick Morin, M.D., with a special thank you gift for his leadership and Health Electives” by Moore, Michelle Mertz, M.D., Mariah support as he transitioned to retirement. The celebration featured the McNamara, M.D. et al. Dean’s Distinguished Lecture in Global Health, titled “My Heart Burns: • Samantha Deans, M.D., OB/GYN resident at UVM Medical Three Words Form a Memoir” by Dr. Majid Sadigh. Center, presented research titled “Knowledge and Attitudes of Family Planning by Men and Women in Rural Uganda” by Dean and Anne Dougherty, M.D., et al.

Northeast Regional Symposium

The second annual Northeast Regional Symposium, hosted by the American University of the Caribbean (AUC) School of Medicine, was held May 12, 2018, in Rye Brook, New York. Majid Sadigh, M.D., delivered this year’s keynote address Best Composition Award, photo by Anya Koutras, M.D. and moderated a panel on ethical dilemmas in short-term global health electives. Bulat Ziganshin, M.D., spoke about the structure and content of the global health elective at WCHN. Other WCHN attendees included Jonathan Rosen, « Originality Award, photo by Pirapon Chaidaron ‘21 Impact Award, photo by Anya Koutras, M.D. M.D., Ms. Joanna Conklin, and Ms. Laura E. Smith.

22 THE UNIVERSITY OF VERMONT AND THE WESTERN CONNECTICUT HEALTH NETWORK GLOBAL HEALTH ANNUAL REPORT 2018 23 GLOBAL HEALTH PROGRAM PHILANTHROPIC EVENTS awards and recognition

Endowed Chair Dinner Climb for a Cause The first Endowed Chair Dinner was held at Le Chateau, On February 9, 2018, Majid Sadigh, South Salem, New York on June 28, 2018. It was attended M.D., director of the Global Health by eight of nine Endowed Chairs, their spouses, and the Program at the University of Vermont donors. Each Endowed Chair spoke about the impact of Larner College of Medicine and their endowment on their respective program. Western Connecticut Health Network, began a nine-day trek up the 19,341- Left to right: John Murphy, M.D., Christian Trefz, Majid Sadigh, M.D., Eva Trefz foot Mount Kilimanjaro to raise funds to build a microbiology laboratory at St. Francis Naggalama Hospital. In the From Dr. Majid Sadigh’s speech: end, more than 100 people contributed over $20,000 to the fundraiser, called I was raised in a small mountainous village in southern Iran, a land of poor but kind and generous inhabitants. I was one of very Climb for a Cause. few children who had the privilege of a warm and supportive family. It was in this setting that I became familiar with the lives of underprivileged, gentle souls. Rumi became my idol as I searched for meaning beyond simple “happiness” throughout my youth… On February 23, 2018, Sadigh received I dreamt of becoming a storyteller who narrates the stories of those who cannot tell their own. I attended medical school with this the Award of Unity from St. Francis Naggalama Hospital board members dream, came to the USA with this dream, and joined Yale, and later on UVMLCOM, with this dream. I focused all my energy on and medical staff in honor of his efforts. relating the story of the underprivileged to those who may not have heard it. It was at Western Connecticut Health Network that I finally discovered people, both in the community and among the leadership, who shared this dream. John Murphy, the CEO of WCHN, immediately embraced the global health philosophy. And in 2016 when he and the Foundation brought my path to overlap with Christian and Eva Trefz, my dream finally came true. Global health at UVMLCOM/WCHN has found an identity, named after a generous family that cares about making a positive impact. Now, whenever I take the podium to advocate for the underserved, the Trefz name moves the idea forward, giving it sustainability and power.

Distinguished Philanthropy Dinner On Wednesday, September 12, 2018, Rolling Hills Country Club in Wilton, Conn., hosted the Distinguished Philanthropy Dinner. Western Connecticut Health Network President and CEO John Murphy, M.D., spoke about the impact of philanthropy and the humanistic mission of medicine, while UVM Larner College of Medicine/Western Connecticut Health Network Global Health Program Director Majid Sadigh, M.D., presented “Encounters at Dr. Sadigh at the End of the World,” in which he reflected on his early observations in Uganda. Mount Kilimanjaro John Murphy, M.D., and Majid Sadigh, M.D., at the Distinguished Philanthropy Dinner

• Sister Jane Frances Nakafeero and other Sustainability (ACCESS), received the • Benjamin Clements, M.D., has been • Jamidah Nakato, Ph.D., assistant lecturer mortality in women with St. Francis Naggalama Hospital leadership 2018 Segal Family Foundation Grassroots appointed director of the global health at Makerere University, received a grant breast cancer. received an award of 5 Stars (95.8%) for Champion Award. program at the UVM Larner College of from Makerere-Sweden to finish her Ph.D. • Stephen Scholand, M.D., has been the second year, based on accreditation • Marat Mukhamedyarov, M.D., Ph.D., D.Sc., Medicine Department of Family Medicine. research project. appointed site director of the global requirements set by the Uganda Catholic director of the global health program at • Professor Rangarirai Masanganise, • Katrin Sara Sadigh, M.D., delivered an health program at University of Awards, Recognition Medical Bureau Program for hospitals in KSMU, has been elected by the university’s MMedSci, FRCOphthal, MBChB, has been oral presentation at the Conference on Zimbabwe College of Health Sciences, Uganda. Academic Board to full professorship in appointed as the new dean of University of Retroviruses and Opportunistic Infections, Cho Ray Hospital in Vietnam, and and Promotions • Robert Kalyesubula, M.D., founder of physiology. Zimbabwe College of Health Sciences. held in Seattle from March 4-7, 2019. Walailak University at South Thailand. the African Community Center for Social Her abstract is on the effects of HIV on • Bulat Ziganshin, M.D., has been appointed director of WCHN International Affairs.

24 THE UNIVERSITY OF VERMONT AND THE WESTERN CONNECTICUT HEALTH NETWORK GLOBAL HEALTH ANNUAL REPORT 2018 25 GLOBAL HEALTH PROGRAM RECENT GUEST PRESENTATIONS

Life and Death in Kolofata: An American Doctor in Africa publications Ellen Einterz, M.D., Peace Corps volunteer and medical doctor in Africa for thirty years, spoke at UVM Medical Center’s Emergency Medicine Grand Rounds on September 6, 2018, and later in the afternoon to the community, about international development, humanitarian assistance, medical treatment in impoverished and presentations communities, armed conflict, and refugees in Africa. Her book, Life and Death in Kolofata: An American Doctor in Africa, is a beautiful narrative along with a compilation Published Manuscripts of her letters home.

Chuang, L., Berek, J., Randall, T., Aguilar, M., Chakraborty, R., Moore, M., Lieh- Cancer Center of Excellence in Rwanda. J McCormack, M., Schmeler, K., Manchanda, Lai, M., Opoka, R., Howard, C., John, C.C.; Glob Oncol. (2018) Sep;(4):1. R ., Rebbeck, T., Jeng, C.J., Pyle D., Quinn, Global Health Task Force of the American Sadigh, M. Sarfeh, J., Kalyesubula, R. The M ., Trimble, E., Naik, R., Lai, C.H., Ochiai, Board of Pediatrics. The Collaborative Role of “It is a treat for me retention of ACCESS nursing assistant K ., Denny, L., Bhatla, N. Collaborations in North American Departments of Pediatrics Academia and Global Health: Benefits and Ethics to meet talented graduates in rural Uganda. J. Nurs. Educ. gynecologic oncology education and research in Global Child Health. Pediatrics. (2018) 142: Pract. (2018) 8: 94. Pierce Gardner, M.D., senior advisor at the Stony Brook students who have in low- and middle- income countries: e20172966. University Global Health Institute, visited the UVM Larner serious global Current status, barriers and opportunities. Umoren, R.A., Mohamed, M.A., Oyerinde, Olpin, J., Chuang, L., Berek, J., Gaffney, D. College of Medicine from October 28-30, 2018. He presented Gynecol. Oncol. Rep. (2018) 25: 65. K .A., Vaucher, Y.E., Behrmann, A.T., Canarie, health interests. Imaging and cancer of the cervix in low- and “Academia and Global Health: Benefits and Ethics” at M ., Dudani, R., Kurbasic, M., Moore, Dougherty, A., Kayongo, A., Deans, S., middle-income countries. Gynecol. Oncol. Family Medicine Grand Rounds, and spoke about his life in I am enthused by M .J., Torres, A.R., Vides, M., Staton, D. Mundaka, J., Nassali, F., Sewanyana, Rep. (2018) 25: 115. global health to medical students and faculty at the noon their energy and International Community Access to Child J ., Migadde, E., Kiyemba, R., Katali, E., conference. Dr. Gardner called the UVM Larner College of Rubagumya, F., Xu, MJ., May, L., Driscoll, Health Program: 10 Years of Improving Child idealism to make Holcombe, S.J., Heil, S.H., Kalyesubula, Medicine/WCHN Global Health Program “a masterpiece that C ., Uwizeye, F.R., Shyirambere, C., Larrabee, Health. Pediatrics. (2018) 142: e20172848. the world a R. Knowledge and use of family planning K ., Fehr, A.E., Gilbert, U.D., Muhayimana, should be the standard for other global health programs.” among men in rural Uganda. BMC Public Vu, M., Yu, J., Awolude, O.A., Chuang, L. better place.” C ., Hategekimana, V., Elmore, S., Mpunga, Additionally, he wrote in a follow-up email: “It is a treat Health. 2018 Nov 26;18(1):1294. Cervical cancer worldwide. Curr Probl T ., Moore, M., Shulman, L.N., Lehmann, L. for me to meet talented students who have serious global – PIERCE GARDNER, M.D. Cancer. (2018) 42: 457. Gladding, S.P., McGann, P.T., Summer, A., Outcomes of Low-Intensity Treatment of health interests. I am enthused by their energy and idealism Russ, C.M., Uwemedimo, O.T., Matamoros Acute Lymphoblastic Leukemia at Butaro to make the world a better place.”

Dr. Jitendra Pariyar, a Nepalese gynecologic oncologist, recipient of the 2018 ASCO IDEA award, and “ From the beginning of time, people have connected with each other through storytelling. Whether sharing what member of the Nepal Society of we have seen with our eyes, what we have built with our hands, or what we have dreamed with our imaginations, Obstetricians and Gynecologists the best of our stories engages the hearts of both the teller and the listener. The global health community here is gave a presentation about one of storytellers, and our program has been made stronger and better by the stories that have been shared by endocervical cancer in Nepal at the caregivers and care receivers, by students and teachers, by the most visible advocates and the quietest who walk Danbury Hospital Tumor Board. among us. In my years working with the Global Health team I have been amazed and humbled by the stories shared, which serve as inspiration to help continue this important work. It is a privilege to help our storytellers be heard and I cannot wait to see what new stories lie ahead.” Jeffrey G. Wong, M.D., (pictured – Carole Whitaker, Assistant Dean for Medical Communications, UVM Larner College of Medicine bottom left), associate dean for medical education at the Penn State College of Medicine, hosted a four-day course for 14 faculty Global Education and Health Systems Lecture from the UNIBE School of Medicine in Santo Domingo, Dominican BOOKS AND COMPILATIONS [A] On November 13, 2018, Daria Artemeva, M.D., Duong Duy Khoa, Republic. The workshops were M .D., Nguyen Thanh Nam, M.D., and Emmanuel Denis Morgan, designed to enhance teaching Notes of Encouragement M .D., four Global Health Program Scholars from Russia, Vietnam, abilities in a multitude of venues The World of Global Health [A] and Uganda, took the stage at Sacred Heart University to share and for a variety of learners. Words of Encouragement experiences of education and healthcare from their home countries Climb for a Cause details Dr. Sadigh’s fundraising efforts. [B] Vermont Medicine, the UVM with education and global health students. Their infectious smiles Larner College of Medicine alumni and warm nature captivated the crowd. Thoughtful questions from Dr. Tracy Rabin, Director of Ebola Book Volume I magazine, featured a photo essay by the audience paired with insightful responses from the panel filled Yale and Makerere partnership, David Seaver spoke at Danbury and Norwalk Tropical Medicine 101 and 202 the room. Those in attendance left with the knowledge of the ways Hospitals’ Global Health Medical were published in Russian and English, Collection of Global Health in which these respective countries are more alike than they are Grand Rounds. in Kazan, Russia newsletters and blog posts [B] different. The series is a joint effort between the College of Health Professions and the Isabelle Farrington College of Education.

26 THE UNIVERSITY OF VERMONT AND THE WESTERN CONNECTICUT HEALTH NETWORK GLOBAL HEALTH ANNUAL REPORT 2018 27 GLOBAL HEALTH PROGRAM Directors and Coordinators GLOBAL HEALTH LEADERSHIP

United States Dominican Republic Uganda continued Western Connecticut 1 Joanna Conklin, MBA 18 Marcos Nunez, M.D. 32 Samuel Luboga, M.D., Ph.D., DSci Health Network Coordinator, Global Health Program, WCHN Dean, Medical School, Universidad Director, Uganda Partnership lberoamericana (UNIBE) St. Stephen’s Hospital, Global Health 2 Randi Diamond, M.D. Information Center, and Homestay Joanna Conklin, MBA Site Co-Director, St. Francis Naggalama 19 Loraine Amell de Abreu, Ph.D. Menoo Jarrett Hospital Dean, International Relations, UNIBE 33 Celestino Obua, M.D., M.Sc, Ph.D. 1 2 3 4 5 6 Robert Jarrett, M.D. Site Director and Vice Chancellor, 3 Howard Eison, M.D. 20 Jomar Florenzán, M.D. Lauri Lennon, MBA Mbarara University of Science and Site Co-Director, St. Francis Naggalama Site Director, Dominican Republic John Leopold, APRN, FNP-bc, MSN, Technology Hospital MSPH India 34 Sr. Jane Frances Nakafeero Tendai Machingaidze 4 Christina B. Gunther, M.A. TBD Director, St. Francis Naggalama Hospital Majid Sadigh, M.D. Director, Global Health Programs, Sacred Site Director Mitra Sadigh Heart University Datta Meghe Institute of Medical Sciences 35 Simon Otim, M.D. 7 8 9 10 11 12 Robyn Scatena, M.D. (DMIMS), Sawangi Meghe, Wardha, India Medical Director, St. Francis Naggalama 5 Audree Frey Stephen Scholand, M.D. Hospital Coordinator, Global Health Program, 21 Tripti Srivastava, M.D. Mary Shah, MLS, AHIP UVMLCOM Site Coordinator (Modern Health Sciences) 36 Catherine Nakibuule, M.D. Laura E. Smith, MScBMC Datta Meghe Institute of Medical Sciences Director, Global Health Program, Amanda Wallace 6 Tendai Machingaidze (DMIMS), Sawangi Meghe, Wardha, India St. Stephen’s Hospital, Kampala Jay J. Weiner, M.D. Site Co-Director, Zimbabwe 22 Shweta Parwe, M.D. Vietnam 13 14 15 16 17 18 Patricia Weiner 7 Mariah McNamara, M.D., MPH Site Coordinator (Allied Health Sciences) 37 Tran Van Vu, M.D. Stephen Winter, M.D. Global Health Program Associate Director, Datta Meghe Institute of Medical Sciences Site Director, Cho Ray Hospital Bulat Ziganshin, M.D., Ph.D. UVMLCOM (DMIMS), Sawangi Meghe, Wardha, India 38 Hoang Lan Phuong, M.D. 8 Dilyara Nurkhametova, M.D. Russia Head of International Affairs, The Robert Larner, M.D. Coordinator of WCHN/AUC/RUSM Global 23 Alexey Sozinov, M.D., Ph.D., D.Sc. Cho Ray Hospital College of Medicine at Health Program Rector, Kazan State Medical University 39 Uyen Tran, M.D. The University of Vermont 9 Swapnil Parve, M.D. 19 20 21 22 23 24 24 Marat Mukhamedyarov, M.D., Ph.D. Site Coordinator, Cho Ray Hospital Site Director, Datta Meghe Institute of Tania Bertsch, M.D. Site Director, Kazan State Medical Medical Sciences (DMIMS), India Zimbabwe Benjamin Clements, M.D. University, Russia 40 Rangarirai Masanganise, Anne Dougherty, M.D. 10 Majid Sadigh, M.D. 25 Alsu Khairutdinova MMedSci, FRCOphthal, MBChB Audree Frey Director, Global Health Program of Western Site Coordinator, Kazan State Medical Dean, University of Zimbabwe College Mariah McNamara, M.D. Connecticut Health Network and University University, Russia of Health Sciences Molly Moore, M.D. of Vermont Larner College of Medicine 25 26 27 28 29 30 Thailand 41 Chiratidzo Ellen Ndhlovu, Majid Sadigh, M.D. 11 Robyn Scatena, M.D. 26 Prachyapan Petchuay, M.D. MMedSci, FRCP Mitra Sadigh Co-Director, Norwalk Hospital Carole L. Whitaker Dean of Walailak University School of Medicine Director, Global Health Program, 12 Stephen Scholand, M.D. University of Zimbabwe College of Christa Zehle, M.D. Uganda U.S. Site Director for Vietnam, South Health Sciences 27 Isaac Okullo, BDS, Ph.D. Thailand, and Zimbabwe Site Director and Deputy Principal, 13 Laura E. Smith, MScBMC Makerere University College of Health 31 32 33 34 35 36 Coordinator, Global Health Program, WCHN Sciences 14 Stephen Winter, M.D. 28 Susan Byekwaso Senior Advisor Coordinator, International Programs, 15 Bulat Ziganshin, M.D. Makerere University College of Health Sciences Global Health Program Annual Director of WCHN/AUC/RUSM Global Health 29 Robert Kalyesubula, M.D. Report 2018 was produced by Program Founder, ACCESS 37 38 39 40 41 The Robert Larner, M.D. College of China 30 Estherloy Katali Medicine at The University of Vermont 16 Fan Wang, MHM Site Director, ACCESS Editorial Direction President, Dalian Municipal Central Hospital 31 Justus Ibrahim Twinomujuni Erin Post, Mitra Sadigh 17 Peishi Yan, M.D. Coordinator, Global Health Program, Creative Direction Associate Clinical Professor of Medicine, Site ACCESS Ann Howard Director, Dalian Municipal Central Hospital

28 THE UNIVERSITY OF VERMONT AND THE WESTERN CONNECTICUT HEALTH NETWORK Global Health Office at Western Connecticut Health Network

Majid Sadigh, M.D. Program Director at Western Connecticut Health Network/University of Vermont Christian J. Trefz Family Endowed Chair in Global Health at WCHN 6-South, Danbury Hospital 24 Hospital Ave Danbury, CT 06810 (203) 739-6459 Majid [email protected]

Global Health Office at The Robert Larner, M.D. College of Medicine at The University of Vermont

Majid Sadigh, M.D. Program Director at Western Connecticut Health Network/University of Vermont 89 Beaumont Avenue Given Courtyard N-100 Burlington, VT 05405 (203) 739-6459 Majid [email protected]

Mariah McNamara, M.D. Associate Program Director University of Vermont 89 Beaumont Avenue Given Courtyard N-100 Burlington, VT 05405 (617) 921- 0739 Mariah [email protected]

Audree Frey Program Coordinator University of Vermont 89 Beaumont Avenue Given Courtyard N-100 Burlington, VT 05405 (802) 656-8378 Audree [email protected]