Global Health Experience

There are several opportunities available for our residents to have some global health experience.

  1. The Society for Education in Anesthesia (SEA) in partnership with Health Volunteers Overseas (HVO) sponsors a competitive fellowship program to send senior residents to HVO pre-approved sites in developing countries to teach anesthesia to trainees.  Some of the pre-approved sites are in Ghana, Malawi, and Vietnam.  Since this experience can be considered a clinical rotation outside of the primary program, pre-approval from the American Board of Anesthesiology Credentials Committee must be obtained before credit can be given.   There are approximately 8 – 9 fellowships available.  The interested resident applies for this fellowship in their CA-2 year and if awarded a fellowship, will go to the site in their CA-3 year.  Travel arrangements are handled by HVO.  Some of our residents who have been awarded a SEA-HVO Traveling Fellowship include:  Jesse Raiten (2006), Matthew Doane (2008), Jessica Kenaston (2009), Kiran Patel (2010), Edward Requenez (2011), Neil Masters (2014), Meghan Prin (2015) and Fatemah Mamdani (2016).

    A strong knowledge of halothane pharmacology is important for global anesthesia providers!

    Daily operating room medication set-up at Queen Elizabeth Central Hospital, Blantyre, Malawi

    General store in rural southeastern Malawi

    Entrance to the Obstetric Anesthesia Procedure Room  at Queen Elizabeth Central Hospital, Blantyre, Malawi

  2. HVO volunteer programs are also available to senior residents who wish to teach anesthesia to trainees in developing countries.  The same HVO pre-approved sites are uses for this as well as the SEA-HVO program.  This experience can also be considered a clinical rotation outside of the primary program so pre-approval must also be obtained.  The same restrictions that apply to the SEA-HVO program apply to this program.  Some of the residents who have taken advantage of this program include: Farooq Qureshi (2010), Robert Kim (2010), and Wesley Clark (2014). 
  3. American Society of Anesthesiologists Committee on Global Humanitarian Outreach (GHO) has a competitive scholarship program for eight (8) U.S. anesthesiology residents to spend a month in Addis Ababa, Ethiopia at CURE Hospital under the direction of Mary Bernard, MD, an ABA-certified anesthesiologist.  As a recipient of this scholarship, residents will have the opportunity to experience the challenges of delivering safe anesthesia in a low-resource, underserved area in a developing country as well as train and educate local anesthesia providers.
  4. Oral/Maxillofacial Mission: Healing The Children Northeast is a humanitarian group with offices in Connecticut that provides free treatment of maxillofacial deformities to underserved patients ranging in age from about 10 weeks to 25 years.  The team consists of Oral Maxillofacial attending surgeons and fellows, anesthesiology attendings, fellows and technicians, and OR and PACU nurses, and sometimes anesthesia residents (accompanied by a board certified anesthesiologist).  Sometimes, dental practitioners and pediatricians have joined the missions.  In general, volunteers donate their vacation time and pay for their own airfare to the destination but in country expenses are covered by the charitable donations.  Some of the countries the group has cared include Guatemala, Ecuador, Nicaragua, Colombia and Bolivia.  Recent volunteers for these missions have been Drs. Amy Mesa-Jonassen (Attending Anesthesiologist), Saima Rashid (Pediatric Anesthesiology Fellow) and Lisa Jacob (Anesthesia resident).

There are several opportunities available for our clinical fellows to have some global health experience.  Fellows may volunteer their vacation time to accompany Anesthesia Attendings who also volunteer their vacation time to go on medical missions to provide anesthesia care to patients in developing countries.  Some of the sponsoring programs include: Children of China Pediatric Foundation, Heart Care International, Doctors without Borders, and Healing The Children Northeast.

  1. Children of China Pediatric Foundation is group that travels once or twice a year to China to provide general, orthopedic, urologic, and plastic surgery repairs to children with congenital or acquired defects.  Some of the children are orphans who would otherwise not have the opportunity to lead a normal life and some are children whose parents cannot afford the procedure.  The Foundation also sponsors some of the Chinese physicians to travel to the United States to observe other complicated procedures.
  2. Heart Care International is a non-profit organization based in Connecticut that just celebrated its 20th year of service.  The group, originally formed at Columbia University Medical Center, provides pro-bono care to indigent children and young adults with heart disease who live in five countries: Guatemala, El Salvador, Dominican Republic, Peru and the State of Chiapas in Mexico.  The patients either have congenital heart disease or acquired heart disease; many have severe or near end-stage forms of acquired valvular heart disease.  The program also attempts to build capacity in the host country by committing a minimum of 5 years of support for medical and surgical services, durable and disposable medical equipment and medications, as well as learning materials, lectures, and direct, hands-on training and continual mentorship to raise the overall level of surgeon, physician, and nursing expertise several times each year.  All medical and surgical personnel who work at Heart Care are volunteers.  Some of the current and former faculty who have volunteered their time include: Desmond Jordan, Harvey Stern, Hoshang Khambatta, Ingrid Fitz-James, and Tatiana Kubacki.  The residents who have volunteered their time have had special expertise and include: Andres Navedo, Jonathan Oster, John Tumillo, Glenn Mann, Edward Requenez, and Anjalee Dave.  
  3. Medecins Sans Frontieres (MSF or Doctors without Borders) was officially created on December 22, 1971.  MSF was created on the belief that all people have the right to medical care regardless of gender, race, religion, creed or political affiliation, and that the needs of these people outweigh respect for national boundaries.  Medical teams in the field provide services that range from basic vaccination campaigns, to maternal and pediatric care, to fighting neglected diseases, to complex surgery.  MSF also advocates for affordable, high-quality medicines for the world's poorest people. MSF recruits board certified or candidates in the examination system as medical personnel to provide medical care to people in crisis in more than 60 countries worldwide.  Two of our faculty members have volunteers their time.  Here are their stories.
    1. Dr. Julia Sobol spent 2 months in northern Nigeria working at a maternal health mission covering emergency obstetrics and elective vesicovaginal fistula repairs.  In addition, she was in charge of the 3-bed ICU and 3-bed step-down unit and logged in 140 operative cases.  She was on call 24/7 for the two months with no days off.  She did some teaching to nurses and other health care providers as well as collected data for the MSF database.  Every few months she has volunteered to speak with other physicians who are applying to MSF.
    2. Dr. Gebhard Wagener in 2001 spent 4.5 months in East Timor at a small district hospital staffed with 1 surgeon, 1-2 internists and 1 anesthesiologist.   The surgical procedures were mainly caesarian sections, pediatric surgery and trauma.  A large part of his job was to train anesthesia personnel in preparation for the hand-over of the hospital to the East Timorese Ministry of Health.  Then in 2006, he went to Liberia for a short mission at one of the main hospitals in Monrovia.  He was responsible for the anesthesia services for the adults as well as a good number of pediatric cases and the small critical care unit.

      Medecins San Frontieres / Doctors Without Borders staff and vehicles in Bacaua, East-Timor

      The “ICU” at the district hospital in Bacaua, East-Timor run by Medecins Sans Frontieres / Doctors Without Borders

      Mamaba Point Hospital in Monrovia, Liberia run by Medecins Sans Frontieres / Doctors Without Borders

      Operating room in Mamaba Point Hospital in Monrovia, Liberia

      Oxford bellows and a simple halothane vaporizer used for minor surgeries at Mamaba Point Hospital in Monrovia, Liberia

  4. Oral/Maxillofacial Mission: Healing The Children Northeast is a humanitarian group with offices in Connecticut that provides free treatment of maxillofacial deformities to underserved patients ranging in age from about 10 weeks to 25 years.  The team consists of Oral Maxillofacial attending surgeons and fellows, anesthesiology attendings, fellows and technicians, and OR and PACU nurses.  Sometimes, dental practitioners and pediatricians have joined the missions.  In general, volunteers donate their vacation time and pay for their own airfare to the destination but in country expenses are covered by the charitable donations.  Some of the countries the group has cared include Guatemala, Ecuador, Nicaragua, Colombia and Bolivia.  Recent volunteers for these missions have been Drs. Amy Mesa-Jonassen and Julia Sobol (Attending Anesthesiologists), Saima Rashid (Pediatric Anesthesiology Fellow), and Lisa Jacob (Anesthesia Resident).

    Healing the Children: Operating room in Thailand with two teams working simultaneously

  5. Global Anesthesiology Fellowship (non-ACGME) is being developed by Dr. Julia Sobol.  This program is still in the planning stages, but applications for academic year 2016-17 are being accepted.  The proposal is for one anesthesiologist who is board certified or in the examination process to spend a year gaining experience as an attending anesthesiologist at CUMC, participating in coursework in global health and teaching and conducting research with colleagues at a partnered institution in sub-Saharan Africa.  The fellowship could be expanded to a two-year fellowship that will culminate in an MPH from Mailman School of Public Health. 
  6. Changing Children’s Lives, Inc., Smile Train and Hands Help, Inc. are three philanthropic organizations that sponsor medical missions to developing nations in order to treat children and adults in need of much needed surgical corrections.  Changing Children’s Lives and Smile Train focus on reconstructive plastic repair of congenital and acquired deformities in children, e.g., cleft lip and palate, burn and congenital deformities.  PGY-4 residents and Pediatric Anesthesia Fellows may donate their time along with a board certified anesthesiologist to join the mission team.  Hands Help, Inc. was founded to provide hand surgery to individuals who are otherwise unable to be helped.  PGY-4 residents, Pediatric Anesthesia Fellows, and Regional Anesthesia Fellows may donate their time along with a Board Certified Anesthesiologist to join these missions.  The philosophy of the mission is to maintain the same standards of care as in accredited US sites without using host nation resources.   Dr. Richard Raker has been an active volunteer for these three organization and has been accompanied by residents (e.g., Leyda Carvajal, MD), CRNAs (e.g., Young Kim, CRNA) and PACU nurses (e.g., Xiomara Castro, RN).

 

 

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Columbia University Medical Center Department of Anesthesiology