Department Chair, Dr. Lawrence Stanberry, Discusses the Global Health Initiative
The Millennium Development Goals were established by the United Nations in 2000 to deal with the issues of extreme poverty, hunger, illiteracy and disease in the 190 developing countries of the world. Goal number 4 was to reduce child mortality by two-thirds by the year 2015. Despite some successes, the outlook is grim. A child born in a developing country is over 13 times more likely to die within the first five years of life than a child born in an industrialized country. Moreover, thirty-seven percent of under-five deaths occur in the first month of life.
The Department of Pediatrics at Columbia University has a long history of participation in international activities (summarized here). As we look to the future, we plan to expand and better coordinate our global health activities. The major focus of the Department is on capacity building. We want to assist regions and countries to become self sufficient in educating healthcare providers and delivering care to their populations. There are five areas of highest immediate priority for the Department:
- Refinement of our newly implemented curriculum for pediatric residents to educate them about the scope, epidemiology and management of healthcare challenges in developing countries (see below).
- Formalizing the structure and organization of our pediatric resident global health electives in developing countries. The Department is committed to electives in the Dominican Republic and Uganda, but residents may apply for electives in other programs that are well established and supervised.
- Completion and implementation of a "global health track" for residents interested in careers in international health.
- Nurturing a collaborative research initiative with the School of Biomedical Engineering at Columbia to bring simple technologies to developing countries aimed at decreasing neonatal mortality. Our future goal is to develop cooperative research projects with physicians in developing nations. Our expectation is that residents on electives will participate in a research study in cooperation with healthcare providers in the host country and Columbia faculty.
- Continued development of our adolescent medicine curriculum for developing world healthcare providers. In many parts of the world pediatric care is limited to children 12 years of age and younger; adolescents are cared for in adult clinics and hospital wards. The aim of the Columbia adolescent medicine curriculum is to provide developing world practitioners who interface with the adolescent patient a culturally appropriate in depth understanding of adolescent development and demonstrate how this understanding can improve the clinical care of the adolescent patient.
This section of our website (sorted by country on the left hand side) provides a "snapshot" of our Department's activities. It is an area that is rapidly evolving and we invite questions about our programs.
Global Health Curriculum
The Global Health Program of the Department of Pediatrics at Columbia University is in an exciting phase of development. A curriculum has been established, sites for pediatric resident overseas electives are being identified and a process is being developed to insure that the overseas elective is a valuable educational experience.
The elective is open to selected 2nd and 3rd year Pediatric residents. The aim is to provide an educational and cultural experience that will influence the course of residents' careers whether that be in the United States or overseas. Since most residents will continue on to careers in the U.S., it is our intention that this experience will better enable them to care for underserved and immigrant members of their practice and that academic interest will be broadened to include pressing issues in resource poor areas of the world. A few individuals will find their life's work in this experience. The specific goals of this elective are to:
- Improve the health of children through partnerships with pediatric institutions outside of the US through bidirectional educational experiences
- Heighten awareness of diverse socio-cultural determinants of health care
- Understand diseases that are uncommon in resource rich areas
- Increase consideration of Pediatrics in a resource poor area as a possible career choice
The curriculum consists of a series of lectures over an 18-month period that address pressing issues in the developing world. The overseas elective is generally a 4-week block in the 2nd or 3rd year of the training program. It consists of a hands-on mentored clinical experience and a project of the resident's design with appropriate mentoring. Plans for the elective are made 9 months to a year before departure. The site of the elective and the project are reviewed and approved by the Pediatric Residency Training Director. Our Pediatric Residents have done overseas electives in the Dominican Republic, Uganda, and other sites. Detailed information on the Dominican Republic and Ugandan sites can be found on the Community Pediatrics web site, then click on Training, Global health Elective.
Future Plans include development of a Global Health reading elective and journal club and for a 4-year Pediatric Global Health training tract that would allow two residents to spend 6 months in their 4th year at an overseas site to complete a project that would become the basis for a career in Global Health.
Global Health Curriculum Table
- Pediatric Morbidity & Mortality in the Developing World, now and in the future
- Growth, Development, Nutrition & Malnutrition
- Newborn Survival
- Vaccine Preventable Diseases
- Epidemiology, Prevention & Treatment of Tuberculosis
- Epidemiology, Prevention & Treatment of Malaria
- Epidemiology, Prevention & Treatment of HIV
- Epidemiology, Prevention & Treatment of Parasitic Diseases
- Diarrheal Diseases & Access to Clean water
- The role of environmental factors in child health
- Sexuality & Adolescence
- Orphans, Families, internally displaced families, child labor, trafficking & Refugees
- The Ethics of International Aid
- How do you develop a career in Global Health?
- Responding to International Humanitarian Crises
- The Role of Governments, and the World Health Organization in addressing Global Health Issues