The Economic and Social Impact of Informal Caregivers at Mulago National Referral Hospital, Kampala, Uganda

BackgroundThe severe deficit of health care workers in Uganda necessitates hospitalized patients to be cared for by a relative. These informal caregivers constitute a crucial component of patient care. Mulago Hospital in Kampala, Uganda, is one of the nation's national referral hospitals, receiving very sick patients. Although studies have been conducted on challenges facing informal caregivers in the home setting, no study has addressed the caregiver burden in the hospital setting.MethodsA survey of 100 randomly selected informal caregivers was conducted in Mulago Hospital's internal medicine wards to evaluate informal caregivers' demographics, impact on patient care, and challenges.ResultsChallenges include emotional burdens, lack of sanitation, accommodation, sufficient health workers, finances, and recognition. Recommendations were given to ensure improve informal caregivers' situations.ConclusionsDespite hardships, informal caregivers recognize the importance of familial presence, thereby setting a new standard for patient care by recreating the comfort of home care in the hospital. Studying the characteristics of these care givers and more fully delineating the sacrifices they make and the challenges they faced provides the basis for a series of recommendations to hospital management aimed both at improved patient care and care of the informal caregiver

Coordinating Community Healthcare Needs to Local Services in Paraiso, Dominican Republic Through Strategic Assessment Strategies

Background: The availability of healthcare services is limited in Paraiso, Dominican Republic with the nearest full-service hospital located 34.1 km away. A local, underutilized clinic was unaware of the needs of this disadvantaged community. Method: Researchers adapted a World Health Organization assessment survey with the goals of determining residents’ priority needs and an appraisal of the current clinic capabilities and gaps in services in order to provide the community with relevant healthcare. 106 families were randomly selected in seven separate geographic areas of Paraiso to participate in the self-report assessment. Researchers, along with a community volunteer, conducted interviews utilizing the 63 question instrument. 105 families agreed to participate representing 504 individuals

Training Young Russian Physicians in Uganda: A Unique Program for Introducing Global Health Education in Russia

Background: Global health is a new concept in Russia. There has been an ongoing academic collaboration between the Yale School of Medicine in the United States and Makerere University College of Health Sciences in Uganda since 2010, and the US Western Connecticut Health Network/University of Vermont College of Medicine since 2012, to introduce global health concepts to Kazan State Medical University (KSMU) in Russia. The purpose was to educate Russian physicians and medical trainees about the practice of clinical medicine and medical education, as well as the general practice of global health in culturally diverse, resource-limited settings. Objectives: The aim of this study was to evaluate the initial outcomes of this multi-institutional partnership and to assess the impact of the global health elective on the participants and on KSMU. Methods: Participants were selected to attend a 6-week elective in global health at Mulago Hospital in Kampala, Uganda. The elective consisted of clinical experience, education about Uganda's common diseases, and region-specific sociocultural classes. It included a predeparture orientation and, upon return, completion of a standard questionnaire to assess the program's impact. Results: Since 2010, there have been 20 KSMU members (4 medical students, 4 interns, 9 residents, 2 fellows, and 1 faculty member) who have participated in the program. As a result of the elective, the participants reported increased knowledge of tropical medicine (70%) and HIV/AIDS (75%), and 95% reported increased cultural sensitivity and desire to work with the underserved. The majority noted a very positive impact of their careers (90%) and personal life (80%). KSMU established the first successful collaborative program in global health education in Russia, leading to the integration of tropical medicine and global health courses in medical school curriculum. Conclusion: This elective has proven highly effective in introducing the concept of global health to faculty, fellows, residents, and medical students at KSMU. It trained these participants to address the challenges faced by physicians in culturally diverse and resource-limited countries

Access, attitudes and training in information technologies and evidence-based medicine among medical students at University of Zimbabwe College of Health Sciences.

Background: The Medical Education Partnership Initiative, has helped to mitigate the digital divide in Africa. The aim of the study was to assess the level of access, attitude, and training concerning meaningful use of electronic resources and EBM among medical students at an African medical school. Methods: The study involved medical students at the University of Zimbabwe College of Health Sciences, Harare. The needs assessment tool consisted of a 21-question, paper-based, voluntary and anonymous survey. Results: A total of 61/67 (91%), responded to the survey. 60% of the medical students were \u2018third-year medical students\u2019. Among medical students, 85% of responders had access to digital medical resources, but 54% still preferred printed medical textbooks. Although 25% of responders had received training in EBM, but only 7% found it adequate. 98% of the participants did not receive formal training in journal club presentation or analytical reading of medical literature, but 77 % of them showed interest in learning these skills. Conclusion: Lack of training in EBM, journal club presentation and analytical reading skills have limited the impact of upgraded technology in enhancing the level of knowledge. This impact can be boosted by developing a curriculum with skills necessary in using EBM

Colonization and decolonization of global health: which way forward?

Despite taking on several forms throughout history such as colonial medicine, tropical medicine, and international health, the field of global health continues to uphold colonialist structures. History demonstrates that acts of colonialism inevitably lead to negative health outcomes. Colonial powers promoted medical advancements when diseases affected their own people, and only did so for locals when in the colonies’ best interests. Numerous medical advancements in the United States also relied on the exploitation of vulnerable populations. This history is critical in evaluating the actions of the United States as a proclaimed leader in global health. A significant barrier to progress in the field of global health is that most leaders and leading institutions are located in high-income countries, thereby defining the global standard. This standard fails to meet the needs of most of the world. In times of crisis, such as the COVID-19 pandemic, colonial mentalities may be more evident. In fact, global health partnerships themselves are often ingrained in colonialism and may be counterproductive. Strategies for change have been called into question by the recent Black Lives Matter movement, particularly in evaluating the role that less privileged communities should have in their own fate. Globally, we can commit to evaluating our own biases and learning from one another

La Representación popular del maguey y el puilque en las artes

El artículo que se presenta a continuación aborda la construcción de la identidad nacional mexicana por medio de la interiorización de representaciones de las artes populares dentro del nacionalismo del siglo xx, si bien toma como base el desarrollo artístico académico del siglo xix. Los símbolos que estudia, el maguey y pulque, propios del centro del país, son vistos como representaciones de un pasado agrario que es necesario adaptar a las condiciones de la modernidad. El autor argumenta que la construcción de la idea de nación puede construirse por medio de representaciones culturales en las cuales el éxito de la integración del imaginario popular depende de la capacidad de las artes en dar un nuevo significado al pasado que se pierde

Presentation_1_ACCESS model: a step toward an empowerment model in global health education.pdf

The approaches to global health (GH) partnerships are as varied as the programs available across the globe. Few models have shared their philosophy and structure in sufficient detail to inform a full spectrum of how these collaborations are formed. Although contributions from low- to middle-income countries (LMICs) have markedly grown over the last decade, they are still few in comparison to those from high-income countries (HICs). In this article, we share the African Community Center for Social Sustainability (ACCESS) model of GH education through the lenses of grassroots implementers and their international collaborators. This model involves the identification and prioritization of the needs of the community, including but not limited to healthcare. We invite international partners to align with and participate in learning from and, when appropriate, becoming part of the solution. We share successes, challenges, and takeaways while offering recommendations for consideration when establishing community-driven GH programs.</p

ACCESS model: a step toward an empowerment model in global health education

The approaches to global health (GH) partnerships are as varied as the programs available across the globe. Few models have shared their philosophy and structure in sufficient detail to inform a full spectrum of how these collaborations are formed. Although contributions from low- to middle-income countries (LMICs) have markedly grown over the last decade, they are still few in comparison to those from high-income countries (HICs). In this article, we share the African Community Center for Social Sustainability (ACCESS) model of GH education through the lenses of grassroots implementers and their international collaborators. This model involves the identification and prioritization of the needs of the community, including but not limited to healthcare. We invite international partners to align with and participate in learning from and, when appropriate, becoming part of the solution. We share successes, challenges, and takeaways while offering recommendations for consideration when establishing community-driven GH programs