GH Blogs and eMagazines

The Christian Trefz Family 

Global Health Diaries and eMagazine 

Compilation 2019

Mulago Hospital Eye Clinic 

3

Editor: Mitra Sadigh 

Creative Director: Amanda Wallace 

Global Health Diaries 

2018 - 2019 

Looking Back While Moving Forward 6 

Graduation: Part III 8 

Graduation: Part IV 9 

Just a Medical Rotation? Think again!: Part II 10 

Challenging Moments in Global Health: Invitations 11 

Learning from Commonalities and Differences 13 

An Amazing First Day in Naggalama 14 

Wishing You All Happy Holidays and a Prosperous New Year 16 

Challenging Moments in Global Health: Inflexible Participants 17 

“I Hope to Someday Be a Good Doctor” 19 

Reader Response: Knowing Your Patients’ Stories 20 

Reader Response: Naggalama Hospital Palliative Care Outreach Team 21 

A More Deeply Connected World: A Note From the Leadership of 

Walailak University School of Medicine, Thailand 23 


Evolution of a Global Health Institute 26 

Evolution of a Global Health Institute 27 

In Another World: Part I 29 


Global Health: A Proving Ground for Physicians On Their Journey 31 

In Awe 32 

Finding Our Grace, Gratitude, and Fortitude 33 

Challenging Moments in Global Health: Defining the Comfort Zone 34 

Flowers of Guatemala 36 

The Value of Sharing Stories 37 

Feeling Grateful: A Reflection on Global Education & Health Lecture Series 38 


Butabika Psychiatric Hospital: 2019 UVMLCOM Global Health Day Reflection Contest Winner 41 

4

Sexual and Reproductive Health Rights: Part I 43 

Sexual and Reproductive Health Rights: Part II 44 

Sexual and Reproductive Health Rights: Part III 45 

Sexual Harassment and Violence Across Global Contexts 46 

Sense of Community: What Uganda Gave Me 47 

Reader Response: Bringing Us Back To Sanity 48 

Pride and Pericardiocentesis 49 


Did You Know That You Had It In You? 52 

The Fight For Gender Parity 53 

Being Asked to Dance 55 

The Value of Seemingly Simple Skills 56 


A Positive Aura 60 

Pilgrimage to the Land of Galaxies and Glaciers: Part I 61 

Stepping With Light: Part I 63 

Safety in Global Health: Don’t Be blinded 64 

Five Years Later 65 

This Week I Met Anthony 66 

The Gate 67 

Challenging Moments in Global Health: Navigating Cross-Cultural Boundaries 69 

No Such Thing As Equal Opportunity 71 

We Are In This Together 72 

Week Two at Walailak University 74 

Capacity Building in Vietnam: A Moment of Recognition 76 

Challenging Moments in Global Health: Navigating Cross-Cultural Boundaries 78 

5

Looking Back While 

Moving Forward 

WRITTEN BY TENDAI MACHINGAIDZE, ASSOCIATE SITE DIRECTOR FOR 

ZIMBABWE UNIVERSITY 

NOVEMBER 3, 2018 

The field of global health has indeed come a long way. During Family Medicine Grand Rounds on October 29, 2018, 

Dr. Pierce Gardner took us on a journey from the indistinct beginnings of global health to where it is today. 

In his presentation “Academia and Global Health: Benefits and Ethics,” Dr. Gardner highlighted how the driving 

force for global health work has changed across the decades. Be it out of humanitarian concerns, self-interest, 

economics, or scientific advancement, men and women across history have sought to cross the geographical and 

cultural divides that separate us, in order to bring healing to those most in need of it. 

Despite the myriad of problems that can be cited regarding work overseas, the passion of those called to work in 

global health, such as Paul Farmer, Jean Pape, Bill Foege, and Majid Sadigh, has broken down barriers and paved 

the way into the future. It is to such giants of global health that we should look for inspiration and guidance, as we 

shape our own dreams to make a lasting impact across borders worldwide. 

What is clear from Dr. Gardner’s insights is that it is paramount for us to look back if we are to move forward in a 

way that is both productive and progressive. Only in hindsight has the need become evident to move from a colonial 

modus operandi to one of capacity building and cultural competency. Western-centric directives that so often took 

more than they gave, have given way to bidirectional initiatives that seek out ways to benefit all countries involved. 

Dr. Gardner praised the UVMLCOM/WCHN Global Health Program for being such an institution that is continuously 

broadening its mandate and refining its ethical lens, in order to promote sustainable developments in medical 

care and education around the world. As the program continues to make advances in capacity building, medical 

education, infrastructure development, and research, there is hope that global health disparities, such as those in 

life expectancy and quality of life, will lessen over time. 

Our future is backlit by the past. So, let us not rush forward blindly. We, the next generation of leaders in global 

health, must look back and allow the light from the past to illuminate our way forward if we are to succeed in 

tackling the mammoth task before us. For we must not only be eager but also educated, not only inspired but also 

informed! 

6

Dr. Pierce Gardner speaking at the UVMLCOM Family Medicine Grand Rounds 

7

Graduation: 

Part III 

WRITTEN BY DR. JUDITH LEWIS, DIRECTOR OF THE PSYCHIATRY 

RESIDENCY TRAINING PROGRAM AT THE UNIVERSITY OF VERMONT 

LARNER COLLEGE OF MEDICINE 


What was reassuringly anchoring for me in this unfamiliar place were the patients. I was riveted by the experience 

of sitting in clinic and hearing their stories. Although the explanations for symptoms took a cultural twist, the 

primary diagnoses were identical to those in the United States. Patients had the same presentations of psychotic, 

mood, anxiety, addictive, and traumatic illnesses. They also had epilepsy, a stigmatized illness treated mostly by 

psychiatrists in Uganda. 

The facilities were profoundly more modest: we sat in bare offices with a desk or a sheet-covered table between us 

and the patient, several beat-up chairs, maybe a computer (often unused), and the same dim fluorescent lighting 

we had in our hotel room. I had to crane to hear patients not only due to their accented English, but also because 

my ears were unaccustomed to the focused listening necessary in such a cacophonous setting. Windows were open 

and office doors, too, so voices drifted from outside continuously, loud enough to drown out the patient’s speech. If, 

on my request, the office door was closed, nurses with 1950’s style white nursing caps pinned to their hair would 

regularly push it open to see who was there, deliver another chart, or ask a quick question. 

Privacy, though present, was configured differently there. One upside to that difference was that my daughter had 

the opportunity to sit in on patient visits with us, getting a rare front seat to what her mother actually does for 

work. She had the incredible privilege of listening to a patient with schizophrenia, a patient with bipolar mania, a 

patient with an alcohol use disorder, and a suicidal patient describe their symptoms to the doctor. That day, in onefour 

hour stretch, the resident I was shadowing admitted three patients, and saw another five in follow-up—and he 

admitted that having me shadow him had slowed him down that day. Needless to say, there was not a lot of time 

spent charting! 

At first I thought these focused histories with the patient nodding their head in respectful agreement to everything 

the white-coated psychiatrist had to say was the way to go! Just think how many patients we could see this way, 

if expectations here were adjusted to fit the volume of the actual need in our own country. But then we saw one 

patient who revealed, only with one last add-on question, that her twelve-year-old son had sudden episodes in 

which he spoke in the voice of his dead sister. The stakes are too high to miss something in either country: that boy 

needed treatment. Dissociative trances (like this boy had), dissociative amnesia, and dissociative identity disorder 

are all seen in Uganda. Dr. Nakasujji, a dedicated, engaged, and observant acute care psychiatrist, spontaneously 

said to me what residents here have heard me exclaim many times: “you wouldn’t believe what I’ve seen in clinic!” 

The practice of acute psychiatry is ceaselessly fascinating and “other worldly” no matter where you practice. Like 

my daughter said to me later in reflecting on her experience, “it is like watching a movie, but one that is hard to 

believe!” 

8

Graduation: 

Part IV 

WRITTEN BY DR. JUDITH LEWIS, DIRECTOR OF THE PSYCHIATRY RESIDENCY TRAINING PROGRAM AT THE 

UNIVERSITY OF VERMONT LARNER COLLEGE OF MEDICINE 


The residents were another bright spot to my visit. I met with a dozen of them, and their chatter reminded me of 

the camaraderie of our own resident group. We had an hour-long discussion about the similarities and differences 

between our two healthcare systems, them agape at the autonomy and legal rights of our patients to refuse 

treatment and me agape at their high patient volumes and moonlighting hours needed to “find money” to support 

themselves. Although I could see blackboards filled with unerased instruction, they found an LCD projector that, 

with the help of a resident’s personal Wifi hotspot, allowed me to forward a PowerPoint on the neuroscience of 

trauma, and voila– I was giving a talk that I would give to my own residents a week later! What a refreshing and 

talented group. 

Ultimately, it was the kids in Uganda that broke my heart. The average number of children per woman is 5.6 and 

the average age is 15 years old. If too old to be strapped to their mother’s back, kids are everywhere playing in 

yards or pushing a tire wheel while running along roadsides. They are adorable, omnipresent, resilient, but also 

quite vulnerable. Some little toddlers wander about without apparent supervision while older children weave in 

and out of stopped traffic to sell goods. As the earlier described bipolar patient told me, a woman in Uganda isn’t 

considered a wife unless she bears a child with her husband. With little social services or public education to speak 

of, most of the children growing up in the slums of Kampala have few prospects. I broke into tears on more than 

one occasion when a child came to beg at our car, and my daughter learned to raise her eyebrows and shake her 

head ever so slightly to signal me to shift my frame. 

With this trip, my emotional knowing finally lined up with what I have cognitively been informed of all along: 

population growth and global poverty are massive problems that challenge our existence and threaten our species. 

I must admit: I don’t feel particularly hopeful. However, perhaps there are ways we can contribute to our global 

partners in the meantime, and I am emotionally resolved to try. 

As the plane lifted off, I could see the red clay of the roads, the lush tropical green, and the huge expanse of Lake 

Victoria. In two short weeks, I had seen animals I’d only encountered in zoos, I’d seen the inside of the slums of 

Kampala, I‘d listened to the stories of the patients of Mulago and Butabika Hospitals, and I’d endured the acrid 

smells, loud noises, simple living spaces, and the heat and humidity of the metropolis of Kampala. Thirty-seven 

hours later, I was relieved to see the lush green fields and forests and the spacious living spaces in Vermont as the 

plane circled and landed in Burlington. 

I felt extremely fortunate to live in a country with a social safety net, however imperfect. I felt renewed energy to 

fight to maintain those benefits, despite the selfish actions of our recent politicians whose social brains are bent on 

garnering respect in corrupted forms (flaunting wealth and power) rather than in more modest and altruistic ones. 

This trip viscerally reminded me that sometimes what stands between poverty and prosperity is the leadership of 

one corrupt, power-hungry social brain intent on serving itself rather than its people. 

9

Just a Medical 

Rotation? 

Think again!: Part II 

JAMIDAH NAKATO, ASSISTANT LECTURER 

MAKERERE UNIVERSITY 

NOVEMBER 24,2018 

The Global Health Office once hosted a participant who had difficulty attending the first few clinical and cultural 

activities because of a physical disability. In the middle of the first week, the office scheduled a cultural excursion 

to a local witch doctor. Participants were given a background of witch doctors, including how they are perceived, 

why their services are sought, and what their contribution is to traditional medicine. The participants couldn’t wait 

to see what the hype was about. The witch doctor, meanwhile, was excited to meet us and eager to share his various 

forms of treatment, including prayer, for a number of ailments. When we returned, everyone referred to their 

normal activities except the participant with special needs. 

When this participant came to the office a couple days later, we were amazed by her ability to walk and talk without 

much discomfort. She shared that she had requested the driver that took us to see the witch doctor to take her 

back for a one-on-one appointment, during which she was given local herbs to rub on her body. On using these 

remedies, she was amazed to find that she had the energy to continue her daily activities with minimal difficulties. 

Not once during the rest of her time in Uganda did we see her with any kind of visible challenge. In fact, she let 

loose and had a good time with friends until the end of the rotation, and even brought the herbs back to the United 

States to continue the treatment 

Are these global health electives simply medical rotations? Think again! 

10

Challenging Moments 

in Global Health: 

Invitations 

JAMIDAH NAKATO, ASSISTANT LECTURER 

MAKERERE UNIVERSITY 

NOVEMBER 30,2018 

Challenging moments are an inherent component of global health electives, and can be ascribed to an array of 

sources including insufficient orientation, unrealistic expectations, unfamiliarity with the culture and way of life, or 

mismatch between participant and elective. “Challenging Moments in Global Health” aims to address these issues 

by featuring real cases that have been written by global health coordinators, directors, and leaders over the years. 

We hope that readers share their responses, thoughts, and personal experiences so that we as a community can 

learn from each others’ insights. 

Compiled by Dr. Majid Sadigh, Trefz Family Endowed Chair in Global Health at WCHN and Director of 

Global Health at UVMLCOM, and edited by Mitra Sadigh, Editor of Global Health Diaries. 

A participant invited a group of Ugandan doctors out for dinner, but the night took an unexpected turn when he 

could not settle the humongous bill. 

The participant explained that he had invited local doctors to an expensive restaurant for a night out. Together, they 

ordered a variety of meals and enjoyed themselves until late into the night. When it came to settling the bill, the 

participant paid his own share and expected the local doctors to pay theirs, but was surprised when they looked to 

him to settle it. In the end, he covered the bill himself, though it was beyond his means. 

We informed the participant of relevant cultural expectations. When you invite someone out in Uganda, you are 

expected to settle the bill. Otherwise, it is common courtesy to inform the invitee that you expect them to settle 

their own bill so they can decide whether or not to accept your invitation. Meanwhile in the United States, it is 

understood that each individual is responsible for his or her own bill unless stated otherwise. The lesson to be taken 

from this scenario is that cultural misunderstandings in global health are inevitable, but can be resolved with 

effective communication. 

11

12 

Photo: Shopkeeper, Majid Sadigh, MD

Learning from 

Commonalities and 

Differences 

DR. RAFAEL KHALITOV, GLOBAL HEALTH SCHOLAR FROM RUSSIA 

DECEMBER 7, 2018 

The differences among healthcare systems around the world are a common topic for observation and research. 

Several studies have compared the healthcare system in Russia with those in Western countries. Though traditionally 

ascribed to varying access to resources and technology, such differences are heavily impacted by culture, which 

can define many aspects of health including disease manifestation, illness perception, treatment receptivity, and 

level of social support that is often vital for recovery. In light of this impact, it is crucial that healthcare providers 

develop strong cross-cultural competencies and awareness. Having completed several global health electives in 

different countries including Russia, the U.S., and Uganda, I would like to share a few observations that relate to 

the ways in which culture can impact health. 

Present and variable across cultures, disease-related stigmas can prevent patients from seeking needed medical 

help. In Russia, for instance, depression continues to be seen as a personal weakness, and is even sometimes 

considered a natural part of aging. As a result, patients are unlikely to seek treatment. Meanwhile, those who are 

diagnosed may have difficulty accepting their diagnosis, thereby complicating disease management. Meanwhile, 

the outcome for depression may be different in the United States where the stigma has been largely overturned 

through social awareness campaigns. 

In both countries, family members play an important role in patients’ emotional and functional states. Culturally 

conscious communication among physicians, patients, and their families is a critical aspect of quality patient 

care. Because hospitalization in Intensive Care Units (ICUs) can cause considerable anxiety for patients and their 

relatives, the family-oriented approach of ICU patient care is now receiving increased attention from Russian 

physicians. Hospitals in large cities are among the first in Russia to invite family members into ICUs for patient care 

participation. Learning more about American hospital etiquette could be a powerful tool for furthering the growth 

of knowledge and culture to advanced patient-centered ICU standards. 

Finally, improving communication skills and empathy reduces anxiety and positively affects patient well-being 

across cultures. Achievable at all levels of a healthcare workforce, tools for adequately responding to illness-related 

emotions dramatically can powerfully enhance the landscape of compassionate healthcare delivery. The effort 

to share ever-evolving clinical knowledge across cultures and healthcare systems increases professionalism and 

cultural awareness for all participants, and in turn allows us to provide better care to our patients. 

13

An Amazing First Day in 

Naggalama 

KIRA MACDOUGALL, AMERICAN UNIVERSITY OF THE CARIBBEAN 

COLLEGE OF MEDICINE CLASS OF 2018 

DECEMBER 15,2018 

I have had the most incredible first few days here. I am grateful I decided on this elective and could not be happier 

with my experience thus far. On Tuesday, Gloria and I joined Shaleen on the palliative outreach trip to small villages 

around Naggalama. Here, palliative care is not just offered to patients with terminal diseases, but also to those 

with chronic conditions. We went to see our first patient who had what I believe was Burkitt’s lymphoma. There 

was a very large mass protruding from the right angle of the mandible, approximately the size of a baseball. It was 

ulcerative and necrotic. However, the patient’s main complaint was irretractable nausea, vomiting, and diarrhea for 

the past three days. 

On examination, it was evident that the patient was severely dehydrated and needed urgent medical attention. 

Gloria, Shaleen and I decided as a team that she needed to be transported to the hospital. The van we came in only 

had so much room, so we stayed behind with Teddy, one of the palliative care social workers as our first patient 

was transported to the hospital. 

On Wednesday, I spent the morning in the Emergency Room. I’m very passionate about emergency medicine and 

loved working with Paddy, one of the clinical officers. He taught me some Luganda and always asked for my opinion 

about patient management. We compared protocols and practices between our two countries. I saw my first-ever 

Malaria case, which was very exciting for me. I then went to theater, where things got even more exciting! 

There is a public health initiative in Uganda to circumcise males above the age of ten free of cost- transportation, 

meals, underwear, and t-shirt included This practice reduces HIV transmission by sixty percent. I had never performed 

a circumcision and was expecting to assist. Well, was I in for a surprise! I watched the first one, assisted 

in the second one, and then performed them myself from then on out. It was such a rewarding experience and I 

am so grateful to the medical team for teaching me this new skill. 

After countless circumcisions, I didn’t think my day could get any better. I was washing my hands after I was done 

when one of the doctors said, “Kira! How are you doing? I’m about to do a c-section if you would like to join.” The 

fact that he already knew my name was shocking to me, as I had only briefly met him during orientation the previous 

day. He asked if I had ever been first assist in a c-section and whether I would like to be. I couldn’t believe it. I 

had been in this hospital for eight hours and was offered first assist in a c-section! BEST DAY EVER! I had only ever 

done one before in England almost a year ago. I didn’t know if the protocols were different, but being the eager 

student that I am, I replied: “Thank you so much Dr. Otim, I would love to.” 

We successfully delivered a healthy baby boy. I was so grateful Dr. Otim included me in the procedure. I went home 

that night in disbelief, and cannot wait to see what else this elective will bring. 

14

Global Health Program participants from American University of the Caribbean College of Medicine and Ross University 

School of Medicine 

15

Wishing You All 

Happy Holidays and a 

Prosperous New Year 

SISTER JANE FRANCES, DIRECTOR OF ST. FRANCIS NAGGALAMA 

HOSPITAL 

St. Francis Naggalama Hospital is honored to be an 

esteemed partner of the UVMLCOM/WCHN Global Health 

Program family. Through this partnership, we have felt 

a burning flame of hope and love as Climb For a Cause 

raised funds for the Microbiology Unit at Naggalama 

Hospital. This fundraising event has not only elevated 

our hospital from national to international recognition, 

but has also deeply touched our hearts. 

I have read “Climb For A Cause” again and again. I find 

the description of two days in particular, quoted below, 

especially inspiring: 

Day 6: “This was the only portion of the climb that I had 

to use all my limbs… brutally cold.” What was going on 

in his mind? He was tired and practically freezing – all 

for Naggalama. 

Day 8: “The trek was slow, tough, and brutally cold. I 

struggled through every minute.” And later, “To finish 

the climb from here you have to call upon your brain to 

drag the hidden energy to the surface.” 

Right to left: Sister Jane Frances, Director of St. Francis 

Naggalama Hospital, Dr. Majid Sadigh, Director of the 

Global Health Program, and Dr. Simon Otim, Director of the 

Global Health Program at St. Francis Naggalama Hospital 

The Microbiology Unit is in its final stages, with equipment on its way. Laboratory staff will receive training through 

a placement at St. Francis Nsambya Hospital, a facility in Kampala that is more advanced than Naggalama, in 

preparation for the new facility. 

Finally, we are indebted to all members of the Global Health Program. The seed was sown by those who introduced 

us to global health, and to the resolve, resilience, foresight, and leadership of program members. We appreciate all 

the medical students, residents, and faculty who found meaning and reason to belong to the spirit of Naggalama 

in 2018. 

Wishing you all happy holidays and a prosperous new year. 

16

Challenging Moments in Global 

Health: Inflexible Participants 

DECEMBER 29, 2018 

Inherent to global health electives, challenging moments can be ascribed to an array of sources including insufficient 

orientation, unrealistic expectations, unfamiliarity with the culture and way of life, or mismatch between participant 

and elective. Our “Challenging Moments in Global Health” series aims to address these issues by featuring real 

cases written by global health coordinators, directors, and leaders over the years. We hope that readers share their 

responses, thoughts, and personal experiences so that we as a community can learn from each others’ insights. 

Compiled by Majid Sadigh, Director of the UVMLCOM/WCHN Global Health Program, and edited by Mitra Sadigh, 

Editor of Global Health Diaries. 

Immediately after landing in the airport near one of our international partner sites, a senior medical student sends 

an email to the Global Health Program asking to split the rotation between a previously agreed-upon rural site and 

another site in the capital city to experience both rural and urban medicine. Less than 48 hours after arriving to the 

assigned rural site, the medical student sends a lengthy note: “Despite the fact that this site is educational and has 

a great number of competent supervisors and clinicians, it is not safe, the night guards doze at their posts, and the 

accommodation lacks good ventilation. The roof in the dining room leaks when it rains, and may contaminate my 

food and threaten my health. There are frequent blackouts, access to the internet is unreliable, and there are ants 

in my bed and mosquitoes in my room.” The medical student demands to be transferred to the capital city. Once 

there, the student frequently complains to the International Office about the quality of the clinical rotation, stating 

that patients are too sick, and nursing staff and supervising doctors too few, and demands to be transferred to a 

new hospital or another clinical ward. 

PROFESSOR HARRIET MAYANJA, PREVIOUS DEAN OF MAKERERE 

COLLEGE OF HEALTH SCIENCES 

This is a very interesting case. I have a few thoughts to share. First of 

all, a resident would be able to more aptly choose between a rural and 

urban healthcare setting than a medical student. Being younger and less 

experienced, medical students are less flexible and adaptable to challenges 

outside their comfort zone. Secondly, not all who opt for a global health 

experience are ready to fully understand or process its weight or meaning. 

Many expect a romantic African experience, and are shocked by reality. 

From my perspective, the medical student in this case is not cut out for 

living outside his or her comfort zone. 

If possible, I would suggest transferring this medical student to a rural site 

in a bigger, less remote town. While such a change may not sound ideal to 

a global health program, it may help the student complete the elective and 

reap some of its benefits within the limits of what she can handle. 

17

In summary, I believe that residents are better equipped to handle the challenges inherent to global health 

electives. Medical students, on the other hand, are still testing life beyond their comfort zone. Some adjust well, 

some work hard to adjust and do to some extent, but a few such as this one simply do not adjust and will likely 

end up practicing in city suburbs within the United States. 

KATRIN SADIGH, MD, GLOBAL 

HEALTH FOGARTY FELLOW, 

BRIGHAM AND WOMEN’S 

HOSPITAL BOSTON/BOTSWANA 

HARVARD PARTNERSHIP 

While it is challenging to anticipate all individuals’ reactions to specific 

events or circumstances, we should expect a certain degree of flexibility 

and humility in the cohort of global health students participating t in our 

programs. Unfortunately, these are not attributes that can be learned 

through systematic training. No modules on professionalism can ensure the 

generation or the espousal of decency. And no matter how comprehensive 

the application process, there will be individuals who are simply not cut out 

for living and working in low- to middle-income countries (LMIC) but still end 

up in these settings, tainting the landscape with unreasonable demands and 

unyielding narcissism. What is at stake is the compromise, even destruction, 

of years-long efforts at trust-building and bidirectional creativity and industry, 

not to mention the damage to individuals. 

The most important method of both preventing and handling such a situation 

is by the establishment of clear expectations at the onset. This can be in the 

form of a written list of what the participant can expect at various stages 

of the experience, including the respective roles of the program and the 

participant. Do not assume common knowledge, but delineate even what 

appears most blatant. Ensure that the participant reads and understands this 

list of expectations, along with resultant consequences should these expectations not be met by either party. The 

participant must agree and commit to this list prior to moving forward. At any point in the global health elective, 

both participants and program administrators can refer to this list to mitigate potentially challenging situations in 

which expectations are not “met.” 

Most people with an intrinsic sensibility of humility understand that a global health elective by its very nature does 

not exist in a sterilized, climate-controlled setting. While the most successful programs provide clear protocols for 

medical and other safety emergencies, and well-designed educational platforms to ensure program objectives are 

met, there will be certain aspects of living and working that may be attenuated but not tightly controlled, such as 

the abundance of insect life. Other elements, such as lack of adequate ventilation or leaks in ceilings, form the 

backdrop of poverty, corruption, or climate extremes within which the global health experience takes place. Medical 

wards and clinics in LMIC combat high burden of disease with a dearth of both human and material resources. Yet 

these very same places teach us the value of community in survival, the persistent relevance of the physical exam, 

and the art of storytelling and gathering to hone that critical skill of diagnosis. These essential lessons are hard-won 

through patience, diligence, attention, and grace, and not by those arriving with shifting demands. 

In summary, global health electives are by definition experiences of choice rather than mandate. This choice, 

however, cannot be based on whimsy, idealism, or ignorance. The world and the role it now demands of healthcare 

workers is too complex for this approach. Thus participants must face this choice with deliberation and honesty. On 

our end, we must communicate more clearly what we expect from our participants, from this next generation of 

global health leaders, and to not stand down when there is misalignment in our goals and vision. 

18

“I Hope to Someday Be 

a Good Doctor” 

KATHERINE CALLAHAN ’21 

JANUARY 5, 2019 

I have repeated the phrase “Yes, Uganda was amazing” over and over for the past two weeks. It isn’t a lie, but it 

also isn’t the full truth. My time in Uganda made me reconsider everything, including why I want to be a doctor and 

whether I will even be a good doctor. I think I have come out on the side of “I hope to someday be a good doctor,” 

but this experience marks the first time in my journey in medicine that I have ever doubted my path. I have wanted 

to be a doctor for as long as I can remember. As a child, my mother shared with me the story of her pregnancy 

and my birth: after an emergency C-section, I died and was resuscitated. My parents were told that I may not 

survive, and may suffer mental deficits if I do. But I pulled through as a large, healthy baby girl. With this story in 

the backdrop of my childhood, I wanted to give others the same opportunity to live that my doctor had given me. 

I worked hard throughout high school, college, and medical school to find myself in Uganda questioning my path. I 

felt that I was the least knowledgeable person in my surroundings, and struggled to visualize a time when I would 

be more competent. I floundered through basic procedures such as catheterizations and nasogastric tubes, and 

my endless response of “I don’t know” to any cardiorespiratory resuscitation- or management-related question 

decreased my confidence by the second. I became frustrated and discouraged. 

I was only able to break through this negativity by spending time in the Operating Room where I found my “happy 

place.” I learned to find positive elements, usually in the form of surgical skills and skin closures, and studied late 

after dinner each night to ensure that I would not get the same question wrong twice. I am worried that I might 

run into these same frustrations and discouragement in my ever-approaching third-year clerkships, but I hope that 

I have started to become more comfortable being uncomfortable. 

Looking back, the hardest challenge was my own impatience. I am a fast-paced, fast-talking, fast-moving kind 

of person who loves efficiency and efficacy – characteristics that could not be more different than the cultural 

norms in Uganda. Each day at the hospital starts slowly, as rounds take up to four hours with only forty patients 

at maximum capacity. Monday and Friday mornings are marked by hours of morning meetings and prayer, during 

which I could not help but feel time was being completely wasted. Even the pace at which patient interviews are 

conducted frustrated me to my inner core. However, despite the continual frustration and impatience, I learned that 

I can tolerate far more than I ever imagined. I also learned that I need to work on my impatience and tendency to 

rush, to slow down and give myself and others time to think and process. 

Now three weeks into classes, I find it hard to believe that I have returned to school. There are days when it 

seems that I never left, as I find myself caught up in daily classes, team-based learning, and endless studying. 

But occasionally, when I have rice or beans with dinner or hear the buzzing of a mosquito, it all comes back and I 

wonder how my six weeks in Uganda went by so fast. 

19

Reader Response: 

Knowing Your Patients’ 

Stories 

DR. MAHSHEED KHAJAVI, ASSOCIATE PROFESSOR OF CLINICAL 

MEDICINE AT FLORIDA STATE UNIVERSITY 


Dear Katherine, author of “I Hope to Someday Be a Good Doctor”, 

I have been practicing medicine for over twenty-five years. I still study every single day, and feel as though I will 

never learn enough. And that’s okay. As long as I can continue knowing my patients and their stories, I will continue 

caring for them. 

Having a child with a fairly rare illness that has resulted in several hospitalizations has given me the gift of being 

on the other side of medicine. I believe the people who have carried both of us were those who listened deeply and 

whose presence demonstrated that they would do their very best. One neurologist spent almost three hours with 

me one night as I watched my son struggle with seizures after a stroke. Several physicians at Johns Hopkins have 

spent hours with us, gathering every little bit of information possible and never for one moment seeming hurried 

or rushed. 

When you start rotations, you will see that there is a myriad of complex and interacting factors that can potentially 

grab you by the collar and pull you away from the heart of medicine. You will have to learn electronic medical 

records systems and also have perfect notes written. You will be expected to give well-compiled presentations 

in front of attendings, and have residents who may or may not encourage you. You will likely be at the hospital 

between 5:00 and 6:00 in the morning and spend twelve to eighteen hours a day in that same environment. 

You might feel exhausted and overwhelmed. But I believe getting to know each and every one of your patients and 

hearing their stories will enable you to find the best options for care. I think if we truly love each patient with whom 

we come in contact, we will continue to be inspired to ask questions, better define our questions, and search for 

answers will ultimately result in the best possible care. 

Medical information doubles about every two years. Knowing this, it is clear that none of us will ever feel as though 

we are utterly competent. But I believe it is enough to have strong analytic tools, academic discipline, a mindset 

of learning, a curiosity that assumes nothing and questions everything, and – most importantly – a profound 

understanding that the connection we make with each patient will determine the care that she or he receives. 

Best of luck to you. 

20

Reader Response: Naggalama 

Hospital Palliative Care 

Outreach Team 

DR. RANDI R. DIAMOND, ASSISTANT PROFESSOR OF MEDICINE IN THE 

DIVISION OF GERIATRICS AND PALLIATIVE MEDICINE AND DIRECTOR 

OF THE LIZ CLAIBORNE CENTER FOR HUMANISM IN MEDICINE AT NEW 

YORK-PRESBYTERIAN HOSPITAL/WEILL CORNELL MEDICAL CENTER 

JANUARY19, 2019 

I was delighted to read Dr. MacDougall’s reflection “An Amazing First Day in Naggalama” depicting her first few days 

at Naggalama Hospital. Her experience, as I have heard from other visiting students and residents, fortifies my own 

impressions and rationale for suggesting Naggalama as a site for the UVMLCOM/WCHN Global Health Program. As 

a palliative care physician and consulting medical director for the Naggalama Palliative Care Outreach team, I feel 

compelled to comment on Dr. MacDougall’s recounting of her patient encounter with the palliative care outreach 

team at Naggalama Hospital. That wonderful team is composed of a nurse with a diploma in palliative care, Prossy, 

and two nurse assistants, Teddy and Immaculate, who have had only short courses in palliative care but continue 

to learn a great deal from experience and from Prossy’s tutelage. Unfortunately, the team does not include a social 

worker. 

There is no substitute for being present with a patient, and though I was not there for the described encounter, the 

scenario provides a platform for a few important teaching points. Although Dr. MacDougall’s limited experience with 

palliative care at the time of her elective may have led her to believe that it is usually only for terminally ill patients, 

that is, in fact, not the case in the U.S. or in Uganda. Palliative care is most certainly intended and appropriate for 

patients suffering with serious chronic illness regardless of the stage of their disease or how close they are to end 

of life. 

I also want to consider the assertion that the participants as a team decided that the patient needed to be 

transported to the hospital. One of the lessons global health electives provide is the importance of valuing the 

experience and opinions of local practitioners. It is also crucial to recognize that the dynamic between doctors, even 

student doctors and nurses – especially those visiting from the Global North – may vary with culture. I hope the 

Naggalama team played a role in the management decision rather than handing it over to the visiting team. After 

all, they understand the cultural milieu best and we are there to learn from them. 

Also worth considering is the actual value of the intervention with which the students were so excited. While this 

patient may have had an overlying acute gastrointestinal illness leading to dehydration, it is also possible that 

someone with advanced and untreated lymphoma and an ulcerative, necrotic facial tumor may have difficulty 

taking in adequate oral nutrition and hydration. This woman’s predicament may have been related to progression 

of her underlying disease. In that framework, and actually even in an acute illness framework – and especially in 

the rural Ugandan cultural setting – one must consider the broader implications of the decision to transport her to 

the hospital for emergency hydration. This decision was certainly based in a Western model of medical care. What 

was the financial implication of transporting this patient to the hospital? Would she use what little money she had 

for intravenous fluids that might, at best, provide temporary benefit at the expense of not being able to feed her 

family? If this was a manifestation of progressive disease, what was accomplished by the intervention? 

21

In palliative care, our greatest interventions may be to help keep a patient physically and emotionally comfortable 

while allowing the inevitable to occur in the face of progression of incurable (at least in her context) disease. 

Sometimes that means not intervening in the ways in which we are typically trained. While our immediate reaction 

as doctors is to try to fix what we think may be a reversible condition, I worry that this intervention may have 

done more to alleviate the distress of visiting medical students/residents than the patient’s suffering, though it is 

distressing to see such sick patients not receive the medical care we wish they would. 

As I said at the beginning, there is no substitute for being present with a patient. I hope that the decision to 

emergently treat this patient was supported by the local team and did not cause any hardship to the patient or her 

family. In being culturally sensitive both to the Ugandan culture and to the culture of palliative care, I hope these 

other perspectives provide some food for thought. 

22

A More Deeply Connected World: A 

Note From the Leadership of Walailak 

University School of Medicine, Thailand 


We enthusiastically welcome Walailak University (WU), the newest member of our global health family. Situated 

in Nakhon Si Thammarat, a city about an hour’s flight from Bangkok, the university sits on a large rural campus 

with ample educational opportunities including rotations in two community hospitals as well as an outpatient clinic 

experience on the university grounds. With a seven-hundred-bed university hospital currently under construction 

and projected to be completed next year, this site is rapidly growing. Dean of the WU School of Medicine Dr. “Menn” 

Prachyapan Petchuay welcomed our collaborative global health vision with open arms as the institution invests 

in capacity building, educational infrastructure, and engagement of junior faculty. We are delighted that the WU 

School of Medicine leadership espouses our philosophy of a holistic bidirectional partnership, a proverbial two-way 

street for medical education. 

Dr. Majid Sadigh, Director of the Global Health Program; Dr. Stephen Scholand, Director of the Global Health Program 

in South Thailand and Vietnam; and Dr. Prachyapan Petchuay, Dean of Walailak University (WU) School of Medicine with 

medical education leaders (back row) and medical students (front row) at a WU-affiliated hospital in Phuket 

23

Here is a note from Dr. Prachyapan Petchuay, Dean of Walailak 

University School of Medicine: 

I strive to nurture my students into well-rounded physicians who 

approach their patients with astute clinical skills and with heart. 

Undeniably difficult to teach, empathy opens a window into a world 

deeper than the classroom where care translates as truly listening to 

patients and seeing the communities in which they live. In imparting 

this way of being, we as teachers are reminded to reflect on the 

meaning of empathy and learn to practice it anew. 

In providing a scaffold on which different perspectives, cultures, 

traditions, and beliefs can converge, the UVMLCOM/WCHN Global 

Health Program encourages a suspending of our own worldviews 

toward better understanding those of others. With time, growth, and 

practice, empathy can embed itself in our beings in such a way that we 

can better care for our each other and communities. We are excited 

to be a part of a network that advocates not only for higher-quality 

healthcare, but for a more deeply connected world. 

24



FEBRUARY 1, 2019 



















The medical student described appears at first glance to be experiencing 

significant discordance between expectations and the reality of the global 

health elective. However, to address possible deeper issues at play, I would 

set up a series of phone conversations to explore the possibility of culture 

shock, social isolation, and mental health issues. I would also seek to 

mobilize local resources to provide additional emotional support. If these 

two interventions were to fall short of ameliorating the dissatisfaction 

and disruptiveness of the medical student, I would be in greater favor of 

arranging an early return to the United States than accommodating another 

transfer, both for the sake of the student and protection of the partnership 

between the two institutions. Lastly, I would re-examine the process of 

participant selection as well as pre-departure training and orientation to 

evaluate whether situations like this could be avoided in the future – namely, 

by ensuring selection of ambassadors for the institution, sufficient resiliency 

training, and alignment of expectations with reality. 

DR. DAVID CHIA, CLINICAL 

ASSISTANT PROFESSOR OF 

MEDICINE AT THE UNIVERSITY 

OF CALIFORNIA SAN FRANCISCO 

SCHOOL OF MEDICINE 

25

Evolution of a Global 

Health Institute 

WRITTEN BY JONATHAN FINE, DIRECTOR OF MEDICAL EDUCATION AT 

WESTERN CONNECTICUT HEALTH NETWORK 


Over its seven-year existence, the Global Health Program at the University of Vermont Larner College of Medicine 

/ Western Connecticut Health Network has grown from international collaborations focused solely on students 

from UVMLCOM students to multidisciplinary, multi-school, and post-graduate activities. During this evolution, 

the Global Health Program has gained international recognition from its many peer-reviewed papers and meeting 

presentations, thoughtful participant reflections distributed through the web, engaging symposia, and ever-growing 

numbers of participants in the United States, Africa, Asia, Eurasia, and the Caribbean. In recognition that the Global 

Health Program services a broad array of health professionals, it is fitting that it emerges from its organizational 

place within medical student administration and assumes the status of institute within the network. 

As an institute, funding and faculty may derive from all healthcare disciplines that wish to participate. This 

inclusiveness is in keeping with appreciation that global health experiences lifts all providers. The resulting 

expansion, in turn, enables global health to mature administratively while advancing new initiatives including 

research projects, interdisciplinary collaboration, a peer-reviewed journal, and a Global Health Teaching Academy. 

Further, as an institute, global health will possess better standing to interact with other organizations, attract 

funding, and recruit talented staff. With the coming creation of another medical school partner with Marist College, 

the Institute expands its key academic associations. 

Our network’s activities in global health have served as defining elements for our academic mission. The humanity 

evoked, the medical knowledge gained by our students, professionals, and partners abroad, and the stimulus 

of selfless commitment to serving patients anywhere together mold our participants into astute healthcare 

professionals and compassionate human beings. We realize in global health the aspirational purposes that draw 

healthcare professionals to their calling. By elevating global health to an institute, we acknowledge and support its 

essential place within our healthcare network. 

26

Evolution of a Global 

Health Institute 

DR. ELENA KOZAKEWICH, MEDICAL RESIDENT AT UVMLCOM 


My mother recently asked me on the phone how I 

was coping with all of the sad and depressing things 

I am seeing every day. Though I told her somehow 

I was managing, I also have a sense that I will keep 

processing some of the sadness for a long time after 

returning home. 

Cases of patients and families with very little linger in 

my mind. A twenty-year-old man with an unknown 

etiology of heart failure who could afford an echo, but 

shared his medicine with his fellow ward mate who 

was alone and could not afford medicine. A twentythree- 

year-old man with no known name, no known 

family, no one to help him, with an unknown etiology 

of encephalopathy, who died on the wards my first 

week. A grandmother whose family told her they would 

return home to get medicine and money but have not 

yet returned to the infectious disease ward. 

One girl has stuck in my mind: a fourteen-year-old 

patient admitted with a new diagnosis of rheumatic 

heart disease and mitral valve dysfunction. She has 

ascites with pulmonary and peripheral edema. We 

went over the echo report with her young father who 

wanted to know what rheumatic heart disease was. He 

asked how long she would have to take the medicines 

we were prescribing, and whether they would cure her. 

The Ugandan resident looked at me before we both 

turned to the father. He proceeded to explain that she 

would likely have to take these medicines forever, and 

that they would help but not cure her. He continued 

that nearly curative surgeries are available in some 

countries, but not in Uganda. The patient’s father 

looked at us with disbelief and emptiness. It was as if 

he could not look at his daughter at that moment. 

Dr. Elena Kozakewich at Makerere University College of 

Health Sciences 

27

Dr. Elena Kozakewich, medical resident at UVMLCOM with Dr. Natalie Wilson and fellow Global Health Program participants 

Later that day I asked the resident how he copes with all the sadness of patients who cannot afford or access 

healthcare. He told me that he has come to a sort of peace within himself that he is not God and cannot save 

everyone, yet he tries to help those he can. I am realizing that I have to adopt that same sort of attitude to survive 

all the depressing stories. I want to buy everyone echos, medicine, trips to other countries for surgeries, but I 

cannot. There is guilt and sadness in every day. But I am trying to look past all the sadness for some hope, some 

positive outcomes, and whatever small victories may come. For example, no one has died on our female infectious 

disease ward this week, and that has brought some peace within me. 

28

In Another World: Part I 

DR. NATALIE WILSON, FORMER MEDICAL RESIDENT AT UVMLCOM 


From the moment we stepped off the plane into a humid, sunny land filled with red dust and all sorts of smells, 

we knew we were in another world. After a long, hot line at immigration and feeling very lucky to find our bags at 

baggage claim, we were greeted by Martine, via sign, and shown to a dusty, beat-up van. We were thankful for 

the breeze through the windows during the hour-long ride from Entebbe to Kampala. Along the way we caught 

our first glimpses into Uganda: women balancing baskets on their head; men carrying bundles of sugar cane on 

bikes; children bathing in tubs; goats, cows, chickens, dogs, and cats wandering along the road; and lots and lots 

of trash, some of it burning. 

As we entered Kampala and the van slowed, we caught more and more stares. I was a minority for maybe the first 

time in my life, and very aware of it. Our hosts welcomed us warmly, showed us to comfortable rooms with fourpost 

beds covered in mosquito nets, and served us delicious local food: rice, beans, and matoke. We of course felt 

exhausted and after a cold shower, quickly fell asleep. 

Our first day at the hospital included a tour, language class, and logistics of exchanging money and sim cards. The 

following day – our first day on the wards – was eye-opening. The buildings themselves were falling apart, with 

concrete floors, chipping paint, old metal beds with rusted springs, and smells of body odor and/or urine or feces. 

I was assigned to the malnutrition unit where I saw rows and rows of cribs with either very thin or edematous 

children. In the U.S., many of these patients likely would have been in an Intensive Care Unit and even intubated. 

The first child I saw was several months old but looked like a premature infant. She appeared quite dysmorphic 

and very tachypneic. I later discovered she had Williams syndrome, a ventricular septal defect, and heart failure. 

I was surprised that she had no nasogastric tube and was breastfeeding. There was no following of in/outs, recent 

chest x-ray, labs, or vitals, and medications were only occasionally recorded as given in the paper chart. 

I learned that many medications must be purchased and administered by parents, who are also required to be 

present to give all feedings – by spoon as there are no bottles – and pay for all lab tests and imaging. Mothers lie 

on the floor next to their child’s bed and are frequently ignored when large groups of doctors and medical students 

stop to discuss their child. I was surprised, but tried to accept these differences. I later thought about how the 

required payment might deter parents from bringing their children to the hospital, thus prolonging treatment. 

While our system in the U.S. is far from perfect, the requirements of families here in Uganda are challenging to 

comprehend – and some conditions seem to be managed without complaint. 

29



MARCH 1, 2019 



















Mismatch between a trainee’s expectations for an elective and the reality 

on-the-ground is not uncommon. I think the best means of preventing 

such predicaments is honest communication and robust pre-departure 

preparation with an emphasis on solidarity. Global health participants 

should be prepared on what to expect with regards to accommodations, 

food, transportation, ward conditions, and clinical supervision. They should 

be warned that working in global health frequently leads to unpredictable 

events and that things might not be as expected. 

DR. MOLLY MOORE, DIRECTOR 

OF GLOBAL HEALTH AT THE 

UNIVERSITY OF VERMONT 

LARNER COLLEGE OF MEDICINE 

PEDIATRICS DEPARTMENT 

When students become frustrated with physical conditions, food quality, 

exposure to pathogens, etc., they should be gently guided away from 

thinking mainly of themselves and their own material wants, and towards 

considering what it is to live and work with those conditions all the time. 

They should use the experience to better understand how their patients live 

and how their fellow students and physicians must work in these conditions 

day in and day out. Unfortunately, in the moment it is easy for a global 

health participant to continue listing a litany of complaints. It is often only 

after their return that they realize the profound gift they received by living 

a life in solidarity with their patients. 

30

Global Health: A Proving Ground 

for Physicians On Their Journey 

DR. STEPHEN SCHOLAND, GLOBAL HEALTH PROGRAM SITE DIRECTOR IN 

THAILAND, VIETNAM, AND ZIMBABWE 

MARCH 9, 2019 

One of the challenges in global health is the need to adapt. It is vitally important to focus on the goal: to become 

the absolute best physician you can be. The practice of medicine is not easy. It is a great sacrifice on many levels, 

beginning early in the education process from passing organic chemistry to scoring well on the MCAT, applying to 

medical schools to undergoing the interview process. Other challenges await once matriculated to medical school, 

in response to which we strive to do our best. In the pursuit of global health, even greater sacrifice is required by 

the very nature of the work we do. It’s important to keep in mind that a global health experience takes us beyond 

our comfort level. It is a baptism into the human condition, the suffering and the pain, that we pledge to embrace 

with our commitment to serve. 

In the United States, we are so very privileged on so many levels. Even our education system is highly privileged. 

Think of visiting your library and being surrounded by computers with high-speed internet connections, bright 

lights, stacks of books and journals, and cozy study areas to settle into. Contrast this against a rickety shack with a 

thatched roof, dirt floor, and blackboard without climate control for bodily comfort. Where would you rather study? 

A global health education breaks down and smashes the beautiful ivory walls that surround us. We can then see the 

true reality: the enormous scale of human suffering that continues; the problems that politicians and societies have 

not solved. How many hundreds of thousands of children will die from diarrhea this year? Diarrhea? How many 

billions of dollars is it for a B1 bomber? Could we do with one less bomber? Could we not, as a society, address 

some of these egregious health disparities more thoroughly? 

How can we lift the veil of ignorance, break out of our comfort zones, and truly open our minds? We must have 

experience. We must see. We must go beyond. It is by challenging ourselves that we grow and improve. Only 

with eyes open and true understanding can we become advocates of change – leaders that change the world, one 

physician at a time. A path in global health is difficult, no question, but we as participants and educators should 

embrace it for the betterment of ourselves and those we serve. 

31

In Awe 

DR. STEPHEN WINTER, SENIOR CONSULTANT FOR THE WCHN/UVMLCOM 

GLOBAL HEALTH PROGRAM 

MARCH 16, 2019 

Medicine in a crowded hospital ward in a resource-constrained country can be emotionally overwhelming. Patients 

generally enter these hospitals with advanced diseases, often accompanied by severe comorbidities such as 

advanced HIV or malnutrition. Mortality rates are much higher than we experience in our home hospitals. During 

my visit to Zimbabwe two years ago, it was not unusual for two or three patients to expire or experience a severe 

event such as a grand mal seizure during the course of rounds on a single day. 

As educators, we often worry about the potential emotional impact of such events on our medical students who 

rotate through these hospitals, especially early-year students who may have never witnessed the death of a 

patient, and set up systems to mentor and monitor them. But I think we rarely consider the emotional toll on 

trainees and young faculty at our partner hospitals who always seem to approach these situations with stoicism 

and acceptance of the local reality. Today, I learned that the reality is quite different. 

As we discussed a patient at the bedside during ICU rounds, a nearby patient unexpectedly developed pulseless 

ventricular tachycardia. His Vietnamese resident jumped into action from rounds and lead successful CPR on the 

patient. She had cared for him over the past month after a fall left him with paraplegia from a high cervical spine 

injury. She left the unit to speak with the family and returned a few minutes later, barely holding back her tears. 

“The family wants to take him home,” she said – the local equivalent of hospice for a ventilator dependent patient. 

“Why am I doing this? Half of my patients die. Maybe I shouldn’t be a doctor.” 

Less than twenty minutes later, I received urgent text messages from another young physician with whom I was 

working that week, one of our Vietnamese Global Health Scholars who had worked with us at Norwalk that year. 

“Where are you? Can I talk to you?” We had been taking care of a young woman who had been unsuccessfully 

extubated four times in the previous two weeks. We developed a plan to extubate her five days prior, and she was 

doing amazingly well off the ventilator and planning on going home that day. But the night before, she suddenly 

coded and died under the care of a covering resident. My friend had come in that morning to face the distraught 

husband and try to provide comfort to the family. He too was fighting back tears, convinced that he had made a 

mistake that led to her death. When we met, he was clutching the multi-volume chart to show me a minor omission 

he had made in her care, certain that he was responsible for her death. 

We often worry about our students undergoing emotionally fraught experiences, but who worries about the emotional 

distress our scholars and their colleagues must endure on a daily basis? Who worries about the repercussions of 

our mistaking their stoicism for lack of personal impact, as if they are somehow immune to bearing witness to so 

much suffering? 

32

Together, we have discussed means of working through feelings of despair, helplessness, and blame that sometimes 

accompany our lives as doctors, and celebrated the many clinical successes from their skills as physicians. Yet I 

worry about these deeply compassionate young doctors who often lack an outlet for their own emotional distress 

as they minister to the distress of patients and their families. I wonder where these wonderful young physicians 

find so much resilience and inner strength. I am in awe. 

Finding Our Grace, 

Gratitude, and 

Fortitude 

DR. RANDI R. DIAMOND, ASSISTANT PROFESSOR OF MEDICINE IN THE 

DIVISION OF GERIATRICS AND PALLIATIVE MEDICINE, AND DIRECTOR 

OF THE LIZ CLAIBORNE CENTER FOR HUMANISM IN MEDICINE AT NEW 

YORK-PRESBYTERIAN HOSPITAL/WEILL CORNELL MEDICAL COLLEGE 

MARCH 23, 2019 

As physicians and medical students, we may initially think we are going to a new place, often in the Global South, 

to share our expertise and teach local healthcare workers about the practice of medicine. In reality, we are going to 

learn – not only about a different medical system but also about cultures, beliefs, values, stories of life and illness, 

and ourselves. This learning may start even before we arrive at our host destination. 

When signing up for a global health experience, we may not be thinking about the stresses associated with 

traveling so far, carrying everything we think we might need for an extended stay, or how isolating it can feel to be 

in a strange place without familiar support systems. Global health experiences can be educational in many ways. 

They challenge us to adjust to new situations and new experiences. To be introspective, to consider our own 

reactions, strengths, and weaknesses. To adapt when things go wrong, and even when things go right but happen 

differently from the way we are used to. To reach out across divides and find commonality and comradery. To find 

our grace, our gratitude, our fortitude, and our recognition of the efforts of others. These global health experiences 

enrich us. Despite the stress, I believe we come back as better doctors and better people. 

33


Health: Defining the Comfort Zone 

MARCH 29, 2019 








Excerpt from Student Reflection: 

“The other students and I are becoming more comfortable in acting on our instincts in realizing we are probably the 

most qualified individuals in the room most times at the hospital. It is a sobering realization.” 

Thank you for your most recent reflection, which I read with great interest, especially the vivid description of your 

experience with sick patients. However, the last paragraph where you describe being the most qualified person on 

the wards worried me. This is a common warning sign that we look out for in reflection pieces. Due to the shortage 

of medical personnel, global health elective participants often find themselves left unsupervised with patients. This 

situation is compounded by the fact that participants coming from the Global North mistakenly may be viewed 

as more experienced or knowledgeable, which may in turn lead to involuntary engagement in an activity that 

participants are not trained for or comfortable doing. Ultimately, this may lead to a safety issue for a patient or 

even the student. 

Please be sure not to engage in any activity for which you have not been 

trained. Remember that your role during the elective is that of a student. You 

are in an international site to learn, rather than to provide “help,” medical 

care, or fill any kind of resource vacuum. Do not be timid in disclosing your 

limitations and your position as a medical student. I am linking a recent article 

from Annals of Internal Medicine regarding the ethics of short-term electives. 

Although it focuses specifically on physicians, I feel many of the same ethical 

principles can be applied to the student experience. 

DR. BULAT ZIGANSHIN, DIRECTOR OF THE INTERNATIONAL AFFAIRS OFFICE AT THE 

WCHN/UVMLCOM GLOBAL HEALTH PROGRAM AND DIRECTOR OF THE GLOBAL 

HEALTH ELECTIVE FOR AMERICAN UNIVERSITY OF THE CARIBBEAN SCHOOL OF 

MEDICINE AND ROSS UNIVERSITY SCHOOL OF MEDICINE STUDENT 

34

DR. RANDI R. DIAMOND, ASSISTANT PROFESSOR OF MEDICINE IN THE DIVISION OF 

GERIATRICS AND PALLIATIVE MEDICINE, AND DIRECTOR OF THE LIZ CLAIBORNE 

CENTER FOR HUMANISM IN MEDICINE AT NEW YORK-PRESBYTERIAN HOSPITAL/ 

WEILL CORNELL MEDICAL COLLEGE 

Responding to student reflections is crucial to the benefit of having them write 

them, and may also be a way of extending their education as the program 

faculty has done. In this case, I am curious as to what the student actually 

meant by “acting on our instincts.” 

Acting on one’s instincts in the face of being witness to human suffering may 

involve reaching out to a patient, being present with a patient, offering to help 

a patient communicate their distress to the appropriate person if they cannot 

communicate on their own. While many medical students are concerned 

about defining their role on a clinical team, they are often counseled that 

spending time with patients and giving them the opportunity to express their 

concerns, something that the rest of the medical team may not actually have 

time to hear, can be perceived by the patient as very valuable. Being a human being, more than being a medical 

student, qualifies you to engage in this type of interaction. In the global health scenario, the value of presence and 

extended communication in the medical care context is not often prioritized, usually because of over-extended staff 

in addition to limited emphasis on these areas in medical education. What visiting students can provide in this way 

can be unique and valuable, and can model an important aspect of good medical care. 

If “acting on our instincts” meant that the students were assuming responsibility for medical interventions in the 

absence of other medical professionals, then we must be concerned about their understanding of professionalism. 

A Physician Charter: Medical Professionalism in the New Millennium issued jointly by the American Board of Internal 

Medicine, the American College of Physicians, and the European Federation of Internal Medicine, asserts the first 

principle of professionalism to be the primacy of patient welfare over our own self-interest. While there are ethical 

concerns unique to the global health experience, the principles of bioethics that guide the way in which we are 

obliged to conduct medical care, which we teach medical students, are applicable to how we conduct ourselves in 

the practice of medicine, wherever it is that we are doing so. The concepts of beneficence and nonmaleficence and 

our primary responsibility to the welfare of our patients, rooted in our commitment to competence in a specialized 

body of knowledge, apply in all settings. 

For students especially but for all physicians, the humility to acknowledge the limits of our knowledge and skill is 

crucial. Though visiting students and professionals may be viewed as having greater knowledge or experience than 

they do or than the local providers do, in the context of a new culturally unique environment, we are all actually 

learners more than we are providers. It may be distressing to witness patient suffering in the face of the shortage 

of medical personnel, but if we wade into providing care that we are not qualified to provide, we risk causing 

greater harm than benefit, thereby breaching our professional responsibility to patients. 

35

Flowers of Guatemala 

DR. JOSE MARQUEZ, INFECTIOUS DISEASES FELLOW AT THE UNIVERSITY 

OF ARIZONA 

APRIL 6, 2019 

We are currently working on developing “Global Health at Home,” which is geared toward serving underprivileged 

populations such as Native Americans, immigrants, and refugees within the United States. Unfortunately, there 

are areas of significant poverty and unmet medical need within our own borders that in many ways mirrors other 

underprivileged regions of the world where preventative healthcare and important healthcare resources are sorely 

lacking. By exploring and hopefully establishing a global health site such as this, we hope to enhance our array of 

clinical experiences and opportunities with a partnership as robust as those found in our other international partner 

sites. 

He was a thin young man, only twenty-eight years old, but had probably experienced more than most do in a 

lifetime. He was shackled to the hospital bed with a visible sadness, confusion, and uncertainty of the future to 

come. Unable to communicate in English, he continued the solitude he had faced in the desert, but now in a sterile 

room with two Border Patrol agents present in body but with emotional distance. They waited, arms crossed in 

brown fatigues, guns at their side, exuding a seriousness centered on intimidation. 

The consult was for bacteremia, MSSA – or methicillin sensitive 

Staphylococcus aureus. The source was a cellulitis of the leg 

caused by apparent multiple scratches and soft tissue injury. 

Cactus spines! Some of the broken-off thorns were still in his leg. 

The patient had been picked up by Border Patrol sometime earlier, 

crossing the vast Sonoran Desert to reach the United States of 

America. He had come all the way from Guatemala, a journey of 

two thousand miles. He had three young children at home, three 

flowers, for whom he needed to care. He had a desperate thirst 

to find a way to provide certainty and security for his family, and 

finding work in another country was the only choice. 

His journey for a better life turned into a journey for survival. 

The scorching sun during the day and frosty moon during the 

night damaged his skin. He had survived several weeks in the 

wilderness, unable to shelter from the elements for very long. As 

his supplies ran out towards the end of his journey, he drank from 

puddles and troughs of animals. “For a better life,” he pressed on. 

Close to his goal, however, he was spotted near the border. He ran 

with a pair of withering shoes eroding into his feet. Filled with a 

cold panic and fear, he ignored his exhaustion until his tired legs 

36

gave out. He fell off a small rocky ledge, crashing into thorny cactus and scrub vegetation. Waves of pain scoured 

his body as the thorns sliced through him. By this time, exhausted, he was almost grateful for the Border Patrol 

hand that picked him up. 

Into detention he went, with chain linked fences, cinder blocks, and fluorescent lights. He was ill from the journey, 

dehydrated and in need of hospital care. The skin and soft tissue injuries were significant and gave rise to a 

localized infection. Staph aureus, a master pathogen, invaded the bloodstream. Now he was febrile. The case was 

easy enough: intravenous cefazolin, ECHO to ensure no heart valve involvement, and localized wound care. But 

what would become of him? What about his family that he left behind? Now, there was no father to provide. The 

hope was fading like flowers in the desert. 

The Value of Sharing 

Stories 

CAROLE WHITAKER, ASSISTANT DEAN FOR MEDICAL COMMUNICATIONS 

AND PLANNING AT THE UNIVERSITY OF VERMONT LARNER COLLEGE OF 

MEDICINE 

APRIL 13, 2019 

From the beginning of time, people have connected with each other through storytelling. Whether sharing what 

we have seen with our eyes, what we have built with our hands, or what we have dreamed with our imaginations, 

the best of our stories engage the hearts of both the teller and the listener. The global health community here is 

one of storytellers, and our program has been made stronger and better by the stories that have been shared by 

caregivers and care receivers, by students and teachers, by the most visible advocates and the quietest who walk 

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. 

37

Feeling Grateful: A Reflection 

on Global Education & Health 

Lecture Series 

WRITTEN BY STEVE MUSITANO, SACRED HEART UNIVERSITY FARRINGTON 

COLLEGE OF EDUCATION CLASS OF 2019, SECONDARY TEACHER 

CANDIDATE 

APRIL 20, 2019 

On March 26th, 2019 at 7 p.m. in the new West Campus building, the Global Education and Health Lecture Series 

at Sacred Heart University (SHU) hosted the “Healthcare and Education in Uganda” panel. This new initiative is 

a collaboration between the SHU Farrington College of Education, the SHU College of Health Professions, and 

Western Connecticut Health Network. 

This presentation allowed health and education students to come together for a night and embrace the unity 

between healthcare and education in the Global South. SHU invited Global Health Scholar Dr. Moses Othin to 

speak about his experiences working in Uganda. From his childhood until now, he has seen a shift in the way 

healthcare is managed in his country. From his early days as a doctor-in-training to eventually graduating top of 

his class, he showed the audience the hard facts of what it’s like to be a doctor in an under-resourced country. 

Unlike physicians in the United States where medicine and technology are readily available at the snap of a finger, 

Ugandan physicians manage with minimal supplies. Along with the health panel, Dr. Othin told us that education 

plays a critical role in the medical field. 

In the United States, we have a specialist for drawing blood, another for taking X-rays, and and so on. But in 

Uganda, Dr. Othin shared, one doctor needs to learn how to execute over one-hundred jobs. With this in mind, 

their doctors are highly qualified, but there are only a few per hospital. Because the doctor-to-patient ratio is very 

small, getting to every patient can be challenging. On top of that, their medical supplies are very hard to obtain, 

seeing that Uganda’s Drug Administration works on a sort of “need now” basis. 

Something I feel the United States healthcare system can learn from is how much love there is in Uganda. Dr. Othin 

said family members take astounding care of their loved ones. They feed them and bathe them. The biggest thing 

I took away is the fact that they are the ones who get the medicine. Thus, within the hospital, the amount of work 

a family does has a huge impact. Also in attendance was Dr. Connie Glenn, a Professor from the SHU College of 

Nursing, and two graduate students who together travelled to Uganda where they received a firsthand experience 

of what it’s like to work in the medical field there. 

The presentation opened my eyes to the world outside of the United States. Most of us think that under-resourced 

countries are filled with sick and dying people, but that’s not the case. Yes, there’s a high rate of HIV/AIDS and other 

diseases, but while on the trip, Dr. Glenn said they were met with nothing but smiles and love. The presenters told 

38

Dr. Moses Othin, Global Health Scholar from Uganda, speaking at the Global Education and Health Lecture Series at 

Sacred Heart University 

us how Americans are so fast-paced and outspoken while Ugandans are very religious and polite. After attending 

this event, I left feeling grateful for everything I have. I know this is a general statement, but in reality, we all take 

everything we have for granted. The U.S. has some of the most advanced technology in our hospitals, 24/7 care 

centers, and new medicine being created every day, among countless other privileges. This presentation made me 

take a step back and realize that what I have is what some people, like many in Uganda, pray for. 

39



APRIL 27, 2019 



















What a wonderful, honest reflection of the many emotional, spiritual, and 

physical challenges of working in global health. The writer describes “a time 

of many firsts” which always requires commitment to pushing outside of 

one’s comfort zone, faith in one’s own abilities to conquer challenges, and 

trust in others to help guide the way. The twin themes of loneliness and 

communication are central not just to this narrative, but to all of global 

health. We are all individuals who crave connection to others, but making 

that connection requires perseverance. The first step is admitting how lonely 

and scary new experiences can be. The next steps are not giving up when 

confronting our fears and instead asking for help. When this writer asks for 

help, so many people help guide the way. While fear and loneliness were 

experienced by just one person in the beginning, joy and success were 

shared in the end by many. Joining the global health community similarly 

enriches us all. 

DR. LILY HORNG, INFECTIOUS 

DISEASES FACULTY AT 

STANFORD UNIVERSITY SCHOOL 

OF MEDICINE 

40

Butabika Psychiatric Hospital: 

2019 UVMLCOM Global Health 

Day Reflection Contest 

Winner 

BRIAN ROSEN, UVMLCOM CLASS OF 2019 

MAY 3, 2019 

I excel at intellectualization. It is a fickle defense mechanism, allowing the observer to fully comprehend the situation 

in front of them without fully engaging in the emotional context. Throughout my medical training, intellectualization 

has aided me at many patient bedsides and through emotionally charged family conferences. I am reminded 

of many moments on neurology wards when a patient’s emotionally charged question was reinterpreted and 

deflected through a purely intellectual and biologic lens. The disease process was stripped of its emotional and 

societal resonance and presented as a simple fact of life. My habit towards intellectualization even followed me 

into psychiatry, a field that fully embraces the nuances and significance of human emotion. It is much easier to 

intellectualize a difficult patient encounter with the Diagnostic and Statistical Manual of Mental Disorders (DSM) 

qualifiers or neuronal processes than it is to simply exist in a difficult moment and let in the anxiety and fear that 

often accompany it. 

Even this introduction to my experiences at Butabika Psychiatric Hospital is an intellectualization. It is my attempt 

to analyze and appreciate the defense mechanism that served me so well and yet has likely met its match. The 

human suffering that I recently witnessed has affected me greatly. Before arriving in Uganda, I imagined rough 

caricatures of what I may expect. Having been pre-warned that conditions in inpatient psychiatry are below what 

one would find in the United States, images of classic asylums immediately came to mind. 

My conception of such places comes intellectually from history books or visually and culturally from films such as 

One Flew Over the Cuckoo’s Nest. Even given the challenging environment I imagined, I was unprepared for the 

visceral nature of my experience. Butabika is located about thirty minutes from the center of Kampala, Uganda. It 

is situated on a lush hill overlooking the tranquil countryside. The peaceful quality of the environment is perhaps 

a prerequisite given the scenes that often occur within its walls. Each psychiatric ward is a separate one-story 

building spread generously across the sprawling facility. Psychiatric patients are divided into child-adolescent, 

forensic, addictions, acute care, sick care, and convalescent (stable) care categories. The general physical upkeep 

and atmosphere of each ward varies dramatically. The acute male ward is my worst fears brought to life before 

my eyes. 

The entrance gate is manned by a psychiatric patient dressed in the simple blue-green patient garb, letting his 

fellow patients enter or leave based on what appears to be whim. Within the walls, patients meander about in 

states of extreme psychosis and mania without any real attempt to intervene in case of conflict. Sanitation appears 

as an afterthought, causing the smell of human suffering to be fully entrenched in my emotional memory. Due to 

the limited security structure, walking around the grounds of Butabika means constantly running into patients in 

the acute throws of psychosis walking aimlessly around the grounds as though in a perpetual daze. The resulting 

41

impression is one of extreme despair and powerlessness. Due to resource constraints, the medications provided to 

such patients are restricted to first-generation antipsychotics that produce a wide variety of symptoms including 

repetitive motions of the limbs or face, drooling, and extreme sedation and lethargy. 

Compounding this is the extreme lack of social work or societal supports available to the patients here. Patients 

are often dropped off by family members in acute states of psychiatric illness and simply left to become wards of 

the state. Quantitative medical tests like thyroid levels, lithium levels, or computerized tomography (CT scans) are 

provided only if the patient can directly pay. Given that patients with mental illness are statistically likely to be less 

educated and more impoverished, this reality is criminally disheartening. In contrast to the patient-centered care 

preached in the United States, encounters at Butabika have often felt like paternalism come alive. Ward rounds 

can sometimes feel closer to tribunals in which medical decisions are decided and read aloud without direct patient 

involvement. 

Amidst this environment, I have felt true despair of the variety that I cannot easily intellectualize away. I struggle 

to understand a system that, due to its resource constraints, treats patients in a manner to which I am simply not 

accustomed. My discomfort participating in psychiatric care at Butabika is immense and yet I wonder if my own 

standards are too unreasonable given the constraints on-the-ground. Am I justified in my fear and discomfort 

or am I simply “othering” another system? I have been questioning my emotions and feelings since beginning 

my time on Butabika’s grounds but have yet to find an answer. Yet maybe that questioning and understanding is 

unnecessary. By explaining away my feelings and concerns, am I simply looking for a way to intellectualize my 

anxiety? I am left with the hope that one day I will make meaning from my inpatient experiences in Uganda. Until 

that time, I will simply sit with the discomfort that I now feel. 

42

Sexual and 

Reproductive Health 

Rights: Part I 

FLORENCE DIBIASE ’19, UVMLCOM CLASS OF 2019 

MAY 11, 2019 

You should see the stuff they stick up there… I’ve seen coat hangers, sticks, and bicycle spokes” – a fifth-year 

medical student at Makerere University College of Health Sciences in reference to treating septic abortion patients 

As a future Ob/Gyn provider, I maintain a strong commitment to the fundamental rights of women. Beyond her 

basic right to gender equality and respect, I believe in a woman’s right to accessing safe and legal abortion as well 

as deciding how many children to have and when. I want to provide these services as a doctor. Every woman has 

a right to safe, consensual, pleasurable, and fulfilling sexual relationships. She should have access to information 

and options for both contraception and safe termination should she require them. 

Reproductive rights are hard enough to discuss in the U.S., especially in certain social circles, often sparking heated 

arguments and tense emotions. Multiple legislative efforts against abortion are proposed weekly in a variety of 

U.S. states, while other states work hard to protect these rights. President Trump is attempting to pass exemptions 

that can restrict women’s access to birth control. Last week, his State of the Union Address also referenced ending 

“late term abortions,” a misleading term that was actually meant to represent twenty-one- to twenty-four week 

abortions rather than those in women about to give birth. Of course, it pleased anti-abortionists and kept the 

tension high. I digress. I recognize my opinions on these issues are strong – I will readily debate with those who 

disagree with me and fight for what I believe is right. That said, I am still assessing how to uphold these beliefs in 

the global health context. 

Prior to coming to Uganda, I researched reproductive rights here on the Guttmacher Institute webpage. The 

birth rate is one of the highest in the world at 5.59 births per woman (2016). Unintended pregnancy is common, 

leading to high rates of unplanned births. Premarital sex is common, with more than one-third of women aged 

fifteen to twenty-four having had sex. One quarter of adolescents age fifteen to nineteen have had a child. Modern 

contraceptive use remains low at twenty-six percent of married women and forty-three percent of sexually active 

unmarried women. 

Abortion is mostly illegal in Uganda. The law makes an exception in the case of endangerment of a woman’s life, 

and in 2006, National Policy Guidelines were passed that further permitted abortion under certain circumstances 

such as rape and incest, HIV infection, and cases of fetal anomaly incompatible with life. That said, abortion laws 

are interpreted inconsistently by law enforcement and because of this ambiguity, medical providers are often 

reluctant to perform the procedure. In 2013, the abortion rate in Uganda was 39/1,000 for women aged fifteen to 

forty-nine. This translates to an estimated fourteen percent of all pregnancies ending in abortion. This rate is even 

higher in Kampala specifically, at 77/1,000 women. 

43

The same study showed 12/1,000 women are treated annually for complications resulting from unsafe abortion. 

While maternal mortality is decreasing (it dropped from 684/100,000 live births in 1995 to 343/100,000 in 2015), 

unsafe abortion remains a significant contributor to mortality. The Ugandan Ministry of Health estimated eight 

percent of maternal deaths were due to unsafe abortion in 2010. Meanwhile, post-abortion care is estimated to cost 

nearly $14 million USD annually. Studies show that restricting access to abortion does not decrease its incidence, 

but merely makes it more dangerous and deadly for women around the world due to unsafe method use. It saddens 

me that we have inexpensive and safe methods to prevent unintended pregnancy and perform early terminations, 

but many women continue to die due to lack of access, implementation, social stigma, or other barriers. 

Sexual and Reproductive Health 

Rights: Part II 


MAY 17, 2019 

I have now been at Kawempe General Hospital for three weeks. I initially carefully avoided the subject of reproductive 

justice altogether, determined to wait to ask questions until I gained a better sense of cultural attitudes. From 

the Ugandans I have met thus far – primarily my host family and surrounding medical students on their Ob/Gyn 

rotation – religion is a vital component of life here. We pray with the host family before most meals, and they 

regularly reference God. A few medical students have asked me if I am Christian. It is interesting to consider how 

the origins of Christianity and other common religions in Uganda came from Western influence when Uganda was 

under European rule. Western influence continues to be present today, in part due to lasting impressions from that 

time and in part due to the opening of the country’s borders during the initial HIV epidemic. I am trying to observe 

how this religious influence has been adapted to fit the realities of East Africa and shapes cultural values. I imagine 

this contributes significantly towards attitudes regarding reproductive rights. 

I have not heard much regarding abortion in my work at the hospital. It has been difficult to tease out the attitudes 

of healthcare providers. When I have hinted at topics to medical students, it has not encouraged enlightening 

conversation. One cannot expect to learn all the nuances of a new culture in three weeks, especially with such 

personal topics. As I am a guest here still trying to understand cultural attitudes, I am trying to avoid asking 

potentially offensive questions surrounding the topic of reproductive rights. 

This week, however, I attended a lecture titled “Sexual and Reproductive Health Rights.” I saw this on the schedule 

and felt curious about how it would go. The general format of lectures in the fifth year medical student class 

involves one or two students presenting daily assigned topics with facilitation by an attending. This lecture was 

given by a timid appearing male student who started with similar statistics to those I referenced above. The 

attending facilitator, a female physician, chimed in frequently. As the discussion turned to abortion, I felt at times 

that the attending’s attitude was very liberal, yet at times, I also disagreed with her views. When she asked 

whether abortion should be legal, the class mostly responded in the affirmative, which somewhat surprised me. 

The professor, however, stated that legalizing abortion would not be effective. 

She proceeded to share her view that legalizing abortion would not make it accessible to the majority of women 

desiring it due to costs, stigma, and lack of willing providers. She spoke about South Africa’s abortion legalization 

and the country’s subsequent struggle with its implementation for these reasons. She clearly acknowledged the 

reality of the problem. I wrote in my notebook her statement: “the men who say abortion is illegal are the same 

men who get women pregnant.” She gave case examples of patients she had treated with septic abortion. One 

woman she treated had the procedure performed by a non-licensed medical person who probed so far into her 

abdomen that they went through the uterus and into the bowel, only realizing their mistake when they started 

pulling feces out of the vagina. 

44

Sexual and Reproductive Health 

Rights: Part III 


MAY 24, 2019 

The attending facilitator argued instead for prevention through education of all women and access to effective 

contraception for anyone who becomes sexually active. She stressed keeping girls in school as a fundamental 

way to decrease the high birth rate, unintended pregnancy, and maternal mortality. This is a more realistic and 

achievable goal, she argued, given that even access to contraception and sexual education are contentious due 

to religious and cultural beliefs. One example cited was about the Ministry of Health being forced to revise its 

statement on providing contraception to adolescents, raising the minimum age from ten to fifteen. Another student 

contributed to the discussion by bringing up the lack of sexual education offered to children. I would love to discuss 

this with him if I can find an appropriate time and place. 

This was my favorite lecture to date because it left me questioning how to establish a woman’s right to reproductive 

control in resource limited and culturally prohibitive environments. I went into the lecture believing abortion should 

be legal everywhere, and I still maintain that belief, but I had not thought through all the logistical complications; 

the economics and cultural context in which laws operate. Of course I want women in Uganda to have access to 

abortion services if they want them, but maybe this lecturer is right? Perhaps the current situation is not sufficiently 

stable or developed enough to successfully implement such a law. 

This is a great challenge of any field or specialty within global health: when there are so many aspects of the 

healthcare system that require aid (in any form), how does one set an achievable and effective goal? Where does 

one direct efforts when one cannot address everything one would hope to? When I think about the environment 

at Kawempe General Hospital, I wonder too how many women are not accounted for in the statistics I read. It 

is resource draining and time-consuming to perform data collection for things like the maternal mortality ratio 

and illegal abortion rates. I imagine many people are not accounted for in the census. Many women never go 

to healthcare centers for antenatal care or deliveries. The scope of the problem is depressingly large. That said, 

understanding the problem through data is the first step. An estimate is better than no estimate, and small 

successes are better than no success at all. 

With a ton of new international students arriving this week and flocking to the labor floor, I decided to explore 

gynecology a bit more having spent the majority of my time thus far helping with deliveries. I have been going 

to the family planning clinic, which is a much calmer environment but an equally valuable clinical experience. As I 

am considering family planning as a career focus, it has been rewarding to see this subspecialty through the lens 

of a Global South nation. With the start of the clinic, advanced nursing staff gives a presentation in Luganda about 

all the different contraception methods available. Then, women bring their blue family planning record cards to 

receive a particular method and/or cervical cancer screening. They use dilute acetic acid to identify premalignant/ 

suspicious lesions of the cervix with referral to oncology if necessary for biopsy. The majority of women here seem 

to prefer copper intrauterine devices and implants as birth control. 

In helping with the insertion of contraceptive devices, I learned that while the Ministry of Health and Kawempe 

General Hospital are supportive of family planning services, women still fear stigma for using contraception. “Make 

sure you can’t see it,” one woman told me as we placed an implanon implant in her arm. “I don’t want people to 

know.” 

45

Sexual Harassment and Violence 

Across Global Contexts 

JUNE 1, 2019 

This post is part of a new monthly series of discussions about sexual harassment across global contexts. Please 

send us your responses as we begin building a platform for this crucial conversation. 

Compiled by Majid Sadigh, Director of the UVMLCOM/WCHN Global Health Program, and edited by 

Mitra Sadigh, Editor of Global Health Diaries. 

Sexual harassment and other forms of sexual violence are ubiquitous. As such, participants of global health 

programs often experience and report such abuses while undergoing international electives. Proper guidance and 

support must be provided so that these individuals can effectively recover and that the source of abuse be rectified. 

The framework for understanding sexual harassment and abuse has fundamentally changed with the widespread 

#MeToo movement that has shaken the historic tolerance of sexual harassment, leading to both discourse and 

action of global impact. In this vein, it is the responsibility of the global health community to educate its members, 

from trainees to faculty and researchers, about methods of advocating for one’s own rights and the rights of others 

in the face of sexual harassment and abuse in the era of the #MeToo movement. 

A global health participant in Uganda expresses that she is uncomfortable walking to and from the hospital in 

Kampala, even when in a group, because men frequently approach her with comments about her looks and 

statements such as “I have always wanted a Mzungu (white) wife… marry me.” She tries to politely decline 

their offers and continue on her way, but she struggles to cope with the unwanted advances that make her feel 

conspicuous and unsafe, and feels targeted despite dressing and behaving according to local customs. 

46

Sense of Community: 

What Uganda Gave Me 

GRACE HERRICK, FOUNDER OF GRACE’S PROMISE INCORPORATED 

JUNE 8, 2019 

My dad is from California and my mom is Portuguese born in Mozambique. My mom’s stories always piqued my 

curiosity about the continent of Africa, a curiosity that continued to grow through high school as I frequently 

attended the WCHN global health evening sessions. In the summer of 2015, I had the opportunity to go to 

Uganda for two weeks during which I shadowed doctors and nurses, visited an orphanage, and went to ACCESS in 

Nakaseke where I learned about the activities of this amazing organization and community. 

I was particularly moved by the work ACCESS does with children and orphans. During one of our home visits, an 

elderly woman sang a beautiful and haunting song. I didn’t understand the words, but the emotions I felt were 

powerful. I felt fully present that day. There existed a feeling of community, a connectedness with one another in 

the villages we visited that is difficult to describe. In the U.S., we do not often see communities in which everyone 

treats one another with dignity and respect. I felt that I was witness to something important. I left ACCESS feeling 

like I had to be a part of that community in a permanent way. I started brainstorming about what I could offer that 

could have lasting impact. After speaking with Dr. Robert and Estherloy, President and Founders of ACCESS, we 

came up with the idea of a preschool program, as that was something the community needed that I could work 

on remotely. We created a curriculum and opened a preschool program that started during my junior year of high 

school. 

To help illustrate why Nakaseke made such an impression about me, let me tell you about my return to Uganda in 

July 2018. The morning we drove to visit the school during my next visit in 2018, we stopped at a street shop in 

Kampala to purchase candy for the children. The shop was small, packed with odd foods and nicknacks and one 

cashier crammed into the corner because space was so tight. The street was loud and bustling with people and 

cars, equally packed in, and I was with my sister and her friend. I stepped onto the street with feelings both familiar 

and strange. Shops and streets in the midst of people hustling about, just like midtown Manhattan. It was in the 

midst of this familiarity that I felt strange. Here I was with my sister and her friend, three American girls so out of 

place in a sea of people as to cause them to stop in their tracks to stare at us. How could something seemingly so 

familiar feel so strange? When I visit Boston or New York City, I feel like a stranger among strangers, and somehow 

that feels comfortable because no one cares. But in Kampala, I feel like a stranger among friends and neighbors, 

and it makes me feel alone – like a real stranger – while also feeling envious of a sense of community that doesn’t 

exist in any city in the US, not even my home Newtown. It is this irony of feeling like a stranger among friends in 

Uganda but a friend among strangers in the US that is so alienating. 

Later, I arrived at ACCESS expecting that we would visit the school program and greet the children with the 

treats. Instead, the they came running to greet us in their bright, electric colored polo shirts chanting “Welcome to 

ACCESS Preschool.” Their warmth, giggles, and bright eyes filled me with so much love that I burst into tears. We 

were then greeted by many other people, some familiar like Dr. Robert and Estherloy, and some new. Embracing 

them felt like coming home. We picked up exactly where we left off when I was 16. 

47

There is something about the way Ugandans greet you that makes you feel immediately welcomed and cared for. 

They extend both their hands to shake yours, then hold your hand in theirs in a warm embrace while talking to you. 

They focus their eyes and attention on you as if you are the only person on the planet. It makes you feel safe and 

connected, like the bond is as strong as family. Never have I been greeted with such strong feelings. It is disarming. 

The children continued running around us giggling, tugging on my dress and requesting my attention. Two grabbed 

my hands, one on either side, and walked me with Dr. Robert to a Welcome Brunch. As we went around the large 

table introducing ourselves, I was struck by the passion and dedication with which community members help the 

preschool to run. Afterwards, we walked to a tent set up with tiny brightly colored chairs where the children put 

on a show, full of life and infectious laughter. The end performance was a dance similar to the conga line dance 

where the little ones lined up and danced their way around. Eventually everyone joined in, including Dr. Robert. It 

was a moment I wish I could have frozen in time. I spoke with parents about their day-to-day lives, their families, 

and their friends. They shared the impact the school has had, and the aspirations they have for their children. The 

stories they shared were intimate and moving with a familiarity of a friend. 

Let me end by talking about Susan, as she perfectly represents what Uganda means to me. By my side throughout 

most of my days in Uganda, she refers to me as her daughter and herself as my African Mama. I am blessed to 

have another mother across the world. She plans our days precisely, but is there to make it work when I want to 

go off the schedule. She is tough in the best way possible, even saying no to me, like, “No Grace, you cannot stick 

your head outside the van in the middle of Kampala with the streets filled like this!” Susan does this purely from 

her heart, her love of people, and her love of her home. And her home is not just her house, and not just country, 

but the entire global health contingent who call upon her when visiting. 

I decided to create my own individualized major in global health at UConn. One of the first papers I wrote on the 

subject was an attempt to understand why the US has undergone a reversal in life expectancy for the first time in 

its history when compared to other Global North nations. A group of Princeton economists noted that the reversal 

is largely due to three factors: opiate overdoses, cirrhosis of the liver, and suicide. They coined the term “deaths 

of despair” to describe this triad. As rich as we are in material goods, we are very poor in community. Uganda, 

on the other hand, is rich in this most important commodity that comes freely. And a sense of community is what 

Uganda has given me. 

Reader Response: 

Bringing Us Back To 

Sanity 

WRITTEN BY DR. CYRUS KAPADIA, MD, FACP, AGAF, PROFESSOR 

EMERITUS OF INTERNAL MEDICINE AT YALE UNIVERSITY 

JUNE 14, 2019 

My eyes were moist as I finished Grace Herrick’s article. It came straight form her heart, and it touched the heart 

of all her readers – of this I am sure. It got me thinking, saying to myself yet one more time: Why can’t we all 

come to the same conclusion, that we are ALL children of God? Surely when He created us he must have felt that it 

would excite us to see some of us black, others brown, yet others with a tinge of yellow and some devoid of color, 

instead of creating us all in the same mold! Alas, imagine His despair and total disbelief at our pettiness in using 

things like color to set us apart. It is the Grace Herricks of the world that hopefully will bring us back to sanity. 

48

Pride and 

Pericardiocentesis 

WRITTEN BY DR. MARCIA GLASS, PROGRAM DIRECTOR AT TULANE 

HOSPICE & PALLIATIVE MEDICINE FELLOWSHIP AND ASSOCIATE 

PROFESSOR OF INTERNAL MEDICINE AT TULANE UNIVERSITY SCHOOL 

OF MEDICINE 

JUNE 22, 2019 

There are no paintings on the walls in the hospitals I have worked at in the capital of Liberia. The bareness of the 

walls parallels the limited equipment I have on hand. Listening to some of these patients, or looking at their X-rays 

without the benefit of modern technology, I get the feeling I am seeing pathology in its most extreme form – the 

way people saw it when the diseases we now treat routinely in the West were first discovered. Listening to the 

sandpaper sound of one man’s pericardial rub, caused by fluid moving around the heart muscle from an infection 

or cancer, I think, “Oh! That’s why we call it a ‘rub!’” Sometimes the challenges of this work, such as helping a 

grandmother survive a simple asthma attack, are rewarding. Other times my co-workers and I face the horror of 

losing a two year-old before we have even made a diagnosis. 

We admit many patients with no obvious source of infection. I treat them with broad-spectrum antibiotics, and 

the young ones usually get better. It is frustrating not knowing what I am treating. There’s always a copy of 

Manson’s Tropical Medicine in my office, but sometimes this information does not help. There is one section which 

says: “diagnosis of splenic disorders in the tropics relies mainly on the astute clinical observations of a practiced 

internist”. Despite seven years as an academic hospitalist in the U.S. and posts with Médicins Sans Frontières and 

other NGOs in Haiti, Liberia, Uganda, Colombia and Ghana, I encounter some patients who make me wish for help 

from a ‘practiced internist’. 

Some cases illustrate how the line between therapy and education often becomes blurred. Pressing on a patient’s 

tender abdomen to ultrasound his kidneys and see the massive cysts inside will not do anything to help him. He 

needs a transplant or dialysis and we cannot do either. But the ultrasound is safe for the patient, fascinating for the 

doctor and may help us recognize this type of disease when we see it again. In this case, the negligible risk to the 

patient seems worth it because of the educational gains. 

Percardiocentesis is a procedure that involves draining fluid from around a patient’s heart and you have to be 

specially credentialed to do so in the U.S., but a non-specialist can do it in Liberia with no supervision as long as he 

can find a needle. Informed consent about our lack of experience is next to impossible with the language barrier, 

so you are left to question: am I doing this to save this man or is he a guinea pig for a western patient back home? 

We should ask this every time we find ourselves in these situations because one can justify almost any procedure 

with “we’re desperate” or “this is the only chance they’ve got.” The problem with that logic is that sometimes the 

best thing you can do for a patient is nothing. In countries with little infrastructure and a limited ability to supervise 

visiting physicians, unethical practices can go unchecked. It is important we expand current international medical 

standards of care and organize regulatory agencies to enforce them. Simply put, there is real need for more 

oversight in all relief work, and in medicine in particular. 

*This post originally appeared in the online UN magazine at: http://www.una.org.uk/content/pride-andpericardiocentesis 

and has also been posted at the HEAL Initiative: https://healinitiative.org/2013/08/01/prideand-pericardiocentesis/ 

49



JUNE 1, 2019 


















The problem is that Uganda has 44 million people with 

52% of them below the age of 15. Ninety-nine percent 

begin school, but half drop out by the age of 18 and many 

move to cities to make a life. Kampala is crowded with 

this age group, most of whom are doing nothing. Stories 

perpetuate the idea that white women are a catch, as once 

you “hook” one, you will flourish in riches. As such, reasons 

for this action include redundancy and trying your luck, as 

one never knows. 

PROFESSOR HARRIET MAYANJA, ASSOCIATE DEAN OF 

MAKERERE UNIVERSITY COLLEGE OF HEALTH SCIENCES 

In terms of how to best handle the situation, I would 

suggest that the participant ignore it and saying nothing. 

I would advise her not to get flustered. Most of these men 

are harmless, and at worst are purse snatchers. However, 

not all women can take this attitude. When one tries to 

respond or even show acknowledgement, it is seen as a 

sign to continue dialogue. But when they get no response, 

they keep trying until they inevitably give up and move on 

to the next person. 

50

I would advise the participant according to the following list: 

1. Continue walking in at least pairs, but ideally a group of 3-4 people. 

2. Keep a purse with small Uganda bills that can be openly flushed, such as to buy newspapers. People always 

peep into purses and if they only see small Uganda notes and loose change, they lose interest. 

3. Behave as Ugandans do. Stop at a street vendor and buy bananas, chewing gum, and mangos, just to 

demonstrate that you are “Uganda wise” and not a “naïve green newcomer.” 

4. See it as a “global learning” episode, and compare it with other cultures that preach speaking with no one and 

ignoring everyone on trains, buses, or on the street. 

A saying in Uganda goes: “If you cannot handle the smoke, get out of the kitchen.” I believe this applies for those 

who really feel nervous about this scenario of living in a town where 80% of the population is below 25 years of 

age, and redundant, and waiting for a “get rich one day miracle.” Bottom line is to stay safe, and the rest is personal 

stamina. 

51

Did You Know That You 

Had It In You? 

JAMIDAH NAKATO, PHD, ASSISTANT LECTURER AT MAKERERE UNIVERSITY 

JULY 5, 2019 

When I was growing up, those around me would often ask, “What do you want to be when you grow up?” This 

question sounded strange in the context of a country characterized by limited resources and a high mortality 

rate. Many of Uganda’s citizens believe in living in the moment and letting tomorrow take care of itself, as they 

understand the many risks out there and the reality that one can die at any time. Having a vision feels futile. 

I had no vision. My usual answer was, “I want to be a lawyer.” 

“Why?” They would ask. 

“Because lawyers are brilliant people that dress sharply and smartly.” 

I knew nothing more than that. Children usually only know about lawyers, doctors, engineers, and the like. On 

receiving the results of my advanced certificate examinations, I was sorely disappointed that I did not score high 

enough to enroll in Law School at Makerere University. I enrolled in an education degree instead. 

Little did I know, life had more to offer. I just had to let myself explore the options that lay beneath the surface. 

While pursuing my undergraduate degree, I vowed to God that I would do whatever it took to make something 

good out of this opportunity that He had given me. My ambition allowed me to graduate with high marks in 

the stipulated time. After rejoicing, I hit the job market hoping to find fast employment. But lo and behold, this 

endeavor turned out to be more difficult than I had thought. My father became concerned watching me walk the 

streets looking for a job to no avail, and asked my uncle who was a director at a bank to counsel me. It is through 

my uncle’s advice that I learned about the opportunity to enroll in a master’s degree program. 

While acquiring my master’s degree, I networked with my lecturers and peers who taught me to be more confident, 

self-driven, and passionate. I became more actively involved in classes and activities. A new me was born. For the 

first time in my tenure as a student, I knew I was destined for greater things. After my master’s graduation, I got 

a job in the Makerere University – Yale University (MUYU) collaboration where everything was new to me. Through 

flexibility and positivity, I was able to hit it off with everyone at work including colleagues and visitors. Through my 

work with this collaboration, I further opened myself to greater opportunities such as travel and new cultures as 

well as management and learning opportunities. In the end, it is through the collaboration that an opportunity to 

pursue doctoral studies arose. 

A few years down the line, I am now a PhD graduate working with Makerere University. At one time, I didn’t know 

I had it in me. By continuing to work with Makerere University, I hope I can inspire those who might not know 

that they have it in them to achieve and make a difference – not only in their lives, but also in the lives of those 

around them. 

52

The Fight For Gender 

Parity 

DR. ANNE DOUGHERTY, ASSISTANT PROFESSOR AT THE UNIVERSITY 

OF VERMONT LARNER COLLEGE OF MEDICINE, AND FOUNDER AND 

DIRECTOR OF THE UVM GLOBAL WOMEN’S HEALTH EDUCATION 

PROGRAM 

JULY 13, 2019 

My focus is on Global Women’s Health, but I also have another role at the University of Vermont Larner College of 

Medicine as the Gender Equity Liaison within the Office of Diversity and Inclusion. This talk brings these two hats 

I wear together in a broad overview. 

First, I am going to go through some statistics really fast to get everyone on the same page. This is the 2019 

reality. The health sector is one of the largest workforces in the world. There are 234 million workers in the health 

and social services sector of which 70% are women. But there is an imbalance in terms of who is leading. It’s led 

predominantly by men. Almost 70% of global health organizations such as the WHO or USAID are headed by men, 

and 80% of board chairs in health care organizations are men. Only 20% of those global health organizations have 

gender parity on the boards, and 25% have parity at the senior management level. This is despite having multiple 

resolutions stating their commitment to gender parity. This is systemic, and gender disparity is only widening. 

Recently, a group of global health advocates coalesced around this topic. The project was an in-depth analysis 

of the state of gender parity and gender equity in global health. The bottom line of this project is to push for the 

narrative to be changed, to push for gender equity both as an end in and of itself as well as a means to an end. The 

final product was a document called Global Health 50/50. The previous statistics come from that report. 

One of the questions is: why have parity? What is the purpose of this work? Is it just for the sake of parity? Is it 

a numbers game that looks good on an annual report? No, it’s not just so you can say 50% of your leadership is 

women. I would posit that the gender inequity in the healthcare workforce is an indicator of a much larger problem 

in global health. 

If we work to achieve parity, what do we get out of this? Again, it’s more than just getting equal numbers. The 

WHO suggests that there are dividends that are “paid out” when you reach gender parity. 

The first dividend is health. It’s very simple. There is a need for expansion of healthcare jobs in order to 

accommodate and achieve universal healthcare and the Sustainable Development Goals by 2030. We cannot do 

this without increasing the number of women involved at all levels. 

Second dividend is gender equality. If you invest in women and their education to gain formal, paid work, this 

will in turn increase women’s empowerment and autonomy, thereby increasing gender equality in society. This is 

a positive feedback loop. 

The third dividend is development. When these newly created jobs are filled, the society is more productive, 

leading to economic growth. 

53

You can see that it is more than just numbers; there are advantages to doing this work. 

When I teach medical students, we talk about why women’s health across the world is poor. We go through 

an exercise in which we dissect the reasons for poor health outcomes in maternal health. We use the “phases 

of delay” model from Thaddeus and Maine. We talk about delays in seeking care, delays in reaching care, and 

delays in accessing adequate care once at a healthcare facility. We talk about why women are dying: post-partum 

hemorrhage, infection, hypertensive disorders of pregnancies, and complications related to abortion. But at the end 

of every single discussion, we come down to the fact that gender inequity underlies lack of access to sexual and 

reproductive health which creates poor health outcomes for women. Mahmoud Fathalla, a former President of the 

International Federation of OB/GYNs (FIGO), said “Woman are not dying because of diseases we can’t treat, they 

are dying because society has yet to make the decision that their lives are worth living.” 

Here is an obvious example. A woman in Afghanistan is laboring at home, and starts bleeding. Her husband is not 

home and she cannot leave the home without permission. She has a female relative with her who will also face 

consequences if she helps the woman leave the home to access health. The woman continues to bleed and dies 

at home. 

Here is a bit more subtle of an example. COPD has always been thought of as a disease of men, particularly 

older men. What we are seeing now, however, is an increasing number of women with COPD, particularity in lowresource 

areas where the rates of smoking among women are fairly low, but the use of biomass fuel and cooking 

in close spaces, or poorly ventilated spaces, is very high. Who’s doing that cooking? There are plenty of examples 

in which women, because of their gender, have exposures to dangerous situation or toxins, such as doing laundry 

in a contaminated river, et cetera. The list could go on. 

While I agree Mahmoud Fathalla, I also think that it is not that simple. Gender intersects with race and socioeconomics 

as well to create poor health outcomes. For example, this is a graph of maternal mortality trends in the U.S. In 

New York City, a black woman has three times the chance of dying during pregnancy and childbirth than a woman 

of any other race. This is regardless of whether that black woman is from the highest wealth quintile or highest 

education quintile. 

Just like in the human body, everything is connected. There is no system that is working in isolation. Chronic 

stress causes activation of cortisol which causes hyperglycemia which causes a damaging effect on the immune 

system. Similarly, women’s health needs to be understood in a dynamic and relational way. The lens through which 

we look at health and gender needs to be intersectional. It needs to include the effects of racism, classism and 

homophobia. 

This is where we stand now. Last month, in a special issue of the Lancet, titled “Gender equality, norms and health,” 

a series of papers detailed the need to acknowledge the role of gender in health outcomes worldwide as well as 

the need for an intersectional lens through which to view gender and health. In one of the editorials, Jocalyn Clark, 

Editor of Lancet Global Health, and Richard Horton, Editor-In-Chief of the Lancet, said “Gender needs to come of 

age in global health: to be firmly feminist, explicitly intersectional and truly global.” This is a powerful statement 

from some really influential people. 

We need now to look at gender equity with a transformative lens. From the Global Health 50/50 report: “We need 

to challenge the underlying causes of gender inequities. Instead of policies that fix women to fit into inequitable 

systems, we need to fix the systems to create decent work for women and close gaps in leadership and pay for 

women.” Women don’t need to change to fit the system. We studied this in academic medicine; it doesn’t work. 

The system needs to be shifted to decrease barriers and allow for equal participation and representation. 

I will leave you with this very simple statement from Melinda Gates who authored a perspective piece in this issue. 

“Our first step is a simple one: we need to stop believing that this is just the way it is.” 

Thank you. 

54

Being Asked to Dance 

DR. MARGARET TANDOH, ASSOCIATE DEAN FOR DIVERSITY & 

INCLUSION, AND ASSISTANT PROFESSOR OF SURGERY AT UVMLCOM 

JULY 20, 2019 

Good afternoon everyone. My name is Margaret Tandoh. I’m the Associate Dean for Diversity and Inclusion at 

the University of Vermont Larner College of Medicine. I am also trained as a trauma surgeon. When people hear 

“diversity and inclusion,” they often shiver. I’ve been in this role for about seven years and I like to think about 

diversity in terms of the best analogy I have heard: that diversity is not just being invited to the middle school 

dance, but being at the dance, sitting in the corner, and being asked to dance. Someone went on to say that 

cultural competence or cultural humility is knowing the steps to the dance. When you hear “diversity inclusion,” 

it’s not just about race and gender. 

Diversity in global health is interesting. I found an editorial that I thought was very interesting in the Journal of 

Policy and Health Planning. It discussed the predominance of northern voices in the discussion of global health 

around the world. One of the examples given is in looking at all the lands of commission of which seventy percent 

have all elite northern leaders. Yet only fifteen percent of the world’s population lives in high-income countries 

while the rest of us live in low- and middle-income countries. 

How do we include those voices? I find it is very interesting that only six of the Consortium of Universities of Global 

Health board members come from the Global South. The article also referred to the Ebola crisis as an example of 

how northerners and the elite did not listen to those on-the-ground, and as a result, the crisis blossomed lasted a 

lot longer than it should have. 

How can we change the narrative? How do we become more inclusive? The excuse is that low- and middle-income 

countries just don’t have the technical knowledge. But it is just not enough. The practical steps they give is first, 

be more deliberate. Establish codes of conduct for these boards and commissions. Include more people from 

the Global South. Instead of holding global meetings in the Global North, host some in low- and middle-income 

countries. You have top global health journals that never have writers from the Global South. Include them. We 

must understand that diversity is more than just representation. You have to be on-the-ground working and also 

thinking about changing the way things are being done. 

55

The Value of Seemingly 

Simple Skills 

DR. ZHOU LI, MEDICAL RESIDENT AT NORWALK HOSPITAL 

JULY 26, 2019 

Due to a shortage of doctors and large patient volume, the MDs here are well-rounded with superb hands-on skills 

in all procedures. Even senior medical students in their sixth (final) year – called “externs” – regularly handle 

procedures that are usually designated to specialists in North America, such as endotracheal intubation, and even 

perform simple surgeries such as Cesarean sections or appendectomies as the only surgeon, as opposed to the 

first assistant! Not surprisingly, hematologists perform their own bone marrow biopsies and nephrologists put in 

hemodialysis catheters for their patients. Interventional radiologists do not work here! In fact, I am not sure if they 

exist in Thailand. 

Coming from the United States where all specialties are becoming increasingly sub-specialized and internists are 

rather hands-off while most invasive procedures are taken over by interventional radiologists, I actually wish I 

could train and work in Thailand in order to hone my procedural skills and become as capable as the Thai MDs or 

older generation of American physicians. 

One thing I know for sure is that I cannot help but feel ashamed when a Thai medical student, anesthetic nurse, or 

paramedic can intubate while I cannot. How can I be a doctor when I have never had the opportunity or training for 

procedures such as intubation, lumbar puncture, or thoracentesis? These are just a few of the procedures I never 

had a chance to learn or practice enough to be good at. 

To be honest, I know most of my fellow residents do not know how to put in peripheral IVs. Skills like these are 

simply lost when our nurses take care of them, and when they cannot, they come not to us but to the resource 

nurses. When the resource nurses also fail, we simply order peripherally inserted central catheter (PICC) lines 

to be done by an interventional radiologist. Similar is getting arterial-blood gas analyses (ABGs) and managing 

ventilators. With respiratory therapists in North America, we MDs don’t have to do these seemingly mechanical 

tasks anymore. But for Thai doctors, after they intubate their patients, they are the ones setting up the ventilator 

and later adjusting the settings. 

The last time I performed an ABG was probably a year ago, and I only got to do it because the respiratory therapist 

took a long time to show up to the patient’s bedside. Fortunately, I knew how to get an ABG, but again I know 

many of my colleagues do not or are not good at it. I think there will be situations in which this loss of hands-on 

skills by many of us in the U.S. due to overwhelmingly good auxiliary support system or birth of numerous other 

health-related specialties may actually hurt patient care. 

56

Dr. Li Zhou with Global Health Program participants of global health and Thai faculty 

I clearly remember, as a medical student rotating in the U.S., witnessing a resuscitation where the patient did not 

have a peripheral IV. Nobody at the scene was able to put one in, so they proceeded to attempt a central line blind 

in the middle of the code. This was when I realized even seemingly simple skills such as peripheral IV access is 

important, despite everyone telling me it’s a useless skill if I end up working in the U.S. 

This is one of the main reasons I am interested in global health. I yearn for the opportunity to learn intubation, 

to run ventilators on my own, to learn everything that a Western medical education and training, despite its 

greatness, failed to teach me. 

57



AUGUST 2, 2019 


















For those of us who live in these settings, we keep a straight 

face and pretend not to hear these comments. I am not sure 

how we can make this participant feel more comfortable, 

as this will happen from time to time. However, it does not 

necessarily mean she will be physically accosted. I suppose 

she will need to make sure she is in the company of trusted 

locals when walking. I wonder how her local friends would 

respond to these comments. I would like to think they 

could “tell off” the perpetrators in their own way and in 

their own language, i.e. to tell them to stop harassing the 

visitor. I am sure that must be doable. Is it possible to 

change the route they will be using to walk to and from the 

hospital as to try and avoid the people who are harassing 

her? I ask because there may be an area with “street kids/ 

vendors” who have nothing to do other than harass people 

that are obviously visitors. 

PROFESSOR CHIRATIDZO E NDHLOVU, MMED SCI (CLIN 

EPI), FRCP, SPECIALIST PHYSICIAN & NEPHROLOGIST 

AT THE UNIVERSITY OF ZIMBABWE COLLEGE OF HEALTH 

SCIENCES 

I think keeping a straight face and looking “unfazed” by 

these remarks may make them stop. I suppose there is 

58

that saying that if you cannot change something then change your attitude to it! 

I do feel sorry for her as this is something she will face in a lot of our countries. Sexual harassment is real. We also 

get “catcalls,” but we have learned to ignore some of these issues. She should not allow them to see that she is 

scared! Otherwise it will not stop. 

I hope this helps, but you may end up needing to evacuate her if she is traumatized by this experience. 

This situation sounds very unfortunate indeed. I would like 

to believe that it’s not a common occurrence, and I hope 

it does not discourage the participant from pursuing their 

work! 

I wonder how often this has happened, and whether she 

has discussed the circumstances of the incident with the 

local support team(s) and sought their guidance? 

RHODA WANYENZE, 

PROFESSOR AND DEAN, MAKERERE UNIVERSITY 

SCHOOL OF PUBLIC HEALTH 

59

A Positive Aura 

JOSE CALDERON, UVMLCOM CLASS OF 2022 

AUGUST 9, 2019 

Even if I had the option of a warm shower, I wouldn’t do it. Cold showers are best given the climate here in the 

Dominican Republic. It’s a lovely home where we’re staying, and the best part is the host family and how welcome 

they make us feel. This past Sunday we attended Zoe’s (my host families’ granddaughter) fourth birthday party. It 

was a Beauty and the Beast theme and it was lovely. It reminded me of all the Spanish birthday parties that I’ve 

been to and I was glad I got to sing along as they wished her a happy birthday. 

My main experience with the local people has been through medical home visits, which we perform mainly for 

the elderly and those who physically cannot make it to the community clinic. I’ve met with Clara, an 87-year-old 

patient who suffers from malnutrition. Yet despite her fragile body and apparent weakness, she does everything on 

her own. She cooks, cleans, and takes care of all household responsibilities with a smile on her face. 

I’ve also met Miguela, an 85-year-old patient with what appeared to be woody edema on her legs. She has suffered 

occasional depressive episodes, and her struggle to walk around the house has led to many falls. Despite it all, 

she received us with a bright smile as soon as we walked in the house. There was this positive aura about her that 

made me feel an instant connection with her. Maybe she reminded me of my own grandma, who despite her own 

personal medical issues is a constant source of positive energy for the entire family. 

I also reflect on another patient with diagnosed sensorimotor polyneuropathy and sickle cell disease. Discussing 

the illness and social history with the patient made me reflect on how difficult it is to live with debilitating conditions 

in a resource-limited setting. She was abruptly laid off because of her progressive neurological symptoms, forcing 

her to take a much lower-paying job at a local lottery ticket booth. Widowed and with two children at home, she 

had very little options. 

Street conditions don’t make it easy for her walks. A cane will only help her to a certain extent as she is forced to 

stagger across rocky and uneven roads. The medical system of ordering supplies is backlogged and often times 

goes unfulfilled. I suspect her symptoms will become more severe and she will relapse back to a depressive state, 

though I truly hope not. 

Outside the clinic the island is absolutely beautiful. La Plaza Colonial in Santo Domingo has such a rich history. I 

also had an opportunity to take a five-hour bus drive to Cabarete and Sosua just North of the country where I had 

my share of seafood, coconut, and other Caribbean delicacies that made the trip worthwhile. 

I’m also happy to state that I am back to my original shade of brown. 

60

Pilgrimage to the 

Land of Galaxies and 

Glaciers: Part I 

DR. MAJID SADIGH ON A CLIMB TO KILIMANJARO’S PEAK 

AUGUST 17, 2019 

This post is the first of a series of reflections on climbing Mount Kilimanjaro as told in an interview 

with Dr. Majid Sadigh. 

My first climb up Kilimanjaro in 2002 was driven by the memory of my father, as well as a desire to experience 

walking into thin air, seeing the 22,000-year-old glaciers, and appreciating the diversity of life and ecosystems on 

the roof of Africa. Though the inspiration behind my two most recent climbs has been to gather money and build 

awareness about global health issues – with last year’s hike raising funds for a microbiology lab in rural Uganda, 

and this year’s for the global health training of nurses – my time on the mountain is deeply personal. The mountain 

puts me through trials of bitter cold and restless sleep, pushing me to my last ounce of strength, but it also builds 

me up. Whatever internal struggles surface, I am able to construct a sense of purpose and preserve it with layers 

of courage that allow it to survive when I return to reality and away from this life force. 

Having grown up in mountainous Iran, mountains have always felt like home for me, and it had long been a dream 

of mine to share this love with my children. This dream first manifested over ten years ago when the three of us, 

along with one of my sons, Keyvan, traveled to Mt. Kenya together. Though I ended up descending on summit 

day with Mitra when she developed altitude sickness symptoms, the time we all shared together was incredibly 

meaningful. Given that the best predictor of mountain sickness is a history of having the condition, I was concerned 

about Mitra making this climb. Meanwhile, my elder daughter Katrin has Raynaud’s disease, a condition in which 

distal arterioles constrict in the cold. In unfortunate cases, the tips of fingers, toes, nose, and ears may be lost. 

In light of these concerns, I could not stay home as my daughters ventured on this undertaking. Thus, another 

motivation was the need to be beside them both to care for them and share Kilimanjaro’s beauty and lessons. 

Among the many teachings the mountain gifts us with, and a motivation for each climb, is the reminder that health 

is a privilege. The last ascent starts at Barafu camp around midnight, and involves fifteen hours of continuous 

challenge up the steep climb to Uhuru peak first through the dark and then under the embrace of sunrise. During 

last year’s climb in particular, I struggled through this stretch with chest tightness and pain, severe exhaustion, 

shortness of breath, and headache, as well as body and joint pain. Undergoing this wide spectrum of discomfort 

reminded me of the discomfort of patients, be they in the hospital, clinic, or emergency room. I returned home 

with heightened empathy and care toward patient’s conditions and complaints, and a greater motivation to help 

ease their discomforts. 

Stepping into the dead zone where everything is barren feels like setting foot on the moon. Surrounded by rocks, 

dust, and lava without any sign of life, the body struggles as the boundary fragile boundary between health and 

61

Dr. Majid Sadigh (left) with a Kilimanjaro guide, taking in the view of Mawenzi peak at Stella’s Point before venturing the 

final stretch to Uhuru 

illness is revealed. Furthermore, the transition from the bottom of the mountain that is rife with a miraculous 

diversity of life up into thin air where life barely subsists reminds us of the close tie between life and oxygen supply. 

It reminds us of the care we owe Mother Nature, and the reality that we rely on other life to survive. I leave the 

mountain with a renewed commitment to the basic principle of the One Health movement: that the health of the 

environment, other life forms, and human beings are inextricable. 

Finally, the inspiration for every ascent that carries me through to the next climb is the spiritual experience of, 

along with each step, looking up at the line of headlamps lighting the path like candles to a sacred temple; the tacit 

solidarity of each individual blending into the group as it makes the pilgrimage to the peak as one unified organism. 

62

Stepping With Light: Part I 

A view of Mawenzi peak shortly before sunrise 

MITRA SADIGH ON A CLIMB TO KILIMANJARO’S PEAK 

AUGUST 24, 2019 

Inhale, right foot, left pole. Exhale, left foot, right pole. Inhale, head up toward the universe. Heart spins 

contemplating each set of eyes that has looked up and surrendered to her bright love. Exhale, visible breath. Heart 

sinks. She holds this love faithfully each night despite our choice to build a world that overpowers her with artificial 

lights and sometimes, artificial care. I contemplate her tragic fall from irreverent muse of myths and legends into 

obsolescence, a star fallen into deep shadow where few know where to find her. 

Inhale, right foot, left pole. Exhale, left foot, right pole. Inhale, head up toward the universe. Heart elates. Spirit 

swells. To behold the luminescent power of this ancient, penultimate dancer who arches over the midnight stage 

with each setting sun, her breath heaving as she thrusts herself most elegantly from one side to the other with 

such spirit that inspired stars propel themselves in tandem. The birth of the shooting star. 

There are many paths up a mountain. Pole pole, slowly slowly, is the path up this one as told by the wisdom of 

Kilimanjaro’s people. This gives the body time and space to adjust as it rises steep into the air where nothing lives, 

but everything dreams. It also permits the spirit to be alive in every capacity and in every moment. 

Inhale, pain. Exhale, pain. A quake pulses through my skull and radiates current outwards like tentacles from its 

epicenter slightly right to my temple. The stars echo under my eyelids and for a few moments, it is difficult to see. 

I imagine the tension exiting through the parting of my lips, but it only accumulates. Inhale, a surge of nausea. 

Exhale, swallow as the surge retreats. Breathe. Ground into my feet. 

Remember me, and I will light the way up to this summit or any other, she tells me with stars shooting like 

telepathic messengers. 

I surrender to her white light. Inhale, gratitude. Exhale, gratitude. Inhale, gratitude. Exhale, whisper for every 

being to feel the freedom I do in this moment, at least for a moment. 

Inhale, right foot, left pole. Exhale, left foot, right pole. The seen, heard, and felt rhythmic synchronicity with the 

steps of my father who has trekked this ascent several times before. My father whose steps led me into this world, 

and lead me now to a land I have neither felt nor seen: the land of glaciers and galaxies. 

63

Safety in Global Health: 

Don’t Be blinded 

STEPHEN J. SCHOLAND, M.D. ASSOCIATE DIRECTOR OF GLOBAL HEALTH 

AUGUST 30, 2019 

It was quite late in the evening, and I was walking alone in a crowded urban market. It wasn’t the best area of 

town, but I needed to do some last minute souvenir shopping for my loved ones at home. I thought of their interest 

and enjoyment in receiving some beautiful and unique handicrafts from local artisans. 

Admittedly my focus was elsewhere. I headed towards a pedicab, a bicycle powered contraption with sidecar, 

enveloped in a tough vinyl shell. As I entered, I heard a shrill whistle, which sprung me from my shopping revere. 

I was weighed down with a few shopping bags, but now as I slid into the pedicab, I realized in essence I was 

‘trapped’ by a sinewy looking passenger who blocked my only exit. The whistle was to alert some unknown and 

unseen accomplices in the crime that was unfolding. Adrenaline shot through my circulation. “Give me your wallet” 

the man said in broken English. I could not go forward, I could not go backwards, I could not get out. I was 

trapped! I pretended I didn’t understand what he was saying, so I asked him to repeat – “what”? It gave me a few 

milliseconds more to think. ‘What if he pulled a knife’, ‘what if he took my cell phone’, ‘what about all these gifts I 

just bought for my family and friends’? 

The man hissed again, “Give me your wallet” My mind raced, but my body was trapped in the pedicab ‘how can 

I escape’, ‘should I fight’, ‘what if he resorts to violence’? Realizing the futility of the situation, I handed over my 

wallet. He withdrew all the cash and handed it back to me, before he slipped out the door. Before I could breathe 

a sigh of relief, a hand snaked back and snatched the glasses off my face– effectively blinding me and ensuring his 

successful escape. I could not run after him, not that I would want to given my situation. 

I was very relieved not to have been a more hapless victim… In fact, I still held onto my priceless cell phone, and 

a sack full of souvenirs. Most importantly I was physically unharmed, it might have been different… 

Looking back, I realized I violated several cardinal rules of safety: 

1. Never travel alone 

2. Be careful going out at night 

3. Maintain critical awareness of your surroundings 

Attention to these basic principles is important, and our Global Health program takes safety extremely seriously. 

Make sure to think about your own safety and review safety protocols prior to your global health experiences. 

64

Five Years Later 

DR. ALBERT TRONDIN, GLOBAL HEALTH PROGRAM ALUMNI, PGY-4 IN 

NEUROSURGERY IN SAN CARLOS CLINICAL HOSPITAL, MADRID, SPAIN 

SEPTEMBER 7, 2019 

My overwhelming gratitude to the Global Health Program manifests in a strong desire to “pay it forward.” The 

program motivated me to develop the tools needed to help others in a meaningful way. After completing my 

medical training and specialty in neurosurgery in Russia, I had the fortune of participating in a six-week global 

health elective in Uganda just before applying for a residency in 2014. The elective was a transformative, eyeopening 

experience. Looking back, it not only helped me pass the forthcoming entrance examination, but also gave 

me the courage to attempt it. 

After undergoing the selection process and two-week pre-departure orientation, my colleagues and I landed in 

Uganda with a strong sense of mission: a responsibility to work hard and perform well. Though we initially felt 

as if we were submerging into an exotic dream-like world, we gradually awoke from dreams and into reality. The 

program was multidimensional in every respect, involving an impressive scope of elements including curriculum 

and training in internal medicine, infectious diseases, biostatistics; entanglements with ethical issues and cultural 

interplay; exposure to a network of new people and ideas; novel perspectives of collaboration and teamwork; and 

pure professional development. I spent most of my time in the Neurosurgery Department of Mulago Hospital, but 

also visited Cure Hospital, a facility in Mbale that specializes in neurosurgical problems. Because neurosurgery is 

one of the most-needed specialities in the Global South, I want to use my skills as a specialist to contribute as 

much as I can. 

The Global Health Program and the density of experiences it provides is a gift. My colleagues and I all feel that the 

only way of expressing our gratitude is to help those around us. The sense of responsibility we felt on the elective 

has carried over from the humanistic work we observed into the humanistic work to which we are now committed. 

That deep sense of connection drives us forward. 

65

This Week I Met 

Anthony 

JOSE CALDERON, UVMLCOM CLASS OF 2022 


This week I met Anthony. I didn’t meet him at the hospital or clinic, but beachside as I enjoyed a cold Corona 

and delicious seafood paella. Although it was August, Anthony was selling heart-shaped Valentine’s Day-themed 

lollipops. I watched him go to each dining table one by one, only to be rejected what seemed to be nine out of ten 

times. When he reached my table, instead of just buying the lollipop for 25 cents, I asked if he was hungry and 

would like to join us for dinner. He was shy at first and politely declined the invitation, but eventually sat down and 

joined me after I said the food was entirely way too much for me to eat on my own. 

I learned that Anthony is fourteen years old, lives with his mother 

and grandmother, and doesn’t know much about his father. I 

learned that he works twelve-hour days, from 9 am to 9 pm. I 

learned that he makes on average four USD a day, two-thirds of 

which goes to his family. I learned that right now he’s working a 

little extra because he has to buy school supplies since classes will 

begin shortly. 

I learned that Anthony doesn’t want to sell lollipops his whole life. 

When I asked what he wanted to study when he grows up, he said 

dentistry and possibly photography. I encouraged him to follow his 

dreams and told him I was proud of him. In this short meal, I not 

only learned that Anthony was hungry but too shy to admit it, but 

I also learned about his life and personal struggles. He reminded 

me of the times when I myself went door-to-door asking people if I 

could cut their yard for a few bucks, as I needed new shoes before 

school started and this was my only option. I was also fourteen. 

Anthony is another constant reminder to value what I have. I hope 

everything works out for him. 

66

The Gate 

ISAAC DE LA BRUERE, UVMLCOM CLASS OF 2022 


I am 63 years old 

If you asked me, I would say that I am happy 

I have friends 

A new family 

A gate. 

I pick mangoes with my neighbors 

And we help each other cook meals 

We play cards 

And gamble with rambutans 

Behind the gate. 

We yell at the futbol players on the old tv during matches at lunch 

And sit together as the sun turns the treetops to gold 

I help some of the older residents walk home in the dark 

And say good night when it gets late 

Sometimes 

Before sleep claims me 

I remember my mother 

And how she looked at the floor when my father told me I had to leave 

I was 18 

When I became a leper 

And first saw the gate. 

During the day I miss my fingers 

And try to recall the ease of twisting a door knob 

But at night I remember her 

And try to recall the feeling 

Of my mother’s arms around me 

On the other side of the gate. 

67

This poem came to me after our visit to the Phud Hong Leprosy Community near our town in Thailand. It was 

an incredibly powerful experience to see how its members have adapted to life within their community. All the 

residents are elderly, as there have been very few new cases of leprosy in the region in the last couple of decades. 

Many members have been there for the past forty years, sharing with us stories about how they were isolated and 

cast out from their families and communities when they were first diagnosed. It is a disease with a terrible stigma, 

especially back in the 1960s and 1970s when many of the people we spoke with first contracted it. 

For many years, members of the Phud Hong community were not allowed to interact freely with the surrounding 

town, and very few people came to visit them. Today, however, modern medication has eradicated the bacteria 

from their bodies and made them non-contagious, allowing them to come and go as they please. Many, however, 

have found that they still prefer life within their community compared to the outside world. I wrote this poem from 

the imagined perspective of an older member in the late 1990s or early 2000s when the community was still gated, 

and based on some of the testimony we heard during our visit. 

In Thailand, the family unit comprises an extremely strong bond. Having that broken, as some members described 

to us, and being disowned by the very people that are supposed to love and support you unconditionally is 

something that really hit home for me. I first imagined rage and fury as the predominant emotions. But many 

members spoke of feeling an indescribable sadness rather than anger. Here, I’ve imagined what someone who 

has gone through this thinks about when they are alone with their thoughts at night, and the emotional rigidity of 

daytime gives way to the melancholy cover of darkness. 

Click here for a documentary by film maker Forough Farrokhzad about leprosy. 

https://youtu.be/cpZ9stU_O7E 

68


Health: Navigating Cross-Cultural 

Boundaries 









During a hotel stay in a crowded urban city, a global health participant notices that an older man, presumably a 

tourist, is in persistent pursuit of the receptionist who is a young female. Each time the participant enters the lobby, 

she sees the tourist making inappropriate advances toward the receptionist despite her clear yet polite discomfort. 

One particularly late and quiet night, the participant notices that the receptionist is working alone in the lobby, and 

the tourist is getting noticeably close. The participant considers asking the receptionist, in private, whether she is 

uncomfortable, but the tourist is so persistent that she is unable to encounter the receptionist alone. 

Being a young female who is aware of the sex tourism industry in urban cities around the world but is unsure of 

cultural expectations, the participant wants to help but doesn’t know how. She is concerned for the receptionist’s 

welfare, but is simultaneously afraid of angering the tourist or making the receptionist more uncomfortable. 

I would suggest no action. The receptionist and the country know the 

potential risks that are present in any country. The receptionist most likely 

knows how to handle such scenarios, and the hotel most likely has cameras 

or secret emergency buttons or other related plans. Since there was no 

physical acousting, I do not think it’s in order for another guest to come in 

at that stage. A person has a right to approach and talk to another adult. 

As long as this does not lead to unwanted physical interaction, I assume the 

adult approached can decline – and hopefully that’s it. A person can persist 

in the hope that the other party may change their mind, and again with no 

physical contact it’s okay. 

PROFESSOR HARRIET MAYANJA, 

PREVIOUS DEAN OF MAKERERE 


Also, the receptionist may have been uncomfortable with the student guest 

looking on more than the person approaching her. Therefore, I suggest doing 

nothing unless there seems to be unwanted physical contact. In that case, 

a third party can politely intervene and indicate that the woman seems to 

have clearly declined. 

69

DR. STEPHEN WINTER, SENIOR 

ADVISOR FOR THE UVMLCOM/ 

WCHN GLOBAL HEALTH 

PROGRAM 

First, I think it is problematic for the participant to take action of any sort 

without the knowledge and acquiescence of the receptionist. Failing to 

understand the local culture and power dynamics between paying tourists 

and employed staff, the participant may inadvertently create a situation 

that puts the receptionist at peril of losing her job if a conflict is created 

that sets the word of the receptionist against that of the tourist and results 

in her termination from employment when the tourist turns the table to 

accuse the receptionist of initiating sexually inviting behavior. In a similar 

vein, for the participant to confront the tourists could also lead to unintended 

consequences of causing harm to the receptionist from the tourist eager to 

deflect blame to her. 

I believe the participant should make a special effort to to have a private 

conversation with the receptionist. Once she has established privacy, she 

should engage the receptionist and tell her that she is concerned about the 

situation and explain that with the permission of the receptionist, she plans 

to discuss her concerns with the hotel manager. This will give the receptionist 

an opportunity to embrace or refuse the involvement of the participant. I 

suspect that the situation being observed by the participant is not an unusual 

problem for a young female receptionist in a hotel catering to western 

tourists, and the show of polite discomfort may be part of her strategy 

for defusing the situation on her own. The ability to independently handle 

this sort of situation may be part of the expectations for her job. Unwanted 

intervention by the participant could result in the worst possible outcome, 

the loss of a job that supports an entire extended family. 

70

No Such Thing As Equal 

Opportunity 

KAYSHA RIBAO, AMERICAN UNIVERSITY OF THE CARIBBEAN SCHOOL OF 

MEDICINE, CLASS OF 2020 

OCTOBER 4, 2019 

The red dust is everywhere: on skin and clothes, in the car and the air. Despite the rain last night, today was 

particularly dusty as we partook in another Family Planning Outreach event. Although we started in late afternoon 

instead of our regular morning start time, I began to understand why. It was the beginning of farming season, 

which means women work until late afternoon before returning home to complete chores. With farming composing 

their main livelihood, it was pertinent that we work around their schedule. 

Communication is key to any event, and Ugandan social media includes 

loud speakers and lively music. As we sat on the grass under the tree 

as our advertisement played in the small village, I spoke to Charity, a 

security guard at ACCESS who had joined us. She described her dream 

of becoming a nurse, and the reality that she could not afford the school 

fees, especially with five siblings. Costs (1 USD = 3,600 shillings) include 

200,000 shillings for primary school, 300,000 shillings for secondary 

school, and 500,000 for university, not to mention the meager income 

for each family. She believes it is her responsibility to pass her dreams on 

to her younger siblings and support them in their endeavors. According 

to Deo, our driver, there is no such thing as loans in Uganda. It was then 

clear to me that there is no such thing as equal opportunity. 

Kaysha Ribao with Ahja Steele, medical 

student at Ross University School 

of Medicine, and James Ssewanyana, 

primary clinician at ACCESS Life Care 

Center as well as Co-Founder and 

Deputy Executive Director at ACCESS 

As I make my way through Paul Farmer’s Pathology of Power, things are 

starting to make sense. Poverty is essentially the cause of the injustices 

I observe, as lack of resources push individuals to vulnerable situations 

in order to simply survive. Poverty excludes the poor from receiving an 

education, which is essential for finding a stable job and having influence 

in the community. It leaves individuals malnourished, which renders them 

vulnerable to sickness and disease. The village children caught my eye as 

they ran around playing and taking care of each other with muddy bare 

feet, yellow snot, and dirty clothes that barely covered their thin bodies. 

These observations make me feel helpless and frustrated. As a systemic 

issue, poverty requires a systemic solution. Poverty pushes the poor to 

the point of anger or despair, leading to political upheaval and eventually 

civil war. War brings on violence, which further exacerbates human right 

violations – sexual assault, torture, displacement, and hunger. Deo 

explained that the war in Uganda left him orphaned, but that he was 

cared for by relatives, bringing meaning to the phrase “it takes a village 

to raise a child.” However, many others were not so lucky. 

71

We Are In This Together 

IRENE SUE, UNIVERSITY OF VERMONT LARNER COLLEGE OF MEDICINE 

CLASS OF 2022 


She lies there in a corner of a ward reserved for adult female patients, clad in a beautiful red embroidered cloth, 

the fabric rising and falling, following the uneven rhythm of her labored breathing. Her concerned daughter looms 

closely nearby, next to the oxygen tank which has not seemed to help, anxiously awaiting Dr. Lenard Okello’s 

instructions as he begins presenting the patient. 

— 

St. Stephen’s Eddwaliro boasts of services including surgery (theater), general medical, dental, laboratory, radiology, 

maternity health, and family planning. There are two wards which, segregated by gender, contain beds partitioned 

by thick, heavy, purple and white curtains embroidered with “SSMH.” There are also four private rooms tucked 

deep within the compound. An x-ray and an ultrasound machine man the radiology department.Phlebotomy and 

laboratory are abut each other, parted by a thin wall, the former occupied by a lone chair and centrifuge machine 

flimsily situated on the floor, and the latter a narrow, cramped working surface on which stands a light microscope 

and an outdated-looking machine apparently designed to analyze blood samples. The results are transmitted to an 

adjacent printer that resembles a slight step-up from conventional typewriters. These rooms, including the theater, 

are ventilated by one or two windows which are never closed to the outside world, buzzing with flies, fruit flies, 

dragonflies, mosquitoes, and various other aflight creatures about which I am somewhat afraid to learn. 

Yet sometimes learning is not a choice, but an inevitability. I have learned that Ugandans speak rather softly, 

especially the women, as they are expected. Autonomy is not prioritized as a fundamental ethical pillar, as we have 

been taught in texts and classrooms. Within a consult room, patients are uninvolved with the decision-making. 

In fact, they are often silent, delegating the clinical reasoning and entrusting their healthcare decisions entirely 

in the hands of the clinician across from whom they are sitting. Privacy is not the cardinal rule; rooms are often 

entered into and left without minding the metal doors which clang so very often and so very loudly, obscuring any 

conversation my colleagues and I are straining to hear. 

The hours stalk, instead of sprint. Rounding through the wards seems to move slowly and lightly. Conversations 

are carried out in hushed tones and without much eye contact, though a reassuring smile and/or some physical 

touch are sometimes dispensed by the clinician. As I stand with Amelia and Andrew by the patient mentioned 

above, I begin to wonder at Dr. Okello’s furrowed brows. The next steps seemed apparent (disregarding my highly, 

extremely limited medical knowledge and experience, of course): fluids, another comprehensive metabolic panel 

and complete blood count, as well as a hemoglobin A1c and arterial blood gas. 

One key piece of information to which I am not privy at the time is that all tests and procedures, as well as the 

length of hospital stay, are, due to lack of any insurance infrastructure, paid out of pocket. Patients and their 

family members are often required to secure funds from other family members, friends, and individuals from 

72

Irene Sue with Amelia Anderson, UVMLCOM ’22, and hospital staff at 

Saint Stephen’s Hospital 

Irene Sue with Samuel and Christine Luboga and their daughter 

the community in order to obtain necessary 

medical interventions for their loved ones. 

Each action is weighed with precise costbenefit 

analysis. Bare necessities must be 

considered, and nothing is done until the 

funds are firmly situated in the cash register. 

I also wonder about the consequences of 

such delays. So much of medicine is timedependent. 

Do diseases and disasters and 

boda boda accidents slow down for Ugandan 

time? 

The daughter’s vigilance always inspires a 

smile in those early mornings. She is always 

there, and one day she brings her son to 

visit his grandmother. While I stand next to 

a medical student from Makerere University 

as we clean and dress the patient’s wounds 

on her right lower extremity, I learn that 

the daughter has recently traveled to China, 

and that her mother fell ill shortly after her 

return. I learn that she is in the agricultural 

business, and that the grandson is a graphic 

designer who bears an ambition of going 

abroad and further honing his skills in the 

industry. I learn that a particular male 

nurse who works in the facility interprets a 

woman’s act of wearing lipstick as a sign of 

“stay away, do not kiss me.” 

The most important and ubiquitous factoid 

I learn from the wards is that despite their 

“limited” (from the perspective of a U.S. 

medical student) resources, the hospital 

staff¾ including the medical officers, medical 

students, nurses, and ancillary members as 

well as patients and their family/friends all 

come together and collaborate in not only 

ensuring that the patients are as well as 

possible with the level of comfort and care 

they can receive, but also put a smile on 

each other in the knowledge that “we are in 

this together.” 

73

Week Two at Walailak 

University 

COLLIN MONTGOMERY, UNIVERSITY OF VERMONT LARNER COLLEGE OF 

MEDICINE CLASS OF 2022 


Week two really saw us begin to get down 

to business with Walailak University. On 

Monday, we toured the university campus 

and enjoyed a welcoming reception with 

the Office of International Relations, where 

we had the opportunity to meet a group of 

French medical students, which was really 

nice. On Tuesday, we took part in a Problem- 

Based Learning exercise with Walailak 

medical students, which served as a 

fantastic review of hypersensitivity reactions 

and contact dermatitis! Wednesday entailed 

an experience in an outpatient clinic with 

a family medicine physician. I was blown 

away by the speed with which the doctors 

here have to work – we saw more than 

fifteen patients in about two hours and 

fifteen minutes. On Thursday, we went to 

Collin Montgomery ’22 with fellow Global Health Program participants 

the community hospital in Tha Sala and 

shadowed in the Tuberculosis Clinic. Finally, 

I spent Friday in psychiatry to observe electroconvulsive therapy, nephrology rounds to learn about dialysis, and 

then pediatrics where I had an absolutely amazing time seeing many patients with dengue and shadowing in the 

Neonatal Intensive Care Unit. 

Meanwhile, Thai hospitality continues to impress me. Everyone we have interfaced with – students, nurses, doctors, 

administrators, restaurant owners, etc – seems to have a genuine interest in ensuring that we have an educational, 

enjoyable, and fruitful experience in Thailand. They all have a tremendous amount of pride in their community and 

serious goals about what they want for the future of Walailak University. Almost every night, students have offered 

to take us to the market and out to dinner, and help us plan out weekend trips, all with the utmost sincerity. One 

could be forgiven for thinking that maybe they are just pulling out all the stops because we are the first group from 

UVM and they want to ensure that the program can continue for years to come; however, the interactions do not 

feel forced. We get along with the students and faculty incredibly well, and it just feels like going to dinner and the 

market with old friends. 

74

Two other things from this week have made a significant impression on me. First, the general practitioners at Tha 

Sala Community Hospital are responsible for an incredible amount. For example, one general practitioner’s (GP) 

weekly schedule entailed filling in for the psychiatrist for two full days performing electroconvulsive therapy and 

managing patients with major depressive disorder, schizophrenia, and substance use disorder. After filling in on 

psychiatry, the GP spent a day in the operating room before rounding out the week with a day on internal medicine 

and another day on “float.” I am having a difficult time wrapping my head around the amount that each GP must 

know and how comfortable they need to be doing such a variety of things. 

Second, the community hospital has an entire wing dedicated to traditional Thai medicine. It is incredibly enlightening 

to see how different Thais look at traditional medicine compared to Americans. Traditional Thai medicine is literally 

integrated into the community hospital where patients can receive oil, foot, therapeutic, and traditional Thai 

massage, cupping therapy, acupuncture, and herbal teas and supplements. The masseuses go to school for four 

years to get certified in Thai Massage. I am hoping to learn more about what they learn and some of the philosophy 

of traditional Thai medicine. 

75

Capacity Building in 

Vietnam: A Moment of 

Recognition 

DR. MAJID SADIGH, TREFZ FAMILY ENDOWED CHAIR IN GLOBAL HEALTH 

AT NUVANCE HEALTH AND DIRECTOR OF GLOBAL HEALTH AT THE 

UNIVERSITY OF VERMONT LARNER COLLEGE OF MEDICINE 


While walking through the Intensive Care Unit (ICU) and Pulmonary Department of Cho Ray Hospital in Ho Chi 

Minh City during my most recent trip to Vietnam, I was struck by the quality improvement in clinical services 

and medical education initiated by our Global Health Scholars. Similar to those I have previously noticed in the 

Infectious Disease ward, these changes are a reflection of Global Health Scholars’ experiences in WCHN hospitals 

and the Global Health Program’s emphasis on capacity building of human resources. So far, twenty-four physicians 

from Cho Ray Hospital have completed three to six months of training at WCHN in various disciplines, among 

them pulmonary, ICU, infectious diseases, cardiology, anesthesiology, rheumatology, neurosurgery, neurology, 

radiology, wound care, and gastroenterology. 

In addition to supervising the medical education of our global health participants, these Global Health Scholars 

have initiated several important changes including the implementation of new treatments such as endobronchial 

ultrasound for lung cancer staging, patient-centered interventions such as smoking cessation counseling and 

treatment, evidence-based treatment protocols such as prone positioning in acute respiratory distress syndrome, 

and patient safety and best practice processes such as multidisciplinary ICU rounds and rounding checklists. These 

initiatives have been deepened by scholarly endeavors including the establishment of a monthly noon conference 

and prolific journal club. 

During this site-visit, I attended a noon conference moderated by one of our Global Health Scholars. A resident 

presented a case in septic shock, which was followed by a discussion surrounding the choice of appropriate 

fluid therapy based on existing evidence. Skillful and analytical, the moderator asked thoughtful questions of the 

audience, encouraging nearly everyone to participate in this well-conducted and interactive learning session. The 

moderator frequently summarized the discussion in order to clarify takeaway points from the literature for younger 

members, which included medical students. I was impressed by this active learning, patient-oriented, case-based 

conference modeled after that of Norwalk and Danbury hospitals. 

I also had the opportunity to sit through the first session of the Pulmonary Journal club, again modeled after that 

of Norwalk Hospital. One of the scholars presented an article selected from the New England Journal of Medicine 

before walking the audience through it. It was clear that the presenting faculty had mastered the skills necessary 

to read and dissect a scientific article. Lastly, my site-visit elucidated the significant increase of interest among 

members of several departments to come to the United States for training, as well as a welcoming enthusiasm 

from the leadership. 

To what can we attribute these great successes? In addition to the talent and commitment of our Global Health 

Scholars and the support of our partner institutions, I congratulate the leadership of graduate medical education at 

Nuvance Health, particularly Norwalk Hospital’s pulmonary and ICU Divisions and Danbury Hospital’s cardiovascular 

76

and pathology divisions, for mentoring such a brilliant group of scholars in multiple countries. We should send more 

of our faculty to our international partner institutions to further support our scholars in their initiatives. 

Capacity building of human resources only works with longitudinal mentorship, which relies on frequent site-visits 

by mentors in order to support individuals in implementing desired interventions. Many exchange programs host 

individuals in the United States for training and then send them back without providing local support. How can we 

expect Global Health Scholars to be instruments of change in their home institutions without continuing to support 

them through the difficult process of creating impact? Our program has been largely successful because of its 

concentration on a mutual, continuous interaction between mentors and mentees. In this respect, we must express 

our gratitude to many of our colleagues at Nuvance Health who frequently travel back and forth to support their 

mentees, and continue to not only maintain but also nurture the connection even from across the world. 

It is time to design an outcome study – similar to what we have already done at Makerere University College of 

Health Sciences in Uganda and Kazan State Medical University in Russia – to quantitatively and qualitatively assess 

the impact of our exchange program at Cho Ray Hospital in medical education and patient care. It would be useful 

to know the perspective of leadership, nursing staff, and faculty members who were not trained at WCHN about 

our scholars and our program. 

Congratulations to our Global Health Scholars, home faculty, international partners, and global health community 

for impacting meaningful change together. 

77


Health: Navigating Cross-Cultural 

Boundaries 









During a hotel stay in a crowded urban city, a global health participant notices that an older man, presumably a 

tourist, is in persistent pursuit of the receptionist who is a young female. Each time the participant enters the lobby, 

she sees the tourist making inappropriate advances toward the receptionist despite her clear yet polite discomfort. 

One particularly late and quiet night, the participant notices that the receptionist is working alone in the lobby, and 

the tourist is getting noticeably close. The participant considers asking the receptionist, in private, whether she is 

uncomfortable, but the tourist is so persistent that she is unable to encounter the receptionist alone. 




I would hang out in the lobby. I wouldn’t do or say anything but I’d make 

my presence known by coughing or sneezing or finding a reason to hang out 

there – “my room is stuffy, just taking some fresh air”- if asked. If possible, 

I would also loop in a colleague to join me as we keep an eye on the tourist 

and receptionist. I’d rather make the receptionist uncomfortable with our 

presence than leave her alone with his. If the tourist is predatory, he will let 

up with others watching him. Predators back down when there’s less chance 

of getting away with stuff. Once he lets up or leaves, I would approach 

the receptionist with a made-up problem that requires me to speak to her 

privately. That’s when I would tell her my observations, see if she’s okay, and 

ask her how she feels and what can be done to protect her. 

DALIA MARTINEZ, FREELANCE 

CONTENT STRATEGIST AND 

FRIEND OF THE GLOBAL HEALTH 

PROGRAM 

78

This is a difficult one. How does the global health visitor know that the 

receptionist is uncomfortable about the attention she is getting from the 

male tourist? Maybe she knows exactly what it means and sees it as a way 

out of her way of life as a waitress! I know someone in Zimbabwe who was 

“smuggled” out to Germany by a visitor. She ended up marrying this man 

and had two kids with him. Unfortunately they are divorced now but the lady 

still lives in Germany. When they left Zimbabwe, the family did not know 

where they were until they received a letter stating such. 

So I am not sure what this country’s culture is around such attention from 

a foreign male. Maybe the cultural expectation is respect, and hence the 

individual may not respond in an assertive way against this man. 

Should the global health visitor not seek help from their supervisor before 

taking this on themselves? 

PROFESSOR CHIRATIDZO ELLEN 

NDHLOVU, DIRECTOR OF THE 

GLOBAL HEALTH PROGRAM AT 

THE UNIVERSITY OF ZIMBABWE 


79

Global Health Newsletters 

and eMagazines 2018-2019 

Editor; Mitra Sadigh 

Creative Director; Amanda Wallace 

This Photo; Majid Sadigh, MD 

1

NOVEMBER 2018 

Welcome! 

Dean Page with Dr. Pierce Gardner 

Welcome Dean Richard L. Page, MD 

We are honored to welcome Richard L. Page, M.D., to his role as the 18th Dean of the University of Vermont 

Larner College of Medicine. Sciences are therefore now eligible to apply for a California Postgraduate Training 

Authorization Letter or a Physician’s and Surgeon’s Certificate. 

2

Global Health Spotlight 

“Looking Back 

While Moving 

Forward” 

BY TENDAI MACHINGAIDZE 

The field of global health has 

indeed come a long way. During 

Family Medicine Grand Rounds 

on October 29, 2018, Dr. Pierce 

Gardner took us on a journey 

from the indistinct beginnings of 

global health to where it is today. 

In his presentation “Academia 

and Global Health: Benefits and 

Dean Page with Dr. Pierce Gardner 

Ethics,” Dr. Gardner highlighted 

how the driving force for global health work has changed across the decades. Be it out of humanitarian 

concerns, self-interest, economics, or scientific advancement, men and women across history have sought 

to cross the geographical and cultural divides that separate us in order to bring healing to those most in 

need of it. 

Despite the myriad of problems that can be cited regarding work overseas, the passion of those called to 

work in global health such as Paul Farmer, Jean Pape, Bill Foege, and Majid Sadigh, has broken down barriers 

and paved the way into the future. It is to such giants of global health that we should look for inspiration and 

guidance as we shape our own dreams to make a lasting impact across borders worldwide. 

What is clear from Dr. Gardner’s insights is that it is paramount for us to look back if we are to move 

forward in a way that is both productive and progressive. Only in hindsight has the need become evident to 

move from a colonial modus operandi to one of capacity building and cultural competency. Western-centric 

directives that so often took more than they gave have given way to bidirectional initiatives that seek out 

ways to benefit all countries involved. 

Dr. Gardner praised the UVMLCOM/WCHN Global Health Program for being such an institution that 

is continuously broadening its mandate and refining its ethical lens in order to promote sustainable 

developments in medical care and education around the world. As the program continues to make advances 

in capacity building, medical education, infrastructure development, and research, there is hope that global 

health disparities such as those in life expectancy and quality of life will lessen over time. Our future is 

backlit by the past. So, let us not rush forward blindly. We, the next generation of leaders in global health, 

must look back and allow the light from the past to illuminate our way forward if we are to succeed in 

tackling the mammoth task before us. For we must not only be eager but also educated; not only inspired, 

but also informed! 

3

Dr. Pierce Gardner speaking to medical students and 

faculty at the UVMLCOM noon conference 

Dr. Pierce Gardner site-visited 

UVMLCOM from October 28-30 

during which he had an introductory 

dinner with UVMLCOM/WCHN 

Global Health Program leadership in 

Shelburne, VT, a dinner meeting with 

Dr. Page and a few leaders of medical 

education, and a debriefing meeting 

with a few of the leadership of global 

health program. He also presented 

“Academia and Global Health: Benefits 

and Ethics” at the Family Medicine 

Grand Rounds, and spoke about his 

life in global health to medical students 

and faculty at the noon conference. 

During the debriefing session, Dr. Gardner called the Global Health Program at the UVMLCOM/WCHN “a 

masterpiece that should be the templates/standard for other global health programs.” Additionally, he wrote 

in a follow-up email: “It is a treat for me to meet talented students who have serious global health interests. 

I am enthused by their energy and idealism to make the world a better place.” 

Establishing a Partnership 

in the Tohono O’odham 

Reservation for Global 

Health Experience 

The vision of “Global Health at Home” is to provide 

clinical experiences with medically underserved 

populations including Native Americans and 

refugees. As part of this project, Dr. Stephen 

Scholand has been working to create an indigenous 

healthcare experience at clinical sites in the 

southwestern United States. On October 13th, 

he visited one such potential site in southwestern 

Arizona, Sells Hospital, looking to develop these 

opportunities. Sells Hospital is a small healthcare 

facility on the Tohono O’odham reservation. Other 

clinical sites under consideration for the rotation 

include a Somali refugee clinic in Tucson. Over the 

coming months, more planning and partnerships will 

be sought to develop an outstanding opportunity to 

work and learn with underserved populations within 

the United States. Watch for more news soon on 

Global Health at Home! 

4

Dr. Stephen Scholand, Site Director at Cho Ray Hospital, Vietnam Global Health Program with Dr. Jason Patel at 

Sells Hospital, Arizona 

Global Health Highlights 

“The Ugandan People Are Extremely 

Warm-Hearted” 

BY SAHAND ARFAIE, CRITICAL CARE SPECIALIST AND CO-DIRECTOR OF THE CRITICAL 

CARE UNIT AT ESSENTIAL HEALTH-FARGO IN NORTH DAKOTA 

Kampala is a large metropolitan area with lots to offer. The city has many neighborhoods, each with their 

own complexity. Slums are surrounded by areas of wealth. Cars, boda bodas, and a few traffic lights make 

for busy streets around-the-clock. Dust and pollution are major issues, just as in many other large cities 

around the globe. Those with reactive airway disease may want to consider loading up on bronchodilators 

and medical masks. 

Ugandan cuisine is unique and composed of various starch options. Internationally, the city is well 

represented with multiple Asian, Middle Eastern, American, and European restaurants. The Ugandan people 

are extremely warm-hearted, passionate, hospitable, and eager to learn about you and where you come 

from. I felt extremely safe and respected throughout my time here. 

5

Dr. Sahand Arfaie and His Work at 

MakCHS 

BY DR. JOSEPH KALANZI, DIRECTOR OF MAKCHS EMERGENCYMEDICINE RESIDENCY 

PROGRAM 

The Emergency Medicine Residency Program at Makerere College of Health Sciences (MakCHS) was 

privileged to work with Dr. Sahand Arfaie, Pulmonary and Critical Care specialist from Essentia Health. His 

visit coincided serendipitously with the start of the academic program. 

The team agreed to focus on essential skills in vascular access, blood gases, and use of ultrasound in the 

emergency setting. These were prioritized as critical areas for residents at the start of their academic 

training. In addition, Dr. Arfaie spent time with residents and faculty in Mulago’s Emergency Department and 

Intensive Care Unit, where he shared his knowledge and experience. 

Dr. Arfaie’s three-week visit was tremendously beneficial to everyone in these two departments. His work 

expedited the process of putting together a new residency program, learning about the essentials of a 

rewarding collaboration, and setting the path for future and bigger steps. 

Dr. Arafie has submitted a draft of a proposed curriculum to establish a three-year fellowship in pulmonary 

and ICU medicine at MakCHS to the educational leadership of Mulago Hospital and MakCHS. 

6

Reflections 

“Relationships” 

BY CLAUDIA FONTES FROM CHO RAY HOSPITAL, VIETNAM 

It is my second week in the Tropical Diseases Department at Cho Ray 

Hospital. We are currently working with Dr. Trung in the designated 

Intensive Care Unit rooms of the department which mainly cares 

for patients with encephalitis, meningitis, and hospital-acquired 

pneumonia who require ventilators. Each room has a designated 

physician responsible for the patients within. Usually there are 

a couple of nurses in the room along with respiratory therapists 

performing chest physiotherapy on each patient. Each day begins 

with an examination of patient vitals and discussion of patient 

presentations and lab values. 

Today, after completing our rounds, I began observing the nurse 

assigned to our room as she moved move from bedside to bedside 

with her cart of supplies to clean each patient and tend to their 

hygienic needs. She meticulously and thoroughly performed her 

tasks as if she were caring for a loved one. Each patient was 

exceptionally clean. I began to think that she was an exceptional 

nurse who valued the importance of her tasks. However, as I 

moved to different rooms, I observed this same behavior in other 

nurses. It was then that I realized that these nurses are trained to 

provide care in this capacity. 

I began to more deeply appreciate this interaction after 

understanding that Vietnamese culture is family-oriented. The 

Vietnamese people often think and behave as part of a collective. 

Hence, taking exceptional care of a patient and assuring that 

each need is met is part of the norm within their healthcare 

system. This ideal is also evident in the manner in which doctors 

interacted with patient family members. It is not strange to find 

family members sitting at the table in the doctor’s lounge as the 

diagnosis, treatment, and prognosis ew explained to them in 

detail. In Vietnamese culture, trust is earned through relationship 

building, and these doctors, nurses, and staff rise to the occasion. 

These photos are from our time with the amazing urology team at 

Cho Ray Hospital. 

7

“Notes from the Field” 

BY LAURENIE LOUISSAINT (RUSM) 

It was quite an eye-opener to see how 

finances and the structure of the medical 

system are limitations that affect the 

care patients are able to receive. Though 

St. Francis Hospital provides high-quality 

care for its patients, those who require 

more extensive workups often need to 

be sent to Mulago, the National Referral 

Hospital, but are hesitant to go because 

of the lower quality of care. 

I am slowly beginning to feel less like 

an outsider and more like a part of the 

team. I am picking up on my Luganda 

and interacting more with the staff. I 

had an amazing time working with Dr. 

Eison and Dr. Diamond. It was truly an 

unforgettable experience. 

From the community La Barquita in 

Santo Domingo, Dominican Republic 

BY GINA CHA 

Sameena Salcin Haque (right) and Gina Cha 

(left) with two family medicine residents and a 

nursing staff in La Barquita 

As part of the diabetic clinic, I was able to see how important 

it is for every patient to be held accountable for their own 

health. Each patient brings their own laboratory work and 

other images performed by other consultants. I find this 

means of healthcare delivery to be beneficial in numerous 

ways. I hadn’t realized how much more compliant patients 

are if they have a little bit of responsibility over their own 

health. This is definitely a tool that I’ll keep in mind as I 

continue on my journey in medicine. I also found the way 

rounds function to be very interesting. Here in the wards, 

a resident represents each subspecialty. For instance, the 

surgical, nutrition, and internal residents present to the 

attending. I like this system much better because the 

attending can gather a comprehensive view of the patient. 

Though it has been difficult to adjust every week to a new 

system and new physician, this week has been a nice 

change. We focused on patient education, and the physician 

tried to teach as much as she could. She also had us teach 

her medical terminology in English, which I thought was 

a nice change of pace. We all optimized and took in our 

situation as a learning experience. 

8

Among the Letters 

DR. SHALOTE R. CHIPAMAUNGA, SENIOR LECTURER AT UNIVERSITY OF ZIMBABWE 


“On behalf of the Green Mountain Returned Peace Corps Volunteer Association, I would like to thank you all 

again for co-sponsoring Dr. Einterz’s visit to Burlington. Your support enabled Dr. Einterz to connect with four 

important stakeholder groups and nearly 200 people while here, including returned Peace Corps volunteers, 

medical professionals, the community at large, and international development practitioners.” 

Wendy Rice, Principal of Vermont Connector and President of Green Mountain Returned Peace Corps 

Association 

“I am grateful for the opportunity to visit WCHN and UVMLCOM and learn about the Global Health Program. 

I also extend my gratitude to the staff whose hospitality aided in a variety of meaningful experiences.” 

Announcements 

SOON TO BE PUBLISHED 

• Ebola Book Volume I 

• The World of Global Health 

• Notes of Encouragement 

9

Follow-Ups 

• Mou with Cho Ray hospital in Vietnam was renewed for another five years 

• Mou with Makerere University School Of Public Health (MAKSPH) is in the MAKSPH legal office for final 

review 

Program Policies 

Global health program participants in international sites are encouraged to directly and immediately 

communicate with the Site Director / Coordinator in the case of an issue with any clinical or cultural 

component. 

Global Health Scholars 

Vacation Days 

For every four-month training, each Global Health Scholar is allotted one full week of vacation and two threeday 

weekends (Friday-Sunday), provided the dates are submitted to the Global Health Program in advance 

for approval. Hospital holidays are automatically granted. Family member invitations also must be approved 

by the Global Health Program in advance. 

Ethical Dilemmas in Global Health 

Integral to global health experiences, a wide range of ethical dilemmas impact students, residents, 

physicians, institutional leadership, and patient populations. Each month, we engage in discussions around 

ethical dilemmas. This month, Dr. Sahand Arfaie, Critical Care Specialist and Co-Director of the 

Critical Care Unit at Essential Health-Fargo in North Dakota, shares his response to the post 

entitled “Cases That Challenge Ethical Beliefs.” 

Read his post here >> 

10

Article of the Month 

The Value of Death 

The Lancet; October 13, 2018 

This is a powerful piece that describes the way in which the medicalization of death strips it of all the layers 

of meaning and cultural significance it has donned over the centuries. We are left in existential crisis, fearing 

death and fighting for immortality. 

Read the article here >> 

Photo and Clinical Quizzes 

Answer to the last issue photo 

Quiz>> 

Stevens Johnson Syndrome (SJS) presenting in an old man at 

Cho Ray Hospital in Vietnam. Though this is a rare case, genetic 

predisposition renders it more common in Vietnam, particularly 

as part of hypersensitivity reaction to sulfa medications. 

Photo Contest 

Submit up to three photos from your global health elective experience. Winners will receive free registration 

to the annualConsortium of Universities in Global Health or Unite for Sight Conferences. 

Submit your photos here >> 

Photo Contest (Dr. Stephen 

Scholand) 

Checking In: Kalalo Cottage Inn in 

Pakwach, Uganda (Majid Sadigh) 

Shopkeeper! (Majid Sadigh) 

Writing Contest 

Submit a 300-word reflection from your global health elective experience to win free registration to annual 

CUGH conference or Unite for Site Conferences. 

Submit your reflection here >> 

Congratulations! 

Congratulations to Sister Jane Frances and other Saint Francis/Naggalama Hospital leadership for 

receiving an award of 5 Stars (95.8%) for the second year, based on accreditation requirements set by the 

Uganda Catholic Medical Bureau (UCMB) Program for hospitals in Uganda. 

12

Our Alumni 

Dr. John Paul Kelada >> 

“I want to thank the WCHN/UVMLCOM Global Health 

Program for supporting my rotation in Cho Ray 

Hospital, Vietnam. Though a few years have passed, 

the program’s influence has been ongoing. I finished my 

family medicine residency this past June, returned from 

a six-week medical trip in rural Guatemala last week, 

and will be sitting for the American Society of Tropical 

Medicine & Hygiene exam at the end of October. I’ll 

be staying within the U.S. until my wife finishes her 

pediatric residency this June, but we hope to continue 

our involvement in sustainable medical trips in the 

future.” 

-John Paul Kelada 

Dr. Trondin with other Russian Global Health Scholars 

(left to right) Dr. Albert Trondin, Dr. Tatiana Afanaseva, 

Dr. Elena 

Dr. Albert Trondin performing a cranioplasty 

Dr. Albert Trondin 

Dr. Albert Trondin, one of the program scholars from KSMU, is finishing his third year of neurosurgery 

training in Spain. He has been instrumental in designing global health modules and other Global Health 

Program 

publications. 

13

Dr. Elena Belousova 

Dr. Elena Belousova has been Chair of the Young Internist Group in the Russian Society of Internal Medicine 

since May 2018, and representative of Russia in the Young Internists in the European Federation of Internal 

Medicine section since August 2018. Her scientific research on the prevalence of inflammatory back pain, 

spondyloarthritis, and ankylosing spondylitis among patients with inflammatory bowel disease was the 

winner of an oral presentation at the World Congress of Internal Medicine in Cape Town, South Africa. 

Above: Dr. Elena Belousova in Pakwach Hospital, Summer 

2014 

Right: Dr. Elena Belousova with a colleague and the President 

of the Russian Society of Internal Medicine, October 2018 

Calendar 

October Calendar 

October 1: Global health elective applications were due. The program received 23 applications this round. 

October 4: UVMLCOM students Katherine Callahan and Nina Dawson spoke at Essex High School. See 

photos and a description of the event here. 

October 5: Dr. Anne Dougherty, Director of the UVM Global Women’s Health Education Program, was the 

keynote speaker at UVMLCOM’s White Coat Ceremony. 

14

October 5: Three Vietnamese colleagues received their certificates from Dr. 

Robyn Scatena. 

October 6: Dr. Morfa arrived to Danbury Hospital for a two-week observership 

in the Department of Surgery. 

October 8: A Global Health Leadership Team meeting was held at UVMLCOM. 

October 8: A meeting was held with Dr. Eison in respect to Naggalama Hospital. 

October 8: A goodbye and feedback session was held with three Vietnamese 

colleagues who finished their elective at Norwalk Hospital. 

Dr. Angel Morfa 

October 9: A meeting and welcoming session was held 

with Dr. Angel Morfa, a surgeon from the Dominican 

Republic. 

October 8, 9, 15, 25, 26, 29: Global health elective 

interviews were held. 

Dr. Scholand, Site Director at Cho Ray Hospital, 

Vietnam Global Health Program, with Global Health 

Scholars at JFK 

October 9: Dr. Shalote submitted a full report on her 

trip and observations at WCHN and UVMLCOM as well 

as her recommendations for some changes in medical 

education at University of Zimbabwe College of Health 

Sciences. 

October 10: Three Vietnamese colleagues returned to Vietnam. 

October 10: A meeting was held with Global Health Day Committee members to discuss the content, 

structure, logistics, and budget of next year’s event. 

October 10: A meeting was held with Dr. Sandra Mini, primary care physician at Danbury Hospital, to 

discuss social support of the Global Health Program and participant involvement in outpatient clinics. 

October 11: Dr. Sadigh and Ms. Amanda Wallace reviewed the final version of the Ebola book.October 12: 

A meeting was held with Dr. Stephen Scholand to discuss the content, structure, and logistics of clinical, 

cultural, and social curricula for the Global Health Scholars. 

October 13: A meeting was held with Dr. Stephen Scholand to discuss the content and structure of a new 

partnership with a healthcare system on a Native American reservation in Arizona. 

October 19: Dr. Sadigh and Ms. Lauri Lennon, Director of Business Operations at WCHN, had an informative 

meeting with Dr. Patricia Tietjen to discuss the future direction of the Global Health Program at WCHN. 

October 20: Dr. Angel Morfa returned back to Dominican Republic after two weeks of observership at 

Danbury Hospital’s Department of Surgery. 

15

October 20: Zohaib Zia (AUC) and Claudia Fontes (RUSM) returned from a six-week rotation in Vietnam; 

Gina Cha (AUC) and Sameena Salcin Haque (AUC) from the Dominican Republic; and Laurenie Louissaint 

(RUSM) from Naggalama, Uganda. 

October 21: Elena Gueorguiev (AUC) arrived to Kazan, Russia for the global health elective. 

October 21: Dr. Emmanuel Denis Morgan, a pathologist from MakCHS, arrived to Danbury Hospital for six 

months of training in the Department of Pathology 

Laura E. Smith, Global Health Program Coordinator at 

WCHN, and Dr. Emmanuel Denis Morgan, a pathologist 

from MakCHS 

Laura E. Smith, Global Health Program Coordinator at 

WCHN, and Dr. Daria Artemeva, a neurologist from 

KSMU 

October 21: Dr. Daria Artemeva, a neurologist from KSMU, arrived to Danbury Hospital for a six-week 

training in neurology. 

October 22: A Global Health Leadership Team meeting was held at UVMLCOM. 

October 23: Dr. Sadigh held a debriefing session with Global Health Scholars from Vietnam at Norwalk 

Hospital. 

October 29: Visiting Scholar Dr. Ambaye Ogato Anata of the Max Planck Institute for Social Anthropology 

gave a lecture at the Fleming Museum as part of a week of talks and panels on social justice, conflict 

resolution, and global health. Read more about Dr. Anata’s week-in-residence here. 

October 29: Dr. and Mrs. Jarrett, Co-Founders of Hearts Around The World and members of the WCHN 

Global Health Committee, had a meeting with Cho Ray Hospital’s administration to address the future of 

the partnership. The next day, they met with Vietnamese Global Health Scholar alumni with whom they 

discussed the idea of creating a Global Health Alumni group at Cho Ray Hospital, which was embraced by 

all members. 

16

November Calendar 

November 5-12: Dr. Scholand and Dr. Sadigh travel to South Thailand to site-visit Walailak University 

before opening the site to global health elective participants. 

November 12: A Global Health Leadership Team meeting will be held at UVMLCOM. 

November 17: Elena Gueorguiev (AUC) returns from the global health elective in Russia. 

November 13: As part of the Global Education and Health 

Lecture Series at Sacred Heart University, UVMLCOM/WCHN 

Global Health Scholars will present “Education and Health 

System in Uganda, Russia, and Vietnam.” During this talk, Dr. 

Emmanuel Denis Morgan from Uganda, Dr. Daria Artemeva 

from Russia, and Dr. Khoa and Dr. Nam from Vietnam will 

highlight health and educational practices in their respective 

countries and identify global leadership initiatives that 

improve health and educational programs. The event will be 

held from 7:00 - 9:00 p.m., and refreshments from 7:00 - 

7:30 p.m. at Sacred Heart University’s Schine Auditorium. 

November 19-21: A Global Health Bridge will be held at 

UVMLCOM. 

November 20: A Global Health Update Luncheon will be 

held with Christian J. and Eva W. Trefz. 

November 21: Students accepted to the global health 

elective will be notified. 

November 26: A Global Health Leadership Team meeting will be held at UVMLCOM. 

November 27: Dr. Sadigh will deliver “Cultural Immersion in Global Health” at Sacred Heart University. 

17

Photo News 

Global Health Scholars from Vietnam in front of their 

residential place in Norwalk, CT 

Sameena Salcin Haque (AUC) screening an individual 

for hypertension in La Barquita in Santo Domingo, 

Dominican Republic 

Global Health Scholars from Vietnam at their residential 

place in Norwalk, CT 

Global Health Scholars from Vietnam at Sacred Heart 

University, CT 

Gina Cha talking to children about hygeine in one 

of the schools in the Dominican Republic 

18

Dr. Sadigh with the Global Health Scholars at UVMLCOM 

Luncheon with medical students and faculty 

Dr. Sadigh with Pierce Gardner, his lifelong mentor 

Dr. Pierce Gardner opening his gift alongside Katherine 

Callahan UVMLCOM ‘21 

Lunch with students 

Ms. Lauri Lennon, Director of Business Operations at 

WCHN, presenting a gift basket to Dr. Pierce Gardner 

19

Dr. Scholand with Dr. Ong, inventor of typhidot. He 

has offered to help our global health program in 

Kuala Lumpur 

Dean Page with global health leadership. From Left to right: Ben Clements Majid Sadigh Dean Page Pierce Gardner 

Anne Dougherty Mariah McNamara 

Dr. and Mrs. Jarrett with Vietnamese Global Health Scholars 

20

DECEMBER 2018 

Global Health Spotlight 

Happy Thanksgiving! 

Global Health Scholars with Ms. Lauri Lennon’s family around the Thanksgiving dinner table 

21

My First Ever Thanksgiving Celebration 

BY DR. EMMANUEL DENIS MORGAN, GLOBAL HEALTH SCHOLAR 

Thursday marked one of the most beautiful moments I have had so far in the U.S. The four hours we spent 

together marked my first ever Thanksgiving celebration. 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, not to mention the warm welcome from Ms. Lauri Lennon’s lovely family members who made all of us 

feel loved and integrated throughout the event. It was an amazing experience that I will always remember. 

The occasion was full of discussions surrounding culture, communication, and social interactions in our 

respective countries. After three hours of socializing, we gathered around the dinner table that was set up 

with carefully selected traditional meals, side dishes, appetizers, and desserts, marking the end of the most 

colorful day of my time in the U.S. 

Advancing Global Health in Southern Thailand 

BY DR. STEPHEN SCHOLAND 

Dr. Stephen Scholand, Dr. Majid Sadigh, Dr. Surin Maisrikrod, Vice President for Global Engagement and Faculty 

Development, and Dean Prachyapan Petchuay “Dr. Menn,” Dean of Walailak University School of Medicine. 

22

Dr. Stephen Scholand and Dr. Majid Sadigh traveled to Tha Sala District, Nakhon Si Thammarat Province, 

Thailand the first week of November to meet with faculty, administrators, and medical students at Walailak 

University (WU) with the goal of establishing a new partnership in medical education. The main university 

in southern Thailand with an outstanding vision for excellence, WU has graduated five classes of medical 

students already, and by 2020, a new university hospital with a 750-bed capacity will be completed to 

facilitate medical education. Dean Prachyapan Petchuay was our gracious host who facilitated meetings with 

key faculty and administrators. 

Our contingent toured the facilities locally in Nakhon Si Thammarat as well as off-site in Phuket, Thailand’s 

famous resort city. The trip was very successful, as a Memorandum Of Understanding (MOU) was agreed 

upon. In fact, Dr. Surin Maisrikrod, Vice President for Global Engagement and Faculty Development, urged 

us to move forward expediently, exclaiming “start now, start now”! 

The vision of this new site follows the established tenets of the Global Health Program, with robust investment 

in capacity building of human resources and educational infrastructure as well as true engagement with 

junior faculty at the institution. It follows our philosophy of a holistic, engaging program with fair balance 

between two institutions, a proverbial ‘two-way street’ for medical education. Medical students believe that 

the faculty-student relationship is the strongest attribute of WU. 

In fact, students address their professors with the title “pee,” a Thai word used to address an older brother 

or sister. The nurturing educational environment at WU is immediately noticeable. Their medical students 

seem happy, dedicated, compassionate, and brimming with enthusiasm for the future. We look forward to 

further developments with Walailak University. 

Global Education and Health Systems Lecture 

BY JOANNA CONKLIN 

On the evening of November 13th, Drs. Artemeva, 

Khoa, Nguyen, and Morgan, four of our Global 

Health Program Scholars from Russia, Vietnam, and 

Uganda, took the stage at Sacred Heart University 

to share experiences of education and healthcare 

from their home countries with education and global 

health students. Their infectious smiles and warm 

nature captivated the crowd. Thoughtful questions 

from the audience paired with insightful responses 

from the panel filled the room. Those in attendance 

left with the knowledge of the ways in which these 

respective countries are more alike than they are 

different. As a joint effort between the College of 

Health Professions and the Isabelle Farrington 

College of Education, the second event in this series 

is scheduled for Spring 2019. 

23

A New Evolving Partnership Between Sacred Heart 

University and Cho Ray Hospital in Vietnam 

Dr. Robert Jarrett, Founder of Hearts Around the World, and Christina Gunther, Director of Global Health Programs 

at Sacred Heart University, with other members of Hearts Around the World and medical staff at Cho Ray Hospital. 

Christina Gunther, Director of Global Health Programs at Sacred Heart University (SHU), and Dr. Robert 

Jarrett, Founder of Hearts Around the World, met with the leadership of the International Office and Teaching 

Center of Cho Ray Hospital, Ho Chi Minh City, Vietnam. SHU’s physician assistant students will join WCHN 

global health participants including UVM medical students for global health rotations beginning 2019. 

24

Member Highlights 

Emmanuel Denis Morgan Thomas 

I am a citizen of South Sudan and graduate of Upper Nile University, 

one of former Sudan’s medical schools in Khartoum where I was 

awarded a Bachelor of Surgery and Medicine (MBBS) equivalent to 

(MBChB) in East African countries in May 2011. I was inspired by 

a group of senior colleagues from Makerere University College of 

Health Sciences who enrolled in South Sudan’s Federal Ministry of 

Health. Having completed my internship under their supervision, I 

noticed that they stood out from their counterparts who graduated 

from other universities. 

Impressed by their professional, personal, and humanistic qualities, 

I decided to apply to MaKCHS where I was lucky enough to be 

admitted in 2014 as the first South Sudanese in the Department 

of Pathology. My responsibilities as a consultant-under-training 

or senior house officer included teaching pathology to medical students, presenting cases during 

clinicopathological sessions, and attending the tumor board and grand rounds. In addition to engaging in 

daily and weekly departmental activities in both histopathology and cytopathology labs, I have completed 

the three-year training period and all necessary requirements for being awarded a Master of Medicine in 

Pathology in January 2019. 

Motivated by the distinguished global health education received by Dr. Caroline Achola and Dr. Phiona 

Bukirwa, two WCHN Global Health Scholars who were my senior colleagues, I applied to the training program 

myself. I have completed one month here out of four, and all I can say is that I am very fortunate to be 

here. The Global Health Team and Pathology Department have been welcoming and supportive, and have 

provided me with a friendly and conducive learning environment. Meanwhile, I have been able to share my 

knowledge in autopsies, performed in large numbers in Uganda, with my colleagues, as well as pediatric 

cancers with pathology residents who are not exposed to diseases of children. 

Following this training, I will join Makerere University as a lecturer whereby I can use my newly acquired 

knowledge, particularly that related to special stains and hematological diseases. I would also like to give back 

to Makerere University to thank the leadership for providing me with the life-changing training opportunity 

at Danbury Hospital as a Global Health Scholar. This training is helping me lay a strong foundation in 

hematopathology, the field that I love most. 

25

Announcements 

Dr. Pierce Gardner’s speech which was delivered at the UVMLCOM Family Medicine Grand Rounds last month 

is now available for view online: 

View his speech here >> 

2018 ANNUAL REPORT 

The 2018 Annual Report will be in celebration of the seventh year anniversary of the Global Health Program. 

Informative, analytical, and scientific, this special report aims to emphasize on the historical facets and 

evolution of different program divisions in the hope of learning from the past to revise the vision and mission 

for the future. We hope to make a digital comprehensive documentary of program accomplishments with 

statistics for use at LCME site visit in 2020, with a handful of hard copies. The highlights will be assembled 

in print for the 2018 annual report. A task force has been assigned to start this process December 1st for 

completion by February 1st. 

Dr. Stephen Scholand has been in contact with Professor Phung Nguyên, Vice Head of the Pediatric 

Department at the University of Medicine and Pharmacy at Ho Chi Minh Medical Center to establish a new 

partnership for global health participants interested in pediatrics training. 

Dr. Shalote Chipamaunga, Senior Lecturer at University of Zimbabwe College of Health Sciences (UZCHS), 

Dr. Rati Ndhlovu, Director of Global Health at UZCHS, and Ms. Mary Shah from Danbury Hospital are starting 

a conversation around potential collaboration/assistance with access to electronic resources as a way of 

strengthening medical education and global health at UZCHS. We at the Global Health Program believe 

that medical libraries are the ”nerve center” in support of medical education, research, and clinical practice. 

Currently, means of strengthening the partnership by amping up access to library resources is being explored. 

Among the Letters 

“I am sending this email from the WCHN Global Health Resource Center. It is gorgeous. When I get the 

webcam, HDMI cable, and speakers, we can arrange a video conference trial. Thank you very much for your 

love and trust. I sent you the first draft of curriculum and am now working on the concept for the Global 

Health Institute.” 

Sam Luboga 

We had a meeting with the Dean of UZCHS to follow up on my recommendations from the visit. He seemed 

to embrace the global health concept and suggested that it should be college-wide in undergraduate and 

postgraduate programs. 

Shalote R. Chipamaunga, Senior Lecturer, Department of Health Professions Education, College 

of Health Sciences, University of Zimbabwe. 

I had a wonderful experience at our Global Education and Health evening at Sacred Heart University (SHU). 

Professor Cima Sedigh from Farrington College of Education at Sacred Heart University did an impressive job 

organizing the event. I am humbly honored to have participated. I am currently completing an ICU rotation 

in Norwalk Hospital, and will move on to radiology next week. I have had a very interesting and productive 

time. For Thanksgiving, we were invited to Ms. Lauri Lennon’s house where we were very lucky to celebrate 

our first Thanksgiving with her family. I was struck by a deep feeling of gratitude for happiness and joy as I 

travelled to New York last weekend. I would like to say thank you to the members of the WCHN Global Health 

Program. I wish them all very happy and peaceful holidays. 

DƯƠNG Duy Khoa 

“I have finished translating Tropical Medicine 101 to Spanish, and am currently translating Tropical Medicine 

202, but at a slow pace due to all of the traveling and interviews.” 

Wendy Perdomo 

Follow-Ups 

• A MoU with Walailak University (WU) has been signed by the authorities of WU, and it is now on its way 

to the WCHN legal office. 

27

Program Policies 


Effective January 2019 

Nomination Process 

Candidates are nominated by global health leadership at the home institution. Once nominated, they are 

interviewed by members of the UVMLCOM/WCHN Global Health Program leadership, in person or via Skype, 

depending on feasibility. 

Preparation 

Global health scholars, in addition to meeting with the leadership of home institution for instruction, should 

also meet with global health program alumni to gain insight into programed expectations before their arrival 

to the U.S. 

Agreements 

Once selected, global health scholars must have a clear agreement with the host institution detailing program 

expectations such as the number of years they will work as a physician or faculty for the home institute 

after training. In addition to their agreed upon responsibilities toward home institution, they are expected to 

supervise medical students and residents from UVMLCOM/WCHN, as well as conduct collaborative research 

activities, participate in preparing annual reports, and other formal publications and global health program 

activities. 

Training Expectations 

During the scholars visit, global health scholars are expected to participate in all medical education activities 

of the department to which they have been assigned. This may include activities such as morning reports, 

grand rounds, noon and other medical conferences. Scholars are expected to attend weekly sessions with 

a respective faculty from the WCHN Global Health Program to discuss a global health-related article, and 

monthly feedback sessions with assigned clinical faculty. They also should expect to deliver monthly formal 

presentations to medical students, residents, and faculty, and participate in ongoing research and writing 

projects in the global health department. 

Scholars write a weekly reflection for the first three weeks, followed by monthly reflections for the remainder 

of the rotation, in addition to a debriefing report, final feedback form, and final evaluation form one week 

before returning home. Certificates are granted upon completion of all of these elements. 

Vacation Days 

Each global health scholar for each four months of training is allotted one full week of vacation and two threeday 

weekends (Friday-Sunday) provided the dates are submitted to the Global Health Program in advance 

for approval. Hospital holidays are automatically granted. Family member invitations also must be approved 

by the Global Health Program in advance. 

28

Article of the Month 

China is accused of locking up hundreds of thousands of Muslims without trial in its western region of 

Xinjiang. The government denies the claims, stating that people willingly attend special “vocational schools” 

which combat “terrorism and religious extremism.” Now a BBC investigation has found important new 

evidence of the reality. 

Read the article here >> 

Welcome! 

We are saying our heartfelt goodbyes to Ms. Marina 

Zakharova, and wishing her good luck in her new career. 

Meanwhile, we welcome Ms. Alsu Khairutdinova as 

the new Coordinator of the Global Health Office at 

KSMU. Ms. Khairutdinova earned her degree in foreign 

languages from Kazan Federal University in 2014, and 

joined the KSMU International Department as Global 

Health Coordinator in 2017. She currently organizes 

clinical rotations for global health participants and 

assists them during their stay in Kazan. 

Reflections 

Elena Gueorguiev (AUC) 

My last week in Kazan is finally here and I can’t believe how fast my time went by! As I reflect on my last 

four weeks in Kazan, I am both humbled and grateful for this experience that was eye-opening in more 

ways than one. I am grateful to have met such wonderful, kind people who welcomed me and shared their 

culture, customs, and way of life. I had a wonderful time living in this beautiful country, even if for only a 

few weeks. 

Being in Kazan was certainly a very new experience. There were many things such as the ease of transportation 

with my own car that I initially missed, but it was not long before I adapted. I am grateful for the friendships 

I formed here, and to the hospital staff, including attendings, nurses, residents, and medical students for 

being so gracious with their time and patience. It was challenging not knowing the language, but everyone 

did their best to accommodate and help me. I am especially thankful to the patients I had the privilege of 

29

speaking with and caring for. I have come to really admire the people here. Though many patients are quite 

poor and at times quite ill, they are incredibly grateful and genuinely kind. It was not uncommon for patients 

to give me a hug or hold my hand as a way of expressing their gratitude. 

Sharing and exchanging medical and cultural knowledge with my supervisors and fellow medical students 

was a valuable experience. I have a lot of respect and admiration for them, as many have left their families 

and countries to study medicine in Kazan. I relate to them at least in part because I too had to move away 

from my family to a new country for the first two years of medical school. However, I did not have to learn 

clinical medicine abroad like they did. Learning about the people, culture, and traditions of an unfamiliar 

place while simultaneously learning clinical medicine is an extraordinary task. Their commitment gives me 

strength and valor to overcome obstacles and challenges that I may encounter during the remainder of my 

medical school training. 

One of the major differences in terms of the healthcare system is in resources. This short experience in 

Kazan has given me a new and deep level of appreciation of the healthcare system in the U.S. regardless of 

its flaws and shortcomings. This observation has given me new energy to finish medical school and prepare 

myself for residency. In fact, the global health elective has given me exactly what I need at this very stage 

of my career: a reminder of why I started this journey of medicine in the first place. There is nothing more 

gratifying than learning how my knowledge and skills can be used to help another human being at a time 

when they are most vulnerable while lessening their suffering and healing them back to recovery. 

While I have never lost sight of this fact, I must admit that this elective solidified it for me in a way I haven’t 

quite experienced before. I look forward to sharing my experience with my family and friends back home. 

Most importantly, I know I will incorporate the experiences I’ve had into my professional journey towards 

becoming a doctor. Knowledge is of no value unless it is put into practice. This experience has not only given 

me knowledge and insight, but has demonstrated how much good can be accomplished when these abilities 

are met to their fullest potential. 

30

Notes from the Field 

Sincere condolences to Ugandans and our Ugandan friends and colleagues for 

the loss of so many lives in the capsized vessel on Lake Victoria 

When an Inconvenience Can Save Your Life 

On Friday, Ugandans were dumbfounded when a vessel capsized on Lake Victoria, killing most of the people 

on board. These were not common Ugandans, but passengers from well-to-do families. The story was 

reminiscent of that of the Titanic. None of us were prepared for this magnitude of a disaster. However, 

something caught my attention. Citing the accounts of some survivors, there were a good number of life jackets 

aboard the doomed vessel that passengers neglected to wear because they were seen as an inconvenience. 

How many times we have seen people lose their lives due to failure to work with inconveniences? 

There is no shortage of examples. Many have lost their lives to HIV/AIDS due to the inconveniences of 

wearing a condom. Many have lost their lives in road accidents due to the inconveniences of wearing a 

helmet or seatbelt. There are other life-saving inconveniences such as swallowing medicine or seeing a 

doctor. We should first reflect on the beauty and importance of life before making a decision that may greatly 

impact it. 

Jamidah Nakato 

Click here to view a video concerning the tragic accident >> 

The lives lost now number thirty-two, but many more are still in the water. No one knows the hour or the 

day. We leave it to the Creator to manage our last moments. 

Be blessed, Sister Jane Frances 

Challenging Moments in Global Health 

Challenging moments are an inherent component of global health electives, and can be ascribed to an array 

of sources including insufficient orientation, unrealistic expectations, unfamiliarity with the culture and 

way of life, or mismatch between participant and elective. “Challenging Moments in Global Health” aims to 

address these issues by featuring real cases that have been written by global health coordinators, directors, 

and leaders over the years. We hope that readers share their responses, thoughts, and personal experiences 

so that we as a community can learn from each others’ insights. 

31

Photo and Clinical Quizzes 

Answer to the last 

issue photo Quiz>> 

A young woman with chronic abdominal 

pain at Mulago Hospital, Uganda 

Answer: Burn marks, a locally accepted 

remedy for abdominal pain. 

Photo Quiz 

What parasite celebrates the occasion to complete its life cycle (Pakwach town by West Nile)? 

32

Photo Contest 

Submit up to three photos from your global health elective experience. Winners will receive free registration 

to the annual Consortium of Universities in Global Health or Unite for Sight Conferences. 

Submit your photos here >> 

Raising Rain (Pakwach, Uganda), Albert Trondin 

Under the Shadow of Wealth: A family in a slum by 

Mulago Hospital (Majid Sadigh) 


Submit a 300-word reflection from your global health elective experience to win free registration to annual 

CUGH conference or Unite for Site Conferences. 

Submit your reflection here >> 

33


“Learning from Commonalities and Differences” 

RAFAEL KHALITOV, MD, RUSSIA 

The differences among healthcare systems around the world is a common topic for observation and research. 

Several studies have compared the healthcare system in Russia with those in Western countries. Though 

traditionally ascribed to varying access to resources and technology, differences in healthcare systems are 

heavily impacted by culture that can define many aspects of health, including disease manifestation, illness 

perception, treatment receptivity, and level of social support that is often vital for recovery. In light of this 

impact, it is crucial that healthcare providers develop strong cross-cultural competencies and awareness. 

Having completed several global health electives in different countries including Russia, the U.S., and 

Uganda, I would like to share a few observations that relate to the ways in which culture can impact health. 

Present and variable across cultures, disease-related stigmas can prevent patients from seeking needed 

medical help. In Russia, for instance, depression continues to be seen as a personal weakness, and is 

even sometimes considered a natural part of aging. As a result, patients are unlikely to seek treatment. 

Meanwhile, those who are diagnosed may have difficulty accepting their diagnosis, thereby complicating 

disease management. Meanwhile, the outcome for depression may be different in the United States where 

the stigma has been largely overturned through social awareness campaigns. 

In both countries, family members play an important role in patients’ emotional and functional states. 

Culturally conscious communication among physicians, patients, and their families is a critical aspect of 

quality patient care. Because hospitalization in Intensive Care Units (ICUs) can cause considerable anxiety 

for patients and their relatives, the family-oriented approach of ICU patient care is now receiving increased 

attention from Russian physicians. Hospitals in large cities are among the first in Russia to invite family 

members into ICUs for patient care participation. Learning more about American hospital etiquette could 

be a powerful tool for furthering the growth of knowledge and culture to advanced patient-centered ICU 

standards. 

Finally, improving communication skills and empathy reduces anxiety and positively affects patient wellbeing 

across cultures. Achievable at all levels of a healthcare workforce, tools for adequately responding to 

illness-related emotions dramatically can powerfully enhance the landscape of compassionate healthcare 

delivery. The effort to share ever-evolving clinical knowledge across cultures and healthcare systems 

increases professionalism and cultural awareness for all participants, and in turn allows us to provide better 

care to our patients. 

34

Congratulations 

Congratulations to Jamidah Nakato for receiving a grant from Makerere-Sweden to finish her PhD research 

project. 

Congratulations to Dr. Katrin Sara Sadigh for acceptance of her abstract on the effects of HIV on mortality 

in Botswana women with breast cancer for an oral presentation at the Conference on Retroviruses and 

Opportunistic Infections, which will be held in Seattle from March 4-7 2019. 

Calendar 

November Calendar 

November 1-7: Christina Gunther, Director of Global Health Programs at Sacred Heart University, traveled 

to Vietnam to meet with the leadership of Cho Ray Hospital to start a new partnership for SHU Physician 

Assistant students. 

November 2: Christina Gunther and Dr. Robert Jarrett, Founder of Hearts Around the World, met with the 

leadership of Cho Ray Hospital. 

November 12: Neelesh Thussu spoke about schistosomiasis as a part of the Global Health Lecture Series 

at Norwalk hospital at 12:30pm. 

November 16: Fourth-year AUC medical student Elena Gueorguiev returned from Russia after completing 

the global health elective. 

November 19: Dr. Sadigh and Dr. Scholand returned 

from their site-visit in South Thailand. 

November 20: Dr. Jonathan Fine and Dr. Sadigh had a 

second-year anniversary meeting with the Trefz family to 

update them on program progress and accomplishments 

over the last year. 

November 21: Dr. Sadigh had a debriefing meeting 

with Global Health Scholars at Danbury Hospital. 

November 21: Global Health Scholars attended a 

session about clinical research with Dr. Petrini at her 

office in Danbury Hospital. 

35

November 27: Dr. Sadigh, Ms. Mary Shah, and Ms. 

Amanda Wallace held a meeting to discuss the details of 

the 2018 Global Health Annual Report. 

November 27: Dr. Sadigh held a meeting with Dr. Vidhun, 

Director of the Pathology Residency Program, to discuss Dr. 

Emmanuel Morgan’s experience at WCHN and to initiate 

more collaboration, particularly around research, between 

the Departments of Pathology at Danbury Hospital and 

MakCHS. 

November 27: Dr. Sadigh had an orientation session 

at the SHU College of Health Education with eight nurse 

practitioner students who will be in Uganda for a two-week 

global health elective in early February 2019. 

November 28: The 2019 Global Health Day committee 

met at Dr. Sadigh’s office to discuss logistics of the occasion. 

November 28: A dinner meeting with Global Health Scholars 

and Dr. Stephen Scholand was held at Dr. Sadigh’s home. 

November 29: At a small gathering was held at Dr. Sadigh’s office during 

which Dr. Daria Artemeva received her training certificate. 

November 30: Dr. Sadigh and Dr. Stephen Scholand had a 3 hour meeting to 

discuss the details of the global health day activities, the global health newsletter, 

the global health annual report and the upcoming site visit to Zimbabwe. 

November 30: Dr. Daria Artemeva returned to Russia after completing a sixweek 

neurology training at Danbury Hospital. 

December Calendar 

December 4: Dr. Sadigh and other members of the Professional Education Committee hold an introductory 

meeting with the new Designated Institutional Officer (DIO), Dr. Glenn Loomis, at 11:00 a.m. 

December 4: Dr. Sadigh holds an introductory meeting with Dr. Glenn Loomis the new DIO, at 4:00 p.m. 

December 5: The UVMLCOM/WCHN Undergraduate Medical Education Retreat Dinner is held. 

36

December 6: Dr. Sadigh holds a meeting with Dean Page and Dean Jeffries to discuss the future direction 

of the Global Health Program. 

December 10-11: Dr. Sadigh makes a monthly administrative visit to UVMLCOM. 

December 12: Dr.s Khoa Duong and Thanh Nam Nguyen will deliver “Healthcare and Medicine in Vietnam” 

at Norwalk Hospital at 12:30 p.m. 

December 12: Dr. Sadigh will be meeting with Dean Alfano and Professor Cima Sedigh at SHU to explore 

potentials for more collaboration in global health education in Uganda. 

December 14: Dr. Sadigh and Ms. Grace Linhard will be meeting with representatives of Praxair Foundation 

who are interested to learn more about the global health program at WCHN. 

December 18: A celebration of the newest Endowed Chair in the Department of Emergency Medicine is held. 

December 19: Amanda Lindo speaks about malaria as a part of the Global Health Lecture Series at Norwalk 

hospital at 12:30 p.m. 

Global Health and the Arts 

A far cry from only a clinical undertaking, global health embodies an intersection of dimensions as numerous, 

complex, and rich as life itself. We need art to process and share our global health experiences, to hold each 

other in our strengths and vulnerabilities, and to harness the power of our shared consciousness. In “Global 

Health in the Arts,” we turn to pieces and projects from across the artistic spectrum, visual to musical 

to lingual, to breathe life into the nuanced, philosophically-rooted aspects of global health engagement. 

As eloquently stated by Tatar-Russian composer Sofia Gubaidulina, “the public applauds composers and 

performers for presenting something that allows people… to bring themselves into a state of wholeness, to 

cure themselves from the state of dispersal and disconnection that they suffer...” 

Project Report: Art in Global Health: Report and Video giving 

Insights and Considerations for Future Artist Residencies 

View the Project Report here >> 

“Art in Global Health was a project by Wellcome Collection to support the creation of artworks that could 

explore, in surprising and insightful ways, how global health research is conducted and how its findings are 

used. Residencies were established in 2012–13 with the five Wellcome Trust Major Overseas Programmes 

in Kenya, Malawi, South Africa, Thailand and Vietnam as well as with the Wellcome Trust Sanger Institute 

in the UK. It was specifically stated that the residencies’ aim was neither to ‘sell’ nor anatomise a particular 

research project. Rather, Art in Global Health aimed to investigate a series of particular local scientific 

projects across the various sites and build up a comparative impression of global health research, both in 

terms of the process of research itself and its place in local and global society.” 

37

Photo News 

Dr. Sadigh with Walailak University medical students 

Dr. Sadigh and Dr. Scholand with a few Walailak 

University medical students 

Dr. Sadigh, Dr. Scholand, and Dean Menn with core 

Walailak University faculty in a restaurant in Nakhon Si 

Thammarat 

Elena Gueorguiev with new friends in KSMU, Russia 

Dr. Sadigh, Dr. Scholand, and Dean Menn with core 

Walailak University faculty 

Dr. Nam in the snow 

38

Photos from Global Education and Health Systems Lecture 

at SHU 

Dr. Daria Artemeva at Sacred Heart University 

Dr. Nam at Sacred Heart University 

Dr. Duy Khoa Duong at Sacred Heart University 

Ms. Lauri Lennon at Sacred Heart University 

Dr. Emmanuel Denis Morgan at Sacred Heart University 

Dean Alfano and Dean Walker at Sacred Heart University 

39


celebrating Thanksgiving 

at Ms. Lauri Lennon’s 

home 

Global Health Scholars after Dr. Emmanuel Denis 

Morgan’s presentation on Ebola 

Left to Right: Dr. Charles Guardia, Dr. Neil Culligan, 

Daria Artemeva, Dr. Robert Bonwetsch, Dr. David Greco 

and Dr. Behzad Habibi. 

We are very thankful to the faculty 

of Danbury Neurological Associates 

who generously mentored Dr. Daria 

Artemeva, a neurology resident at 

KSMU, for 6 weeks. 

Global Health Scholars at Dr. Robyn Scatena’s home on 

Halloween 

40

January 2019 Volume 1 


Global Health eMagazine 



41

HAPPY NEW YEAR! 

“Let our New Year’s resolution be this: we will be 

there for one another as fellow members of humanity, 

in the finest sense of the word.” 

– Goran Persson 

42

PERSPECTIVES 

Katrin Sadigh, MD 

Global Health Fogarty Fellow, Brigham and Women’s Hospital Boston/Botswana Harvard 

Partnership 

There are a few key elements to working in the global health arena that I would like to share with medical students 

and residents interested in the field. First and foremost, strong mentorship is key to success. However you wish to 

define success, be it academic (such as publications or promotions), or personal (fulfillment, expansive growth), 

find a mentor you respect and who can challenge you to new creative and productive heights. We all need many 

mentors, not only for different stages of our careers but even for single projects, as each can fill a pertinent, 

well-defined role. Second, be open and flexible in the early stages of training. Take a step back and merely 

observe for a while. Say “yes” to projects or other opportunities, and watch doors open to places you didn’t know 

existed. Once you have gained a sense of the people and their customs, the landscape and your own role within 

it, only then learn to say “no, thank you” and focus on what you have committed to. Third, be humble. Expect 

to be surprised, perplexed, angry, impatient, amused, or simply wrong. It is only by living outside our comfort 

zone that we begin to grow, to see our own blind spots and strengths. By pushing our limits, we recognize that 

our perspective is only one of many and that we have much to learn before we can contribute. Lastly, cultural 

nuances are not the same as injustices. You will witness injustice almost everywhere and in many guises. Keep 

your thoughts sharp and your heart open. Do not become immobilized by anger. Remind yourself that you are 

building a set of skills that will be real power in your hands one day - and on that day, fight hard. 

Both exciting developments and new challenges await students of global health. Advancements in medicine and 

biotechnology have led to novel therapeutics and diagnostics for a spectrum of diseases. Blurring of geopolitical 

43

orders, new roads, and flight routes have made the world bigger and more accessible. Global access to the 

internet and its connectivity platforms has brought forth almost instantaneous broadcasting of events, both of 

small and large consequence, along with unending amounts of data. This also means that there is much more 

to learn and triage as a student, including a rise in noncommunicable disease and emerging or re-emerging 

infectious diseases - and all within the complicated backdrop of climate change, perpetual wars, civil unrest, and 

shifting international alliances as governments turn inward. The new generation of global health students must 

insist that we preserve our respect for one another and our differences, to push ourselves to learn about what we 

fear or do not understand, and when in doubt or when met with resistance, to work harder. 

SPOTLIGHT 

Dr. Swapnil Parve with the leadership of Datta Meghe Institute of Medical Sciences, India 

OUR NEWEST PARTNER; DATTA MEGHE INSTITUTE OF MEDICAL 

SCIENCES (DMIMS), INDIA 

We would like to welcome aboard our newest partner, Datta Meghe Institute of Medical Sciences (DMIMS). A 

prestigious private medical university in India, DMIMS is located in Sawangi (Meghe), a small town approximately 

70 kilometers from Nagpur which is the third-largest city and winter capital of the state of Maharashtra. The 

institution consists of faculty in general medicine, dentistry, nursing, ayurveda, and physiotherapy, among many 

other fields. 

44

DMIMS has a student body of over 4500, including members from a diverse array of countries including the USA, 

UK, and Bahrain. The hospital has over 1500 beds and serves approximately 325,000 patients annually. DMIMS 

is an institutional member of the Consortium of Universities for Global Health (CUGH), and has worked with the 

National Institute of Health (NIH), and other eminent global health institutions around the world. 

Through this first-of-its-kind tripartite collaboration with DMIMS, WCHN Global Health Scholars receive their 

conceptual and sim-lab training at WCHN and their “hands-on” training under the auspices of DMIMS. Meanwhile, 

WCHN supports DMIMS to build local capacity, introduce various certificate courses and fellowships, and explore 

new areas for research. 

The project will be monitored by Dr. Lalitbhushan Waghmare, Dean of Interdisciplinary Health Sciences. Dr. Tripti 

Srivastava and Dr. Shweta Parwe will serve as Global Health Program coordinators for mainstream and allied 

health courses. The appointed director will soon be announced. 

HIGHLIGHTS 

DR. DARIA ARTEMEVA, GLOBAL HEALTH 

SCHOLAR FROM RUSSIA 

I have been fascinated by the secrets of human psychology, physiology, and the 

brain since my early years of education. The integration of these principles in the 

field of neurology satisfies my curiosity and passion for these mysteries. 

As a second-year resident in Neurology Department at Kazan State Medical 

University, I am currently conducting research on sleep disorders in children. 

I believe science can unite people from around the world while benefiting from 

different backgrounds and perspectives. As I see it, the United States is a 

country with a great diversity of people and landscapes. It is with this view that 

I joined the 

Algarysh grant exchange program. I yearned to see new approaches in the treatment of neurological diseases, 

especially in the country most known for advancements in medicine. I first heard about the Global Health 

Program from my colleagues Yulia Troshina and Anna Nalbat following their training at Danbury and Norwalk 

Hospitals. Through my own experience, I have found that this transformative program enhances participants’ 

clinical efficiency, communication skills, medical knowledge, and research prowess. 

During my time at Danbury Hospital, I have been impressed by the friendly interactions among colleagues and 

patients, elegant algorithms and protocols of diagnostics and treatment, and smoothly coordinated work of doctors 

of different specialties, even in emergency situations. I have been particularly impressed with the management 

of patients above ninety years of age. Doctors always advocate for patient health and quality of life. Within the 

first six weeks of my internship, I was exposed to rare medical cases including transient global amnesia caused 

by bilateral embolic ischemic stroke in the thalamus, cavernous sinus thrombosis presented only by ipsilateral 

III cranial nerve palsy, and possible immune mediated myopathy. I hope that I have reciprocally contributed to 

45

the neurology team at Danbury Hospital by bringing a different perspective of medical care, Russian curiosity, a 

hunger to grow, and the desire to improve quality of life. 

This experience has given me a broader lens of patient symptoms and syndromes. I now have greater confidence 

treating patients with different types of strokes and preventing stroke in my patients at KSMU. I have learned new 

approaches to treating the most frequent neurological conditions such as epilepsy, Bell’s palsy, and headaches. 

At the same time, I have had the chance to meet incredible and highly professional doctors and residents. Each 

teaching session with my supervisors inspired me to delve further into discussed topics and seek answers to 

important questions. I send a heartfelt thank you to everyone who welcomed and supported me during my 

training at WCHN. 

DR. NAM, GLOBAL HEALTH SCHOLAR FROM 

VIETNAM 

Global Health: My journey of Gratitude and Inspiration 

I graduated from the University of Medicine and Pharmacy at Ho Chi Minh city 

in 2013. After completing an extra one-year training in pulmonary and critical 

care medicine, I began working as a pulmonologist at Cho Ray Hospital. I 

expect to complete my master’s program, which I started this year, by 2020. 

Being in charge of in-patient treatment, with most patients in acute, severe, 

or critical condition, is a little stressful for me as a young physician. Part of my 

job also involves serving as co-investigator. I am interested in interstitial lung 

diseases, lung cancer, and clinical research. 

The Global Health Program was implemented in Cho Ray Hospital several years 

ago, but I am the first pulmonologist to participate. Through my participation, I strove to sharpen my view of 

the American healthcare system, the ways in which physicians manage patients, and the differences in medical 

education - and from there to improve the quality of care I provide my patients. 

As a Global Health Scholar, I spent most of my time in the Pulmonology Department, Intensive Care Unit, and 

Sleep Medicine. I joined outpatient visits, fellows consults, case presentations, ambulatory case discussions of 

attending doctors and fellows, lectures at noon conference and grand rounds, streamings of Yale University’s State 

Chest, and the pulmonary journal club. I learned a tremendous amount from these sessions. Smoking cessation, 

pulmonary rehabilitation, and palliative care were particularly novel experiences. I also had a great meeting 

with Dr. Joann Petrini and her colleagues who gave me precise ideas for my projects and inspired me much with 

clinical research. I raised questions to clarify several issues with residents, fellows, and attending doctors during 

case discussions and tried to make comparisons between the American and Vietnamese healthcare system where 

relevant. I even gave a presentation about the Vietnamese healthcare system at Norwalk Hospital as well as at 

Sacred Heart University’s Global Health and Education Lecture series. 

Two things especially impressed and inspired me throughout the training. First was learning about the doctorpatient 

relationship and communication. Doctors are aware not only of disease, but also patient living conditions 

and environments. Based on equality and patient-centered care, the relationship can sometimes blossom into 

a long-lasting friendship. Second is the quality of comprehensive care and use of evidence-based medicine in 

clinical practice, which together allow chronic patients a higher quality of life. I was moved seeing patients over 

ninety years of age living happily with long-term oxygenation and enrolled in rehabilitation programs. 

I felt incredibly grateful and inspired as the course came to an end. All the mentors, hospital staff, and global 

46

health faculty provided me with a warm welcome, caring atmosphere, and emotional support as I enriched my 

clinical and cultural knowledge. This training has inspired me to work toward providing a higher quality of care 

while helping me realize that I can do so even with limited resources. 

AMONG THE LETTERS 

WE HAVE FORGOTTEN THE “VOW OF POVERTY” 

This was a thought-provoking presentation given by Pierce Gardner that can be used to discuss global health 

challenges and lessons learned from them. Something I got out of it that I feel our students and staff in Zimbabwe 

have lost is the “vow of poverty” as we provide service. I feel we have lost those ideals/values in the way we 

practice. 

Perhaps the suggestion at the start of the talk that everyone should identify a mentor in life is what is lacking 

in the way we train our students. Though we are trying to provide mentorship, it is mostly extended to our 

postgraduate students, which is probably too late. How do we get our undergraduate students to realize the 

importance of having a mentor when our student staff ratio is too large to provide them with mentorship? 

Some years ago, I felt that global health visitors from the Global North “role model” ideal work ethics. I now feel 

some of this gap explains why we keep getting strikes year after year! 

Cheers 

Rati Ndhlovu 

I left Connecticut yesterday with a heavy heart. I am going to spend one more month in the U.S. meditating 

in a Buddhist monastery in upstate New York. I will write you an email about my whole experience at Norwalk 

Hospital. I feel very lucky to have this opportunity. I learned so much and enjoyed it so much at the same time. 

In fact, I feel that I have received a lot. 

I wish you, Anne, and your beloved family a very happy holiday season and new year. Happiness and peace to 

you all. I hope to see you again - maybe in Vietnam. 

With gratitude, 

Khoa 

I was touched by Sr. Jane Frances comments. She is an extraordinary leader. It’s remarkable to be able to count 

one’s successes in life at the end of the year based on the people we have met and the common efforts at shared 

goals, such as building a lab together and strengthening educational programs. We should all advocate for hope 

everywhere we go! 

Katrin Sara Sadigh 

47

Today I had a very successful meeting with the leadership of Datta Meghe Institute of Medical Sciences. Located 

in a remote part of India, this medical school is a large, private university with big hospitals (~1000 bed multi 

specialty hospital). They have agreed to our proposal. 

Swapnil 

NOTES FROM THE FIELD 

We met with administrative staff at Cho Ray Hospital on the morning of October 29th. We discussed the WCHN 

Global Health agenda and expectations of Vietnamese scholars, expressing that we would like to know their 

suggestions toward improving cooperation and participation of scholars with global health in Danbury and 

Norwalk Hospitals. They were very receptive and thankful. We also mentioned that the Global Health MoU is due 

for renewal. The meeting ended well. 

On Tuesday October 30th, with Drs. Lan, Khanh and Sang’s cooperations, we attended a meeting with Global 

Health Scholar alumni where we discussed starting Global Health Alumni in Cho Ray Hospital and appointed Drs. 

Lan, Khahn, and Sang as senior alumni officers. They agreed to have a meeting once a month, stay in touch with 

the global health office by Skype, and provide regular reports. When asked for their suggestions toward making 

their trip to Danbury and Norwalk more successful, most of them expressed that they prefer to come in groups 

of two and seek greater involvement in rounds and conferences. 

We asked our senior alumni officers to be involved in future selection of scholars, and to make sure the scholars 

speak English. We interviewed a few potential scholars to come to Danbury Hospital in future. 

Robert and Menoo Jarrett 

REFLECTIONS 

A WEEK AFTER RETURNING TO THE USA 

DANIEL NAMKOONG (AUC) 

While in Vietnam, I was rotating in a medical system that I was completely unfamiliar with and living in a culture I 

was unfamiliar with among people who spoke a language foreign to me. Despite all of this, returning home came 

with its own stressors. Having been away for an entire month, there was much to attend to upon returning to a 

vacant apartment. In addition to the sudden exposure to spring’s natural allergens, I also returned to NYC during 

its typical volatile seasonal transitions involving sudden swings in temperature from morning to night and day 

to day. This made me nostalgic for the consistency of Ho Chi Minh City’s weather – hot, humid, and predictable. 

While it’s nice to be home, the transition back has certainly been more burdensome than I imagined. 

48

GINA CHA (AUC) 

It has also taught me to be a better listener, someone who understands that the importance of medicine is not in 

just giving prescribing medications, but rather in treating the patient as a whole. Understanding that improving 

a patient’s health comes from understanding a patient’s socioeconomic status, family stability, education, access 

to medicine, and overall mental health. Since returning to my rotations in the States I’ve learned that the 

healthcare system here focuses much more on medication and treating the pathophysiology rather than the 

patient’s psyche. I’ve come to learn that this idea of Western medicine with prescription drugs really takes 

away from proper treatment. I’ve appreciated and am thankful for the opportunity I have had in the Dominican 

Republic where I have met a number of great people. I will forever appreciate my experiences there, because I 

believe that without them, I wouldn’t have learned what I know today. It has definitely opened my eyes and given 

me the tools to becoming a great physician in the future. 

SAMEENA SALCIN HAQUE (AUC) 

I continue to wonder how we live in a world where so many people face such dire poverty. The lack of access to 

clean water, continuous electricity, equal rights, and healthcare should not still be issues in 2018. One thing that 

really stuck out to me in the Dominican Republic was the extreme wealth gap. Many Dominicans live in tiny tin 

roof shacks with their entire family. Many girls do not know how to read or write and are kept at home to take 

care of their younger siblings. 

As healthcare professionals and global citizens, we owe it to our next generation to do better. We need to come 

up with solutions to tackle these problems. Unfortunately, the root cause of many of these issues is often corrupt 

governments. Until the local people decide to fight corruption, as outsiders, there is not much that we can do. 

CHALLENGING MOMENTS IN 

GLOBAL HEALTH 

INFLEXIBLE PARTICIPANTS 

Written by Professor Harriet Mayanja, previous Dean of Makerere University College of Health Sciences, and 

Katrin Sara Sadigh, MD, Global Health Fogarty Fellow, Brigham and Women’s Hospital Boston/Botswana Harvard 

Partnership 


an email to the Global Health Program asking to split the rotation between a previously agreed-upon rural site 

and another site in the capital city to experience both rural and urban medicine. Less than 48 hours after arriving 

to the assigned rural site, the medical student sends a lengthy note... and demands to be transferred to the 

capital. Once there, the student frequently complains to the International Office about the quality of the clinical 

rotation, stating that patients are too sick, and nursing staff and supervising doctors too few, and demands to be 

transferred to a new hospital or another clinical ward. 

49

PHOTO AND CLINICAL CASE 

QUIZZES 

ANSWER TO LAST ISSUE PHOTO QUIZ 

QUESTION: What parasite celebrates the occasion to complete its life cycle (Pakwach town by West Nile)? 

ANSWER: Schistosomes 

Schistosomes, or blood flukes, have a complex life cycle that begins in the human portal system. Adult schistosomes 

predominantly reside in the portal circulation, where 300-3000 eggs are released by each female parasite every 

day. These eggs penetrate into the bladder or intestines and are shed in the urine or stool, depending on the 

species. Once they reach fresh water, the eggs transform into ciliated motile embryos called miracidia (upper 

right photo). The miracidia must then find and enter the intermediate host, the snail (shown here in the right 

middle picture). Within the snail, the miracidia further maturate into cercaria (shown in the lower right picture), 

and are released into the water in response to the presence of light. This responsiveness to light explains why 

the risk of contracting schistosomiasis is greatest in the warm waters of daylight. Cercaria are highly motile and 

infective. They gain access into the human host by penetrating the skin, and then travel through the lymphatic 

system and veins until they reach the lungs and finally the portal circulation of the liver where they become adult 

schistosomes, select mates, and begin the whole process anew. 

50

PHOTO QUIZ 

A patient with AIDS at Mulago Hospital in Kampala, Uganda 

ANNOUNCEMENTS 

NEW PUBLICATIONS 


Art Designer; Amanda 

Wallace 


Art Designer; Amanda 

Wallace 

Photos; David Seaver 

Text; Erin Post 

51

LOOKING AHEAD 

We are looking forward to working with Dr. Glenn Loomis, Chief 

Medical Operations Officer at Health Quest and President of Health 

Medical Practice, P.C. Prior to arriving at Health Quest, Dr. Loomis 

was President and CEO of St. Elizabeth Physicians in Crestview 

Hills, Kentucky as well as Senior Vice President of St. Elizabeth 

Healthcare, a five-hoBspital system in Edgewood. He also has 

extensive experience as a physician and educator, having served 

as Program Director of the Family Medicine Residency Program at 

Mercy Health and Associate Director of the Family Practice Residency 

Program at St. Francis Hospital. Dr. Loomis also served in multiple 

positions during his four-year tenure in the United States Air Force 

Medical Corps. 

After graduating cum laude in psychology/biology at Ohio State 

University, he went on to study medicine at the College of Medicine 

and then complete a family medicine residency at Community Hospitals of Indianapolis where he was Chief 

Administrative Resident. He is board certified in family medicine by the American Board of Family Medicine, 

has completed fellowships in Teaching and Health Care Policy, and holds a Master of Science in Healthcare 

Management from University of Texas at Dallas. Having published in multiple medical journals, Dr. Loomis has 

been highly involved in teaching and research. 

CONGRATULATIONS 

TO DR. BELSKY ON HIS 

RETIREMENT 

Dr. Belsky (right) at his retirement ceremony 

Dr. Belsky, arguably the grandfather of global health at Western Connecticut Health Network, served as Chief of 

Medicine for the Atomic Bomb Casualty Commission in Hiroshima/Nagasaki from 1969 to 1972. He founded the 

residency program at Danbury Hospital in 1975 with three residents from three countries. In 1997, Dr. Belsky 

was a consulting endocrinologist for the Marshall Islands Medical Program at Kwajalein Island (Atoll). He was also 

a team member of Diabetes Educators to Russia and China in 1987. 

52

In 1986, Dr. Belsky founded Danbury Hospital’s Research Day which is now named in his honor. He has taught 

at Tufts University School of Medicine, Yale University School of Medicine, Hiroshima University, University of 

Vermont Larner College of Medicine, and Danbury Hospital. Those of us who have had the fortune of working with 

him continue to be inspired by his passion for the practice of medicine, education, research, and making human 

connections. We celebrated the long career of Joseph L. Belsky, MA, MD, MACP, on December 5, 2018. 

On December 18th, Dr. Joseph Belsky saw his last patient after sixty years of practicing medicine in the section 

of endocrinology. He will continue his research in the coming years, and We look forward following his work as he 

continues his research in the coming years. By Mary Shah 

Congratulations to Benjamin Clements, the director of global health in department of family medicine at 

UVMLCOM, and his wife for the birth of their son on December 6th. 

FOLLOW-UPS 

Dr. Scholand with Desiree Golden APRN, in a refugee clinic, Tucson, Arizona 

53

GLOBAL HEALTH AT HOME 

Update: Arizona Global Health Site 

Dr. Stephen Scholand has been working to build an indigenous global health site for underserved populations 

within the United States. Provisionally referred to as “Global Health at Home,” this clinical experience will include 

healthcare of Native American and socioeconomically deprived populations including immigrants and refugees. 

Thus far, Dr. Scholand has engaged the leadership at several sites including Sells Hospital, a small healthcare 

facility on the Tohono O’odham Reservation in southern Arizona only a few miles from the Mexican border. Another 

clinical site under review is the Chiricahua Community Health Center which is part of the Indian Health Service. 

A third site includes a refugee clinic in Tucson through the University of Arizona. Together, these compound 

experiences 

promise a wealth of clinical and cultural exposures to medically underserved populations in the desert Southwest 

of the United States. 

Further logistical and developmental support has been continued with the procurement of low-cost housing in 

Tucson. Participants may need to avail of public transport in Tucson, or utilize Uber for travel within the city. 

Efforts for a homestay model are under review on reservation areas. 

The signed MoU with WU in South Thailand has been submitted to the legal office of WCHN for final review and 

approval. 

ARTICLE OF THE MONTH 

How to Restore the Credibility of UNAIDS 

“The UNAIDS Secretariat is in crisis, a crisis which threatens its vital work.” Astonishing does not even begin to 

describe the findings and recommendations of an Independent Expert Panel, set up to investigate harassment, 

including sexual harassment, bullying, and abuse of power at UNAIDS… 

Read more here >> 

54

GLOBAL HEALTH 

AND THE ARTS 

Wangari Maathai, the Nobel Peace Prize 

winner 

For the year, two thousand and four 

An environmentalist from remote Kenya 

Said in a soulful voice from her selfrealized 

soul 

So that all eager souls can hear it loud 

and clear: 

‘We are called to assist the Earth to heal her wounds 

And in the process heal our own, 

Indeed, to embrace the entire creation 

In all its diversity, beauty and wonder, ‘ 

And, what a discreet declaration we did finally hear 

From a recognized world thinker 

At a time of materialistic impatience lacking due ponder 

It does ring like a lulling music to numerous ears 

Many of us hear Earth’s cry owing to her grave wounds 

But can’t articulate in the way Wangari Maathai did 

Yet mother Earth does speak out to our heart 

Only the compassionate souls do have the ear to hear 

In fact, Mother Earth is groaning in pain 

From centuries of neglect by her very own children 

Whom she has been nourishing with all she has got 

Yet can’t meet their endless selfish demands 

Demanding more and more from her limited resource 

Yet she is still carrying on as all mothers do 

At the expense of her own health creating happiness for 

us 

Hence, suffering all the time in pain 

As she can’t replenish her reserve the way she wants to 

Wangari Maathai 

This imbalance is affecting the health of all beings too 

From the unicellular to multicellular to all humans 

Creating rare diseases, aberrations and extinctions 

That we do see now all over the world 

Because when we go against the will of Mother Nature 

There is no other way for us but to suffer 

And as we reach the extreme limit as we have now 

Her ecological health is truly in grave danger 

So bad that she needs our concerted efforts in this 

endeavor 

Ensuring all of us across the globe working for her together 

It seems though we have reached the rock bottom, at last 

The way to our survival now is to go upward or perish 

So let’s resolve today not to make this an end of our 

journey 

But an era of a new beginning for a balanced future 

55

TUSHAR RAY 

Tushar Ray is a Ph.D. Biochemist. He began to 

perceive the viewpoints of modern scientists in the 

light of spiritual wisdom like ancient poets in India, and 

wanted to combine his knowledge in biochemistry with 

traditional spiritual science to express the basic unity. 

He has written poems in both Bengali (since childhood) 

and English (since the 1980’s). His series “Om Poems: 

Self-Meditation and Science and Spirituality in 

Balance” was published in 2004 by Publish America 

in Baltimore, Maryland and is available in major 

bookstores worldwide. 

SONITA ALIZADEH 

Sonita Alizadeh narrowly avoided being a child bride. Now she raps about ending forced marriage. 

https://mashable.com/article/sonita-alizadeh-rapper-end-child-marriage/#htMEC5dNtgqV 

56

PHOTO CONTEST 

Happy Christmas (Svetlana Bogatyr) 

Under the fingers of love (Majid 

Sadigh) 

Life By Water (Albert Trondin) 

Under the fingers of love (Majid 

Sadigh) 

57

CALENDAR 

DECEMBER CALENDAR 

December 3rd: Dr. Liliia Urazaeva, Cardiologist 

from Kazan Federal University, Russia, arrived 

to Danbury Hospital for five weeks of training 

in cardiology. 

December 6: Dean Page and other medical 

education leadership of UVMLCOM had several 

meetings with the leadership of WCHN at 

Norwalk Hospital. 

December 11: Dr. Sadigh had a final debriefing 

session with Global Health Scholars at Norwalk 

Hospital. 

December 12: Dr. Sadigh and Ms. Lauri Lennon had an 

introductory meeting with Dean Alfano and Professor 

Cima Sedigh at Sacred Heart University’s Farrington 

College of Healt h Education. 

December 12: Dr. Peter Agaba, Global Health Scholar 

from MakCHS, received a certificate of completion for 

his training in ICU medicine, pulmonary medicine, and 

anesthesiology from Dr. Robyn Scatena, Associate 

Director of the Global Health Program at Norwalk 

Hospital. 

December 14: Dr. Sadigh and Ms. Lauri Lennon had 

a meeting with members of the WCHN Foundation 

to discuss strategies in support of the Global Health 

Program, and specifically Global Health Scholars. 

December 16: Dr. Nam and Dr. Khoa, Global Health 

Scholars from Vietnam, received certificates of 

completion for their training in ICU medicine, pulmonary 

medicine, and anesthesiology from Dr. Robyn Scatena, 

Associate Director of the Global Health Program at 


58

From Lt. to Rt. Dr. Nam, Dr. Scatena, and Dr. Khoa 

December 17: Dr. Sadigh had a meeting with Dr. Khoa to discuss the details of a research project assessing the 

impact of the Global Health Program on Global Health Scholars in Vietnam. 

December 17: Dr. Sadigh had a meeting with Dr. Ian Weir, Director of the Pulmonary and Sleep Medicine 

fellowships at Norwalk Hospital, to discuss the potential of a partnership in Puerto Rico. 

December 17: Dr. Sadigh had a meeting with Dr. Robyn Scetana to discuss 2019 Global Health Day as well as 

the Global Health Scholars Program at Norwalk Hospital. 

December 18: Dr. Sadigh had a monthly meeting with Ms. Andrea Rynn, the Director of Public and Government 

Relations, to discuss ways of publicizing the Global Health Program and further growing our community. 

December 18: A celebration of the newest Endowed Chair was held at WCHN. 

December 19: Dr. Sadigh made an administrative trip to UVMLCOM where he met with several Global Health 

Program and medical education leaders. 

December 21: Dr. Stephen Scholand traveled to Arizona for the second time to establish the first site for Global 

Health at Home. 

59

JANUARY CALENDAR 

January 3: Dr. Vo Phuong Loan, Global Health Scholar from Vietnam, returns to Vietnam after four months of 

cardiology training at Danbury Hospital. 

January 3: Dr. Cheleng Brifkani, a medical resident at Norwalk Hospital, leaves for a six-week global health 

elective at Cho Ray Hospital, Vietnam. 

January 6-8: Dr. Sadigh makes an administrative trip to UVMLCOM to meet with the Global Health Interest 

Group and program leadership. 

January 7: Dr. Sadigh, Dr. McNamara, and Dr. Moore hold the first introductory welcome session with seventeen 

UVMLCOM medical students selected for the Global Health Pathway. 

January 7: A welcome dinner at Dr. Mariah McNamara’s home, attended by Global Health Program alumni and 

the Global Health Team, is held for UVMLCOM students selected for the Global Health Pathway. 

January 7: Fourth-year RUSM students Mariama Barry, Fred Bien-Aime, and Andres Camacho begin a six-week 

global health elective in Naggalama, Uganda, and Samantha Elias Boustani begins a six-week global health 

elective in the Dominican Republic. 

January 8: Fourth-year RUSM students Dawn Marie Hill and Jessica Kate Hudson travel to Russia for a six-week 

global health elective. 

January 10: Dr. Liliia Urazaeva, Global Health Scholar from Russia returns home after five weeks of cardiology 

training at Danbury Hospital. 

January 12: Dr. Moses Othin, Global Health Scholar from Uganda, arrives for a four-month training in pulmonary 

medicine, ICU medicine, and anesthesiology at Norwalk Hospital. 

January 12: Dr. Bulat Ziganshin, Director of the Global Health Program for AUC/RUSM, Ms. Lauri Lennon, 

Director of Business Operations at WCHN, Ms. Laura E. Smith, Coordinator of the Global Health Program at 

WCHN, and Mr. Jeffrey B. Anderson, Northeast Regional Coordinator at AUC, travel to Uganda for a one-week 

administrative site-visit. 

January 13: Fourth-year RUSM student Antonia Nwankwo travels to the Dominican Republic for a five-week 

global health elective at UNIBE. 

January 21-25: Global Health Bridge is held for third-year UVMLCOM students. 

60

PHOTO NEWS 

GLOBAL HEALTH LEADERSHIP OF DATTA MEGHE INSTITUTE OF 

MEDICAL SCIENCES, INDIA 

From left to right: Dr. Lalitbhushan Waghmare, Dean of Interdisciplinary Health Sciences at DMIMS; Dr. Shweta Parve, 

Global Health Program Coordinator for Allied Courses at DMIMS and Dr. Tripti Srivastava, Global Health Program 

Coordinator for Mainstream Courses at DMIMS. 

Dr. Quazi Syed Zahiruddin 

Director, Research and Development 

Associate Dean, Global Health 

61

Dr. Swapnil Parve with the leadership of Datta Meghe Institute of Medical Sciences, India 

GLOBAL HEALTH SCHOLARS AT NORWALK HOSPITAL 

Dr. Khoa, Dr. Nam, and Dr. Agaba, Global Health Scholars, Norwalk Hospital 

62

From Lt. to Rt. Dr. Khoa, Dr. Scatena, and Dr. Nam 

63

RESOURCES 

Site Specific information 

Ho Chi Minh City and Cho Ray Hospital 

Kasensero Uganda 

Paraiso and the PAP Hospital 

Tropical Medicine Modules 

The Homestay Model of Global Health Program video 

Ebola book 

Global Health Diaries and Newsletters 2015-2016 



The World of Global Health book 

The World of Global Health Video 

A Connecticut Doctor in Africa, by journalist Mackenzie Riggs 

Climb for a Cause 

Global Health Annual Reports 

Global Health Program Website 

Global Health at WCHN Facebook 

Photographs from Uganda, by photojournalist Tyler Sizemore 

UVM Larner College of Medicine Blog 

Previous Issues of the Global Health Newsletter 

Global Health Reflections and Photos 

Publications 

64

FEBRUARY 2019 Volume 2 





65


We enthusiastically welcome our first wave of Global Health Pathway students at UVMLCOM. Each of th ese 

thirteen individuals has demonstrated interest in and aptitude for global health competencies, research, and 

health advocacy. We received over twenty-five outstanding applicants but were only able to offer a spot to 

seventeen. We congratulate UVMLCOM for attracting and recruiting such a talented student body. 

(left to right) Prasanna Kumar, Adam Ross, Isaac de La Bruere, Alexa Pius, Collin Montgomery, Ray Mak, Amelia 

Anderson, Kalin Gregory-Davis, Jose Calderon, Elena Martel, Kathleen O’Hara, Irene Sue. Missing: Alim Esemenli 

WCHN/AUC/SHU DELEGATES IN UGANDA 

Dr. Bulat Ziganshin, Director of International Affairs and AUC/RUSM Electives at the Global Health Program; Lauri 

Lennon, Director of Business Operations at WCHN; Laura E. Smith, Coordinator of the Global Health Program at 

WCHN; and Jeffrey Anderson, AUC Senior Regional Clinical Coordinator for the Northeast, traveled to Uganda to 

meet with the leadership of our partner sites at MakCHS, St. Stephen’s Hospital, St. Francis Naggalama Hospital, 

ACCESS and Nakaseke Hospital. Their main agenda focused on gathering feedback for quality improvement, 

exploring opportunities for expansion, and celebrating new developments. 

Hosted by Dr. Isaac Okullo, Reverend Professor Samuel and Christine Luboga, and the Naggalama and Nakaseke 

Guest Houses, these delegates were particularly impressed by the homestay models and quality of medical 

education. While visiting all our partner sites, they explored potential for new collaborations with the newlyestablished 

Emergency Medicine Residency Program at MakCHS as well as research projects with ACCESS. 

66

Their trip coincided with two important opening receptions: the WCHN Global Health Information Center where 

participants staying with the Lubogas will undergo orientation and supplementary sociocultural curriculum, and 

the Microbiology Lab at St. Francis Naggalama Hospital. We are delighted that our delegates were able to celebrate 

these memorable events with our esteemed partners in Uganda. 

Delegates with Professor Charles Ibingira, Principal of MakCHS 

Global Health Program delegates and St. Francis Naggalama Hospital administration celebrating the opening of the 

Microbiology Laboratory 

67

The WCHN Global Health Information Center 

Opening of the WCHN Global Health Information Center at Reverend Professor Samuel and Christine Luboga’s Homestay 

68

The idea of establishing Global Health Information Centers in Uganda, and gradually in our other international 

partner sites, reflects the extent of our community involvement. Collaborative in both idea and implementation, its 

main objectives involve providing resources to the surrounding community and steering Global South interest in 

global health. However, our greater vision conjures 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 sites will also be the 

support hub for participant orientation, sociocultural curriculum, and matching of participant needs with available 

resources and vice versa. While the classes held at the centers will be offered mainly to our own participants, we 

intend to eventually open them to international participants in other programs. 

Our delegates at WCHN Global Health Information Center 

Dr. Stephen Scholand, Global Health Program Site Director in 

Thailand, Vietnam, and Zimbabwe, and Tendai Machingaidze, 

Global Health Program Associate Site Director in Zimbabwe, Site- 

Visited University of Zimbabwe College of Health Sciences (UZCHS) 

Dr. Stephen Scholand, Global Health Program Site Director in Thailand, Vietnam, and Zimbabwe, and Tendai 

Machingaidze, Global Health Program Associate Site Director in Zimbabwe, site-visited the University of 

Zimbabwe College of Health Sciences (UZCHS). During their trip, they convened with the UZCHS and Parirenyata 

Hospital leaders Dr. Margaret Borok, Dr. Pamela Chidawanyika, Dr. Rati Ndhlovu, and Dr. James Hakim as well as 

Clinical Research Center staff. They also met with special guests and department heads during a dinner meeting 

hosted by the Machingaidze family. Meeting highlights include engagement of the Pediatrics Department at 

Parirenyatwa Hospital for an enriched pediatric experience for our global health participants. The possibility of a 

partnership with KidzCan, a children’s cancer charity that runs a children’s oncology ward at Parirenyatwa, was 

also discussed. Through this partnership, global health participants would gain exposure to retinoblastoma, Wilms 

tumor, leukemias, lymphomas, and other pediatric cancers. 

69

Dr. Stephen Scholand, Tendai Machingaidze, UZCHS department heads and medical education leaders with the 

Machingaidze family 

Dr. Stephen Scholand and Tendai Machingaidze with members and leadership of “Changing the World” KidzCan charity 

in Harare 

70

FACULTY AND STAFF SPOTLIGHT 

MR. JEFFREY ANDERSON; 

AUC Senior Regional Clinical Coordinator For The Northeast 

Jeffrey Anderson, a member of the WCHN Global Health Program delegates 

who recently visited our international partner sites in Uganda, joined AUC in 

2016 as the Senior Regional Clinical Coordinator for the Northeast. Through 

this role, Mr. Anderson advises AUC students - including those enrolled in 

the WCHN/UVMLCOM Global Health Program - remotely from his home 

in Connecticut and on-site at AUC’s clinical rotations in NY, CT, MD, and 

Washington, DC. Prior to joining AUC, Mr. Anderson spent twenty years as a 

marketing and communications executive in the financial services industry. 

Mr. Jeffrey Anderson during a house visit in Nakaseke, Uganda 

71

JUSTUS IBRAHIM TWINOMUJUNI 

Coordinator Of International Programs And Research Engagement At The African Community 

Center For Social Sustainability (ACCESS), Uganda 

My extensive background in education, research, and administration come 

to play in my current role as senior Clinical Instructor at the ACCESS 

School of Nursing and Midwifery. My work also involves community health 

development, research innovations, and coordination of UVMLCOM/WCHN 

global health participants at the ACCESS Headquarters in Nakaseke. 

I am passionate about global population health in relation to research 

conduction, with a specific focus on maternal-child health and health 

systems governance. I am inspired by the information age during which 

the concept of a global village dissolves all boundaries. In the spirit of this 

grand connectivity, I am joyful and proud to call myself a citizen of the 

world. 


Zim has been at it again, but this time is a lot worse than in 2017. Then we felt safe. Now we do not know 

what the immediate future holds for us. The looting and destruction of property in some areas, especially in 

Bulawayo, was bad. We are otherwise okay for now. 

Chiratidzo Ndhlovu 

My heart breaks for you and the marvelous people of Zimbabwe. Even though I was in Zimbabwe for only a short 

time, the country and its people left an indelible mark on me. It hurts so much to see so much suffering and loss 

in a place that should be releasing the intelligence and creativity of the very special people who live there. I will 

pray for the good health and safety of you, your family, and your country. Please stay in touch. 

Dr. Stephen M. Winter 

Rati — I am so sorry for all that you are going through. I hope that peace, law, and order return to Zim soon. Stay 

safe and let us know if and how we can help. 

Aparna Oltikar 

Chairperson of Danbury Hospital’s Department of Medicine 

72

I am so happy about how well the Naggalama relationship has worked out. It seems to be a great experience for 

our students. I congratulate and admire Dr. Eison and Dr. Randi Diamond for their investment in this partnership 

because of the relationship’s intrinsic value. The decision to donate the proceeds from the last Kilimanjaro climb 

to the hospital lab was brilliant. It really locked in the relationship and gained the complete support of the hospital 

administration. Congratulations to the members of the WCHN Global Health Program for their outstanding work. 

I love watching how the program has developed and moved forward. 

Dr. Stephen M. Winter 

The translation of Tropical Medicine 202 to Spanish is moving along nicely. I am currently working on the last third 

of the book, and have made some annotations of possible typos. I will share them with you later. Warm regards. 

Dr. Wendy Perdomo 

Global Health Scholar from UNIBE, Dominican Republic 

Dear Bulat, 

Thank you for that powerful message of gratitude for your experience during the recent site visit to Uganda. We 

continue to do the best we can as a staff body at St. Francis Naggalama Hospital. 

Meanwhile, another fourth-year UVMLCOM student will be rerouted for her global health rotation from Zimbabwe 

to Naggalama from April 1 - 26. We surely will take her more so for the eventual strengthening of the Orthopedic 

Department which still needs boosting. Her plan to specialize in Orthopedic Surgery is most welcome as I find 

her a good fit in this area. 

Otherwise, we were quite excited to get to know you and your simplicity in fitting into our local situation. Ours is 

a beautiful country with simple, welcoming people - hence maintaining this culture in the workplace. 

Be blessed as you continue to make a difference in this world. 

Sister Jane Frances 

We thank Dr. Bulat Ziganshin and his team for being part of the ACCESS vision. We are so delighted to have 

our friends come and see the organization in-person. We prayed for a long time for the entire UVM team come 

and visit us, a dream that is slowly coming to fruition. The visit was well-graced, especially when the team met 

Nakaseke Hospital’s new Director. With his assurance and administration, I have no doubt that our expectations 

will be realized. 

We look forward to a fruitful continued collaboration. 

Katali Estherloy 

73

Dear Bulat and the Global Health Program team, 

I am glad we got to meet, though briefly. I look forward to future collaborations with your medical students. Do 

let me know when you have confirmation of dates. I am sure this partnership will become exemplary and unique, 

with many creative educational/ research projects and publications burgeoning from it! 

Kind regards, 

Joseph Kalanzi 

Dear Dr. Bulat Ziganshin and the team, 

Thank you for the appreciation. We too appreciate the time and resources you put into interchange with us. 

Your presence meant a lot to us in terms of networking and working together for the common good. I personally 

believe that this is a strong step in ensuring fruition of the global health agenda and a means of achieving big 

beyond our expectations. Thank you for your continued support and guidance with sincere understanding. 

Sincerely, 

Justus 


“We are all happy, doing well, and having an amazing time in Uganda. Sister Jane Frances and her staff at St. 

Francis/Naggalama Hospital are amazing. Palliative care community visits were sad but I’m glad we did them, as 

they were really eye-opening. I’m amazed by how grateful everyone is, even if they are living under the bleak 

shade of poverty. The WCHN Global Health Information Center at Reverend Professor Samuel and Christine 

Luboga’s home looks professional and is up and running beautifully.” 

Lauri Lennon 

Director of Business Operations at WCHN 

“Yes, I can confirm that the two medical students slated for Zimbabwe are most welcome to join the other three 

expected from February 18th - March 29th. Indeed we have enough room and plenty for them to do. Best 

regards.” 


Director of Saint Francis Naggalama Hospital 

74

Interested in the Bond We Will Create 

Initially nervous about being in a new country, living with a family I did not know, and surrounded by people 

speaking a language I could barely understand, I hoped I would acclimate well to my new environment. However, 

this apprehension quickly faded as I boarded my flight and began hearing Spanish all around me. Butterflies of 

excitement fluttered, and I could not wait to begin this new adventure. 

I felt warmth and comfort stepping into the apartment I would be staying in. Marissa, my Dominican mom, 

welcomed me into her home with open arms. I instantly felt at home with my new family. Though my Spanish 

is weak, Marissa and I have been able to communicate well enough to feel a bond. She truly treats me like her 

daughter. We even planned a day for her to teach me how to make a traditional Dominican dish. The way she and 

her family have treated me is more than I ever expected or could ask for. I look forward to my next few weeks 

with them and am interested in the bond we will create. 

Samantha Boustani 

(RUSM), Dominican Republic 

The Welcome 

The welcome in Uganda has not stopped since we arrived at the airport. I have yet to come across a staff member 

at the hospital who has not been willing to guide me to where I am headed or teach me when I am on their 

service. What I love the most so far is the opportunity to experience medicine in all its forms. 

Aside from life at the clinic, we have been able to experience the cultural side of our trip through interactions 

with the community, be they with patients or staff. A staff member at the Guest House teaches us not only about 

Ugandan cuisine but also the language and way of life. She has been an amazing asset to us so far, and has made 

sure that all our questions and concerns are addressed appropriately. 

Mariama Barry 

(RUSM), St. Francis Hospital, Naggalama, Uganda 

How It Is Easy to Fall in Love 

Coming here, I expected to learn the practice of medicine in a low-resource community. What I did not expect 

is the extent to which my heart would grow here. One thing I love about medicine is that it is the equalizer. No 

matter your race or wealth, everyone becomes ill and needs medicine to bail them out. Though finances are at 

the forefront of every patient’s mind at Naggalama Hospital, from what I’ve seen, hospital staff try their best to 

see every patient. 

The greenery, tropical temperature, and occasional breeze made me instantly fall in love with this beautiful 

country. It reminds me of the Caribbean where I received my medical training as well as the place where my 

parents grew up. Simply being in Naggalama Hospital has been a blessing. 

Fred Bien-Aime 


75

Poverty Has Captured My Heart 

Buildings covered with a dust became the common landscape. But an overwhelming sight of poverty was what 

captivated my heart. It was a surreal feeling. Hours ago I left the United States, a country with such abundance, 

and entered a country that displays such need. Once we arrived to Naggalama, I felt ready to start and do my 

best to help. Touring the hospital was sublime. Doctors and nurses working together with few resources to help 

the sick triggered a heart of service within me. I wanted to become that doctor who denied himself for the benefit 

of others. People struggling to survive are grateful for a program that reaches out to them. Their welcoming eyes 

displayed hope in us, and that empowered my mission. 

Andres Camacho 


Similarities and Dissimilarities 

Since landing in Kazan, everything has been an absolute delight. We walked thirty-five miles sightseeing the 

beautiful city during our first week. Though it is cold here, I have been mostly comfortable outside with the 

gear I brought with me. Bringing different clothes to change throughout the day is a transition, but I am quickly 

acclimating to the climate shift from inside to outside. Our first week in the Intensive Care Unit has been quite 

a unique experience, as learning the differences in medical practices and medications has broadened my clinical 

knowledge in such a short time. I have particularly enjoyed conversing with attendings and residents about 

the likes and dislikes of our medical systems; learning the different protocols of sepsis, dialysis, central line 

placement, and pulmonary embolism; and seeing diseases I have never seen in the United States. I am most 

eager to learn about additional pharmaceuticals unique to Russia in the next week. 

https://www.instagram.com/p/Bs7hRdAAT9b/?utm_source=ig_web_button_share_sheet 

Jessica Hudson 

(RUSM), Kazan, Russia 

“Mutuality and Bi-directionality”: A Case of Global Health 

Principles in North Central Uganda 

We are a team of individuals who believe in collective responsibility as the unveiling portal of embracing each 

other’s contribution towards achieving global health agendas. It is by revering the essence of mutuality that we 

seek to coexist in favour of this agenda. Global health engagements thrive when all parties interact with each 

other’s continuum in connection to worldview resonance. It is cognizable that running a global health program, 

though a collective responsibility, gains greater meaning when feedback, both negative and positive, is leveraged 

toward revolutionizing stipulated practice models. Liveliness of global health principles lies in the dicta of respect 

for humanity and standard protocols, synergy of each other’s strengths, and open mindedness/diversity in 

tackling actual and potential operational challenges without rescinding global health quintessence. 

Justus Ibrahim Twinomujuni 

ACCESS, Nakaseke, Uganda 

76

The Most Beautiful Music Was Coming From a Back Room 

Although trekking through the Moscow airport to get to the right terminal resulted in me missing my flight, I 

found Aeroflot to be one of the most forgiving and willing airlines I’ve ever encountered, and I was able to get a 

later flight to Kazan with no issue. 

Alsu met us at the airport and guided us through many things we needed here in Kazan. We were escorted to 

our dorm which is comfortable, much bigger than expected, and has all that is needed. Although there was no 

electricity in half of the apartment - my room and the bathroom - I was able to get ready the next morning in the 

dark with no problems. 

The evening of arrival, Ramil escorted us to many places: the town center, which is a mall with many shops and 

also the site of our bus stop; Bauman Street, a main tourist area with beautiful Christmas lights lining the street; 

Kazan Kremlin; and the beautiful Mosque which we were able to enter. We also went inside the Orthodox Christian 

Church where the most beautiful music was coming from a back room. I’m not sure if it is always playing or only 

during rehearsals, but it resonated throughout the entire building and stopped me in my tracks. Of course we had 

to cover our heads out of respect, and I ended up looking like a Babushka! 

Dawn Hill 

(RUSM), Kazan, Russia 


“AS CONGO ELECTION NEARS, RIOTERS STORM AN EBOLA CENTER 

AND UNREST GROWS” 

“Protesters stormed an Ebola triage center in the volatile eastern region of Congo on Thursday and set fire to parts 

of it in a new wave of violent political unrest, aggravated by delays in a long-anticipated election. The violence 

erupted a day after the electoral commission excluded Beni and another eastern city, Butembo, from the elections 

set for Sunday. Both cities are hot spots in the region’s Ebola crisis, and the commission blamed the outbreak in 

announcing the exclusion. The town of Yumbi was also excluded, but ostensibly because of violence, not Ebola.” 

Click here to read the full New York Times Article 

FRONTLINE: THE EBOLA RESPONSE IN THE LEAD UP TO DR CONGO’S 

PRESIDENTIAL ELECTIONS 

“On Dec 26, 2018, DR Congo’s Independent National Electoral Commission (CENI) declared that elections in 

the Beni region, Butembo, would be postponed until March due to concern about an ongoing Ebola outbreak, 

essentially preventing people in the region from voting in the Dec 30 presidential election. Local populations 

accused the government of using the disease to prevent the Beni electorate from voting, the area being a 

stronghold for opposition leader Martin Fayulu.” 

77

An Ebola Treatment Center this month in Beni, Congo. 

Credit: Diana Zeyneb Alhindawi for The New York Times 

Click Here to read the full article 

In Beni, Congo, election delays have prompted violent 

protests over the past week. Credit; Alexis Huguet/Agence 

France-Presse — Getty Images 


GLOBAL HEALTH 

Challenging moments are an inherent component of global health electives, and can be ascribed to an array of 

sources including insufficient orientation, unrealistic expectations, unfamiliarity with the culture and way of life, 

or mismatch between participant and elective. “Challenging Moments in Global Health” aims to address these 

issues by featuring real cases that have been written by global health coordinators, directors, and leaders over 

the years. We hope that readers share their responses, thoughts, and personal experiences so that we as a 

community can learn from each others’ insights. 


Written by Dr. David Chia 

Clinical Assistant Professor of Medicine at the University of California San Francisco School of 

Medicine 







transferred to a new hospital or another clinical ward... 

Read more here 

78

ANNOUNCEMENTS 

CONGRATULATIONS! 

To Dr. Anton Gryaznov for his acceptance to the Residency Program of University of Maryland’s Department of 

Nuclear Medicine and Radiology. 

• The Global Health Program website is in the process of being updated. 

• Bootcamp for Global Health Pathway students has been set for June 22, 2019. 

• Three leadership members from the Makerere University School of Public Health will visit UVMLCOM in early 

April. 

• The Microbiology Lab at St. Francis Naggalama Hospital opened on January 16th during the WCHN/AUC 

delegate visit. 

• The first WCHN Global Health Information Center opened in Uganda. 

We welcomed Global Health Program delegates Dr. Bulat Ziganshin, Lauri Lennon, Laura E. Smith, and Jeffrey 

Anderson on Tuesday, January 15th. We took advantage of their presence to open the Microbiology Lab the next 

day before their departure. We were delighted that the team was here to join the celebration our celebrated this 

special occasion. It was an exciting moment for us all. 

Sister Jane Frances, Director of St. Francis/Naggalama Hospital 

UNREST IN ZIMBABWE 

Our Global Health Program site in Zimbabwe 

has been temporarily closed due to recent 

widespread anti-government demonstrations. 

Our hearts go out to our friends and their 

families during this time of hardship. You are 

in our thoughts and prayers. The global health 

participants who were originally stationed at 

University of Zimbabwe have been relocated 

to Uganda. 

Protesters gather on the streets during demonstrations over 

the increase in fuel prices in Harare, Zimbabwe on Monday. 

(Tsvangirayi Mukwazhi/AP) 

click here to read the Washington Post article 

79

EBOLA SCREENING MEASURES EXPANDED AT ENTEBBE 

INTERNATIONAL AIRPORT 

The World Health Organization has ordered 

mandatory Ebola screenings for all passengers 

passing through Entebbe Airport. Those with 

a fever will fill out a questionnaire, and those 

suspected of infection will be quarantined. Though 

there are no reported cases of Ebola in Uganda 

as of present, the nation’s strong surveillance 

systems and public health infrastructure are being 

mobilized to prevent the spread of Ebola from the 

Congo. Though historically successful, political 

instability preventing healthcare workers from 

accessing high-risk areas is making confinement 

challenging. 

Click here to read the full article >> 


QUIZZES 

ANSWER TO LAST ISSUE PHOTO QUIZ 

QUESTION: A patient with AIDS at Mulago Hospital in Kampala, Uganda (Photos courtesy of Dr. Majid Sadigh) 

ANSWER: Asymmetrical edema of extremities due to interruption of lymphatic system function by Kaposi Sarcoma 

(KS). KS nodules are shown on the dorsum and plantar surface of the feet. 

80

PHOTO QUIZ 

A patient with AIDS 

at Mulago Hospital in 

Kampala, Uganda 

GLOBAL HEALTH 

AND THE ARTS 

“AIDS WARNING” 

Tendai Machingaidz 

Global Health Program Associate Site Director 

in Zimbabwe 

Interview with Gilbert Douglas, Former Artistic 

Director of Tumbuka Contemporary Dance 

Company 

Gilbert Douglas was born in 1968 in Mbare, Harare. 

While rehearsing with an informal break dancing group, 

Douglas was spotted by Vivienne and Chris Hamblin 

from the National Ballet of Zimbabwe. The Hamblins 

were doing outreach work in high-density, low income 

areas, and invited him first to a workshop and later for 

a three-year dance foundation course with the National 

Ballet. 

Tumbuka Contemporary Dance Company was 

established by British choreographer Neville Campbell 

in 1992. As a visiting choreographer to the National 

Ballet of Zimbabwe, Campbell was impressed with the 

talent he saw in dancers from the “townships” who were 

81

completing the three-year course. Subsequently, Campbell moved to Harare to form a professional company with 

these dancers, one of whom was Gilbert Douglas. 

Kutumbuka is a Shona word that means “to sprout or flower.” Through Tumbuka, Campbell afforded his dancers 

the opportunity to express themselves via a unique fusion of modern and traditional dance styles. Tumbuka 

quickly rose to international acclaim, with tours in Senegal, Malawi, South Africa, Botswana, Mozambique, Angola, 

Ivory Coast, South America, Reunion, France, Switzerland, Germany, Belgium, Slovakia, Belize, and Denmark. 

Many of the works that Tumbuka performed were influenced by the culture and society in which the dancers 

lived. The group used dance not only as a means of self-expression, but also as a voice that spoke out on 

important contemporary issues. Following Campbell’s departure, Gilbert Douglas was appointed as Tumbuka’s 

Artistic Director in April 2004. Below is an interview with Douglas on works they performed that addressed the 

controversial topic of HIV/AIDS in Zimbabwe: 

“We did two different works with Tumbuka on HIV/AIDS and they were inspired by different issues pertaining 

to the scourge. The first one was called “AIDS Warning” and was choreographed by Neville Campbell around 

1998. This was at the height of the epidemic in Zimbabwe. I don’t know if you remember, at the time, we were 

attending at least two to three funerals of people we knew per week. This was a “fun” dance aimed at warning 

about promiscuity and promoting the use of condoms. We would even bring condoms into the performance 

82

venues to distribute to audience members. We hoped it would generate debate among people who saw the piece 

on condom use, as back then it was still taboo (in our culture). We also took the piece into schools as it was very 

relevant to young people, but sadly the government policy did not accept discussion on (the use of condoms) 

– I think that at the time it was thought of as something that would promote prostitution among the youth…. 

However, we were part of a large group of artists who were preaching the same idea and it definitely helped to 

change behaviour and spread (knowledge) especially among the youth. 

The second piece (which) I choreographed as a solo in 2007 was called “Ngwangwa” – one of the many sarcastic 

nicknames HIV/AIDS had been given. It germinated from how much in the mid-2000s, stigma was killing more 

people than the virus. It was taboo, especially in the townships to discuss one’s HIV status. I can vividly remember 

people going as far as hiding their sick loved one from (their) neighbours out of fear of what was going to be 

said, (despite the fact that) culturally visiting the sick (is) important support. What inspired me personally at 

the time was being asked by (the) management of Tumbuka, to go as a group to a New Start Center to be 

(personally) tested (for HIV). The fact that (the Company made) this testing compulsory was not only disturbing, 

but unsettling for the (members of the dance) Company. Remember, this was the height of stigma for anyone to 

reveal their status. (It) felt like personal, physical, and career suicide. This was not idea timing and (it) was an 

impossible situation to be (placed in). 

The hardest part was being at the New Start Center and having to reveal your results to your colleagues as 

proof (because if you didn’t) you (would) become paranoid that you will be judged and ostracised. As a result, 

the fear generated an unspoken discrimination and suspicion between the dancers which was unhealthy in the 

studio. (The Company became) a place where stigma was bred, (because of a) well intended idea (that was not) 

thought through. I (choreographed) my piece (“Ngwangwa”), to (portray) how stigma affected everyone in my 

community. The piece didn’t quite get developed to my satisfaction, and there was no proper showing which I 

(still) wish I had got the opportunity to do.” 

Gilbert Douglas left Zimbabwe in 2012. He now lives in Australia where he continues to teach, choreograph, and 

occasionally perform. Douglas completed a Master of Community Cultural Development at Victorian College of 

the Arts at University of Melbourne. Together with his wife Margie Mackay, a ritual and performance artist, he also 

creates large-scale community performance events. 

“[They] used dance steps as vocabulary, building eloquent metaphors that personified the passions and pains of 

the human heart. Feeling came first, fuelling the movement to take flight, allowing [them]…to be bigger, stronger, 

more beautiful than they felt before they stepped onto [the] dance floor…It was disciplined freedom. [They] paid 

for it in sweat. And [they] loved it.” ~ Tendai Machingaidze (Acacia, 2014) 

83

PHOTO CONTEST 

Christmas Lights on Bauman Street, Kazan, Russia 

(Dawn Hill, RUSM) 

Nostalgia (Dr. Majid Sadigh, Director of the Global Health 

Program) 

Classroom, Uganda (Dr. Albert Trondin, Global Health Program alumni from Russia) 

84

CALENDAR 

JANUARY CALENDAR 

January 4: Norwalk Internal Medicine Resident, Dr. Cheleng Brifkani arrived in Vietnam for a global health 

elective. 

January 7: The first session of the Global Health Elective course was presented by Dr. Molly Moore and Dr. Mariah 

McNamara. 

January 7: RUSM student Samantha Boustani arrived in the Dominican Republic for the global health elective. 

January 7: An introductory meeting was held with 

thirteen first-year UVMLCOM students selected for 

the Global Health Pathway. 

January 7: A kick-off dinner was held at Dr. Mariah 

McNamara’s home for the first class of UVMLCOM 

Global Health Pathway students. 

January 7: The application deadline for fourth-year 

global health elective students. 

RUSM student Samantha Boustani with Danny Capellan, 

Coordinator of Global Health at UNIBE, and Dr. Jomar 

Florenzán, Director of Global Health at UNIBE 

January 7: Senior RUSM students Andres Camacho, 

Fred Bien-Aime, and Mariama Barry arrived in 

Naggalama, Uganda for the global health elective. 

January 8: Senior RUSM students Dawn Hill and Jessica 

Hudson arrived in Russia for the global health elective. 

Senior RUSM students with the leadership of 

Naggalama Hospital 

Senior RUSM students Jessica Hudson (left) and 

Dawn Hill (right) 

January 8: Mary Shah, a member of the UVMLCOM/ 

WCHN global health leadership, spoke about cultural 

competency and patient-centered care at Danbury 

Hospital’s Medical Grand Rounds. 

85

January 10: Dr. Majid Sadigh met with a member of 

human resources to discuss the qualifications required 

for a new Global Health Program coordinator. 

Mary Shah speaking at Danbury Hospital’s Medical Grand 

Rounds 

January 10: Dr. Liliya Urazaeva, Cardiologist from 

Kazan Federal University, Russia, received her 

certificate for five weeks of training in cardiology. 

Dr. Moses Othin, Global Health Scholar from Uganda 

January 13: Dr. Moses Othin, Ugandan Global Health 

Scholar from Mulago Hospital, arrived at Norwalk 

hospital for four months of training in pulmonary 

medicine, intensive care medicine, and anesthesiology. 

January 13: Senior RUSM student Antonia Nwankwo 

arrived in the Dominican Republic for the global health 

elective. 

January 14: Dr. Sadigh made a monthly administrative trip to UVMLCOM where he was introduced to Global 

Health Pathway students and attended the Global Health Leadership Committee meeting. 

January 14: Dr. Mariah McNamara spoke about the burden of global diseases at the second session of global 

health curriculum, held at UVMLCOM. 

January 14: A pre-departure orientation session was held at UVMLCOM for three psychiatry residents and a 

senior medical student travelling to Uganda in February and March. 

86

RUSM student Antonia Nwankwo with Danny Capellan, Coordinator of Global Health at UNIBE, and Dr. Jomar Florenzán, 

Director of Global Health at UNIBE 

Dr. Mariah McNamara speaking at the global health elective course, Burlington, VT 

January 17: Dr. Majid Sadigh held the first debriefing meeting with Dr. Moses Othin, Global Health Scholar from 

Uganda, at Norwalk Hospital. 

January 21: AUC and WCHN delegates returned from a one-week visit in Uganda. 

87

January 21: Senior UVMLCOM students Flo DiBiase, Jayne Manigrasso, and Nikki Leonard departed for the global 

health elective in Uganda. 

January 22-25: Global Health Bridge was held for third-year 

UVMLCOM students. 

January 22: Three senior UVMLCOM students arrived in Uganda 

for the global health elective - two for rotations in OB/GYN and the 

other in medicine. 

January 22: Dr. Majid Sadigh convened with two parties: a WCHN 

Foundation representative to explore the possibility of funding 

Healthcare Educators Without Borders, and a WCHN Human 

Resources representative to follow-up on a discussion regarding 

recruitment of an administrative coordinator for the Global Health 

Program. 

January 23: Dr. Majid Sadigh met with the educational leadership 

of WCHN to discuss the possibility of establishing a Global Health 

Institute and Teaching Academy at WCHN. 

UVMLCOM students Florence DiBiase, 

Jayne E. Manigrasso, and Nicole Leonard 

at Makerere University College of Health 

Sciences, Uganda 

January 24: Dr. Majid Sadigh held a weekly debriefing meeting with 

Dr. Moses Othin, Global Health Scholar from Uganda, at Norwalk 

Hospital. 

January 24: A pre-departure orientation training was held for senior 

UVMLCOM student Amber Meservey and resident Omkar Betageri. 

January 24: During a meeting with Danbury Hospital’s Pathology Residency Program Director Dr. Ramapriya 

Vidhun and Ugandan Global Health Scholar Dr. Emmanuel Denis Morgan, Dr. Sadigh discussed Dr. Vidhun’s 

upcoming trip to Uganda which is aimed at exploring the possibility of sending pathology residents to MakCHS 

and initiating collaborative research projects. 

January 24: Dr. Majid Sadigh gave a 

talk about Ebola in the Congo to medical 

residents at Danbury Hospital. 

January 25: Dr. Mariah McNamara 

facilitated “A Conversation with Bassem 

Youssef: From Cardiothoracic Surgery 

to Political Satire in the Middle East” at 

UVMLCOM. 

January 28: Dr. Majid Sadigh held a 

weekly briefing session with Dr. Moses 

Othin, Ugandan Global Health Scholar at 


January 28: Dr. Majid Sadigh held a 

meeting with Dr. Robyn Scatena to discuss 

the format of plenary session Reflections 

from the Field during Global Health Day. 

Dr. Emmanuel Denis Morgan, Global Health Scholar from Uganda (left) 

with Dr. Vidhun, Director of Danbury Hospital’s Pathology Residency 

Program 

88

January 28: Dr. Majid Sadigh held a debriefing session with Global Health Program delegates about their 

experiences in Uganda. 

January 28: A Global Health Leadership Team meeting was held at UVMLCOM. 

January 29: Dr. Majid Sadigh held an introductory meeting with Dr. Glenn Loomis, Chief Medical Operations 

Officer and President of Health Quest Medical Practice at Health Quest Systems, Inc. at Danbury Hospital. 

January 29: Dr. Sadigh convened with members of the Global Health Day Committee to discuss the details of 

this important event. 

FEBRUARY CALENDAR 

February 4: UVMLCOM residents Omkar Betageri and Adam Hinzey and fourth-year students Naomi Hodde, 

Brian Rosen, and Amber Meservey depart for a global health elective at MakCHS, Uganda. 

February 8: Medical resident Dr. Syed Ahmed speaks about typhoid fever at Norwalk Hospital’s Medical Noon 

Conference. 

February 11: UVMLCOM resident Dr. Cheleng Brifkani returns from the global health elective in Vietnam. 

February 11: A Global Health Leadership Team meeting is held at UVMLCOM. 

February 11: A Global Health Journal Club meeting is held at UVMLCOM. 

February 12: The second lecture of the Global Health/Education series, held at SHU’s Schine Auditorium from 

7 - 9 p.m., will feature Ugandan Global Health Scholars Drs. Othin and Morgan speaking about the healthcare and 

medical education systems in Uganda. 

February 12-14: Dr. Stephen Scholand and Dr. Majid Sadigh travel to 

Arizona to finalize the Memorandum of Understanding with Chiricahua 

Community Health Centers (CCHCI). Serving Cochise county that shares 

a one-hundred mile border with Mexico and where one-fourth of families 

earn less than $25,000 per year, CCHI welcomes every child - of whom 

there are 15,000 - and their family regardless of financial standing. 

February 15: Medical resident Dr. Jonathan Kandiah speaks about amebic 

diseases at Norwalk Medical Hospital’s Noon Conference. 

February 15-27: Dr. Sadigh departs for a ten-day visit to India to sign the 

Memorandum of Understanding alongside the leadership of Datta Meghe 

Institute of Medical Sciences (DMIMS) in Sawangi-Meghe (Wardha). 

March 2: February 16: Senior RUSM students Antonia Nwankwo and Samantha Boustani return from global 

health electives in the Dominican Republic; Jessica Hudson and Dawn Hill from Russia; and Mariama Barry, Fred 

Bien-Aime, and Andres Camacho from Uganda. 

89

February 17: Senior AUC students Soubhi Alhayek, Amber Brewster, Timothy Martin, Constance Steinmann, 

and Rebecca Gerrity depart to Uganda for the global health elective, while Crystal Douglas and Adrianna Kordek 

travel to Vietnam. 

February 17: Senior RUSM students Hans Joachim Kaus and Peter Biggane depart to Russia for the global health 

elective; Karri Hester, Samantha Hayes, Francesca Blazekovic, Vishal Mehta, Ana Carolina Barbosa-Hack, and 

Awista Ayuby to Uganda; and Rick Garcia and Heidi Lentz to Vietnam. 

February 19: Dr. Stephen Scholand, Global Health Program Site Director in Thailand, Vietnam, and Zimbabwe, 

speaks about rabies at Norwalk Hospital’s Medical Noon Conference. 

February 21: UVMLCOM resident Naomi Hodde returns from the global health elective in Uganda. 

February 25: The third session of the Global Health Elective course is held at UVMLCOM. 

PHOTO NEWS 

WCHN/AUC/SHU DELEGATES IN UGANDA 

In the MakCHS International Office 

Our Delegates and Molly Higbie (first from 

left), Assistant Director of Global Health 

at Sacred Heart University, with Phionah 

Kinwa of the International Office at 

MakCHS 

90

With Professor Ocama, Chairman of the Department of 

Medicine at MakCHS 

With Drs. Charles Musoke and Peter Agaba, Global 

Health Scholars from Uganda 

In the Makerere University Yale University (MUYU) Office at 

MakCHS 

In Mulago Hospital’s Specialised Women’s Department 

In Mulago Hospital’s Accident and Emergency Department 

Lauri Lennon, Director of Business Operations at WCHN, at 

Anna and Isaac Okullo’s home 

91

Delegates in front of Naggalama Hospital’s Administration Building 

Delegates with Dr. Otim, Chief Medical 

Officer at St. Francis Hospital, Naggalama 

Delegates in the new Microbiology Lab at Naggalama Hospital 

WCHN/AUC/SHU DELEGATES IN NAKASEKE 

Delegates at the ACCESS Headquarters 

Delegates at Nakaseke Hospital 

92

WCHN/AUC/SHU DELEGATES AT ST. STEPHEN’S HOSPITAL 

Delegates at St. Stephen’s Hospital 

Delegates at St. Stephen’s Hospital 

Delegates with Dr. Joseph Kalanzi, Director of the Emergency Medicine 

Residency Program at MakCHS, at the National Dance Theater. 

93

The WCHN Global Health Information Center, located on the 

lower level of Nabacwa Guest House where our participants 

live at Reverend Professor Samuel and Christine Luboga’s 

homestay. 

A room at Nabacwa Guest House at the Luboga’s 

Homestay 

SPECIAL MOMENTS 

Susan Byekwaso, Coordinator at the MakCHS International 

Office, and Lauri Lennon, Director of Business Operations 

at WCHN 

Estherloy Katali, Coordinator of the Global Health Program 

at ACCESS, and Lauri Lennon, Director of Business 

Operations at WCHN. 

Lauri Lennon, Director of Business Operations at WCHN, 

with children in the Nakaseke community 

94

KSMU 

RUSM medical students with medical residents at KSMU 

RUSM students in the OB/GYN Department at KSMU 

95

RESOURCES 







Ebola book 















Publications 

Tropical Medicine Course 

Tropical Medicine Booklets (101 and 102) 

96

MARCH 2019 Volume 3 



“Sitting in that garden, for 

the first time I was an alien, 

I was a sailor – landless and 

disconnected. And I was 

sorry that I had never felt this 

particular loneliness before.” 

Ta-Nehisi Coates, 

Between The World and Me 



97

PERSPECTIVES 

OGANDO FAMILY MY DOMINICAN FAMILY 

Above left: RUSM students Antonia Nwankwo (left) and Samantha Boustani (right) with Maritza and Jesus Ogando 

(host family in middle) 

Above right: Samantha with her host family’s granddaughter Zoe 

I’ve heard people frequently ask why American children leave the house and move away so quickly. I’ve really 

been reflecting on this lately as I consider a location for residency and decide where I want to spend the next 

three to five years. I was once one of the “typical” American kids that rushed to be on my own at eighteen. I’m 

grateful for the independence I’ve gained, but my perspective on the support of family has changed. I now deeply 

value it. My Dominican family has been amazing. In the house is Mami Marissa, Papi Jesus, and Wellington. 

Nearby in the next building is our sister Esmeralda, her husband Dandy, and the family’s first grandchild, their 

daughter Zoe. I see Esme and Zoe every day. Mami looks after Princess Zoe before and after school until Esme 

gets off work. The system they have built works very well. 

Like any other three-year-old, Zoe definitely wants everything her way. She’s rather entertaining. I play with her 

often, watching her dolls die and come back to life after a fall from the mountain that is the dining room table. 

She’s quick to correct my Spanish and bribe me to play with her. Wellington is like any other brother: we see him 

when it’s time to eat. Jesus works as a school gym teacher and makes sure we have plenty of activities to engage 

in. He’s taken me on tours, introduced us to his friends, and sat down to carve out some “father-daughter” time 

with a beer. Just like any other parent, he worries when we are out and stays up until we arrive home, even 

though he attempts to act like he doesn’t. 

Mami doesn’t speak much English but we have conversations through body language and the bit of Spanish I 

have picked up along the way. She takes pride in cooking our meals, arranging them just as she would in the 

restaurant she used to run. Marissa is a fantastic woman who treats me just like her own child. The love she 

shows every day is so genuine. I love that the house is filled with noise, as it makes me think of memories I’ve 

shared with my own family. I deeply appreciate the dynamic they share. No matter what everyone is doing, they 

all come home for lunch and dinner. 

I think we often get so caught up in living that we don’t take the time to enjoy the people we are living with. Our 

98

host family took us in like their own. We celebrated Esme’s pregnancy with a gender reveal party attended by 

friends and family. I was traveling that weekend but I made sure to be there because she is my sister. We have 

different personalities but it works so well. Our birthdays are even on the same exact day! I wasn’t expecting to 

be so emotional about leaving. The bond we have built is solid, and the foundation set in stone. This family shows 

their love for each other in multiple ways and has gone the extra mile to make sure we feel this in every way. The 

experience with this family has grounded me and reiterated why being together is the center of a strong family. 

Antonia Nwankwo, BS, COA 

MS4 Ross University School of Medicine 

Class of 2019 


PARTNERSHIP WITH THE DATTA MEGHE INSTITUTE OF MEDICAL 

SCIENCES (DMIMS), SAWANGI (MEGHE), WARDHA, INDIA. 

Program Director Dr. Majid Sadigh and Global Health Program India Site Director Dr. Swapnil Parve recently 

embarked on a site-visit to the Datta Meghe Institute of Medical Sciences (DMIMS), Sawangi (Meghe), Wardha, 

India. During their visit, Dr. Sadigh delivered a talk on Ebola Virus Disease to undergraduate medical and dental 

students and presented a two-day introductory course on biostatistics to residents. Multiple high level-meetings 

were held, during which DMIMS leadership learned about the unique features of the Global Health Program. The 

leadership expressed interest in establishing an Office of Global Health at their campus as well as willingness 

to host the first batch of medical students, residents, and faculty at DMIMS as early as next month. Dr. Sadigh 

extended an invitation for them to join us at the Annual Global Health Event in Danbury, CT this June. The sitevisit 

concluded with the parties entering into a formal partnership by signing the Memorandum of Understanding 

(MoU). 

99

TOWARD ESTABLISHING A GLOBAL 

HEALTH SITE IN ARIZONA 

In mid-February, Dr. Stephen Scholand, Global Health 

Program Site Director in Thailand, Vietnam, and 

Zimbabwe, and Global Health Program Director Dr. Majid 

Sadigh ventured on an exploratory visit for a new global 

health site in Arizona. This new potential site, tentatively 

dubbed “Global Health at Home,” aims to provide learning 

opportunities primarily through the Indian Health Services 

(IHS).* 

Unfortunately there are areas of significant poverty and 

unmet medical need within the United States that in many 

ways mirrors other underprivileged regions of the world 

where preventative healthcare and important healthcare 

resources are sorely lacking. By exploring and hopefully 

establishing a global health site such as this one, we 

hope to enhance our array of clinical experiences and 

opportunities with a partnership as robust as those found 

in our other international partner sites. 

Dr. Sadigh and Dr. Scholand with Dr. Patel (right) and 

Emergency Medicine staff 

100

*Please note that the word “Indian” is incorrect, but the federal government that funds the IHS has yet to update 

itself on this reference. There is much to be said about the marginalization of indigenous peoples here in the 

United States – and more will be forthcoming through our global health channels here. 

101

On February 13th, Dr. Sadigh and Dr. Scholand visited the Pediatric Center of Excellence at Chiricahua Community 

Health Center Institute (CCHCI) in Douglas, Arizona. Located near the ancestral home of the Apache legend of 

Geronimo, the CCHCI serves a large portion of the medically underprivileged population of southern Arizona, of 

whom one–third are living below the federally defined poverty level. The site and its associated clinics provide 

healthcare over a wide area approximately the size of Connecticut and Rhode Island combined. Mobile medical 

clinics are utilized for outreach into communities too far to access the brick-and-mortar care facilities of the 

CCHCI. Dr. Jeffrey Holzberg led a tour of the area and discussed his passion for delivering care in the region. It 

was quite clear that he is a strong advocate for practicing the type of medicine we call “global health” in the United 

States. We look forward to further developments in Global Health At Home. 

Dr. Sadigh and Dr. Scholand with Dr. Jeffrey Holzberg 

DINNER WITH INFECTIOUS DISEASES FELLOWS 

On February 13th while on an 

exploratory global health trip to 

Native American reservations 

in the desert Southwest, Dr. 

Scholand and Dr. Sadigh enjoyed 

a night out in Tucson with 

infectious disease fellows from 

the University of Arizona. What 

do infectious disease fellows 

and global health scholars talk 

about over dinner? Why, Ebola of 

course - as well as other deadly 

filoviruses, the role of bats as 

102

important viral reservoirs, and other interesting topics such as autochthonous Chagas cases occurring in the 

United States. It was a fantastic evening in Tucson, a city with much to offer including the UNESCO designation 

as a “World City of Gastronomy,” beautiful mountain parks, and towering saguaro cacti (Carnegiea gigantea), 

some measuring over forty feet tall! We hope that a Tucson-based global health site will soon come to fruition! 

ESTABLISHING A GLOBAL PEDIATRIC ROTATION WITH THE 

UNIVERSITY OF PHARMACY AND MEDICINE IN HO CHI MINH CITY, 

VIETNAM 

Dr. Winter, senior advisor of the Global Health Program, had a productive meeting with Dr. Hong, head of the 

Global Health Department, and Dr. Vu, head of the Pediatric Department at the University of Pharmacy and 

Medicine in Ho Chi Minh City, Vietnam to discuss the possibility of establishing a global health partnership in 

pediatrics with this institution. The university leadership expressed enthusiasm for medical education and global 

collaboration. 

103

AUC NEWS: AUC AND WCHN VISIT GLOBAL HEALTH PROGRAM SITE IN 

UGANDA 

Jeffrey Anderson, AUC’s Senior Northeast Clinical 

Coordinator and Global Health Advisor, joined members 

of the WCHN/UVMLCOM Global Health Program during 

a recent trip to Uganda, one of five countries where 

AUC students can complete a six-week global health 

elective as a part of our partnership with WCHN and 

Danbury Hospital. The trip provided an opportunity 

to visit local hospitals and clinics where AUC students 

train and hear from physicians and other healthcare 

professionals involved in their clinical experiences. In a 

presentation delivered to AUC’s Global Health Interest 

Group, Mr. Anderson discussed his trip and provided 

an overview of the Global Health Program. 

Watch a short video of WCHN/AUC delegates’ trip to 

Uganda >> 


MOLLY HIGBIE 

Molly Higbie is the Assistant Director of Global Health Programs and the 

Director of Student Experience for the College of Health Professions at 

Sacred Heart University (SHU) in Fairfield, CT. Previously, Molly served as 

the Manager of Academic and Administrative Services for NYU Abu Dhabi’s 

Sheikh Mohamed bin Zayed Community Programs in both their New York 

and Abu Dhabi, United Arab Emirates offices. In her current current role at 

SHU, Molly supports graduate and undergraduate students as they prepare 

to engage in global health experiences. She also assists in the preparation of 

faculty-led global health programs for SHU College of Health Professions and 

College of Nursing programs. An avid traveler, Molly still has a long “to-visit” 

list. She is excited to share that passion with students and faculty through 

her work at SHU and Western Connecticut Health Network. 

104

DANNY CAPELLÁN 

Danny Capellán is the Incoming Student Coordinator at Universidad 

Iberoamericana (UNIBE) in the Dominican Republic where he collaborates 

developing programs with several partner institutions. In 2010, he obtained 

a bachelor’s degree in Tourism at UNIBE where he went on to pursue a 

master’s degree in Integrated Marketing Communications in 2014. In 2017, 

he began coordinating short-term and faculty-led programs between UNIBE 

and Western Michigan, Clemson, and Michigan State Universities. He also 

develops collaborations with Western Connecticut Health Network, which 

provides medical students the opportunity to undergo clinical rotations in 

the Dominican Republic through UNIBE’s affiliated hospitals. Most recently, 

Capellán has taken on the role of teaching Lodging Operations and 

Intercultural Communication. 


DR. PETER AGABA 

Global Health Scholar from Uganda 

I am an anaesthesiologist and lecturer in the Department of Anaesthesia and 

Critical Care at Makerere University College of Health Sciences (MakCHS). 

My interests lie in perioperative care of neurological patients and critical 

care, and my goal is to play a leading role in research, medical education, 

and patient care in these areas in Uganda and sub-Saharan Africa. 

Limited to supervising international medical students rotating in Mulago 

Hospital’s Anaesthesia Department, my global health involvement had been 

mostly peripheral until recently. I learned about the WCHN/UVMLCOM Global 

Health Program at the start of 2018 through an email from the dean about 

available slots for training at WCHN. At that moment, I saw an opportunity 

to further my goals in critical care and neuroanaesthesia. 

My time in the United States has been enriching in many respects, professionally and otherwise. Among the many 

new experiences I’ve had is the concept of multidisciplinary rounds in the Intensive Care Unit (with nutritionists, 

pastors, as well as physical and occupational therapists) and the use of electronic medical records. I have also 

spent time in San Antonio on an intraoperative neuromonitoring (IONM) course with the goal of starting an IONM 

service in Mulago and eventually a training program. 

I have observed several similarities and differences between the medical education systems in Uganda and the 

United States. Medical education in the United States, and experiential learning in particular, is structured with 

excellent simulation facilities and proper supervision. For instance, a resident will have performed simulated 

central venous line insertions before inserting one in a patient. Meanwhile during journal clubs in the Pulmonology 

105

Department, I noted a similar structure to those we run in Uganda with the exception that our fellows choose the 

articles and residents present them. 

Of the many highlights from my time in the United States, a few clinical moments stand out: the Point-Of-Care 

Ultrasound Course I attended at UCONN, the day I spent at Danbury Hospital’s Simulation Lab, and another day 

spent in the operating room performing CT-guided epidural steroid injections. Concurrently, my social spotlights 

include soaking up the local culture and history with Vietnamese Global Health Scholars who are outgoing, 

friendly, and a joy to be around. On return home, I hope to transplant a few ideas such as an annual critical care 

ultrasound course for our residents. I want to thank the WCHN Global Health Team for this wonderful opportunity. 

EXCHANGE OF ENERGY 

Dr. Emmanuel Denis Morgan with members of Danbury Hospital’s 

Department of Pathology 

In the last few days, I have heard 

many stories - both from Dr. Emmanuel 

Morgan himself and those with whom 

he has interacted - chronicling his 

four-month visit to the United States. 

Whether detailing his invitation to 

participate in a Diwali celebration with 

the Danbury Hospital Department 

of Pathology Chair or recounting his 

experience at the Medical Examiner’s 

Office in New York City, one theme 

is consistent: Emmanuel’s passion. 

Passion for learning, passion for 

people, and passion for life. Emmanuel 

shared with us over a farewell lunch 

that he did not expect to feel so warmly 

included during his time in the United 

States. The fact that he was is surely 

rooted in the fact that the energy he 

exudes is unavoidably reciprocated by 

everyone he meets. Emmanuel came 

here for an exchange of ideas involving 

his deep interest and passion for 

pathology, but it was our exchange of 

energy that made his time with us truly 

memorable. 

By Joanna Conklin 

Medical Education & Global Health 

106


I have been spending a lot of time with students and seeing a great deal of scholars with lots of plans for next 

week. The adorable Dr. Tho has even invited me to her home for dinner on Sunday to meet her parents. That 

should be fun. They are the most wonderful group. I adore them all. 

Stephen Winter 

Dear All, 

I have been performing daily informal and slightly more formal check-ins with all five UVM medical students 

since arriving on Tuesday. We have engaged during wonderful meals at the Okullo’s and during other times at 

the hospital. We have spoken about the inherent challenges in trying to integrate into a new hospital and clinical 

team. I think finding an appropriate role is probably difficult for everyone at the beginning. 

We have also spent quite a bit of time discussing the unique and positive aspects of this experience in Kampala. 

What a wonderful place with amazing hospitality and learning opportunities! Susan has been so instrumental and 

helpful, and the Okullo homestay is more than anyone could ever ask for. 

I feel very lucky to be here playing a role in this experience, and our students have expressed sincere gratitude 

as well. 

Respectfully, 

Naomi Hodde 

Wonderful and well-deserved recognition of the Global Health Program which is distinguished from other U.S. 

programs in its greater focus on real collaboration and capacity building with international partners. I believe you 

are the model that should set the gold standard for other programs to emulate. 

Congratulations and all the best to your wonderful team! 

Pierce Gardner 

I have good news. The Minister of Health has agreed to launch the WCHN Resource Center at a media event on 

the 1st of March at 10:00 a.m. Ugandan time. This is intended to introduce what you and we are doing in the field 

of global health to the Ugandan audience. 

I wish you could participate. Medical students Kerri and Samantha will participate in-person. I am trying to get 

the video conferencing to work so you can participate live. I know it will at an awkward hour for you, but we will 

be really pleased to have you included. 

Sam Luboga 

107


ETHICAL OBLIGATIONS REGARDING SHORT-TERM GLOBAL HEALTH 

CLINICAL EXPERIENCES: AN AMERICAN COLLEGE OF PHYSICIANS 

POSITION PAPER 

“The primary goal of short-term global health clinical care experiences is to improve the health and well-being of 

the individuals and communities where they occur… however, these activities involve several ethical challenges. 

Addressing these challenges is critical to protecting patient welfare in all geographic locales, promoting fair and 

equitable care globally, and maintaining trust in the profession. This paper describes 5 core positions that focus 

on ethics and the clinical care context and provides case scenarios to illustrate them.” 

Click here to read the full article >> 


QUIZZES 

 

“Here a young construction worker presents several 

days after an injury with a metal wire to the hand (as 

shown). What does he have? Will he survive?” (Photos 

courtesy of Dr. Stephen Scholand) 

108

REFLECTIONS 

A BEAUTIFUL NEW YEAR 

Written by Lauri Lennon 

Director of Business Operations at WCHN 

January 1, 2019, I began to organize for my trip to Uganda. I ordered a few things off Amazon: bug spray, 

a safari hat, a small rechargeable fan, etc. I changed my Facebook cover picture to the Ugandan flag, which 

features a pattern of black, yellow, and red stripes that repeats twice, forming six equal horizontal bands with a 

grey crowned crane - the national symbol - at its center. Black for the people of Africa, yellow for the sunshine of 

Africa, and red for the brotherhood (color of blood) of African people, through which all Africans are connected. 

The grey crowned crane is known for its gentle nature, with its raised leg symbolizing the forward movement of 

the country. I think of the gentle and soft-spoken nature of the Ugandan colleagues who have visited the U.S. The 

grey crowned crane must be a beautiful bird. 

As I look out the window, I can’t believe my eyes and the plethora of activities surrounding me. There are people 

EVERYWHERE in Kampala: on the main streets, side streets, in stores, outside of stores - people sitting and 

laughing and doing laundry in a bucket, people cooking on small fires. Everyone is dressed superbly, whether in 

the city or in a village. Dress might be soiled from a day’s hard work in the village, but the inherent sense of style 

is beautiful to my eyes. The smells remind me of summer barbeques roasting marshmallows by an open fire. My 

eyes fill with tears, what a beautiful place! 

Kampala is an exciting city! It’s alive and well and never sleeps, much like New York City! Roads aren’t paved 

with concrete, but are rather packed with beautiful red dirt. Each business is lined in a tightly knit formation, all 

in a row, in brick buildings. Merchandise is laid out on handmade African mats, mannequins, or sometimes on 

the head of a very talented African man or woman. It’s all there! Cell phones, clothing, produce, meat, hardware 

stores, hair salons, furniture stores, supermarkets, places to eat, pharmacies, construction companies, night 

clubs, and even places to purchase coffins! A car clearly labeled “Driving School” makes me wonder how young 

men and women in the U.S. would handle driving on Kampala’s streets. The roads are full of matatus, with people 

packed from top to bottom and front to back, and boda bodas on which up to 4-5 people ride at once, and helmets 

worn only by the driver. There are little to no traffic rules, but people simply make it work without yelling, cursing, 

or honking. 

During our stay in Kampala, we were hosted by two wonderful, caring, and loving families: the Okullos and 

the Lubogas. We are treated like kings and queens. Each evening, we are welcomed with a warm heart and 

honest gesture of “How was your day? You must be very tired.” “Welcome home” is an understatement to say 

the least. We are home in their homes, never feeling like a guest or stranger. We are treated like family, and I 

quickly become fast friends with the women helping run the homestay. I wake up at sunrise one morning to the 

Muslim prayer. The only time I remember hearing this is on the HBO series “Homeland.” As I lay in bed listening, 

109

I remember to stay in this moment and appreciate how blessed I am to be on this journey. 

In Kampala, we spend a considerable amount of time at the orphanage, Sanyu Babies Home. I look around and 

smile as we are all engaged with the children: holding and/or feeding an infant, wiping the runny noses of a 

toddler, throwing a ball to a child, or pushing as many toddlers on the swing as we can, remembering there are 

only three swings but ten to fifteen anticipating toddlers! I admire the mamas who care for the children every day. 

They are making such a difference. It’s hard to leave. I make a mental note to spend more time at the orphanage 

during my next visit. 

Before going to Naggalama, a village an hour away from Kampala, we buy bread, rice, and soap to give as 

small gifts to patients during our palliative care rounds. These simple items, I learn later, are a luxury to many 

Ugandans. Palliative care rounds are eye-opening. The gifts are accepted with gratitude and happiness by the 

local community members we visit. Despite being very sick, they rejoice in our small gift as if they won a million 

dollars. I text my family to remind them how lucky we are, and to be kind to everyone. I encourage them to 

always help others and to open their hearts to them. I begin to notice the feet of Ugandans: just like mine but 

calloused from hard work. It helps me remember that we are all the same. On rounds, we are welcomed by four 

patients, most of whom are smiling despite their illness. I will never forget their faces and the compassionate care 

provided them by the St. Francis Hospital staff. 

In Nakaseke, a village two hours north of Kampala, we join members of the African Community Center for Social 

Sustainability (ACCESS) on community outreach rounds where we meet such happy, grateful people. One sings 

us a song about asking God to grant us anything we want in life. Another woman shows us the healthy piglets 

she is proud of raising. We visit two elderly women who remind me that all we need in life is friendship and love. 

We tease them, asking who is older, and even though I don’t understand the language I can tell they are happy 

as they sit on the floor of their small, concrete home by a small cooking fire. I cozy up between the two women 

on the floor and wish I could stay longer. Life is simple; poor but simple. 

Back home under the cold winter’s night, I look to the stars and remember. I think of the young girl paralyzed 

from the waist down lying on the concrete floor of her small home, and the enormous energy with which her smile 

filled the room the minute we entered. I think of the woman who sang to us in Luganda in her beautiful purple 

Gomezi and her concern about her children’s reading since the solar lantern she had been given stopped working. 

I look at the stars and miss the two elderly ladies and the feeling of content that enveloped their home. I wonder 

if they are looking at the same star. The people of Uganda are certainly gentle human beings, much like the crane. 

Florence DiBiase, UVMLCOM ‘19 

In Kawempe, mothers certainly smile upon meeting their babies, but we move rapidly from one woman to the 

next, an assembly line of vaginal exams, deliveries, and perineal repairs. It doesn’t appear to have the same 

“defining moment” quality for these women. Perhaps it is the fact that grand multips are the norm. Or perhaps I 

am still learning to read the nonverbal language of this culture. 

Nicole Leonard, UVMLCOM ‘19 

Most of the patients I saw had diseases that I had only learned for Step 1 and tumors of sizes I had only seen 

in photographs, thinking they were dramatic examples. It turns out it is not uncommon for tumors to grow to 

unbelievable sizes when not intervened with. I remember learning about different cancers and infections specific 

to people living with HIV, but I had never seen any of them before. On my first day alone I saw multiple cases 

of Kaposi sarcoma, squamous cell carcinoma of various locations, and other opportunistic infections coexisting 

with these other conditions. I learned that the acronym “ISS,” which stands for “immunosuppressive syndrome,” 

is used in patient charts to indicate HIV positive status. 

110

Jayne Manigrasso, UVMLCOM ‘19 

This second half of fourth year is going to fly by. I can’t believe I’m almost technically a doctor. We’ll be here for 

six weeks, and then Match Day is two weeks after we come back, and then graduation is two months after that. 

It’s happening so fast. This is definitely the time to appreciate, accept, and be fully present for every learning 

experience that comes my way. I feel better about my ability to be flexible and accepting compared to the person 

I was after my first year of medical school. I’m more sure of myself and the person I’ve become. I’m ready! 


GLOBAL HEALTH 


Written by Dr. Molly Moore 

Director of Global Health at the University of Vermont Larner College of Medicine Pediatrics 

Department 

Challenges are an inherent component of global health electives, and can be ascribed to an array of sources 

including insufficient orientation, unrealistic expectations, unfamiliarity with the culture and way of life, or 











transferred to a new hospital or another clinical ward... 

Read More 

111

GLOBAL 

HEALTH 

AND THE ARTS 

Rudy L. Ruggles, Jr. 

COMING HOME TO AFRICA 

Written by Rudy L. Ruggles, Jr. 

“If you haven’t traveled and explored Africa it’s hard 

to describe how moving the experience is. During this 

trip I had the experience of dining with Bishop Tutu’s 

closest colleague - Tutu was in hospital - and talking 

with several people who were in prison with Nelson 

Mandela. Particularly poignant was a visit to Mandela’s 

grim cell on Robben Island Prison, where he spent 

18 of his 27 years of incarceration. This poetic effort 

demonstrates that I was deeply affected. I wrote it 

while on safari in the Okavango Delta in Botswana, 

enjoying some of Africa’s infinite natural treasures. 

I named this poem after its beginning line instead of 

perhaps a more suitable “Coming Home to Africa.” As 

you may know, “dream time” is what the Australian 

Aborigines call “the time before time.” 

IN “DREAM TIME” 

Written by Rudy L. Ruggles, Jr. 

In “Dream Time” all was Gondwanaland. 

The ocean freshly born, 

With every grain of life yet to emerge. 

We were there, waiting – aimless, 

No thought of time, or hope. 

Eons set the land adrift as the Earth contorted, 

Still groaning in its birth pangs. 

At a pace only God could detect, 

Land-forms drifted slowly apart, 

Like pieces of a puzzle never again to be solved. 

Sparks of life glinted in the sea, 

A broth portending nothing, then. 

Our continent rode the back of Africa 

‘til we slowly parted ways. 

Mare Atlanticus took shape between us, 

An ocean-bottom seam tracing, even now, our historic unity. 

Life had then begun on these and other land-arks 

And in the sea surrounding. 

God’s magic hand formed creatures long-forgot 

That tried to gain a foothold on the spreading Tree of Life. 

Upon the still slowly writhing ground of Africa, 

Man’s first steps were heard an age ago. 

With time, some men stayed in their verdant home, 

And others wandered, 

Following the horizon by day and the star-filled heavens at 

night. 

And soon we’d reached the Earth’s extremes, 

Or settled along the way. 

Adapting, changing, resonating to God’s tones, 

Forming a chorus of Mankind, singing together with all our 

hearts, 

Rejoicing in the miracle of our life 

And the Heaven-born miracle of our common birth, 

And mourning the mystery of our individual death. 

But could it be that this diaspora of epochs, 

That drove us to explore unknown lands, 

Was meant to cloud our memory of Africa, our birthplace? 

Our souls took form here and never really left our home. 

Our brothers and sisters who stayed in Africa today uplift our 

spirits. 

Those of us who now visit our homeland to meet others who 

were 

Here when our Mothers and Fathers lived long ago, 

We are at once blessed by renewing our Brotherhood, 

And cursed by knowing that Evil has too often 

Broken our promise to God to rejoice in the common holiness 

Of our human spirit. 

We are among the fortunate, called home to meet our living 

ancestors, 

To learn their names, to look into each other’s eyes, 

To feel the bond in our differences, 

And sense the throbbing of a single heart among us. 

We, the fortunate, are forever changed by coming Home to 

Africa. 

112

ANNOUNCEMENTS 

Dr. Ramapriya Vidhun, Director of the Pathology Residency Program at Danbury Hospital, will visit Makerere 

University on March 17th with the following objectives: 

1. Validate breast biomarkers (ER/PR) in the Uganda Cancer Institute (UCI) laboratory 

2. Deliver a ground rounds presentation titled “Molecular classification of breast tumors and essence of biomarker 

adjuvant testing in classifying/treating breast tumors” 

3. Present a multi-headed slide session with pathology residents on challenging breast cases 

4. Deliver a powerpoint lecture on papillary breast lesions 

5. Hold a meeting with the educational leadership to explore the potential for sending Danbury Hospital pathology 

residents to MakCHS for the global health elective 

FOLLOW-UPS 

WCHN delegates with the leadership of St. Franicis Naggalama Hospital at 

the opening celebration of the new microbiology lab” 

Click here to see more photos from the lab’s opening celebration 

It was only a year ago that Majid Sadigh, 

Director of the Global Health Program 

at UVMLCOM and the Christian J. Trefz 

Family Endowed Chair in Global Health 

at WCHN, completed his 19,341 foot 

climb of Mount Kilimanjaro. His climb 

of the tallest and most recognizable 

mountain in Africa was fueled by the 

need to build a microbiology laboratory 

at St. Francis Naggalama Hospital, 

the only one-hundred-bed Hospital in 

Uganda’s Mukono District. St. Francis 

Naggalama Hospital provides medical 

care to the 303,900 residents who 

live in its catchment area as well as 

the people who reside in neighboring 

districts. We are thrilled to report that 

construction of the microbiology lab is 

complete! Thank you for supporting 

this dream and making it a reality. 

113

PHOTO CONTEST 

A mural on a wall of Ajanta Caves 

(Majid Sadigh) 

Bandra Fort in Mumbai (Majid Sadigh) 

The Garden of Colors; Uganda (Connie Steinmann MS4, AUC) 

Fatherhood, Taj Mahal (Majid 

Sadigh) 

114

CALENDAR 

FEBRUARY CALENDAR 

February 1: A Praxair tour and meeting with the Praxair leadership was held at the Praxair Headquarters in 

Danbury, CT to discuss the details of Global Health Day. 

February 4: UVMLCOM faculty member Dr. Naomi Hodde, psychiatry residents Adam Hinzey and Brian Rosen, 

and senior medical students Amber Meservey and Omkar Betageri arrived in Uganda for their elective in global 

health. 

February 5: Dr. Majid Sadigh had a follow-up meeting with Lauri Lennon, Director of Business Operations at 

WCHN, and members of the WCHN Foundation to debrief the conclusions from the Praxair meeting. 

February 5: Dr. Majid Sadigh had a meeting with Dr. Ruggles, WCHN Scientific Research Committee Chair, to 

discuss the possibility of traveling to Uganda together. 

February 5: Dr. Majid Sadigh had a meeting with Dr. Harold Cedeño, medical resident at Danbury Hospital, to 

discuss his global health elective in Uganda. 

February 5: Dr. Majid Sadigh had a meeting with the WCHN global health leadership to discuss the short- and 

long-term plans for the program and to put together an executive committee for the program. 

February 6: Dr. Sadigh had a meeting with Catherine Winkler, a Scholar Nurse Practitioner, to discuss the 

opportunities for her to volunteer with the Global Health Program. 

February 8: Medical resident Dr. Syed Ahmed spoke about typhoid fever at Norwalk Hospital’s Medical Noon 

Conference. 

February 11: A Global Health Leadership Team meeting was held at UVMLCOM. 

February 11: A Global Health Journal Club session was held at UVMLCOM. 

February 11: UVMLCOM resident Dr. Cheleng Brifkani returned from the global health elective in Vietnam. 

February 12: The second lecture of the Global Health/Education series held at Sacred Heart University was 

cancelled due to inclement weather. 

February 12-14: Dr. Stephen Scholand and Dr. Majid Sadigh travelled to Arizona to finalize the Memorandum 

of Understanding with Chiricahua Community Health Centers (CCHCI). Serving Cochise county that shares a 

one-hundred mile border with Mexico and where one-fourth of families earn less than $25,000 per year, CCHI 

welcomes every child - of whom there are 15,000 - and their family regardless of financial standing. 

February 15-27: Dr. Sadigh departed for a ten-day visit to India to sign the Memorandum of Understanding 

alongside the leadership of Datta Meghe Institute of Medical Sciences (DMIMS) in Sawangi-Meghe (Wardha). 

115

February 15: Medical resident Dr. Jonathan Kandiah spoke about amebic diseases at Norwalk Medical Hospital’s 

Noon Conference. 

February 15: march 2: Dr. Stephen Winter site-visited Cho Ray Hospital. 

February 16: Senior RUSM students Antonia Nwankwo and Samantha Boustani returned from global health 

electives in the Dominican Republic; Jessica Hudson and Dawn Hill from Russia; and Mariama Barry, Fred Bien- 

Aime, and Andres Camacho from Uganda. 

February 17: Dr. Emmanuel Denis Morgan, Global Health Scholar from Uganda, returned home after completing 

four months of pathology training at Danbury Hospital. 

February 17: Senior AUC students Soubhi Alhayek, Amber Brewster, Timothy Martin, Constance Steinmann, 

and Rebecca Gerrity travelled to Uganda for the global health elective, and Crystal Douglas and Adrianna Kordek 

to Vietnam. 

February 17: Senior RUSM students Karri Hester, Samantha Hayes, Francesca Blazekovic, Vishal Mehta, Ana 

Carolina Barbosa-Hack, and Awista Ayuby travelled to Uganda for the global health elective; Rick Garcia and Heidi 

Lentz to Vietnam; and Peter Biggane to Russia. 

February 19: The UVMLCOM Communications Team held a meeting to plan for Global Health Day. 

February 19: Dr. Stephen Scholand, Global Health Program Site Director in Thailand, Vietnam, and Zimbabwe, 

spoke about rabies at Norwalk Hospital’s Medical Noon Conference. 

February 21: Dr. Naomi Hodde, family medicine faculty at UVMLCOM, returned from Uganda. 

February 25: Dr. Molly Moore presented “Payers and Players in Global Health” at the Introduction to Global 

Health Elective Course. 

February 27: Dr. Sadigh returned from India. 

MARCH CALENDAR 

March 1: Fourth-year medical students Nicole Leonard, Jayne Manigrasso, Florence DiBiase, and Omkar Betageri, 

and psychiatry resident Adam Hinzey, return from Uganda. 

March 2: Dr. Stephen Winter returns from a capacity building trip in Vietnam. 

March 4: UVMLCOM Psychiatry residents Sam Evenson and Smita Lahoti travel to Uganda for the global health 

elective. 

March 4: Call for photo, reflection, and poster submissions and award nominations for Global Health Day will be 

sent to the UVMLCOM community. 

March 6: A Danbury Hospital Global Health Leadership Team meeting is held. 

116

March 9: UVMLCOM fourth-year medical students Brian Rosen and Amber Meservey return from Uganda. 

March 11: A Global Health Leadership Team meeting is held at UVMLCOM. 

March 15: Dr. Ramapriya Vidhun, Danbury Hospital Pathology Residency Program Director, travels to Uganda to 

visit Makerere University. 

March 17: Senior RUSM student Hans-Joachim Kaus travels to Russia for the global health elective. 

March 18: UVMLCOM fourth-year medical student Beth Doughty travels to Uganda for the global health elective. 

March 24: Deadline for Global Health Day submissions and award nominations. 

March 25: A Global Health Leadership Team meeting is held at UVMLCOM. 

March 29: Senior AUC students Soubhi Alhayek, Amber Brewster, Timothy Martin, Constance Steinmann, and 

Rebecca Gerrity return from global health electives in Uganda, and Crystal Douglas and Adrianna Kordek from 

Vietnam. 

March 29: Senior RUSM students Karri Hester, Samantha Hayes, Francesca Blazekovic, Vishal Mehta, Ana 

Carolina Barbosa-Hack, and Awista Ayuby return from global health electives in Uganda, and Peter Biggane from 

Russia. 

OUR STUDENTS AT UNIBE 

PHOTO NEWS 

The community clinic in La Barquita, Dominican Republic 

(Left to Right): Antonia Nwankwo (RUSM), Isabel 

Diaz Md (family medicine residency coordinator at 

Plaza de la Salud), Dr. Melanio Villa ( PGY2 family 

medicine), and Samantha Boustani (RUSM) 

117

Dr. Robert Reid Cabral with UNIBE and RUSM students in the 

children’s hospital 

Dr. Melanio Villa at Plaza de la Salud 

Goodbye to Our Ugandan Global Health Scholar, Dr. Emmanuel 

Denis Morgan 

Dr. Emmanuel Denis Morgan with members of Danbury Hospital’s Pathology Department 

118

Dr. Emmanuel Denis Morgan with the Director 

of the Pathology Residency Program at a 

fundraising event for children in India 

RUSM students with Vietnamese Global Health Scholars 

Dr. Stephen Winter with Vietnamese global health scholars and RUSM medical students 

A handshake to commemorate the signing of the 

Memorandum of Understanding between the WCHN/ 

UVMLCOM Global Health Program and the Datta Meghe 

Institute of Medical Sciences (DMIMS), India 

Dr. Sadigh and Dr. Swapnil Parve with medical and dental 

students at Datta Meghe 

Institute of Medical Sciences (DMIMS), India 

119

Welcoming ceremony at Shalinitai Meghe Superspeciality 

Hospital (DMIMS main hospital) 

Biostatistic Lectures to the residents at DMIMS 

A feedback session with AUC students at the African Community Center for 

Social Sustainability (ACCESS), Uganda 

120

RESOURCES 







Ebola book 















Publications 



121

April 2019 Volume 4 



Do not go where the path may 

lead, go instead where there is no 

path and leave a trail. 

- Ralph Waldo Emerson 



122

PERSPECTIVES 

WHY A GLOBAL HEALTH INSTITUTE 

Written by Jonathan Fine, MD 

Over its seven-year existence, the Global Health Program at the University of 

Vermont Larner College of Medicine / Western Connecticut Health Network has 

grown from international collaborations focused solely on students from UVMLCOM 

to multidisciplinary, multi-school, and post-graduate activities. During this evolution, 

the Global Health Program has gained international recognition from its many peerreviewed 

papers and meeting presentations, thoughtful participant reflections 

distributed through the web, engaging symposia, and ever-growing numbers of participants in the United States, 

Africa, Asia, Eurasia, and the Caribbean. In recognition that the Global Health Program services a broad array of 

health professionals, it is fitting that it emerges from its organizational place within medical student administration 

and assumes the status of institute within the network. 

As an institute, funding and faculty may derive from all healthcare disciplines that wish to participate. This 

inclusiveness is in keeping with appreciation that global health experiences lift all providers. The resulting 

expansion, in turn, enables global health to mature administratively while advancing new initiatives including 

research projects, interdisciplinary collaboration, a peer-reviewed journal, and a Global Health Teaching Academy. 

Further, as an institute, global health will possess better standing to interact with other organizations, attract 

funding, and recruit talented staff. With the coming creation of another medical school partner with Marist 

College, the Institute expands its key academic associations. 

Our network’s activities in global health have served as defining elements for our academic mission. The humanity 

evoked, the medical knowledge gained by our students, professionals, and partners abroad, and the stimulus 

of selfless commitment to serving patients anywhere together mold our participants into astute healthcare 

professionals and compassionate human beings. We realize in global health the aspirational purposes that draw 

healthcare professionals to their calling. By elevating global health to an institute, we acknowledge and support 

its essential place within our healthcare network. 

THEY ALL BELONGED TO ONE RACE 

Written by Sister Jane Frances 

Director of St. Francis Naggalama Hospital 

What happened to that Ethiopian Airways flight bound for Nairobi has made me reflect 

further and deeper on life. One-hundred fifty-seven people from many nationalities 

perished in a microsecond. One gentleman was angry at the airport agents for missing 

this flight as a result of his first flight being delayed. Think about that for a second. 

Death doesn’t segregate or select based on nationality or race, first class or economy. At that moment, all 

passengers belonged to a single human race without class or ethnic divisions. They all screamed together and 

perished together. Some were headed to close million-dollar business deals; some to expand new businesses, 

123

worrying about potential success or failure; some had misunderstandings with family and friends; but none of 

these circumstances were determinants at that specific hour. Their time was up. Whatever their worries were, 

time was up. 

This event conjures a big lesson about the simplicity of life. Whatever we burden ourselves with won’t matter 

anymore when the time comes. We will all go through the same process, regardless of social or economic rank. 

Your cologne or iPhone won’t save you from anything. I have learned that as long as we are alive, we should work 

for a better, simplified life on Earth. We sometimes overburden ourselves with too much that ends up depressing 

us, and all for what? A mansion? An expensive car? A big plot of land? It’s okay to work hard and stay busy but 

it’s not okay to be greedy. Life is as simple as we came to it: naked. May the Good Lord rest in peace the deceased 

and put them in a better place. 


DR. RAMAPRIYA VIDHUN’S TRIP TO UGANDA 

Dr. Ramapriya Vidhun, Director of the Pathology Residency Program at Danbury Hospital, made a week-long 

visit to Makerere University College of Health Sciences (MakCHS) where she delivered a series of lectures at 

the Uganda Cancer Institute and MakCHS Pathology Department and held multiple meetings with university 

leadership to explore the possibility of cross-continental research projects and exchange of pathology faculty and 

residents. 

Dr. Ramapriya Vidhun at the Uganda Cancer Institute 

124

GRAND LAUNCH OF THE WESTERN CONNECTICUT HEALTH NETWORK 

INFORMATION CENTER 

Written by Reverend Professor Samuel Luboga 

On March 1st 2019, Honorable Dr. Jane Ruth Aceng, Minister of Health of the Republic of Uganda, launched the 

Western Connecticut Health Network Information Center at Nabacwa Guest House in Namere Mpererwe under 

the “Homestay Concept: Cross-Cultural Understanding for Effective Global Health and Medical Training.” 

“As Minister of Health, I want to make a commitment and pledge that wherever I go, I will speak about the 

Nabacwa Guest house and the Western Connecticut Health Network Information Center so people can get to 

know about it, and encourage students to come so that you can have many more students,” she committed. 

“Thank you very much and congratulations. You have done us proud to have this as a model and the first of its 

kind in the country. We are extremely proud of you. Thank you very much.” 

The Homestay Concept for Global Health was developed in 2013 between Makerere University College of Health 

Sciences and WCHN/University of Vermont College of Medicine to offer global health elective participants - in the 

field of medicine, nursing, and other professions - a conducive family environment while on attachment instead of 

living in a hotel or hostel. The model provides learners an opportunity to be immersed in the culture of the people 

among whom they have come to live and learn about health in an environment other than their own. 

125

THE WCHN /UVMLCOM GLOBAL HEALTH PROGRAM DELEGATES IN 

DOMINICAN REPUBLIC 

Members of the WCHN/UVMLCOM global health leadership Dr. Mariah McNamara, Ms. Lauri Lennon, MBA, and Dr. 

Benjamin Clements conducted a three-day administrative site-visit to the Dominican Republic. During this trip, 

they met with the leadership of UNIBE and affiliated hospitals to establish a primary care model in global health 

and explore the possibility of expanding the activities of the current exchange program. 

(Left to right) Dr. Benjamin Clements (U.S. Site Director, Dominican Republic), Dr. Jomar Florenzán (Program Site Director 

in Dominican Republic), Dean Nuñez (Dean of UNIBE School of Medicine), Ms. Lauri Lennon, MBA (Director of Business 

Operations), Dr. Mariah McNamara (Global Health Program Associate Director), Dr. Loraine Amell Bogaert (Dean of 

International Relations, UNIBE) at UNIBE 

BEAUTIFUL COUNTRY AND PEOPLE 

Written by Lauri Lennon 

Although short, the trip was productive. Site visits were made to UNIBE, the outpatient clinic at the Community 

La Barquita, the Hospital de la Plaza de la Salud, the Hospital Universitario Maternidad Nuestra Senora de la 

Altagracia and the Instituto Nacional de Diabetes Endoncrinologia y Nutricion. All sites proved to be excellent 

educational experiences for our students to enhance their skills and knowledge in medicine. We were hosted 

by the love of the Ogando Family and our site coordinator Jomar Gonzalez. We enjoyed delicious food and a 

wonderful historical tour of Santo Domingo by Samuel Bisono. 

Plans to expand our collaboration in the areas of Simulation and Family Medicine were discussed as was the 

capacity building component to share knowledge with a resident in surgery and OB/GYN. 

Thank you to our friends of the Dominican Republic-your beautiful country and people will be remembered always. 

126

THE GLOBAL EDUCATION AND HEALTH LECTURE SERIES AT SACRED 

HEART UNIVERSITY 

The second event in the Global Health & Education Lecture series at Sacred Heart University took place on March 

26th, 7:00 – 9:00 pm. The well-attended event featured speakers from the U.S. and Uganda, including reflections 

from SHU nursing students who recently returned from clinical rotation at Mulago Hospital, St. Stephen’s Hospital 

and Kawempe Hospital in Kampala, Uganda. 

Dr. Connie Glenn, RN, MSN, FNP, DNP, clinical assistant professor at SHU’s College of Nursing described a rich 

experience while leading the FNP and DNP student team in Kampala. Dr. Moses Othin, M.D. from Uganda spoke 

in detail about the education and healthcare systems, adding comparisons to the U.S. Dr. Othin is currently a 

resident at Norwalk Hospital through Western CT Health Network’s Global Health Program. FNP student, Traci 

Umbreit, and DNP student, Katherine Miciak, both described “life changing” experiences during their time in 

Kampala. The panel confirmed that many of the differences between the two countries is access to resources and 

education. 

Christina Gunther 

REFLECTION FROM CHO RAY HOSPITAL, FEBRUARY 2019 

Written by Dr. Stephen Winter 

Senior Advisor to the Global Health Program 

During a capacity building visit to Cho Ray Hospital in Ho Chi Minh City, Vietnam, I met with representatives 

of the University of Medicine and Pharmacy at Ho Chi Minh City (UMP) and the University Children’s Hospital. 

Meeting attendees included the Chair and Vice Chair of the University Department of Pediatrics and Head of 

Global Health at UMP. The meetings centered on developing a collaborative relationship between WCHN and 

UMP to support student elective rotations in pediatrics at the University Children’s Hospital. The potential for 

a bidirectional collaboration was enthusiastically endorsed over two working meetings to develop the outlines 

of the collaboration. This new collaboration will expand our footprint in Vietnam to include Cho Ray Hospital, 

a tertiary referral center for Southern Vietnam, along with the University of Medicine and Pharmacy and its 

affiliated University Hospital and Children’s Hospital which together act as the primary academic medical center 

for southern Vietnam. 

127

THE INFORMATION AGE MAKES STRANGERS OLD FRIENDS 

Written by Justus Ibrahim Twinomujuni 

Global Health Participants Coordinator ACCESS Nakaseke Centre 

I was excited to meet our long-awaited participants - Connie Steinman, Timothy Martin, Soubhi Alhayek, and 

Amber Brewster - at ACCESS after developing our bond via e-mail and Skype calls. It felt as though we were 

longtime professional friends. It is in the spirit of this valued connection that we shared ideas and discussed 

matters of relevance in relation to effective elective placement learning outcomes. I attribute all this to the 

information age, the era that enriches prior engagement between participants and coordinators, and eventually 

the entire global health team. Prior engagement using information technologies is indeed vital in orientation, 

adaptation, and blended learning for global health participants. 


Dr. Prachyapan Petchuay 

Dean of Walailak University School of Medicine 

I grew up in Nakhon Si Thammarat, a region where both sides of my family 

have their origins. Following my medical education at Mahidol University in 

Bangkok, I spent three years working at Maharaj Hospital in my home city 

as part of the requirement that newly qualified medical doctors spend three 

years working in a public hospital. It was during this time that I developed 

an interest working in rural communities with limited access to quality health 

care. 

Driven by the severe shortage of general surgeons in the region, I returned to Bangkok in 1992 to study surgery 

at Chulalongkorn University. After completing residency I returned to Maharaj Nakhon Si Thammarat Hospital 

to work as a general surgeon with a focus on breast cancer and traumatic patients. In 1997, I received a 

government sponsorship for a year’s training in vascular surgery at the University Hospital of Wales in Cardiff, 

United Kingdom. 

An emerging emphasis on rural health care rendered Maharaj Nakhon Si Thammarat Hospital a teaching hospital 

with the remit to cooperate with other medical schools to train more doctors for the region. Uncertain about our 

ability to become an effective training institution, I applied for and was awarded a government scholarship to 

study medical education at the University of Cardiff’s Medical Education unit where I received an MSc in 2003 

before continuing with PhD. studies at the University of Birmingham, with a thesis focus on medical training in 

Thailand’s rural regions. 

On return, I joined the hospital’s medical education faculty while helping Walailak University establish its own 

medical school. I became a full-time member in 2011 following my appointment as the Associate Dean of 

Medicine. In the few years to follow, I was appointed chairperson of the Committee on Medical Education for 

the Consortium of Thai Medical Schools, board member of the General Medical Council of Thailand, and Dean of 

Walailak University School of Medicine - a=the position which I am currently holding. 

128

CONDOLENCES 

CONDOLENCES: 

Written by Mary Shah 

Our hearts are heavy for the family, friends, and colleagues of those who perished in the Ethiopian Airlines 

crash. There were passengers from at least thirty countries, and many worked for the United Nations and other 

humanitarian organizations. There were writers, teachers, students, professionals, tourists, and journalists. More 

importantly, they were human beings whose loved ones and colleagues are now filled with great sorrow. 

Loss is never easy, whether it is the result of an instant accident or the course of a drawn-out disease. I attended 

a memorial service for a dear friend of our family this past weekend. It was full of tears, memories, and laughter. 

Her son remembered that she was not perfect, but it was the imperfections that made us love her even more. 

The Vietnamese monk Thich Nhat Hanh wrote, “impermanence 

does not necessarily lead to suffering. What makes us suffer is 

wanting things to be permanent when they are not.” We could 

focus on the loss, or fragility of life, or pain of dementia. Or 

we could focus on that which we can control: working kindly 

with older people, taking time to listen to how someone’s 

day is going, being grateful for what we can accomplish 

together. Take a moment, clear your head, and find a way to 

make a connection to the point where you can overlook those 

imperfections and rejoice. 

Click here to read about theEthiopian Airline Crash >> 

NATURAL DISASTER IN ZIMBABWE 

Cuclone Idai - Events as they happen >> 

129

A Note from Tendai Machingaidze 

Global Health Program Site Co-Director in Zimbabwe 

The cyclone was indeed terrible and its effects continue to devastate many. However, despite the terrible 

economy, Zimbabweans all over the country have put aside their own needs to amass an overwhelming amount 

of donations that have been made through various charities, such as Miracle Missions, to help the victims of the 

cyclone. Hopefully these efforts continue strong so that those who survived can rebuild. Currency continues to 

be the big issue, with incredible shortages of cash and hyperinflation of goods and services. It is, however, safe. 

I have not heard of any incidences after the demonstrations that went on at the beginning of January. 

A Note from Professor Rati Ndhlovu 

Director of the Global Health Program at University of Zimbabwe College of Health Sciences 

You may be aware that the eastern part of Zimbabwe has been hit hard by Cyclone Idai. We have areas like 

Chimanimnai which have been wrecked by flood waters, and about 50 deaths including three school kids who 

were crushed while sleeping during a mudslide. We are now trying to get disaster relief to those areas. The 

Zimbabwe Medication Association is fundraising for this effort. I know there have been requests via social media 

for doctors to come and help the injured. The roads to Chimanimani town have been damaged, so there is need 

to airlift helpers into the areas, using helicopters, I presume. 

We are in trouble. I came back from the Conference on Retroviruses and Opportunistic Infections (CROI) to find 

the senior doctors protesting! You may have seen my name linked to the Save our Hospitals Initiative. Started 

prior to the cyclone disaster, this was meant to help our central hospitals after the recent protest by senior doctors 

who have now gone on “emergency mode” due to lack of basic commodities like gloves and bandages. We have 

our first meeting today at 5 pm, during which we will be strategizing about how to fundraise for these central 

hospitals! I will send you the message via Whatsapp as I do not think I have it on email. You may email Pangu 

Ndapedza with any questions at hopewell2@post.harvard.edu. 

FLOODS KILL AT LEAST 18 IN SOUTHERN IRAN, NEARLY 100 WOUNDED 

At least 18 people were killed and 

around 100 others were wounded 

in flash floods in Iran’s southern 

province of Fars, Iran’s semi-official 

Tasnim news agency reported on 

Monday, following devastating 

floods in the north. The floods 

struck during the Persian New Year 

holiday when many government 

offices were closed. 


130

CONDOLENCES: 

Written by Majid Sadigh 

We lost Dr. Rinat Sabirov, a friend, colleague, and exceptional human. 

“More pleasant than the sound of love’s call, naught I heard: A memorial, 

that in this revolving dome remained.” 

It is with deep sadness and regret that I announce the death of Dr. Rinat 

Sabirov, the Director of Medical Education at KSMU in Chelny, on Friday, 

March 13th. My life holds pages after pages of good memories of him and 

his family. He taught me the language of love; to speak with eyes and 

generous actions rather than with the tongue. 

Such a tragedy. 

Such a big loss for us all! 


ABOUT THE MATCH 

All UVMLCOM Global Health Program participants were matched into the best national primary care-related 

residency programs: 

• Khaled Al Tawil: Stanford University for Preliminary Surgery, and Zucker/Northwell Lenox Hill Hospital in New 

York, NY for Diagnostic Radiology 

• Omkar Betageri: University of Florida COM-Shands Hospital in Gainsville, FL for Internal Medicine 

• Julia Cowenhoven: Children’s Hospital-Boston for Pediatrics 

• Florence DiBiase: Brown/Women and Infants Hospital of Rhode Island for OBGYN 

• Elizabeth Doughty: University of Colorado SOM-Denver for Pathology 

• Midori Eckenstein: University of Utah for Neurology 

• Morgan Hadley: University of Kansas SOM-Kansas City for Orthopaedic Surgery 

• Eric King: University of Massachusetts Medical School for Family Medicine 

• Nicole Leonard: University of Utah for Pathology 

• Jayne Manigrasso: Oregon Health & Science University for Anesthesiology 

• Amber Meservey: Duke University Medical Center for Internal Medicine 

• Brian Rosen: Dartmouth-Hitchcock Medical Center for Psychiatry 

• Zachary Wunrow: University of Vermont Medical Center for Psychiatry 

131

Congratulations to Dr. Alex Kayongo, Global Health Scholar from Uganda, and his 

wife Mrs. Kayongo for the birth of Lauren Kayongo. 

Congratulations to Sister Jane Frances Nakaferro, Director of Saint Francis 

Nagalamma Hospital, for receiving the Rotary Outstanding Service Award. 

Congratulations to Jamidah Nakato for receiving a Ph.D. in Business Management 

from Nelson Mandela University in South Africa. 

Congratulations to Wendy Perdomo, M.D. for her acceptance to the Internal 

Medicine Residency Program at Danbury Hospital. 


Thank you for sharing Ethical Obligations Regarding Short-Term Global Health Clinical Experiences: An American 

College of Physicians Position Paper 

I had the opportunity to study it word by word last night after receiving it. The content clearly hits on the point. 

One would be prompted to feel that it is overly direct to the point... but being passionate about moral philosophy 

I understand how ethical topics are touchy. It’s surely an applicable article for the Global Health Program in which 

we are all involved. 

I too highly recommended it and keep it part of my deferential documents as I play my part of operationalizing 

global health activities. 

Sincerely, 

Justus 

From ACCESS 

132

DI had an amazing day today in the hospital and with the scholars at ChoRay Hospital in Vietnam. I am 

constantly in awe of these extraordinary people. Their emotional depth and generosity takes my breath away. 

I am looking forward to talking to you more when I get home. 

Steve Winter 

It was a pleasure to host Dr. Swapnil and Dr. Sadigh at our institute. Thank you very much for addressing our 

students, undergraduates, and post-graduates on important aspects like Ebola and biostatistics. Instilling the 

curiosity of the learner is most vital for learning, and you actually did that! Students loved the sessions. We 

look forward to a rewarding partnership in the future for our mutually identified areas. 

As rightly suggested by you, our team, two faculty members representing research and academics, would love 

to visit the University of Vermont during the first week of June. We request you to mail an invitation for the 

event to help us plan the trip. This visit will give us insight into various global health initiatives and ideas while 

helping us explore the university’s areas of expertise wherein DMIMS can collaborate, particularly in the Skills 

and Simulation Lab, Teaching Academy, and basic science research. 

Best regards, 

Dr Tripti K Srivastava, MD, FAIMER, AFAMEE, MPhil, PhD 

Professor of Physiology 

Convener, MCI Nodal Centre for Faculty Development 

Director, School of Advanced Studies 

Jawaharlal Nehru Medical College, 

Sawangi(M), Wardha,Maharashtra 


WE STAND TOGETHER 

“Terrible beyond contemplation”, wrote a friend from New Zealand last week after the assaults on two mosques 

in Christchurch. Most politicians unreservedly condemned the March 15 attacks, examples of white nationalist 

terrorism that left 50 people dead and many injured. There have been notable exceptions to this worldwide 

revulsion, with some voices legitimising the hate speech of alleged perpetrator Brenton Harrison Tarrant, the 

28-year-old Australian now charged with murder. Australian Queensland Senator Fraser Anning wrote about 

“the growing fear within our community, both in Australia and New Zealand, of the increasing Muslim presence”. 

While most responses to these terror strikes have appropriately emphasised solidarity among New Zealand’s 

communities, one regrettably sees that what took place in Christchurch lay at the violent end of a spectrum of 

xenophobia that is now authorised and accepted in political discourse. No one concerned about protecting and 

strengthening peaceful and just societies can disclaim responsibility. 

133

Read the full article here >> 


QUIZZES 

Editor; Dr. Stephen Scholand 

Site Director for Global Health Program partnerships in Thailand, Vietnam, and Zimbabwe 

A NOTE FROM THE EDITOR 

“Your Participation Is Requested” 

Introductions and Ideas from the Clinical Case Editor 

I’m an Infectious Diseases physician and global health practitioner who is passionate about medical education. 

Our program has established this eMagazine for the advancement of global health perspectives, principles and 

practices. I’m proud to introduce this “Clinical Cases” section in which we aim to highlight the human condition 

and humanity of a patient. 

How might a patient’s culture, beliefs, societal norms, and socioeconomics affect their illness? How might these 

and other global health factors affect their treatment and outcome? We are not looking for “zebras,” the most 

exotic disease or bizarre presentation. Rather, we want to focus on the patient themselves. What are they experiencing? 

What should we know about them Why are they suffering in this way? These are clinical cases from a 

unique global health perspective. 

134

How is this case emblematic of what we do? We care for and treat patients with compassion and love. We are 

physicians, physicians in training, medical professionals, and others who are human beings with heart. What is it 

that we care about the most? What is it about this patient that we can all learn from? This section will provide all 

this and more. Hopefully, we will teach each other and remind ourselves to always do the best we can. 

We would be grateful to you if you could submit a photo (de-identified and with informed consent, please), along 

with a story. Never mind how long or how short the case! We very much want you to participate – whether you’re 

a medical student, resident, colleague, faculty member, or other Global Health participant. Don’t be shy! We want 

cases and perspectives from the Global North to the Global South, to properly showcase the global health fire 

that burns within us. 

Thank you, 

Stephen J Scholand, MD 

PHOTO QUIZ >> 

From Drs. Howard Eison and Randi Diamond 

An older man of unknown exact age living in a remote area in rural Uganda with no access to medical care is 

referred to the local palliative care community outreach team. He described having joint pains for many years 

involving primarily his hands, feet, and knees, with increasing swelling of these joints over time. Periodically 

the swellings would ulcerate and produce an off-white discharge that was described as pus-like. Besides the 

pains in his joints, he denied constitutional symptoms and offered no complaints on a review of symptoms 

except intermittent episodes of right flank/right lower quadrant pain that would last for a few days. He had one 

episode of gross hematuria in the past but can’t remember details. 

136

REFLECTIONS 


February 16, 2019 

I walked into this elective with certain expectations. I thought the biggest thing I would learn is enhancement of 

my clinical skills. Instead, I observed injustice. I saw a drastic, uneven distribution of resources of public versus 

private institutions and the immense impact it has on patients and their families. I watched a different healthcare 

system operate and withstand limited resources. I feel this experience will make me a better doctor and a better 

person. I hope to continue working with underserved communities, from here in the United States to other parts 

of the Global South. I plan to join the movement to help eradicate the injustice of unevenly distributed resources. 

I hope to contribute more to the cause in the future. 

Connie Steinmann MS4 

Uganda: Week 1 

In Uganda Living and Learning 

February 17-22, 2019 

What an exciting and eye-opening first week in 

Uganda it has been! From the week’s start, I have 

found myself feeling incredibly lucky to experience 

this country’s vibrant culture and people. Already, 

I feel this has been an invaluable and incredible 

experience for me both as a medical student 

and as a human being. I am lucky to have the 

opportunity to travel to such a unique place and 

get a glimpse of life halfway across the globe. 

(Left to right) Connie Steinmann, Soubhi Alhayek, Timothy 

Martin, and Amber Brewster, senior AUC students at 

ACCESS(Dean of International Relations, UNIBE) at UNIBE 

Our week began with an orientation to our home at ACCESS and Nakaseke Hospital. Nakaseke has proven itself 

to be a vibrant community of friendly faces. Every single local person we have interacted with has wished us 

“hello” and “you are very welcome here!” The sweet children in the town run up to hold our hands and walk us 

home. The merchants in the shops are all kind and helpful. The doctors, nurses, and midwives in the hospital 

have greeted us enthusiastically and welcomed us into their workplace. 

The hospital experience has been invaluable. On Tuesday, we began work in the labor and maternity wards. 

Because my interest lies in OB/GYN, I was of course overjoyed that we would start our experience in my favorite 

medical specialty! However, although obstetrics is my area of interest, I was surprised by how little I felt I knew. 

How can we help these mothers without the technology I had grown accustomed to using!? There were no 

fetal monitoring systems, no tocometers, and no way to track fetal heart rates. There were no blood tests or 

ultrasound machines! At first, I felt lost. How can we work patients up without these very important diagnostic 

tools? How can we take care of them? 

137

The midwives at Nakaseke Hospital were quick to show us that there are many ways we can assess our laboring 

patients with nothing but a good history and physical exam. They taught us so many new clinical medicine skills. 

We truly had to use just our eyes, ears, and hands to determine the state of our patients. I felt like I was learning 

“old medicine,” but in a good way! This is the way medicine used to be practiced before we had the technology 

we have now back home in the States. I was so happy for the opportunity to pick the minds of the Ugandan 

midwives. Their experience in clinical medicine taught me so much this week, and I know I will be a better doctor 

because of it. 

Meanwhile, I was able to observe a Caesarean section in the operating “theatre,” treat patients with postpartum 

hemorrhage, preeclampsia, and a retained placenta, and to witness the care and delivery of many laboring 

mothers. The experience was unforgettable, and I loved seeing how Ugandans make medicine work in an 

environment with such limited resources. 

I can only hope the weeks that follow will be as full and exciting as this one was. I have adjusted quickly to the 

slower pace of this African life. We spend some portion of every day with our housemates and fellow medical 

students reading books, reflecting on our experiences, playing cards, and drinking Nile beer (sourced from 

Uganda!) on the front porch with our new friends. This way of life suits me, and I am very happy to be in Uganda 

living and learning. 


GLOBAL HEALTH 

DEFINING THE COMFORT ZONE 

Challenges are an inherent component of global health electives, and can be ascribed to an array of sources 

including insufficient orientation, unrealistic expectations, unfamiliarity with the culture and way of life, or 






138

GLOBAL HEALTH 

AND THE ARTS 

Editor; Tendai Machingaidze 


A NOTE FROM THE EDITOR 

It is my honor to introduce you to the “Global Health and the Arts” section of our eMagazine. At its heart, 

global health is about connecting with people. As global health practitioners, we must transcend barriers of race, 

language, culture, socioeconomic status, and religion if we are to reach our patients around the world. In order 

to achieve this lofty goal, we must build and rebuild multifaceted frameworks of how we view the world and its 

diverse citizens. The intersection of global health and the arts affords us the opportunity for both introspection 

and extrospection. As we look inside ourselves, we are forced to define and refine our passions and motivations 

for working in healthcare, and we are thus able to clarify and rectify our vision and mission. Then, as we look 

outside of ourselves, we come face-to-face with the harsh realities of the world, juxtaposed by the beauty and 

strength of humanity. The arts evoke emotions in us that open conversations, drive actions, hearten empathy, 

and foster possibilities that we would not otherwise be aware of. As we engage in multidisciplinary connections 

and collaborations, we step out of the science bubble of just treating diseases and focus on the people before us. 

Only in this way can we gain the capacity and competency to truly reach the world. 

I invite you to submit contributions to “Global Health and the Arts.” Poetry, prose, music, drawing, painting, 

photography, dance – whatever provokes and/or inspires you! There is no set format for submissions, and 

creativity is greatly welcome. Let’s explore ourselves and the world more deeply, and so give birth to the best 

versions of ourselves in global health. time.” 

RESPONSIBLE STORYTELLING IN GLOBAL HEALTH 

ADVICE FROM EMMY AWARD-WINNING FILMMAKER LISA RUSSELL 

By Tendai Machingaidze 

I had the privilege of attending a workshop by Lisa Russell, MPH at the Unite for Sight Global Health and Innovation 

Conference at Yale University in 2018. In addition to being an Emmy Award-winning filmmaker, Russell is a prolific 

global and TEDx speaker, a Fulbright Specialist, founder of Storyshifter and #Create2030, as well as a UN/NGO 

contracted arts curator and storyteller. 

In the workshop titled “Responsible Storytelling: Changing the Narrative of Global Health,” Russell shared clips 

from her film Heroines of Health (2017). The film profiles three female leaders in global health in India, Kenya, 

and Indonesia. Russell used it to bring to life the concept of “Narrative Justice” and the need to “shift the story” 

in global health today. As a woman from Zimbabwe who has all too often cringed at the unflattering clichéd ways 

that underprivileged communities are depicted in the West, I was enthused and challenged by Russell’s advocacy 

for social justice through “responsible storytelling.” I recently reached out to Lisa Russell seeking advice on how 

139

global health participants should tell stories of their experiences abroad. Below are the questions I posed to her, 

along with her inspiring and thought-provoking advice. 

TM: Tendai Machingaidze 

LR: Lisa Russell 

TM: What is “Narrative Justice”? 

LR: To give context to this question, I have to start with how I became interested in storytelling in the first 

place. I did not go to film school, nor did I ever think of becoming a filmmaker. In 1999, while working as a 

humanitarian aid worker in Kosovo and Albania, I was put in a situation where I was forced to take a hard look 

at how journalists were covering the war, especially around stories focused on women and rape as a tool of war. 

The Kosovar women made it clear that they did not want to be stereotyped one-dimensionally as Kosovar women 

“who had been raped.” After becoming a filmmaker and traveling around the world producing films for UN/NGO 

agencies on pressing global health and development stories, I started struggling with my own work. How could I 

tell these stories ethically when they focus on very serious issues? How could I not be seen like the journalists in 

Kosovo telling emotionally exploitative stories? What’s the alternative? Making films about poor people smiling? 

Narrative Justice is a concept I embraced and have spoken about at various conferences and workshops throughout 

the years in an effort to create dialogue about responsible global health storytelling and, to be honest, to help 

me figure out for myself how to embrace my work in a manner that I felt was credible and helpful. Narrative 

Justice is based on the idea that the act of storytelling is rooted in ideals of social justice, whether it be about the 

storytellers themselves (i.e. those who have access and equal opportunities to tell stories) or whether it’s about 

those whose stories are being told (i.e. those whose rights in how they are portrayed in those stories comes into 

question). The term “narrative justice” was developed in reference to an incredible resource called the “Charter 

of Storytelling Rights” that was written by David Denborough on behalf of Dulwich Centre Foundation based in 

Australia. Structured like the UN Charter of Human Rights, the Charter of Storytelling Rights has a series of seven 

articles that touch on how those who have experienced trauma have rights in how, when, and where they share 

their stories. 

After years of struggling with how to address the plethora of emotionally exploitative content - otherwise known 

as “poverty porn” - I found the Charter of Storytelling Rights and used it as a discussion tool to ask really difficult 

questions I was having at the time about my own career. In other words, are we as the global health community 

embracing ethical and responsible tactics in how we capture and tell stories or deliver messages about our work? 

TM: Why is it particularly necessary to “Change the Narrative of Global Health” in today’s society? 

LR: Since the beginning of my career, global health, stories were often based around charitable stories which 

perpetuated pity for individual “victims,” and tended to glorify aid institutions and aid workers as “saviors.” Instead, 

I think it’s necessary to shift the narrative to one of a justice-based approach, which takes responsibilities off of 

individual behaviors but instead challenges the systems that keep people in poverty and perpetuate inequalities in 

health. When we talk about the Ebola crisis, for example, we can’t just talk about the thousands of West African 

“victims” who sadly lost their lives to this epidemic. Rather, we must also address why the only two infected 

individuals to receive life-saving treatments were white, Western doctors. 

If we refuse to address the systemic problems of global inequality in access to quality healthcare, then we are 

perpetuating a power imbalance that benefits the privileged but not the constituents who are in need. If our 

global health stories are necessary to move audiences to care about those experiencing trauma or ill health (and 

140

to donate), there are various storytelling devices available that we can tap into. Trauma-based stories are not the 

only ones to move audiences. Stories of inspiration, passion, and innovation can also be incredibly moving. I’m 

not saying not to tell the more serious stories - they are valuable, for example, in times of true natural disasters 

- but we need to have a better balance in the types of stories being told about our community. 

TM: What advice would you give to global health participants on how to relay stories of their experiences in 

developing countries when they return to the United States? 

LR: I think if you truly want to work responsibly in global health, you have to understand systems of privilege 

and power - especially white privilege - and challenge your own within your work. It’s a lifelong commitment to 

understand, recognize and “unlearn” the inherent privilege you may be entitled to as a Caucasian or a man, and 

to use that privilege in the service of others. With that said, some basic suggestions: do not make yourself the 

“hero” of the story. While being of service to others can make you feel good and worthy, you are not being a hero 

for doing so. You are being human. If you come back and tell the story of your field work, tell a story about a local 

hero. Record them telling their own story. Research the systems that created the hardship your field work was 

based on and ask challenging questions on how to challenge that system. 

TM: What responsibility do global health participants have as storytellers of their experiences? 

LR: Their responsibility as storytellers is to be humble and acknowledge that you only have a snapshot of the 

reality of what you experienced. You do not understand the nuances of the local culture so it’s not your role to 

speculate on what they can or should do to improve their conditions. Your role is to observe, ask them what you 

can do, and then use your access to your family, your fellow students and other Americans to open doors for their 

voices to be heard. It is not about you. Your contribution as a volunteer, intern, or aid worker is equally measured 

to the experience you received. There is no hierarchy and that must come through in your storytelling. 

TM: How can global health participants help to “shift the story” through the photos and videos they 

post on social media? 

LR: The first rule of thumb: First do no harm. A great resource to explore is “No White Saviors” on Instagram 

which has an ongoing dialogue on power and privilege when it comes to global health and humanitarian aid. 

Another Instagram account is “Barbie Savior.” Both of these sites may make you feel uncomfortable, but the best 

way to truly become a responsible storyteller is to listen without being defensive. Remember, this is not about you 

as much as it’s not about them, it’s about the SYSTEMS (including colonization) that have perpetuated worldwide 

poverty and inequality that has led to inequalities in health. 

TM: Why are the arts crucial to global health and achievement of all the Sustainable Development 

Goals (SDGs)? 

LR: Arts are crucial to global health and the achievement of the SDGs for many reasons. The most obvious 

ones are that artists can help move people, reframe how we see the world, and use their art to shine light in a 

way that a report or research paper cannot. Additionally, artists - especially professional working artists - have 

exceptional creative thinking and problem-solving skills. In order to live and survive as a working artist, they 

have to wear many hats - entrepreneur, educator, change maker, etc. - that those with regular schedules and 

work environments do not have to wear. Why wouldn’t we want those skills in a room where policy and decision 

makers are trying to come up with solutions to, for example, climate change. My current work with Create2030 

intends to not only provide a platform for artists to create and share work about the SDGs, but also to build 

institutional credibility for artists and creatives in the UN/NGO space. Learn more about Lisa Russell, Storyshifter, 

and Create2030 at: 

141

Lisa Russel Films 

TEDx Talk 

Create2030 film 

Create2030 website 

142


We were supposed to have a collaboration between the ACCESS Nursing School, which trains lower-level nurses 

and midwives, and Sacred Heart University and the UVM Nursing Program, but things didn’t work out very well. 

On another note - though all our other programs are doing very well - the Nursing School is quite struggling. 

This is largely a result of the stringent measures and terms of the nursing governing bodies as well the nature of 

students we serve. 

Each student is required to pay about 1,200 USD a year, a fee that is difficult to afford for families from rural 

areas. They are always defaulting on school fees. Yet we have to feed, accommodate, transport, and teach the 

students, and pay large staff salaries. I would like some guidance on this issue, and also ask if you know any 

contacts that may be willing to support the nursing education of lower-levels care in Uganda, or anyone who can 

share training materials like mannequins, medical equipment, nursing textbooks, videos, and volunteer tutors. 

I look forward to hearing from you. 

Robert Kalyesubula 

143

“Teaching is at the core of medicine. You pass on what 

you know and share your ideas. I had an amazing time 

over the past few weeks teaching a lecture series to 

some smart, amazing, and curious nursing students at 

ACCESS Health Training Institute.” 

Soubhi Alhayek, fourth-year 

AUC medical student 

Learn more about ACCESS here >> 

FOLLOW-UPS 

The MoU between University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam and Western CT Health 

Network, Inc has been fully executed. 

The MoU between the Datta Meghe Institute of Medical Sciences (DMIMS), Sawangi (Meghe), Wardha, India and 

Western CT Health Network, Inc has been fully executed. 

The MoU between Chiricahua Community Health Centers, Inc. in Arizona and Western Connecticut Health 

Network, Inc is under discussion. 

144

PHOTO 

CONTEST 

Editor; Albert Trondin 

Albert Trondin; Volcanic Park “Timanfaya,” Dust from Sahara Desert! 

Photot by Majid Sadigh, MD 

Photo by Majid Sadigh, MD 

House Call (Dr. Howard Eison) 

“More pleasant than the 

sound of love’s call, naught 

I heard: a memorial, that 

in this revolving dome 

remained” 

-Hafiz 

145

ESSAY CONTEST 

I SOY DOMINICANA! 

Written by Samantha Boustani, MS4 

Goodbyes are never easy. Throughout 

my medical school journey, I have met 

numerous people and then said farewell 

countless time. Today was one of the hardest 

ones. Standing in the living room speaking 

to my mom, Marissa, one last time I began 

to thank her for everything. She responded 

by saying that Nia and I were mejor hijas, 

or best daughters. That is exactly how I felt. 

From the moment we walked into the door, 

she welcomed us with open arms. 

She worried about us when we were late, 

checked on us when we were sick, and cared 

for us as if we were her own flesh and blood. 

I do not see her as my global health elective 

host. I see her as my family. We were blessed 

to be put with such a phenomenal family. 

Every member of the household taught us 

RUSM students Antonia Nwankwo (left) and Samantha Boustani (right) 

with Maritza and Jesus Organda (host family in middle) 

something about the Dominican culture. Mom showed us the food. Dad showed us the area and how to be safe 

in the streets. Sister showed us the restaurants and cultural attractions. 

Marissa’s cooking is out of this world. Her food is made with love. She made us lunch and dinner every day. 

Typically, I barely stay home, spending days at the library and eating out a lot. In the Dominican Republic, 

however, I can home every day, excited to see what mom had cooked. Every dish was phenomenal. She made us 

traditional Dominican dishes such mangu concebolla (mashed plantains with onions), queso frito (fried cheese), 

and sancocho (traditional soup). So many different kinds of rice and beans with various flavors. So much variety 

I didn’t even know existed. I can write a whole essay just about the cuisine. 

I loved playing with their three-year-old granddaughter, Zoey and sitting in the living room chit-chatting with their 

daughter Esmeralda, my sister. Dad, who is a gym teacher and coaches several sports teams, would show me 

around the colonial zone. I went with him to volleyball practices and played with the elementary school girls he 

teaches. It was so much fun. I plan on seeing them when they come to visit New York City in April. 

The kindness of Marissa and her family made the experience very different from what it would have been had I 

lived alone. Having that space for exchanging cultural norms and learning each other’s traditions was incredibly 

meaningful. My own family even noticed how happy I was living with such warm, loving people. My sister, 

Esmeralda, says I acclimated so well that I am half Dominican now. I soy Dominicana! 

146

CALENDAR 

MARCH CALENDAR 

March 1: Hon. Dr. Jane Ruth Aceng, Minister of Health of the Republic of Uganda launched the Western Connecticut 

Health Network Information Center at Nabacwa Guest House - Namere Mpererwe, in Uganda. 

March 1: Dr. Majid Sadigh held a meeting with Dr. Rastegar and Dr. Tracy Rabin, Director and Associate Director 

of the Global Health Program at Yale, respectively. 

March 1: Fourth-year UVM medical students Nicole Leonard, Jayne Manigrasso, Florence DiBiase, and Omkar 

Betageri, and UVM Psychiatry resident Adam Hinzey returned from the global health elective in Uganda. 

March 4: Dr. Majid Sadigh and Ms. Lauri Lennon had a meeting with members of the WCHN Foundation to 

discuss the details of Global Health Day at Praxair. 

March 4: Dr. Majid Sadigh held a debriefing session with Drs. Eison and Diamond about their recent trip to 

Naggalama. 

147

March 4: UVM Psychiatry residents Sam Evenson and Smita Lahoti travelled to Uganda for the global health 

elective. 

March 4: A Global Health Elective class, “The Reductive Seduction of Other People’s Problems,” was held with Dr. 

Molly Moore and Dr. Ben Clements. 

March 5: Dr. Majid Sadigh made his monthly administrative trip to Burlington. 

March 6: A global health leadership meeting was held at Danbury Hospital. 

March 6: A meeting was held with Dr. Jan Carney to discuss the upcoming visit by Makerere University School 

of Public Health leadership. 

March 9: Fourth-year UVM medical students Brian Rosen and Amber Meservey returned from the global health 

elective in Uganda. 

March 10: The call for Global Health Day photo, reflection, and poster submissions and award nominations went 

out to the UVMLCOM community. 

March 11: A Global Health Leadership Team meeting was held at UVMLCOM. 

March 13: A meeting was held with the Communications Team to plan UVMLCOM Global Health Day on April 29th. 

March 14: Dr. Sadigh spoke to medical residents at Danbury Hospital about the structure and the content of the 

Global Health Program at WCHN. 

March 15: Dr. Ramapriya Vidhun, Director of the Pathology Residency Program at Danbury Hospital, went to 

Uganda for a week of educational and administrative activities. 

March 17: Fourth-year UVM medical student Beth Doughty travelled to Uganda for the global health elective. 

148

March 18: A global health elective presentation was delivered to new fourth-year students during the Prep For 

Practice course. 

March 25: Deadline for Global Health Day submissions and award nominations. 

March 25: A Global Health Elective class, “Social Determinants of Health,” was held with Dr. Molly Moore and Dr. 

Michelle Dorwart. 

March 25: A Global Health Leadership Team meeting was held at UVMLCOM. 

March 26: Dr. Majid Sadigh, Director of the Global Health Program, along with Global Health Program Coordinators 

Joanna Conklin and Laura E. Smith, held a meeting with the global health and global education leadership of 

Sacred Heart University to discuss the future direction of the collaboration between these two institutions. 

March 26: The Sacred Heart University Global Education and Health Lecture Series presented a Panel Discussion 

on “Healthcare and Education in Uganda” at West Campus. 

March 26-29: Dr. Mariah McNamara, Dr. Ben Clements, and Ms. Lauri Lennon, MBA conducted a site-visit in the 

Dominican Republic. 

From Left to Right: Katherine Miciak and Traci Umbreit, 

Nurse Practitioner students, Dr. Moses Othin, and 

Professor Constance H. Glenn 

March 29: Sixteen students from AUC/RUSM completed their global health electives: 

• Russia: Peter Biggane (RUSM) 

• Uganda, ACCESS: Timothy Martin (AUC), Constance Steinmann (AUC), Amber Brewster (AUC), Soubhi 

Alhayek (AUC) 

• Uganda, St. Stephen’s: Karri Hester (RUSM) , Samantha Hayes (RUSM) 

• Uganda, Naggalama: Rebecca Gerrity (AUC), Francesca Blazekovic (RUSM), Vishal Mehta (RUSM), Ana 

Carolina Barbosa-Hack (RUSM), Awista Ayuby (RUSM) 

• Vietnam: Crystal Douglas (AUC), Adrianna Kordek (AUC), Rick Garcia (RUSM), Heidi Lentz (RUSM) 

March 31: Makerere University School of Public Health leadership members arrived for a five-day visit to 

UVMLCOM. 

149

APRIL CALENDAR 

April 1 - May 10: AUC students Isabel Barros Lopes, Roberto Martin Veloso, and Niveta Aravind, along with 

RUSM students Monika Shenouda and Asima Mian, travel to Vietnam for the global health elective while AUC 

student Austin McEvoy travels to the Dominican Republic. 

April 1: Fourth-year UVM medical student Morgan Hadley travels to Uganda for the global health elective. 

April 1: A Global Health Elective Class, “Cultural Exercise,” is held with Dr. Molly Moore and Dr. Andrea Green. 

April 1: The WCHN Reception will be held at the Alumni House event to answer global health-related questions. 

April 6: UVM Pediatric resident Alex Laventure travels to Dominican Republic for the global health elective. 

April 8: A Global Health Elective Class, “Global Women’s Health,” is held with Dr. Molly Moore and Dr. Anne 

Dougherty. 

April 8: A Global Health Leadership Team meeting is held at UVMLCOM. 

April 12: Dr. Sadigh and Dr. Stephen Scholand meet with the leadership of Chiricahua Community Health Centers, 

Inc. in Arizona. 

April 17: A Dining with the Deans event is held with the topic “Global Health Electives.” 

April 22: A Global Health Elective Class, “Child Health,” is held with Dr. Molly Moore and Dr. Molly Rideout. 

April 22: A Global Health Leadership Team meeting is held at UVMLCOM. 

April 23: The posters, photos, and reflections display is featured in Given Courtyard for the UVMLCOM community 

to view and vote in advance of Global Health Day. 

April 26: Closer Look Day is held, during which accepted applicants will have a chance to view the Global Health 

Day displays. 

April 29: A Global Health Elective class, “Humanitarian Emergencies in the Context of Climate Change,” is held 

with Dr. Molly Moore and Kelsey Donovan. 

April 29: Global Health Day is held at UVMLCOM, with the awards reception from 4-5:30 p.m. 

150

PHOTO NEWS 

REMEMBERING DR. RINAT SABIROV 

Dr. Rinat Sabirov with Dr. Sadigh and the leadership of medical 

education and public health, Chelny 1999 

Dr. Rinat Sabirov, Downtown New Haven, CT, 

October 2012 

Teaching nursing students at ACCESS 

151

Teaching Session at ACCESS, Nakaseke, Uganda 

Timothy Martin, senior AUC medical student at ACCESS 

152

(Left) Dr. Ramapriya Vidhun with Dr. Emmanuel Denis Morgan, Global Health Scholar from Uganda, at the Uganda 

Cancer Institute (Right) Dr. Ramapriya Vidhun with Professor Charles Ibingira, Provost of MakCHS 

Grand Launch of the Western Connecticut Health Network Information Center 

153

Honorable Dr. Jane Ruth Aceng, Minister of Health of the Republic of Uganda (center) with Reverend Professor Samuel 

and Christine Luboga and invited guests at the launching of the Western Connecticut Health Network Information 

Center at 

Nabacwa Guest House - Namere 

DR. MARIAH MCNAMARA, DR. BENJAMIN CLEMENTS, AND MS. LAURI 

LENNON IN THE DOMINICAN REPUBLIC 

At the Cardiology Institute 

154

At the Institute of Tropical Medicine and Global Health 

With Dr. Ammar Ibrahim, Director of the Diabetic 

Hospital (second from left) 

From Left to Right: Dr. Benjamin Clements, Maritza and Jesus 

Organda (host family in middle) and Dr. Mariah McNamara 

155

The Sacred Heart University Global Education and Health Lecture 

Series 

(Above and above right) Professor Constance H. Glenn, 

Sacred Heart University College of Nursing 

Professors Christina Gunther (College of Health 

Professions) and Cima Sedigh (Isabelle Farrington College 

of Education) at Sacred Heart University delivering opening 

remarks 

Dean Alphano (Isabelle Farrington College of 

Education) at Sacred Heart University introducing the 

speakers 

From Left to Right: Katherine Miciak and Traci Umbreit, 

Nurse Practitioner Students, Sacred Heart University 

College of Nursing and Dr. Moses Othin, Ugandan Global 

Health Scholar at WCHN 

156

Professor Constance H. Glenn, College of Nursing (sitting) and 

Professor Christina Gunther, Director Global Health Program, College 

of Health Professions, Sacred Heart University 

To see more photos, click here >> 

APPEAL FOR VOLUNTEERS 

Click here for more information 

157

RESOURCES 







Ebola book 















Publications 



Presentations by Global Health Scholars 

158

May 2019 Volume 5 





159

PERSPECTIVES 

SEXUAL AND REPRODUCTIVE HEALTH RIGHTS 

Written by Florence DiBiase, MS4, UVMLCOM 

This week, however, I attended a lecture titled “Sexual and Reproductive Health Rights.” I saw this on the 

schedule and felt curious about how it would go. The general format of lectures in the fifth year medical student 

class involves one or two students presenting daily assigned topics with facilitation by an attending. This lecture 

was given by a timid appearing male student who started with similar statistics to those I referenced above. 

The attending facilitator, a female physician, chimed in frequently. As the discussion turned to abortion, I felt at 

times that the attending’s attitude was very liberal, yet at times, I also disagreed with her views. When she asked 

whether abortion should be legal, the class mostly responded in the affirmative, which somewhat surprised me. 

The professor, however, stated that legalizing abortion would not be effective. 

She proceeded to share her view that legalizing abortion would not make it accessible to the majority of women 

desiring it due to costs, stigma, and lack of willing providers. She spoke about South Africa’s abortion legalization 

and the country’s subsequent struggle with its implementation for these reasons. She clearly acknowledged the 

reality of the problem. I wrote in my notebook her statement: “the men who say abortion is illegal are the same 

men who get women pregnant.” She gave case examples of patients she had treated with septic abortion. One 

woman she treated had the procedure performed by a non-licensed medical person who probed so far into her 

abdomen that they went through the uterus and into the bowel, only realizing their mistake when they started 

pulling feces out of the vagina. 

She argued instead for prevention through education of all women and access to effective contraception for 

anyone who becomes sexually active. She stressed keeping girls in school as a fundamental way to decrease 

the high birth rate, unintended pregnancy, and maternal mortality. This is a more realistic and achievable goal, 

she argued, given that even access to contraception and sexual education are contentious due to religious and 

cultural beliefs. One example cited was about the Ministry of Health being forced to revise its statement on 

providing contraception to adolescents, raisin the minimum age from ten to fifteen. Another student contributed 

to the discussion by bringing up the lack of sexual education offered to children. I would love to discuss this with 

him if I can find an appropriate time and place. 

This was my favorite lecture to date because it left me questioning how to establish a woman’s right to reproductive 

control in resource limited and culturally prohibitive environments. I went into the lecture believing abortion 

should be legal everywhere, and I still maintain that belief, but I had not thought through all the logistical 

complications; the economics and cultural context in which laws operate. Of course I want women in Uganda to 

have access to abortion services if they want them, but maybe this lecturer is right? Perhaps the current situation 

is not sufficiently stable or developed enough to successfully implement such a law. 

160

This is a great challenge of any field or specialty within global health: when there are so many aspects of the 

healthcare system that require aid (in any form), how does one set an achievable and effective goal? Where does 

one direct efforts when one cannot address everything one would hope to? When I think about the environment 

at Kawempe General Hospital, I wonder too how many women are not accounted for in the statistics I read. It 

is resource draining and time-consuming to perform data collection for things like the maternal mortality ratio 

and illegal abortion rates. I imagine many people are not accounted for in the census. Many women never go 

to healthcare centers for antenatal care or deliveries. The scope of the problem is depressingly large. That said, 

understanding the problem through data is the first step. An estimate is better than no estimate, and small 

successes are better than no success at all. 


GLOBAL HEALTH DAY AT UVMLCOM: APRIL 24-29 

Written by Audree Frey 

Global Health Program Coordinator 

Larner College of Medicine, University of Vermont 

(left to right) Tendai Chiware, M.D., Mercedes Avila, Ph.D., Sheila Chamberlin, 

C.O., and Molly Moore, M.D., with Dean Rick Page, M.D. and Mariah 

McNamara, M.D. 

The Global Health Program at the University of Vermont Larner College of Medicine (UVM LCOM) and Western 

Connecticut Health Network (WCHN) hosted “A Celebration of Global Health” on April 29th. The day included 

two panel discussions which were new additions this year. The first panel, “Women in Global Health,” featured 

UVMLCOM panelists Dr. Margaret Tandoh, Associate Dean for Diversity and Inclusion and Assistant Professor 

of Surgery; Dr. Tendai Chiware, Fellow and Clinical Instructor in Reproductive Endocrinology and Infertility; 

and Dr. Anna Zuckerman, a third-year resident in Pediatrics. The session was moderated by Dr. Katie Wells 

and Dr. Mariah McNamara. The second panel, “Academic Collaboration in Global Health,” featured panelists Dr. 

Thomas Willson, Plastic Surgeon and Assistant Professor of Surgery; Sheila Chamberlin, Orthoptist and Surgical 

Assistant in the Department of Surgery, Division of Ophthalmology; Dr. Maria Mercedes Avila, Associate Professor 

of Pediatrics, Health Equity and Inclusive Excellence Liaison, and Director of the Vermont Leadership Education 

161

in Neurodevelopmental Disabilities Program (VT LEND). The session was moderated by Dr. Naomi Hodde and Dr. 

Mariah McNamara. Both sessions were well-attended, setting the foundation to implement similar programming 

in the future. 

The day culminated with a reception and awards ceremony. Dr. Mariah McNamara was the master of ceremonies, 

while Dr. Rick Page delivered remarks about the importance of the Global Health Program at UVMLCOM. Dr. 

Molly Moore presented the poster, photo, and reflection awards. Katie Wells, M.P.H. won the Global Health Poster 

Award for a poster she created with Rashida Nambaziira; Jason Murphy, M.D.; Stacey Chamberlain, M.D., M.P.H.; 

Mark Bisanzo, M.D.; Brian Rice, C.M., M.Sc., entitled “Gender disparity in injury outcomes: increased mortality 

in female children under five in Uganda.” Photo contest recipients included Anya Koutras, who won both the 

“Most Thoughtfully Composed Photo” and “Most Original Photo” awards and Scott Mitchell ‘20 who won the “Most 

Impactful Photo” award, featured under “Photo News.” Fourth-year medical student Brian Rosen ‘19 won the 

reflections portion of the contest, featured in the “Reflections” section. 

Finally, Dr. McNamara presented the annual Global Health Awards. 

• Mercedes Avila, Ph.D., and Shelia Chamberlin, C.O. received the 2019 Global Health Leadership & Humanitarian 

Award. This award was inspired by Dr. Patricia O’Brien, Assistant Professor of Medicine in the Division of 

Hematology/Oncology who is an exemplary humanitarian and leader of global health. The award recognizes 

individuals who are passionate about health equity and work towards addressing disparities, combating 

marginalization, and helping the underserved. 

• Tendai Chiware received the 2019 Citizen of the World Award. This award was inspired by infectious disease 

specialist Beth Kirkpatrick, the Chair of Microbiology and Molecular Genetics and Director of the Vaccine 

Testing Center. Dr. Kirkpatrick is an accomplished physician-scientist and leader in vaccine research, as well 

as dedicated global health champion. This award recognizes an outstanding leader and scholar who dedicates 

their work to the advancement of humanitarian pursuits. 

• Dr. Molly Moore received the 2019 Global Health Education Award, named for Dr. Majid Sadigh, Global Health 

Program Director at UVMLCOM and Christopher J. Treftz Family Endowed Chair in Global Health at WCHN. 

This award recognizes an outstanding global health educator who inspires students to become leaders in 

global health. 

After the official portion of the program, guests enjoyed refreshments, perused displays featuring submitted and 

winning photos, posters, and reflections, and spent time networking with one another. The celebration was a 

success, with events well-attended and participants engaged and energized. We look forward to celebrating with 

our WCHN and international colleagues in Danbury in June! 

162

CLOSER LOOK DAY AT UVMLCOM, 

APRIL 26 



Larner College of Medicine, University of 

Vermont 

On Friday, April 26, 2019, the University of Vermont 

Larner College of Medicine Admissions team hosted 

50 accepted students and 28 of their families 

for Closer Look Day. This was an opportunity for 

accepted students to visit UVM LCOM and learn 

more about our campus, curriculum, and culture 

before making the life-changing decision of where 

to go to medical school. As part of the program, Dr. 

Majid Sadigh, Director of Global Health at WCHN 

and UVM LCOM, gave a presentation introducing the 

prospective students to our Global Health Program. 

The presentation included photos and descriptions 

of the elective experiences we offer at each of 

our international sites, some nuts and bolts of the 

application and pre-departure processes, as well 

as a philosophical and poetic explanation of what it 

means to practice global health. The students were 

engaged and excited about the program, and asked 

several questions after the presentation. If previous 

years are any indication, some of these students 

will choose UVMLCOM because of our Global Health 

Program! 

Dr. Sadigh with Dr. Janice Gallant, the Associate Dean for 

Admissions at UVMLCOM after presenting to prospective 

medical students and their parents 

Dr. Sadigh speaking to prospective medical students and 

their parents during Closer Look Day 

PROGRESS TOWARDS GLOBAL HEALTH AT HOME IN ARIZONA 

Written by Dr. Stephen Scholand 

Dr. Majid Sadigh and Dr. Stephen Scholand visited Southern Arizona from April 12 – 14 to further advance the 

establishment of a “Global Health at Home” teaching site. The doctors met with some of the Infectious Diseases 

fellows at the University of Arizona, including Global Health Diaries contributor Dr. Jose Marquez. They discussed 

in further detail the plight and healthcare needs of immigrants in this challenging political environment. 

Dr. Sadigh and Dr. Scholand traveled together through the wide-open spaces of the southern Arizona desert to 

Douglas, a town right on the U.S.-Mexican border. This part of the country was clearly not “full,” with only very few 

settlements to be seen for miles and miles. There, in Douglas, they met with Dr. Jonathan Melk, CEO of Chiricahua 

Community Health Center (CCHC), who graciously provided a tour of some of their clinical sites and offices. Dr. 

Melk identified himself as a mentee of Dr. H. Jack Geiger, who created the community health center model in the 

U.S. during the Civil Rights era. 

163

(left to right) Jeffrey Holzberg, Stephen Scholand, Majid Sadigh, 

Darlene and Jonathan Melk 

Dr. Melk relayed how inspired he was to work 

with Dr. H. Jack Geiger, who is known for 

creating the community health center model 

in the U.S. during the Civil Rights era, and 

how attention to health, poverty, and civil 

rights pervaded the CCHC mission. A selfdescribed 

Star Wars enthusiast and aspiring 

mountaineer, Dr. Melk related on a personal 

level how he worked hard every day to 

support CCHC and its employees in such a 

medically underserved area. One outstanding 

accomplishment was the transition of the 

region from a poorly vaccinated population 

to one recognized by the CDC for excellence 

in vaccine coverage. Another inspiring aspect 

of the CCHC story is its ability to provide 

outstanding healthcare through a fleet of 

mobile clinics to serve isolated populations 

who would otherwise receive care. 

Dinner with infectious diseases fellows 

Following the discussions, the doctors discussed 

their visions for the future, including how the 

two potential partners might work together 

for mutual benefit. It was agreed that CCHC 

and UVMLCOM/WCHN would take the next 

steps towards cementing their partnership. Dr. 

Melk was invited to present at the UVMLCOM/ 

WCHN Global Health Conference held from 

June 2-4 in Danbury, CT. Meanwhile, faculty 

member Dr. Jeffrey Holzberg was invited 

for training at WCHN to develop a research 

project. Our global health community looks 

eagerly forward to advancing the partnership 

between UVMLCOM/WCHN and CCHC! 

Dr. Jose Marquez (left) and Dr. Majid Sadigh 

164

HEALTHCARE AND EDUCATION IN UGANDA 

Written by Kevin Pacelli 

Graduate Student, Secondary English Teacher Candidate, Sacred Heart University Farrington College 

of Education 

On March 26th, 2019 at 7 p.m. in the new West Campus building, the Global Education 

and Health Lecture Series at Sacred Heart University (SHU) hosted the “Healthcare 

and Education in Uganda” panel. This new initiative is a collaboration between the SHU 

Farrington College of Education, the SHU College of Health Professions, and Western 

Connecticut Health Network. 

This presentation allowed health and education students to come together for a night 

and embrace the unity between healthcare and education in the Global South. SHU 

invited Global Health Scholar Dr. Moses Othin to speak about his experiences working 

in Uganda. From his childhood until now, he has seen a shift in the way healthcare 

is managed in his country. From his early days as a doctor-in-training to eventually 

graduating top of his class, he showed the audience the hard facts of what it’s like to be a doctor in an underresourced 

country. Unlike physicians in the United States where medicine and technology are readily available at 

the snap of a finger, Ugandan physicians manage with minimal supplies. Along with the health panel, Dr. Othin 

told us that education plays a critical role in the medical field. 

In the United States, we have a specialist for drawing blood, another for taking X-rays, and and so on. But in 

Uganda, Dr. Othin shared, one doctor needs to learn how to execute over one-hundred jobs. With this in mind, 

their doctors are highly qualified, but there are only a few per hospital. Because the doctor-to-patient ratio is very 

small, getting to every patient can be challenging. On top of that, their medical supplies are very hard to obtain, 

seeing that Uganda’s Drug Administration works on a sort of “need now” basis. 

Something I feel the United States healthcare system can learn from is how much love there is in Uganda. Dr. 

Othin said family members take astounding care of their loved ones. They feed them and bathe them. The biggest 

thing I took away is the fact that they are the ones who get the medicine. Thus, within the hospital, the amount 

of work a family does has a huge impact. Also in attendance was Dr. Connie Glenn, a Professor from the SHU 

College of Nursing, and two graduate students who together travelled to Uganda where they received a firsthand 

experience of what it’s like to work in the medical field there. 

The Global Education and Health Lecture Series at Sacred Heart 

University 

Dr. Moses Othin, Global Health Scholar from 

Uganda, speaking at the Global Education and 

Health Lecture Series at Sacred Heart University 

165

The presentation opened my eyes to the world outside of the United States. Most of us think that under-resourced 

countries are filled with sick and dying people, but that’s not the case. Yes, there’s a high rate of HIV/AIDS 

and other diseases, but while on the trip, Dr. Glenn said they were met with nothing but smiles and love. The 

presenters told us how Americans are so fast-paced and outspoken while Ugandans are very religious and polite. 

After attending this event, I left feeling grateful for everything I have. I know this is a general statement, but in 

reality, we all take everything we have for granted. The U.S. has some of the most advanced technology in our 

hospitals, 24/7 care centers, and new medicine being created every day, among countless other privileges. This 

presentation made me take a step back and realize that what I have is what some people, like many in Uganda, 

pray for. 

MUSIC CURRICULUM: AN INVESTMENT IN THE FUTURE 

UNDERSTANDING BETWEEN THE PEOPLE OF THE UNITED STATES OF 

AMERICA AND THE PEOPLE OF UGANDA 


Reverend Professor Samuel Luboga passing books to Mrs. Sanyu Sevume, Head of the Sunday School 

Last year on July 27, 2018, St. Stephen’s Hospital had the pleasure of hosting four special guests: Ana-Cristina 

Herrick and Cathy Young Cane with their daughters, Catherine Marie Herrick and Samantha Kane, respectively. 

Together, these women made a generous contribution to the expansion of the hospital, for which we are very 

grateful. They also shared with us the “Sing-Along Music Curriculum” compiled by Samantha, promised to send a 

set of the songs written in easy-to-read flip-books to the children in our community, and distributed valued gifts 

to children and their parents. 

166

Nothing I heard that day adequately prepared me for the excitement I and the rest of the church family felt the 

day the books were received by the children of the Sunday school. It was Sunday morning. With us were two 

students from Ross University School of Medicine, Karri Else Hester and Samantha Hayes, who helped us lift the 

prized books into the church. There are ten books, one for each month from January through May; one for the 

three months of summer; and one for each month September through December. At the time when the children 

came forward to be prayed for before proceeding to their special classes, I made a presentation of the books to 

Mrs. Sanyu Sevume, Head of the Sunday School, which received a thunderous applause from the children. Karri 

and Samantha knew some of the songs and sung along the player, much to the delight of the children and the 

rest of the congregation. 

Samantha Hayes was able to come back the following Sunday to teach the children to sing the songs, an event that 

they thoroughly enjoyed. This donation speaks volumes to the children’s hearts by showing them that there are 

people out there who, despite not knowing them, care enough about them to send them an abundant 128 songs. 

It is teaching them generosity, caring, and love for all people. Learning and singing each other’s songs is a truly 

effective way of developing “people-to-people” love and understanding, as songs are an expression of culture. 

Furthermore, this is connecting young and adult generations to one another. It is rather like an inheritance; love 

handed down from one generation to the next. It is truly an investment in the future understanding between the 

people of the United States and the people of Uganda. 

Upon receiving the music curriculum, the head of the Sunday School stated: “God is good all the time. We, the 

little ones of God at St. Stephen’s Church of Uganda Mpererwe, want to thank you so much for loving us although 

you have not seen us before, and for the wonderful gift of songbooks full of nice songs that teach us to love God 

while stimulating our little brains in many other ways. We will always remember you. God bless you always.” 

We look forward organizing a concert and presenting it to the adult congregation once the children have mastered 

the songs. It is our hope that the concert will create demand for these songs among other community groups, and 

that many will start to want to know how they too can get a set of these songs. Fortunately, we have hard copies 

in A4 format. We will allow them to photocopy and teach them to other children elsewhere in the community. 

We will send you photographs and a video recording. In the meantime, please accept our sincere gratitude. Thank 

you to the UVMLCOM/WCHN Global Health Program for this wonderful collaboration which is bearing fruit of every 

kind that affects people of all ages. Thank you Ana-Cristina for encouraging and coming along with the Kane 

Family. Thank you Samantha Kane for undertaking an amazing holiday project that produced such a wonderful 

collection of childhood songs. Thank you Cathy Young Kane for raising a brilliant young lady Samantha and for 

encouraging her through the project. Thank you for the donation and we thank global health participants from 

Sacred Heart University for being bearers of good news. “How beautiful are the feet of those who bring good 

news” (Romans 10 15). 

167

UGANDAN COLLEAGUES FROM MAKERERE UNIVERSITY SCHOOL OF 

PUBLIC HEALTH (MAKSPH) VISIT UVMLCOM 



Larner College of Medicine, University of Vermont 

On March 31, 2019, leadership from the Makerere 

University College of Health Sciences School of Public 

Health in Kampala, Uganda came to Burlington, Vermont 

for an administrative visit to the University of Vermont 

Larner College of Medicine. Dr. Nazarius Tumwesigye 

and Dr. Noah Kiwanuka, the former and current chair, 

respectively, of the Department of Epidemiology and 

Biostatistics spent three days at UVMLCOM as we explored 

ways to strengthen and grow our new partnership. They 

met with Dr. Majid Sadigh, Director of the UVMLCOM/ 

WCHN Global Health Program; Dr. Mariah McNamara, 

Associate Director of the UVMLCOM/WCHN Global Health 

Program; and Dr. Jan Carney, Associate Dean for Public 

Health, to identify objectives and expectations for the 

visit. Together, the group identified many opportunities for 

collaboration. During the course of the visit, our guests 

met with several key faculty in global and public health. 

Each of these meetings built connections between our 

institutions and yielded many exciting ideas for next steps 

in our partnership. Dr. Naz and Dr. Noah also toured our 

Clinical Simulation Laboratory during their visit, joined the 

first-year Global Health students for their Global Health 

elective course where they participated in a cultural 

exercise facilitated by Dr. Andrea Green, and had a 

meeting with the students who will be rotating in Uganda 

this summer. 

Mariah McNamara and Audree Frey with delegates from 

Makerere University College of Health Sciences School 

of Public Health 

Our guests attended a dinner for first-year medical students interested in spending their clinical years at Western 

Connecticut Health Network, helping us highlight the Global Health opportunities available for students at the 

WCHN campus, and the Global Health Leadership Team hosted them for dinner at A Single Pebble restaurant on 

their last evening with us. Overall, this was a productive and successful visit that left everyone feeling excited 

about the partnership. Now we will build upon the connections that were made and bring the plans for future 

collaborations to fruition! 

168


Dr. Jose Marquez 

Infectious Diseases Fellow at the University of 

Arizona 

Jose Marquez is currently an Infectious Disease Fellow at Banner 

University Medical Center in Tucson, Arizona, where he also completed 

his internal medicine residency. He previously completed his academic 

studies within the University of California education system with a 

bachelor’s degree in molecular biology at UCSD and medical studies 

at UCSF. A native from Tijuana/San Diego, Jose grew up with a binational 

upbringing giving him a unique perspective to the challenges 

and differences of medical care in both countries. This awareness has 

been instrumental providing culturally sensitive care and addressing 

emotional needs for patients who are navigating through an unfamiliar 

and complicated system. During his spare time, Jose enjoys hiking 

and playing soccer. 


Congratulations to 

Jamidah Nakato for 

completing her PhD. 

Jamidah Nakato with 

her supervisor Professor 

Eileen Noxolo Mazibuko at 

her graduation ceremony 

in South Africa 

169


Dear Majid, 

Thank you so much for your and Steve’s visit to our borderlands global health project. I truly enjoyed our 

meeting, I learned a great deal, and have been thinking of the possibilities since. I also appreciated the printed 

material you left for us. I am making my way through it, and must say that it is so engaging to allow my mind to 

go outside of the borders of our service area that I and my team work so hard every day to serve. 

We are truly honored by your interest in partnering with Chiricahua. I felt that our organizations’ missions have 

a great deal in common, and our conversations brought me back to the days when I was a medical student at 

Weill Cornell dreaming of practicing global health and somehow being a part of making our world a healthier and 

happier place for all. 

I gratefully accept your offer to speak on the topic of “Global Health At Home” on Monday, June 3rd. We will plan 

on arriving on Sunday, June 2nd. Again, thank you so much for your visit. It was truly a pleasure to meet both 

you and Steve. 

Sincerely, 

Jonathan Melk MD 

CEO/CMO 

Chiricahua Community Health Centers, Inc. 

I appreciate all the opportunities I have had through the UVM/WCHN Global Health Program. I am thrilled 

to inform you that I matched at my top choice- Brown/Women & Infants Hospital in Rhode Island. This is an 

incredible Ob/Gyn program with a unique global health-specific track! I am very excited to move through the 

next phase of my medical training and appreciate your help in getting here. I am grateful for my time at UVM 

and hope to stay in touch. 

Sincerely, 

Flo DiBiase 

Dear Naz and Noah, 

Sorry for being tardy in replying your email. Thank you for visiting us in Burlington. 

You both impressed everyone with your personal and professional skills. 

I am glad that my colleagues in Burlington are now connected with you and Makerere University School of 

Public Health. I am looking forward to a mutually rewarding and long-standing partnership in education and 

capacity building. 

I would appreciate receiving a short paragraph on the future direction of the partnership considering the current 

level of interest and resources. 

Warm regards! 

Majid 

170

I would love to help the global health program with gynecologic cancer and laparoscopy training in Uganda or 

the Academy. I would like to learn and work with you on improving pathology capacity. 

Best, 

Linus Chuang 

Many thanks for all your efforts toward this collaboration and for our recent visit to UVM. We will send you a short 

write-up on the future direction next week. We have already worked out the research projects for the medical 

students who are visiting this summer. We will send you and Mariah briefs on each so that you can decide. Once 

again thank you Majid for all your help and support regarding this matter. 

Noah 

I think the eMagazine is very well-written. This volume is a wonderful geographic showcase of our growing 

program. As someone who participates in the program, I appreciate all the acquainted faces and interviews. I 

can feel the quality of being a family. 

I feel that a snapshot of our program at the beginning would help outsiders more easily connect to the program. 

Our aim, our scope, our activities... a brief description at the beginning. 

We at Cho Ray Hospital had a wonderful time with our latest global health participants. Rick, Heidi, Adrianna, 

and Crystal were enthusiastic and lovely. We had a wonderful farewell dinner with the special presence of Rick’s 

family. 

Khoa 

Dear Majid! 

I hope you are well. I know that you are planning to visit Kazan this May. I repeat my request that I wrote to 

you about last year, but unfortunately we didn’t have a chance to see you. 

Last year, we started journal club sessions at the Epidemiology and EBM Department. Students of different 

faculties (about 15 students of 3-6 years) present and discuss articles related to various fields of medicine. We 

try to use the model of JC, which I have seen at Yale. Of course it’s far from ideal now, but we do our best. 

I know that you have an extremely busy schedule during your visits, but maybe it would be possible for you 

to give some sort of “master-class” for my students, as you did a few years ago with the article about the use 

of corticosteroids for PCP. It could be even the same article. I’d like them to have the possibility directly learn 

from you the general methodology of reading and analyzing articles. 

To be honest, it’s not only my request. My students delegated me to ask you. If it’s possible, the best time for 

students is at 16-17, after their classes. The possible dates for me are 14-17/05 and 23-24/05. If these dates 

are not good for you, we will try to find some solution to the problem. 

Thank you in advance. 

Best wishes, 

Gulshat 

171


GLOBAL HEALTH URBANIZATION - AN EMERGING HUMANITARIAN 

DISASTER 

In 2008, the proportion of the world’s 

population living in urban areas crossed 

the 50% mark. The current rates of 

urbanization suggest that in China, 870 

million people — more than half the 

population — will be living in cities within 

less than a decade, and the capital of 

Botswana, Gaborone, will grow from 

186,000 to 500,000 inhabitants by 2020.1 

Most observers believe that essentially all 

population growth from now on will be in 

cities: the urban population is projected to 

grow to 4.9 billion by 2030, increasing by 

1.6 billion while the rural population shrinks 

by 28 million.1 This transition is happening 

chaotically, resulting in a disorganized 

urban landscape. Although many expect 

urbanization to mean an improved quality 

of life, this rising tide does not lift all boats, 

and many poor people are rapidly being 

absorbed into urban slums. 

A doctor examining a child in a slum in Chandigarh, India, 2008 

Read the full article at Harvard.edu 


This has been an eye-opening trip in many ways. Not only will I never forget therelationships forged with 

colleagues and the host family in Uganda, but I also look forward to bringing back and incorporating the 

knowledge gained in my medical career moving forward. 

Omkar Betageri, senior medical student, UVMLCOM 

172

PHOTO AND 

CLINICAL CASE QUIZZES 

THE ANSWER TO LAST ISSUE’S PHOTO QUIZ 

From Drs. Howard Eison and Randi Diamond 

An older man of unknown exact age living in a remote area in rural Uganda with no access to medical care is 

referred to the local palliative care community outreach team. He described having joint pains for many years 

involving primarily his hands, feet, and knees, with increasing swelling of these joints over time. Periodically the 

swellings would ulcerate and produce an off-white discharge that was described as pus-like. Besides the pains 

in his joints, he denied constitutional symptoms and offered no complaints on a review of symptoms except 

intermittent episodes of right flank/right lower quadrant pain that would last for a few days. He had one episode 

of gross hematuria in the past but can’t remember details. 

ANSWER: This older man living in a remote area without access to medical care presents to the outreach team 

with symptoms of polyarticular joint swelling and pain over many years. Without the benefit of diagnostic tests 

that might be available in resource-rich settings (e.g. radiographs to look at erosive changes in the joints, blood 

tests for evidence of inflammatory or autoimmune processes, or joint aspiration for microscopy and analysis), 

all that might help guide the clinician narrow diagnostic possibilities, the clinician in this setting must rely on 

obtainable history and examination findings. 

Faced with a patient with a longstanding history of a multiple joint swellings and deformities, the differential 

includes rheumatoid arthritis, autoimmune arthritides such as lupus, psoriatic or reactive arthritis, and gout, 

each with its own respective typical presentations. Infectious causes would be less likely given the many years of 

symptoms, but should always be considered when faced with inflammatory joint findings. 

173

Patient examination should focus on symmetry and number of joints involved, evidence of other findings such as 

skin rashes, oral or genital ulcerations, evidence of autoimmune disease, and signs of inflammation in the joints 

as well as elsewhere (e.g. serositis, Raynaud’s phenomenon) and constitutional signs such as fevers or weight 

loss. 

In this case, however, the physical examination reveals the diagnosis without need for the unobtainable tests. 

Extra-articular swellings involving multiple joints and history of nodules erupting at times expressing a white 

(often described as cheesy) substance, and the pathognomonic nodule (tophus) on the ear can only be tophaceous 

gout. A result of longstanding hyperuricemia and urate crystal deposition in various tissues, gout most commonly 

affects older males. Left untreated, chronic tophaceous gout may develop over years leading to polyarticular 

joint destruction and deposition of tophi (monosodium urate crystals) in soft tissue and joints. They are most 

typically found on the helix of the ears (as seen in one of the photos); on fingers, toes, wrists and knees; on the 

olecranon bursae; and on the Achilles tendons. They can be painful and may at times ulcerate, expressing the 

classic “cheesy” substance. 

Though an aspiration of one of the affected joints could have been performed in the field to confirm the diagnosis 

of urate arthropathy with microscopy back at the base hospital, it would have caused pain and risked joint 

infection without changing management. His description of flank pain and gross hematuria likely represents 

another manifestation of his presumed hyperuricemia, passage of urate renal calculi. 

While lowering of the uric acid level through lifestyle and pharmacologic intervention is the usual method of 

preventing further progression, this solution is unpractical in this setting. Though change in diet is frequently 

advocated for reducing uric level, this patient’s diet of rice and matoke is already low in purines. Given his 

underlying malnutrition, any limitation on food intake would have other dire consequences. Meanwhile, uric acidlowering 

medications such as allopurinol are not readily available in this setting. 

The team decided that the objective in this patient was to improve his mobility and reduce his discomfort. 

They plan to monitor his condition with regular visits, obtain crutches for him should his walking stick become 

insufficient, provide him with a steady supply of paracetamol with added ibuprofen during flares, and deliver food 

on a regular basis. 

PHOTO QUIZ 

By Majid Sadigh, MD 

A young woman from a village 

close to Lake Victoria in Uganda 

with a history of hemoptysis 

and lower extremity paralysis 

of six months 

174

REFLECTIONS 

Brian Rosen ‘19 

The winner of the best reflection contest. 

Uganda Reflection Week 3: Butabika Psychiatric Hospital 

I excel at intellectualization. It is a fickle defense mechanism, allowing the observer to fully comprehend the 

situation in front of them without fully engaging in the emotional context. Throughout my medical training 

intellectualization has aided me at many patient bedsides and through emotionally-charged family conferences. 

I am reminded of many moments on neurology wards where a patient’s emotionally charged question was 

reinterpreted and deflected through a purely intellectual and biologic lens. The disease process was stripped of 

its emotional and societal resonance and presented as a simple fact of life. My habit towards intellectualization 

even followed me into psychiatry, a field that fully embraces the nuances and significance of human emotion. It 

is much easier to intellectualize a difficult patient encounter with DSM qualifiers or neuronal processes than it is 

to simply exist in a difficult moment and let in the anxiety and fear that often accompanies it. 

Even this introduction to my experiences at Butabika Psychiatric Hospital is an intellectualization. It is my attempt 

to analyze and appreciate the defense mechanism that served me so well yet has likely met its match. The 

human suffering that I recently witnessed has affected me greatly. Before arriving in Uganda I imagined rough 

caricatures of what I may expect. Having been prewarned that conditions in inpatient psychiatry in Uganda 

were below what one would find in the United States, images of classic asylums immediately came to mind. My 

conception of such places comes intellectually from history books or visually and culturally from such films as one 

flew over the cuckoo’s nest. Even given the challenging environment I was imagined I was unprepared for the 

visceral nature of my experience. 

Butabika is located about 30 minutes from the center of Kampala, Uganda. It is situated on a lush hill overlooking 

the tranquil countryside. The peaceful quality of the environment is perhaps a pre-requisite given the scenes that 

often occur within its walls. Each psychiatric ward is a separate one-story building that are spread generously 

across the sprawling facility. Psychiatric patients are divided into child-adolescent, forensic, addictions, acute care, 

sick care, and convalescent (stable) care categories. The general physical upkeep and atmosphere of each ward 

varies dramatically. The acute male ward is my worst fears brought to life before my eyes. The entrance gate is 

manned by a psychiatric patient dressed in the simple blue-green patient grab letting his fellow patients enter or 

leave based on what appears to be whim. Within the walls patients meander about in states of extreme psychosis 

and mania without any real attempt to intervene in case of conflict. Sanitation appears as an afterthought, 

causing the smell of human suffering to be fully entrenched in my emotional memory. Due to the limited security 

structure walking around the grounds of Butabika means constantly running into patients in the acute throws of 

psychosis walking aimlessly around the grounds as though in a perpetual daze. The resulting impression is one 

of extreme despair and powerlessness. 

Due to the resource constraints of Uganda the medications provided to such patients are restricted to first 

generation anti-psychotics that produce a wide variety of symptoms including repetitive motions of the limbs 

175

or face, drooling, and extreme sedation and lethargy. Compounding this is the extreme lack of social work or 

societal supports available to the patients here. Patients are often dropped off by family members in acute states 

of psychiatric illness and simply left to become wards of the state. Quantitative medical tests like thyroid levels, 

lithium levels, or CTs are provided only if the patient can directly pay. Given that patients with mental illness are 

statistically higher to be less educated and more impoverished, this reality is criminally disheartening. In contrast 

to the patient centered care preached in the United States encounters at Butabika have often felt like paternalism 

come alive. Ward rounds can sometimes feel closer to tribunals in which medical decisions are decided and read 

aloud without direct patient involvement. 

Amidst this environment I have felt true despair of the variety that I cannot easily intellectualize away. I struggle 

to understand a system that due to its resource constraints treats patients in a manner that I am simply not 

accustomed. My discomfort participating in psychiatric care at Butabika is immense and yet I wonder if my own 

standards are too unreasonable given the constraints on the ground. Am I justified in my fear and discomfort 

or am I simply othering another system? I have been questioning my emotions and feelings since beginning my 

time on Butabika’s grounds and yet have yet to find an answer. Yet maybe that questioning and understanding 

is unnecessary. By explaining away my feelings and my concerns am I simply looking for a way to intellectualize 

my anxiety? I am left with the hope that one day I will make meaning from my inpatient experiences in Uganda. 

Until that time I will simply sit with the discomfort that I now feel. 

Nicole Tittarelli 

Physician Assistant Studies graduate from Sacred Heart University College of Health Sciences 

One of the most memorable experiences during my physician assistant education was my clinical rotation in 

Kampala, Uganda. After 24 hours of flying across the Atlantic, followed by several hours of driving, my classmate 

and I arrived to the Luboga Family’s home-stay, nestled on a quiet hill in the Mpererwe district of Kampala that 

would be our home for the next four weeks. 

Each day the students and I would take a twelve person-capacity taxi ride through Kampala, a vibrant city full of 

life and culture. During our journey, we would pass by numerous people, watch boda boda (motorcycle) drivers 

weaving in and out of traffic, and observe vendors selling goods on the side of the road. The fertile Ugandan land 

provides an abundance of vegetation. No matter where you go, you can buy the most delicious, high-quality, 

organic fruit I have ever tasted. Our days would end at the homestay with consisting of a home-cooked meal 

enjoyed with the family while sharing stories about medicine, culture, and tradition. 

The majority of the trip was spent at Mulago Hospital and St. Stephen’s Hospital, both located in Kampala. 

My days started off with morning rounds with the team, consisting of the attending physician, residents, and 

students. We would see each and every patient on the ward, conduct a full history and physical, and come up 

with a treatment plan. During this process, the attending would ask us questions about the case or disease, and 

it was our job to know every detail about the patient and their illness. One of the biggest challenges for everyone 

on the team was when the patient or the patient’s family couldn’t afford treatment, which often comprised of an 

antibiotic costing less than 10 USD. It was important to tailor our plan based on patient needs and availability 

of resources while still providing the highest-quality care. This was an eye-opening experience that changed my 

outlook on healthcare systems and patient care. This experience has led me to continue on a journey in global 

health and inspired me to work with underserved populations. 

176

CHALLENGING MOMENTS 

IN GLOBAL HEALTH 

CHALLENGING MOMENTS IN GLOBAL HEALTH: INFLEXIBLE PARTICIPANTS 

Written by Dr. Lily Horng, 

Infectious Diseases Faculty at Stanford University School of Medicine 

Immediately after landing in the airport near one of our international partner sites, a senior medical student 

sends an email to the Global Health Program asking to split the rotation between a previously agreed-upon rural 

site and another site in the capital city to experience both rural and urban medicine. Less than 48 hours after 

arriving to the assigned rural site, the medical student sends a lengthy note: 

Read more at uvmmedicineglobalhealth.wordpress.com 

GLOBAL HEALTH 

AND THE ARTS 



BETWEEN THE WORLD AND ME 

By Ta-Nehisi Coates 

For the past several years, I’ve greeted Ta-Nehisi Coates’s essays 

and blog posts for The Atlantic with nothing short of gratitude. As 

an African-American, he makes me proud. There is no other way 

to put it. I do not always agree with him, but it hardly matters. 

In a media world populated with pundits, so-called experts and 

public intellectuals driven by ego and familiar agendas, Coates’s 

voice stands nearly alone — a black man raised in the streets of 

Baltimore who narrowly escaped the violence that lurked around 

every corner and dodged the clutches of the prisons and jails that 

were built for him, and who now speaks unpopular, unconventional 

and sometimes even radical truths in his own voice, unfiltered. He is 

invariably humble, yet subtly defiant. And people listen. 

“Sitting in that garden, for the first time 

I was an alien, I was a sailor – landless 

and disconnected. And I was sorry that 

I had never felt this particular loneliness 

before.” 

-Ta-Nehisi Coates, 

Between The World and Me 

177

READ MORE: 

https://www.youtube.com/watch?v=HDqxo3zQlW0 

https://www.gradesaver.com/between-the-world-and-me/study-guide/themes 

How to Put Ta-Nehisi Coates on Stage 

https://www.nytimes.com/2015/08/17/books/review/ta-nehisi-coates-between-the-world-and-me.html 

ANNOUNCEMENTS 

UGANDA CATHOLIC MEDICAL BUREAU ANNUAL HEALTH ASSEMBLY 

Written by Sister Jane Frances Nakafeero 

Sister Jane Frances, second from right 

The Uganda Catholic Medical Bureau (UCMB) held the 2019 Annual Health Assembly on March 27-28 with the 

theme “Building Effective Community Partnerships Towards Universal Health Coverage: Transforming Challenges 

into Opportunities for the Catholic Health Network.” During this assembly, Sister Jane Frances participated as 

a member of a panel discussion called “Partnerships, Community Engagements, and Partnerships: Challenges, 

Risks, and Opportunities for the Catholic Health Network.” The discussion addressed several critical challenges 

including potential areas of cooperation for faith-based organizations and associations with Private-Not-For-Profit 

(PNFP) health facilities, how one gets to know about and engage with community structures using practical 

examples, how community partnerships facilitate achievement of universal health coverage, and how to finance 

and sustain these community partnerships. 

178

MENTAL HEALTH PROJECT 


We are implementing a mental health project funded by Jamie’s Fund through Uganda Protestant Medical Bureau 

(UPMB). The project aims to improve mental health by strengthening leadership in mental health, providing 

comprehensive, integrated community-based mental health services, implementing strategies for promoting 

mental health, and strengthening information systems and research for mental health. 

Staff member Reagan Amwesiga was trained in diagnosis and management of common mental illnesses like 

depression, schizophrenia, dementia, and alcohol and substance abuse from Butabika Hospital in August 2018. 

He was tasked by management to organize training for other health workers and community members around 

Mpererwe. 

The training for health workers (nurses and clinicians) was conducted at Nabacwa Guest House for fifteen staff 

members from April 8-11, 2018, with the support of Jamies’ Fund. We also plan to conduct community mental 

health education on the April 25, 2019. 

PHOTO CONTEST 


Sabino Canyon, Tucson, Arizona (Majid 

Sadigh) 

Uganda (Albert Trondin) 

179

ESSAY CONTEST 

Connie Steinmann, MS4, AUC 

Twenty-two-year-old Hope lies crumpled in her bed as I peer at her wasting body. Her 

mother looks on with interest from the end of the bed. Hundreds of pairs of brown 

eyes from the dingy hospital ward watch me as I lay my hands on her cold skin. “She 

comes in every few months with fevers and sweats,” the head nurse had told me. 

“She has an immunosuppressive syndrome.” 

“But why? She is HIV negative,” I respond. The head nurse shrugs her shoulders and 

walks away to complete her duties. Alone, the nurse seems to be the sole human in 

charge of the over thirty patients in the female ward with the help of several young 

nursing students. 

I do not know much, but I do know Hope is sick. On admission, her hemoglobin was 

3.2 - severely anemic - and spiking fevers of 102 °F. Her body is now covered in a 

cold sweat. She is limp and weak, barely responsive as I perform a quick physical exam. Her mother hands me 

a chest X-ray film which I hold up to the light of the open windows. From the small amount I know about chest 

X-rays, it appears to be relatively clear. 

The next day, I pull the doctor from our host site into the ward to see Hope. Dr. R is not an employee of at this 

rural Ugandan hospital, but none of the hospital staff seem to mind his presence in the wards. In fact, they 

welcome him warmly. I guess they will take whatever help they can get in these rural settings. “She’s quite sick,” 

I say as I fill in Dr. R on the small amount of information I have about Hope. 

Dr. R has a discussion with Hope’s mother in Luganda, then turns to our group of American medical students. 

“Recurrent infections, fevers with sweats, severe anemia” he states, “I think you should know this diagnosis.” 

“Leukemia.” 

Dr. R nods, but presses on. Hope’s skin is ice-cold, covered in a cold sweat. Her blood pressure is a meek 74/51. 

“This girl is in septic shock,” he states. “This is what is going to kill her if we do not intervene.” 

My fellow medical students and I rush to demand fluids from the head nurse. She states the hospital ward is out 

of fluids. We race down the hall to the maternity ward to find normal saline. Quickly, we hook Hope up to some 

fluids as Dr. R lectures the nursing students on fluid resuscitation. “Give her two units of blood,” he commands 

and rattles off a list of antibiotics to add to her treatment regimen. He glances up at me, “write this in her chart!” 

I did not know I was allowed to write orders in a patient’s chart! I open it to find a measly few entries from nursing 

students, all several days old. No one had been caring for Hope. Hope had been dying in her bed for who knows 

how long. I scribble Dr. R’s orders into Hope’s chart, and then reemphasize to the nursing students the necessity 

of getting her blood pressure up and maintained above 100 systolic. They nod their understanding. I’m giving 

orders to nurses for the first time in my life. 

180

The next day when I check in on Hope, she is slightly more alert. Her skin is warming up. She is no longer 

sweating from shock. Her clinical picture appears better, although I know that curing her from septic shock is only 

a temporary solution if she really does have a leukemia. They say Hope’s family has no money, so she cannot be 

transferred to a larger intensive care unit in the capital city. We may have prolonged her life for now, but I am 

not sure for how long. 

I remember when I began my medical school journey I had scribbled on my phone a note from orientation that 

was in one of the many powerpoints: “with great privilege comes great responsibility.” For the first time, in a 

rural hospital in the middle of Uganda, I look around a hospital ward and realize I am one of the most qualified 

people in the room. I have had the privilege of the highest education. I have the most access to information. I 

have great responsibility. The prospect scares me. I’m scared because Hope likely would have died that day if 

I had not dragged a doctor in to help me examine her. I’m scared because I still need so much help diagnosing 

and treating patients. I’m scared because the responsibility of Life is perhaps the greatest responsibility there is. 

I know I am still a student for now. But soon enough, I may be the most responsible person in the room. People 

will be looking to me for orders. I still have a lot to learn. 

* names have been changed to protect patient privacy 

CALENDAR 

APRIL CALENDAR 

April 1: Dr. Sadigh made an administrative visit to UVMLCOM. 

April 1: Six students from AUC/RUSM began their global health electives: 

Dominican Republic: Austin McEvoy (AUC) 

Vietnam: Niveta Aravind (AUC), Isabel Lopes (AUC), Roberto Veloso (AUC), Asima Mian (RUSM), and Monika Shenouda 

(RUSM) 

April 1: A Global Health Elective Class with the topic “Cultural Exercise” was presented by Dr. Molly Moore and Dr. 

Andrea Green, 

April 1-3: Makerere School of Public Health delegates site-visited UVMLCOM. 

April 2: Dr. Sadigh met with Mr. Morris Gross to discuss the possibility of constructing a site for the soon-to-be Global 

Health Institute. 

April 3: Dr. Sadigh met with members of the WCHN Foundation to discuss the future direction for development of the 

Global Health Scholars program. 

181

April 5: Dr. Sadigh had an informative meeting with Andrea Rynn and members of public relations at WCHN to 

discuss strategies of involving media with the Global Health Program. 

April 8: A Global Health Elective Class with the topic “Global Women’s Health” was presented by Dr. Molly Moore 

and Dr. Anne Dougherty.” 

April 8: A Global Health Leadership Team meeting was held at UVMLCOM. 

April 8: Dr. Sadigh had a debriefing meeting with Dr. Vidhun, Director of the Pathology Residency Program at 

Danbury Hospital, to discuss methods of expanding the current exchange program between the Departments of 

Pathology at WCHN and Makerere University College of Health Sciences. 

April 8: Dr. Sadigh interviewed candidates for the global health coordinator position at the WCHN/UVMLCOM 

Global Health Program. 

April 8: Dr. Sadigh had a meeting with Dr. Robyn Scatena in respect to Global Health Day, which will be held at 

Danbury Hospital in early June. 

April 9: Dr. Sadigh gave a talk about the UVMLCOM/WCHN Global Health Program to the global health interest 

group at Bridgeport Hospital. 

April 9: Dr. Sadigh had a debriefing session with Ugandan Global Health Scholar Dr. Moses Othin at Norwalk 

Hospital. 

April 10: Dr. Sadigh had an introductory meeting with Dr. Glenn Loomis, the new Director of Medical Education 

and Innovation Department. 

April 10: Dr. Sadigh had an orientation meeting with Dr. Chaubey, Director of Palliative Care at WCHN to define 

the objectives of Dr. Chaubey’s trip to Uganda in July. 

April 10: The monthly global health committee meeting was held. (Link to the minutes) 

April 11-14: Dr. Sadigh and Dr. Scholand met with the leadership of Chiricahua Community Health Centers in 

Douglas, Arizona to discuss the details of establishing a Global Health at Home Site, under the name “Border 

Medicine.” 

April 15: Dr. Sadigh held a meeting with Catherine Winkler, a scholar NP, to discuss her volunteer involvement 

in the Global Health Program including establishing a new section in the eMagazine focusing on nurses in global 

health and participation in research projects. 

April 16: Dr. Sadigh, Dr. Fukumoto, Dr. Patrick Zimmerman, and Ms. Lauri Lennon had a meeting to discuss 

hosting Dr. Carlos Castillo Delgado, a junior surgeon from Hospital General de la plaza de la Salud in the Dominican 

Republic for four weeks of training at Danbury Hospital and UVMLCOM. 

April 16: Dr. Sadigh held the first orientation session with Dr. Zhou “Wendy” Li, a medical resident at Norwalk 

Hospital who will be participating in a six-week global health elective this summer. 

April 16: Dr. Sadigh had a debriefing session with Ugandan Global Health Scholar Dr. Moses Othin. 

182

April 17: Dr. Anna Ziganshina, a senior medical resident at Danbury Hospital and alumnus of the Global Health 

Program, spoke about gender medicine at the medical grand rounds. 

April 18: Dr. Sadigh had several 

meetings with the Global Health Interest 

Group at Norwalk Hospital. 

April 18: Monthly Global Health 

Leadership Team meeting at WCHN 

April 19: Dining with the Deans was held 

at UVMLCOM, featuring the topic “Global 

Health Electives.” 

April 19: Dr. Sadigh and Dr. Rudy 

Ruggles had a meeting to discuss the 

establishment of a new scholarship 

program in global mental health. 

April 22: A Global Health Elective 

Class with the topic “Child Health” was 

presented by Dr. Molly Moore and Dr. 

Molly Rideout. 

April 22: A Global Health Leadership 

Team meeting was held at UVMLCOM. 

April 23: Posters, Photos, and Reflections display was featured in the Given Courtyard for the LCOM community 

to view and vote in advance of Global Health Day. 

April 23: Dr. Sadigh had a final debriefing meeting 

with Ugandan Global Health Scholar Dr. Moses Othin 

at Norwalk Hospital. 

April 23: Dr. Sadigh had a second orientation session 

with Dr. Zhou “Wendy” Li, a senior medical resident 

at Norwalk Hospital who will be participating in a 

global health elective this summer to supervise the 

medical education of UVMLCOM medical students. 

During this meeting, Dr. Zhou “Wendy” Li was 

introduced to Dr. Moses Othin who will be working in 

Mulago Hospital’s ICU as a faculty member starting 

May 2019. 

April 23: Dr. Sadigh had a meeting with Dr. Robyn Scatena, the Director of Global Health at Norwalk Hospital, to 

discuss the details of Global Health Day which will be held at Danbury Hospital on June 3-4. 

183

April 24: Dr. Moses Othin received a certificate for completing four months of training in anesthesiology, ICU 

medicine, and simulation laboratory from Dr. Robyn Scatena at Norwalk Hospital. 

April 24: Dr. Sadigh attended the Endowed Chairman meeting 

where he presented the concept of the Global Health Institute 

and Teaching Academy to the Endowed Chairs, and Dr. John 

Murphy, the CEO of Nuvance Health. 

April 25: Dr. Sadigh met with the educational leadership of the 

WCHN OB/GYN Department to explore the possibility of a joint 

effort between UVMLCOM and WCHN in establishing a global 

health partnership with the Hospital Universitario Maternidad 

Nuestra Senora de la Altagracia (Maternity Hospital) in the 


April 26: Closer Look Day was held, during which accepted had 

the opportunity to view the Global Health Day displays. 

April 26: Dr. Sadigh made an administrative trip to UVMLCOM 

where he met with Global Health Program leadership and delivered 

a presentation about the Global Health Program to nearly eighty 

accepted students and their parents visiting the school for final 

matriculation decisions as part of Closer Look Visit. Dr. Sadigh 

also met with the leadership of UVMLCOM’s Psychiatry Program 

to establish a new scholarship in global mental health. 

April 26: Dr. Mosis Othin returned to Uganda after four months of training at Norwalk Hospital. 

April 27: Dr. Sadigh interviewed several KSMU faculty, residents, and senior medical students over Skype for 

Global Health Program scholarships. 

April 29: A Global Health Elective Class with the theme “Humanitarian Emergencies in the Context of Climate 

Change” was presented by Dr. Molly Moore and Kelsey Donovan. 

April 29: Global Health Day was held at UVMLCOM, with the awards reception held from 4-5:30 p.m. 

MAY CALENDAR 

May 1: Dr. Ziganshin speaks on genetics of aortic diseases at the Danbury Medical Grand Rounds. 

May 6: Application deadline for fourth-year global health elective. 

May 7-13: Global health elective interviews are held for fourth-year medical students. 

184

May 9-19: Dr. Sadigh makes an annual trip to Russia to participate in teaching tropical medicine and evidencebased 

medicine courses at KSMU, in addition to fulfilling administrative and scientific responsibilities. 

May 10: Six AUC/RUSM students complete global health electives in the Dominican Republic and Vietnam. 

May 13: Four students from AUC begin global health electives: 

• Dominican Republic: Seth Perry (AUC) and Stefanie Rulli (AUC) 

• Uganda, Naggalama: Iyabo Akinsanmi (AUC) and Matthew Myrick (AUC) 

May 13: A Global Health Leadership Team meeting will be held at UVMLCOM. 

Week of May 13: Debriefing sessions will be held with fourth-year medical students who traveled in February 

and March. 

May 20: A Global Health Elective Course with the theme “Humanitarian Emergencies” will be presented by Kelsey 

Donovan. 

May 20: Dr. Cathy Nakibuule, Director of Global Health at St. Stephen’s Hospital, arrives in Connecticut. 

May 27: A Global Health Leadership Team meeting will be held at UVMLCOM. 

PHOTO NEWS 

MAKERERE UNIVERSITY COLLEGE OF HEALTH SCIENCES SCHOOL OF 

PUBLIC HEALTH (MAKSPH) 

185

Dr. Moses Othin receiving his certificate 

Dr. Anna Ziganshina’s Medical Grand Rounds at Danbury Hospital 

186

CLOSER LOOK DAY 

With Carole Whitaker 

THE GLOBAL HEALTH DAY 

Dean Page 

Dr. Mariah McNamara; The Associate 

Director of the Global Health Program 

Dr. Molly Moore 

Carole Whitaker and Dr. Mariah 

McNamara 

187

THE WINNERS OF THE ANNUAL 

NAMED AWARDS 

THE WINNER OF THE BEST 

POSTER 

(left to right): Tendai Chiware, M.D., Mercedes Avila, Ph.D., 

Sheila Chamberlin, C.O., and Molly Moore, M.D. 

WINNERS 

OF PHOTO 

CONTEST 

The Most Thoughtfully Composed 

Photo:“Leaving Clinic in Engeye” in Edegaya, 

Uganda (Dr. Anya Koutras) 

The Most Original Photo: “Well Child Visits at 

Engeye” in Edegaya, Uganda (Dr. Anya Koutras) 

THE WINNER OF THE BEST 

REFLECTION 

Brian Rosen 

Most Impactful Photo; Untitled (Scott Mitchell) 

188

Jamidah Nakato’s Graduation from Nelson Mandela University in South Africa 

Dean Prachyapan Petchuay and Dr. Scholand in South Thailand 

189

RESOURCES 





Ebola book 















Publications 


Tropical Medicine Booklets (101, and 202) 

Presentations By Global Health Scholars 

Program Partners 

190

June 2019 Volume 6 



“Determine that the thing can and shall be 

done and then we shall find the way” 

-Abraham Lincoln 



191

PERSPECTIVES 

ON BECOMING AN ENDOWED 

CHAIR 

Written by Majid Sadigh, MD 

Christian J. Trefz Family Endowed Chair 

in Global Health and Director, Western 

Connecticut Health Network and the University 

of Vermont Global Health Program 

Occupying a chair is an honor of the highest magnitude. 

Not only does it fall upon a chair to uphold the principles 

and values that brought upon that honor, but one 

also shoulders the responsibility of representing the 

individual or family for whom the chair is named. The 

Christian J. Trefz family endowed chair in global health 

was founded on the belief that it is our humanity that 

makes us human, and that humans can be kind and 

motivated to bring about sustainable impact. Members 

of this donor family have espoused a spirit of giving 

and a dedication to pursuing solutions to difficult 

problems through innovation and hard work. My 

experiences in the global health setting have solidified 

the understanding that it is not only good intention 

that brings about progress, but a commitment to 

tangible and measurable outcomes as well as a sense 

of accountability when one falls short of these goals. 

I have seen that the most fundamental truths, such as poverty and injustice, can often be explained away with 

articulate turns of phrases and heavy-handed econo-political jargon. Occupying the Christian J. Trefz family 

endowed chair in global health provides me with a stronger, even more transparent platform to share my work 

and message of hope. This is what I would tell the donor family if they were here at this moment: that I am 

honored to wear this mantle, and that my work in collaboration with so many leaders in the global health arena 

will only continue to grow and evolve with the support of this endowment 

. 

Since acquiring this title, the program has sponsored greater numbers of scholars to come to WCHN for training, 

and deployed more faculty and residents to our international partner sites for capacity building of human 

resources. The program has also expanded through the development of new partnerships in China, India, and 

Thailand. Meanwhile, our small newsletter has evolved into a robust eMagazine that stands as a comprehensive 

global health resource. I am excited for the many strokes of progress in the coming year, made possible by the 

generosity of the Trefz family. 

192


DR. SADIGH’S VISIT TO KSMU: MAY 9-19 

Dr. Sadigh made his annual 

administrative and teaching trip to 

Kazan, Russia where he met with 

KSMU’s leadership, global health 

interest group, and global health 

scholars. He also delivered a series 

of talks to residents, students, 

and faculty on various topics 

including student mistreatment; 

antibiotic resistance; mentoring of 

PhD students in clinical research, 

biostatistics, and journal club; 

as well as the KSMU-WCHN/ 

UVMLCOM collaboration, which was 

dedicated to the memory of Rinat 

Sabirov. Meanwhile, Dr. Sadigh 

oriented the 2019 global health 

participants for their upcoming sixweek 

electives in Uganda and the 


193

VIETNAMESE SCHOLARLY 

VISIT TO CONNECTICUT 

In early May, Dr. Anh Tho Vo visited Connecticut 

from Cho Ray hospital in Ho Chi Minh City as 

part of ongoing efforts to advance clinical 

research endeavors in the Global Health 

Program. Dr. Vo presented findings at the 

37th annual Connecticut Infectious Disease 

Society meeting, hosted at Yale University 

in New Haven. Her poster entitled “Clinical 

features of Streptococcus suis infections in 

a major urban hospital in Ho Chi Minh City, 

Vietnam 2014-2017” was well received. Dr. 

Vo reviewed important clinical findings of 

this virulent zoonotic pathogen that causes 

significant morbidity and mortality in Vietnam. 

It was a very productive visit that provided 

an important platform to support further 

collaborative global health research. Dr. Vo 

expressed interest in spearheading further 

studies at Cho Ray with international cooperation. Her latest research topics include CMV epidemiology and clinical 

outcomes in renal transplant patients in Ho Chi Minh, as well as investigation of emerging community-associated 

MRSA infections, which appear to be increasing. Dr. Vo was grateful for the opportunity and promised to provide 

continued support for our global health scholars visiting Cho Ray. We look forward to future developments in 

clinical research through our program. 

WELCOME 

We welcome Dylan Ochoa as Global Health Program 

Coordinator at the WCHN/UVMLCOM Global Health 

Program 

Dylan Ochoa recently completed his Master of Public 

Health at the University of Edinburgh after receiving 

his Bachelor’s degree in biomedical sciences at Texas 

A&M-Kingsville. Growing up on the U.S./Mexico border 

where he witnessed many immigrant health issues pour 

into his community motivated him to travel abroad to 

the U.K. to obtain his MPH with a focus in global health. 

194


Dr. Rebecca Gerrity (recent AUC graduate & WCHN 

Global Health Elective alumna) receives the Excellence 

in Community and University Service Award 

We are excited to learn that Dr. Rebecca Gerrity 

received (photo below) the Excellence in Community 

and University Service Award during the graduation 

ceremony on Saturday, May 18, an award given to 

graduates with exemplary records of service to both 

AUC and their surrounding communities. 

(Photo Left) Dr. Rebecca Gerrity receiving the Excellence 

in Community and University Service Award, presented by 

Dr. Golden Jackson, AUC’s Assistant Dean for Community 

Engagement 

Congratulations to Susan Byekwaso, Coordinator 

of the International office at MakCHS, for acquiring 

a Master’s Degree in Management Science from the 

Uganda Management Institute on May 31st, 2019. 

195


Dear All, 

This is to let you know that I have been speaking with partners I made while at Makerere University. Among them 

is Dr. Majid Sadigh who was a physician for many years at Yale and is now Director of the Western Connecticut 

Health Network/University of Vermont Global Health Program. This program began in 2012 and is currently 

running in Uganda, Zimbabwe, Dominican Republic, Russia, Vietnam, and the USA. 

I have already met some of you with his daughter, Dr. Katrin Sara Sadigh, who has been here in Botswana for a 

while now carrying out her research as a Fogarty Research Fellow. We have seen a number of people including 

the International Education and Partnerships Office, and have already kickstarted the processes as Dr. Majid 

Sadigh requested. He will soon be visiting University of Botswana as well. 

Essentially, it is a two-way exchange for health professionals, residents, and medical students to experience 

new skills and cultures in different world settings that is expected to cause change in these young professionals. 

Those from the USA spend time in Botswana where they undergo new healthcare challenges and witness how 

they are overcome in many underserved communities. Meanwhile, those from low- and middle-income countries 

spend time learning skills in better resourced environments in the USA where they are paired with mentors who 

emphasize ethics in patient-centered, continuous medical education and research. The program in Uganda has 

had tremendous success with many of the fellows returning home to strengthen patient care while serving as 

faculty, and have been able to set up their own research teams and partnerships. 

As Chair of the FRPC, this is a great opportunity for FoM to get her faculty, residents, and students mentored 

in research in a bid to create the global leaders in research of tomorrow. The Deputy Director, Legal services 

requested for a memo from me detailing the purpose and benefits for this collaboration which I have endeavored 

to put down here and also minutes of a departmental meeting. 

I need your guidance on this. We anticipate that Faculty of Medicine, Health Sciences and Psychology will benefit 

from this collaboration: physicians (all MMeds), physicians-in-training, medical students, nurses, and laboratory 

trainees. I could easily put together a departmental meeting to support this, but it goes beyond the department 

and serves more faculty of medicine and health sciences. 

Kindly see memo attached, the 2016 Annual Global Health Report for an idea of the program and a draft MOU 

for your attention. 

Kind regards, 

Assoc. Prof. Lynnette Tumwine Kyokunda 

(MBChB, MMed Anat. Path., FCPath (ECSA), PhD) 

Head, Department of Pathology, & Chair, Faculty Research and Publication Committee, Faculty of 

Medicine, University of Botswana 

196

Hi Majid, 

I am grateful that you came to visit our program, that you gave us this chance, and that we are moving forward. 

While Chiricahua is succeeding, it no exaggeration that it is a struggle every single day. Unfortunately, there is 

no shortage of forces anxious to see what they can get or take from organizations like Chiricahua. The “south to 

north” flow of resources is very real, and stemming this flow and remaining successful often feels like it requires 

one to have nerves and resolve of steel. 

I truly look forward to formally tapping back into the wider world of global health. This was my dream as a 

premedical student and my universe as a medical student. While I am fortunate to lead a team that does global 

health work every day, I especially look forward to being connected to a larger network that can inspire us to think 

wider, learn and apply lessons from others—while of course contributing in any way that we can. 

See you soon! 


CEO/CMO Chiricahua Community Health Centers, Inc 

Thank you Dr. Sadigh for sharing your work with us. We are very excited to be part of your very successful 

program. I recognized many of my own students who have benefited from the Global Health Program and they 

are beaming! 

Congratulations on your award as well! 

Alluta continua! 

Lynnette 

Hello Ms. Smith, 

Thank you so much for reaching out! It was an honor to be selected for the service award. I feel incredibly 

lucky to have attended a school that emphasizes community outreach as AUC does. 

Uganda certainly does hold a very special place in my heart and I hope to be able to return to Naggalama 

someday with much more knowledge! I cannot thank you enough for the opportunity to have experienced the 

people, place, and medicine of Uganda through the global health elective. I will be sure to keep in touch and 

hope to have many more global experiences to report back on in the future! 

All the best, 

Rebecca Gerrity 

197


TRAINED DOGS IDENTIFY PEOPLE WITH MALARIA PARASITES BY 

THEIR ODOUR 

Work has shown that people infected with malaria parasites produce a body odour that is detected by mosquitoes, 

which results in malaria mosquitoes preferentially feeding on asymptomatic, malaria-infected individuals. In the 

future, malaria detection dogs could be used to detect individuals infected with malaria at ports of entry in 

countries or regions that are malaria free or approaching malaria elimination. 

Read the full article here >> 

SITE SPECIFIC INFORMATION 

BOTSWANA UNIVERSITY, BOTSWANA 

About the Country: 

Botswana is a landlocked country in Southern Africa with a population of just over two million. Its landscape 

is defined by the Kalahari Desert and Okavango Delta which transforms into a lush animal habitat during the 

seasonal floods. The massive Central Kalahari Game Reserve, with its fossilized river valleys and undulating 

198

grasslands, is home to numerous animals including giraffes, cheetahs, hyenas, and wild dogs. One of Africa’s 

most popular tourist destinations, Botswana has many beautiful sites such as Chobe National Park which is home 

to over 120,000 elephants. Due in part to its reserves of diamonds, Botswana is a politically stable and wealthy 

nation with most of its population enjoying a high standard of living. In fact, it has maintained one of the world’s 

highest economic growth rates since 1966. 

About the Leadership: 

Dr. Linette Kyokunda, Head of the Department of Pathology and Chair of the Faculty Research and Publication 

Committee at Botswana University serves as the Director of Global Health. 

About the Institution: 

The University of Botswana (UB) was established in 1982 as the nation’s first institution of higher education. The 

university has three campuses: the main one in the capital Gaborone, one in Francistown, and another in Maun. 

The faculty is currently located at the Sir Ketumile Masire Teaching Hospital (SKMTH), established in 2014 as 

a 450-bed state-of-the-art facility close to the main campus. In a year or so, this hospital is expected to begin 

offering specialist medical services. The Faculty of Medicine uses Princess Marina Hospital as its teaching hospital, 

and employs up-to-date teaching methods and technology in all its offerings. 

About the Clinical Experience: 

Although Botswana has the second highest HIV prevalence in the world, it has also registered tremendous 

successes in its HIV/AIDS program to the current only 1% of HIV-related mortality with one of the most robust 

HIV prevention and treatment programs. Students will also see patients with advanced AIDS with opportunistic 

infections and neoplasia as well as malaria, sexually transmitted diseases, diarrheal diseases, and tuberculosis. 

Attached are images of visiting faculty at the Department of Pathology from the University of Pennsylvania who 

spend at least three to four months annually at the University of Botswana training anatomic pathology residents 

in systemic histopathology and ancillary techniques. 

Prof. Cooper from UPenn at SKMTH 

Sir Ketumile Masire Teaching Hospital (SKMTH) houses 

Faculty of Medicine 

199

UNIBE, DOMINICAN REPUBLIC 


The Dominican Republic is beautiful with amazing scenery and beaches highlighted by the historic city of Santo 

Domingo. It is only a short flight away from JFK and located within the same time zone as the Eastern part of 

the USA. 


Universidad Iboamericana (UNIBE) College of Health Sciences and its several affiliate sites are our partner 

institutions in the Dominican Republic. The leadership of UNIBE, including Dr. Amado Castaños Guzman, President 

of UNIBE; Dr. Marcos Núñez, Dean of UNIBE College of Medicine; Lorraine Amel, Dean of International Affairs at 

UNIBE; Danny Capellán, Coordinator of Global Health at UNIBE; and Dr. Jomar Florenzán, Global Health Program 

Site Director is visionary and welcoming to new ideas. 


UNIBE is the most progressive institution among the nation’s eleven medical schools. It is affiliated with several 

other institutions that exist as part of the Global Health Program, including Asociación Instituto Dominicano de 

Cardiología (AIDC) and Hospital General Dr. Vinicio Calventi. UNIBE medical students are knowledgeable, with a 

majority fluent in English. 


The clinical experience offered in the Dominican Republic is rich and expansive. Students are exposed to a wide 

diversity of tropical infectious diseases including malaria, tuberculosis, HIV, Zika, Dengue, and Chikungunya, in 

addition to more common chronic conditions such as diabetes, hypertension, and cardiovascular diseases. The 

clinics and hospitals to which medical students are assigned have astutely skilled and supportive staff. Community 

outreach programs have been popular among participants undergoing the global health elective. With the 

kind Organda family welcoming participants at the airport, introducing them to the community, familiarizing them 

with the city, and helping them immerse in the colorful Dominican culture, participants are given a place to truly 

call home. 

DATTA MEGHE INSTITUTE OF MEDICAL SCIENCES (DMIMS), INDIA 


Datta Meghe Institute of Medical Sciences (DMIMS), located in central India in the state of Maharashtra, is our 

partner institution in India. At approximately 450 miles and 50 miles from Mumbai and Nagpur, the state’s capital 

and second capital, Maharashtra is one of the most peaceful and economically developed states. 

200


The Global Health Program was established at DMIMS under the guidance of Mr. Sagar Meghe and Sameer 

Meghe, members of the Board of Management; leadership of Dr. Vedprakash Mishra, Pro-Chancellor and Chief 

Advisor as well as Vice Chancellor Dr. Rajiv Borle; and supervision of Dr. Lalit Waghmare, Dean of Interdisciplinary 

Health Sciences, along with coordinators Dr. Tripti Srivastava and Dr. Shweta Parwe. 


The Global Health Program was established at DMIMS under the guidance of Mr. Sagar Meghe and Sameer 

Meghe, members of the Board of Management; leadership of Dr. Vedprakash Mishra, Pro-Chancellor and Chief 

Advisor as well as Vice Chancellor Dr. Rajiv Borle; and supervision of Dr. Lalit Waghmare, Dean of Interdisciplinary 

Health Sciences, along with coordinators Dr. Tripti Srivastava and Dr. Shweta Parwe. 


The rural and super-specialty hospital affiliated with the university caters to the population of nearby cities, towns, 

and villages. Participants will be exposed to a significant amalgamation of infectious diseases such as dengue 

hemorrhagic fever, malaria, typhoid fever, intestinal parasites, and tuberculosis as well as other noncommunicable 

diseases such as oral cancers due to tobacco use as well as cardiovascular, pulmonary, and kidney diseases. 

KSMU, RUSSIA 


Kazan State Medical University, located in the capital of Tatarstan 500 miles to the southeast of Moscow by the 

Vulgary river, is our partner institution in Russia. It is the land where East meets West and Christians and Muslims 

harmoniously coexist; the land of art, music, ballet, opera, and sports. 


Under the leadership of Rector Alexi Suzinov, Director of Global Health Program; Professor Marat Mukhamedyarov, 

Head of the International Office at KSMU; and Coordinator Alsu Khairutinova, the Global Health Program has 

established annual courses in tropical medicine, evidence-based medicine, epidemiology, and biostatistics at this 

site. 


KSMU is the third largest medical university in central Russia and the oldest partner of the Western Connecticut 

Health Network / University of Vermont Larner College of Medicine Global Health Program. The institution also 

has a medical residency program accredited by the Canadian Royal College. 

201


Participants observe a wide array of clinical manifestations including hemorrhagic fever, the European form of 

Lyme disease, tick-borne encephalitis, intestinal parasites, malaria, tuberculosis, and HIV, as well as chronic 

diseases including cardiovascular and pulmonary illnesses. Medical students stay in dormitories in a beautiful part 

of Kazan, and undergo an organized supplementary sociocultural curriculum on Saturdays. 

WALAILAK UNIVERSITY SCHOOL OF MEDICINE, THAILAND 


The meeting point between South and East Asia, Southern Thailand is set against the beautiful backdrop of 

mountainous Khao Luang National Park. The campus is spread over 3,600 acres of farms, parks, and forests. 

With its extensive and modern educational facilities, sports centre, services, and accommodation for staff and 

students, the university provides an ideal learning environment. Situated in Nakhon Si Thammarat Province at 

the center of Southern tradition and culture, Walailak University is near Nakhon Si Thammarat airport’s twelve 

daily return flights to Bangkok, along with regular bus service to Bangkok, Phuket, Krabi, Had Yai, Koh Samui, 

and Malaysia. 


The Global Health Program at Walailak University is led by Dean Prachyapan Petchuay as coordinator; Vice 

President Charun Bunyakarn; and President Dr. Sombat Thamrongtanawongs. The Board of Administration 

council is chaired by Professor Dr. Vichit Srisa-arn who determines university policies and guides the university’s 

administration team. 


Walailak University School of Medicine was formally established in 2007. The medical curriculum has been approved 

by the World Federation of Medical Education with an Educational Performance Excellence Standard. A six-year 

program consists of pre-medicine, pre-clinical, and clinical years. In the first three years, students take courses 

at Walailak University before completing three years of clinical practice at two local affiliated community facilities: 

Trang and Phuket Hospitals. Our 750-bed university hospital is currently under construction and projected to be 

completed by 2020. Enrollment is open to all suitably qualified and motivated students with a specific emphasis 

on those who reside in the local provinces of Nakhon Si Thammarat, Trand, Krabi, Phang-Na, and Phuket. 


Health centers, clinics, and community and regional hospitals affiliated with the university provide stematic 

healthcare from primary to tertiary levels to six million residents and ten million tourists. Tropical and infectious 

diseases are the focus for participants who are interested in visiting. For those who seek experience in alternative 

medicine, they will want to try traditional Thai medicine: the art of healing using ancient knowledge of massage 

together with herbs and natural products to combat and ease health conditions. 

202

UGANDA 


Known as the “breadbasket of East Africa,” Uganda is visually stunning in lush blue and green. Among popular 

attractions are the source of the Nile River in Jinja, gorilla trekking in the Bwindi Impenetrable Forest, safaris at 

Elizabeth Park and Murchison Falls, cultural dance performances, and temples representing a diversity of religious 

faiths. 


The leadership is strong, curriculum comprehensive, and support system foundational in each of our several sites 

in Uganda. Among the many leaders is Charles Ibingyira, Provost of MakCHS; Dr. Robert Kalyesebula, Founder 

of ACCESS, Nakaseke; Sister Jane Francis and Dr. Simon Otim, Director and Medical Director of Naggalama 

Hospital; and Catherine Nakibuule, Director of the Global Health Program at St. Stephen’s Hospital. 


We have several partner institutions in Uganda, including Makerere University College of Health Sciences 

(MakCHS), the most prestigious university on the East coast of Africa; St. Stephen’s Hospital, a community 

203

hospital close to Makerere University; the African Community Center for Social Sustainability (ACCESS) in rural 

Nakaseke; and Nagalamma Hospital in rural Nagalamma. Participants are generally assigned to rural sites unless 

they are interested in Ob/Gyn, in which case they rotate through Mulago Hospital in Kampala. Students in 

Kampala are housed via the homestay model, while those in rural sites stay in safe, modern living quarters close 

to their respective clinics. With English the official language of learning, medical students, residents, and faculty 

are all fluent English speakers. 


Students will see common and uncommon infectious diseases including HIV, tuberculosis, sleeping sickness, 

malaria, schistosomiasis, elephantiasis, and opportunistic infections of advanced HIV. Students in all of our 

international partner sites in Uganda undergo one to three days of vigorous orientation upon arrival. 

CHO RAY HOSPITAL, VIETNAM 


Vietnam is the easternmost country on the Indochina Peninsula in Southeast Asia. The landscape is stunning, 

complete with hills, tropical forests, and mountains. The largest city in Vietnam, Ho Chi Minh has gone by several 

different names during its history, reflecting settlement by different ethnic, cultural, and political groups. 

Today, the city’s core is still adorned with wide elegant boulevards and historic French colonial buildings, and 

there are many attractions for those interested in learning its history including the Vietnam War. 


Tran Van Vu, the CEO of Cho Ray Hospital; Dr. Hoang Lan Phuong, Director of the International Office; and Dr. 

Uyen Tran, Director of the Training Center stand as a strong collaborative leadership team. 


The Global Health Program has two partner institutions in Vietnam: Cho Ray Hospital, a three-thousand-bed 

high-technology modern facility in Ho Chi Minh City that serves as a tertiary center for patient referrals from 

both underserved and affluent communities, and Ho Chi Minh Medicine and Pharmacy University. The staff of 

both institutions are welcoming and knowledgeable. Although the overwhelming majority do not speak English, 

the Global Health Program has trained twenty-one junior faculty at Western Connecticut Health Network who 

are now familiar with the medical education and healthcare system of the United States and have a mastery of 

the English language. These global health scholars supervise and train Global Health Program participants who 

rotate in Vietnam. 


The hospital provides advanced tertiary and primary care to adults and has all specialities and subspecialties 

including pulmonary, intensive care, cardiology, surgery, emergency medicine, anesthesiology, and tropical 

medicine. The pathology in this hospital is diverse and includes a wide spectrum of cardiovascular and pulmonary 

diseases, snake bites, tuberculosis, lung flukes, malaria, and soft tissue infection. 

204

ZIMBABWE 


Zimbabwe is a beautiful country with one of the best medical education systems in the world. The main language 

is English, and faculty and residents among the best-trained and educated in the world. Students live 

in apartments within the hospital. Harare is famous for its many sculptures, natural landscape, and national 

parks, as well as Victoria Falls. Due to political and economic instability, this site is currently closed but we anticipate 

its reopening by September 2019. 


Chiratidzo “Rati” Ellen Ndhlovu, Director of the Global Health Program at UZCHS and recipient of the 2018 Consortium 

of Universities in Global Health Velji Global Health Education Award; Rangarirai Masanganise, Dean of 

UZCHS; and Dr. Shalote Chipamaunga, Senior Lecturer at the Department for Health Professions Education at 

UZCHS together comprise a strong and skilled leadership team. 


Our partner in Zimbabwe is University of Zimbabwe College of Health Sciences (UZCHS), Zimbabwe’s only 

medical school. Parirenyatwa Hospital, a two-thousand-bed facility with many satellite clinics, labs, and hospitals, 

and Harare Hospital, a twelve-hundred-bed facility nearby, serve as teaching hospitals for UZCHS, with a 

shuttle providing transportation between them. Students are housed on the Parirenyatwa campus across from 

the hospital. 


Participants are exposed to a diverse array of conditions and tropical diseases in the medical center. This site 

offers particularly strong education and training in HIV, as many patients with advanced HIV and HIV-related 

diseases are cared for at university hospitals. 

REFLECTIONS 

AFTER TWO MONTHS 


Two months have come and gone and I do not know where the time went. I feel like it was just yesterday that I 

stepped off the airplane in the Dominican Republic, greeted by Wellington, Marissa’s youngest son. I remember 

being overwhelmed by all that was going on around me: other passengers reuniting with their family members, 

the sun’s brightness when I stepped outside, the scent of this new environment, and my scarce understanding of 

205

the conversations around me. I nervously wondered how I would acclimate to this new country barely knowing 

the language, questioning whether I would even make it through the whole six weeks. To go from that feeling to 

now wishing I could go back! 

I am currently messaging my sister, Esmeralda (Marissa’s daughter), checking on how her daughter is doing 

and how her pregnancy is coming along. She is sending us pictures of my favorite dessert, habichuela con dulce 

(sweet beans) and I tell her I am wishing I was there to enjoy it with them in the living room while chit chatting. 

I never thought I would have such a lasting experience. I greatly miss the Dominican Republic and plan to go 

back one day. I have continued to practice my Spanish and even purchased a book in Spanish by a renowned 

Dominican-American author, Julia Alvarez, called “En el Tiempo de las Mariposas,” with the hope of strengthening 

my language skills. This global health elective strengthened my desire to continue working with international as 

well as national underserved communities with limited access to healthcare. 

UGANDA, WEEK FOUR 

Brian Rosen, UVMLCOM, MS4 

Religion does not often impact my life in the United States. It comes up sparsely in my social circles and is most 

often encountered tangentially in the news. Although religion does not often impact me personally, I am not 

ignorant of its impacts on others. I have often seen the positive impact that clergy visits have on ill patients or 

have witnessed the power of religious communities to comfort those without social support. The flip side of this 

benefit can sometimes be seen through a psychiatric lens. Religiosity is often magnified or fostered in episodes 

of psychosis or mania and may become a dangerous crutch for the mentally ill. In addition, the slippery slope 

between delusion and religious belief can provide challenges. If a “delusion” is culturally accepted, then it is not 

considered a manifestation of mental illness. A delusion not shared by the collective other immediately gets 

flagged. In Uganda it is this distinction that I have struggled with the most. 

The stigma of mental illness is alive and well in Uganda. Many of the patients I saw over the past month were 

initially determined to be possessed by demons or thought to be morally suspect. Many of the tribal cultures 

fully support the belief that evil spirits travel freely in the world and frequently inhabit those of weak moral 

standing. It was often a monumental challenge to present schizophrenia, bipolar, or epilepsy as anything other 

than possession. Due to the prevailing wisdom, patients would often be first taken to a traditional healer and then 

eventually a priest for an exorcism. Only after many months or years had passed would these patients make their 

way to a primary care physician or psychiatrist. 

Beyond simply being an issue of eventual access to care, the cultural belief system around demons, possession, 

and faith-based healing muddied the waters of diagnostics. If a patient describes seeing demons or expresses a 

belief that they are possessed, can this be considered a delusion worthy of psychiatric diagnosis? Is it possible 

that they are simply expressing a culturally agreed upon belief? In addition, it was common for family members 

to report seeing demons possess the patient or to report attenuated symptoms after a faith healing had taken 

place. Taken at face value, I might be tempted to diagnose multiple patients and their family members with Folie 

a deux. 

Ultimately it becomes necessary to disregard these observations and focus on other signs or symptoms of illness. 

Of note, psychiatrists would often in the course of treatment recommend the direct intervention of Jesus rather 

than an antipsychotic or mood stabilizer. As an outsider, I remain convinced in my belief that antipsychotics are 

the appropriate starting treatment for psychotic illness and that witnessing a possession constitutes a delusion. 

However, I recognize that, as an outsider, my views on therapeutic psychiatric treatments are also open to 

cultural interpretation. 

206

CLINICAL CASE REPORT 

A RARE NATURAL DEATH IN THE KAMPALA 

MORTUARY 

Elizabeth Doughty, MS4, UVM 

A thirty-nine-year-old male police constable was brought to the city 

mortuary by local law enforcement after passing away at home. Minimal 

clinical history was received with the decedent, but we were informed 

that the patient had been feeling unwell for some time and had been 

unable to leave bed for the last week. On general examination, the 

patient appeared wasted with prominent rib bones and older-thanstated 

age. Additionally, there was significant unilateral edema of the 

right lower extremity. The abdomen had a firm mass in the right lower 

quadrant that appeared fixed with no overlying skin changes. The patient had poor dentition. Internal examination 

revealed a prominent 20 x 20 x 20 cm firm white-grey nodular mass fixed to the abdominal wall and bladder 

located primarily in the right lower quadrant, but crossing the midline. The mass involved the colon and was 

compressing the iliac vessels. 

There was no involvement of the bladder urothelium. Cut sections of the mass revealed a predominantly 

homogeneous whorled pattern. There was significant periaortic lymphadenopathy. The pancreas had been 

replaced by tumor. There was a 4 x 4 cm nodule on the thoracic surface of the diaphragm. There was no 

hepatic or pulmonary tumors identified. There was significant pulmonary edema and bilateral basilar pneumonia. 

Bilateral hydronephrosis was noted. Histologic examination of the tumor revealed a smooth muscle neoplasm 

with moderate mitosis and several foci of necrosis. The cause of death was labeled as malignant leiomyosarcoma 

arising from the bladder wall causing outlet obstructive edema of the right lower extremity causing immobility 

causing pneumonia. Non-urothelial bladder cancer makes up less than 5% of all bladder malignancy. Within 

this subset are the non-epithelial tumors which are very rare and include bladder sarcoma (leiomyosarcoma, 

rhadomyosarcoma), carcinosarcoma/sarcomatoid carcinoma, paraganglioma, melanoma, primary lymphoma, 

lymphoepithelioma-like carcinoma, metastatic disease. Risk factors include a history of local irradiation, prior 

cyclophosphamide treatment, and schistosomiasis. In a review of over 1500 patients with soft tissue sarcoma, ten 

had tumors that arose from the bladder (1). Another study looked at 19 patients with primary bladder sarcoma 

treated at MD Anderson between 1985 – 2004 which showed a higher male predominance (63%) compared to 

female (37%) (2). Both studies had a higher prevalence of leiomyosarcoma over rhabdomyosarcoma. The mean 

age at presentation was 57 years (range 22-94). 

Patients most commonly presented with painless hematuria, lower urinary tract symptoms, or microhematuria 

(2). Metastatic disease was present in 20% of patients at presentation (1), but only 15% of cases are identified 

early (T1 stage) (3). Surgical resection is gold-standard treatment for localized disease, however when complete 

resection is not possible due to extensive invasion or metastatic spread a chemotherapeutic approach is suggested 

(2). The three-year relapse-free survival was only 26% for patients with local high-grade disease or metastatic 

disease (1). 

Due to the very low occurrence rate of this entity, it is unlikely to occur at UVM. However, given the markedly 

increased access to health care in the United States, patients would be more likely to seek medical care earlier 

207

in the disease course. However, masses in the lower peritoneal cavity can grow quite large before significant 

symptoms develop. 

1. Russo P, Brady MS, Conlon K, Hajdu SI, Fair WR, Herr HW, Brennan MF. 1992. Adult urologic sarcoma. J Urol; 

147: 1032-1036. 

2. Spiess PE, Kassouf W, Steinberg JR, Tuziak T, Hernandez M, Tibbs RF, Czerniak B, Kamat AM, Dinney CP, 

Grossman HB. 2007. Review of the MD Anderson experience in the treatment of bladder sarcoma. Urol Oncol; 

25: 38. 

3. Ribeiro JGA, Klojda CAB, De Araujo CP, Pires LAS, Babinski MA. 2016. Giant leiomyosarcoma of the urinary 

bladder. J Clin Diagn Res; 10: PD14-PD15. 


GLOBAL HEALTH 

SEXUAL HARASSMENT AND VIOLENCE ACROSS GLOBAL CONTEXTS 

Sexual harassment and other forms of sexual- and gender-based violence are ubiquitous. As such, participants of 

global health programs often experience and report such abuses while undergoing international electives. Proper 

guidance and support must be provided so that these individuals can effectively recover and that the source of 

abuse be rectified. The framework for understanding sexual harassment and abuse has fundamentally changed 

with the widespread #MeToo movement that has shaken the historic tolerance of sexual harassment, leading to 

both discourse and action of global impact. In this vein, it is the responsibility of the global health community to 

educate its members, from trainees to faculty and researchers, about methods of advocating for one’s own rights 

and the rights of others in the face of sexual harassment and abuse in the era of the #MeToo movement. 

Read more here>> 

208

GLOBAL HEALTH AND 

THE ARTS 



ART, EXILE, & GLOBAL HEALTH 

“Art is our weapon. Culture is a form of resistance.” 

-Shirin Neshat 

Shirin Neshat is one of the best-known Persian artists in 

the Western world. Born on March 26, 1957 in Qazin, Iran, 

Neshat was forced to leave her home country before the 

Iranian Revolution in 1979 and move to the United States 

were she attended the University of California at Berkeley. It 

wasn’t until 1993 that Neshat was able to make her first trip 

back to Iran. 

Neshat’s early photographs such as the Unveiling (1993) 

and Women of Allah (1993–97) series were overtly political, 

exploring the notion of femininity in Iran. Neshat then moved 

on to produce a series of videos including Turbulent (1998), 

Rapture (1999), and Fervor (2000), that used ambiguous 

narrative and imagery as a means of exploring various 

themes regarding women. 

Neshat’s first solo exhibition was at Franklin Furnace in New York in 1993. Since then, she has shared her work at 

prestigious galleries around the world. Since 2000, Neshat has also participated in film festivals featuring various 

works and collaborations including Mahdokht (2004) based on Shahrnush Parsipur’s novel Women without Men. 

Neshat’s work unapologetically delves into themes such as gender, identity, religion, pain, and violence. Neshat 

has won many awards for her work, from the First International Prize at the Venice Biennale in 1999 to the Lillian 

Gish Prize in New York in 2006. 

Artists such as Shirin Neshat who, despite being separated from their country and culture, seek to explore their 

identity and how it relates to the world at large, are an important asset to global health work. They open us 

to aspects of the world and ways of thinking that we would not otherwise be exposed to. As we see the world 

through their eyes and feel their pain and suffering, we not only better understand others but we also question 

our own ways of being. We are pushed to reframe how we see the world and relate to it as health workers, both 

in our work overseas and in our service to immigrants within our communities at home. 

Find out more about Shirin Neshat at: 

https://www.ted.com/speakers/shirin_neshat 

https://www.youtube.com/watch?v=-ieW6Et3TEo&feature=youtu.be 

Shirin Neshat 

209

ANNOUNCEMENTS 

Dr. Sadigh, Professor Linus Chuang, the Chairman of the Department of OB/GYN at WCHN and Dr. Damanjeet 

Chaubey, Director of the Palliative Care Program at WCHN will be traveling to Uganda on July 20 for a week. 

Professor Linus Chuang would like to explore the possibility of collaboration in Obstetrics and Gynecology with 

Makerere University in Kampala. This collaboration could include high risk obstetrics, gynecologic laparoscopic 

surgeries, gynecologic oncology, and other areas. Secondly, he plans to meet with the fellows of The International 

Gynecologic Cancer Society at Uganda Cancer Institute. This organization has been established recently in 

collaboration with Duke University and UCSF. 

Dr. Damanjeet Chaubey is hoping to establish a fellowship in palliative care with Makerere palliative team. 

A Memorandum of Understanding between Botswana University and WCHN is under review. 


PHOTO CONTEST 

Tunnel of Sun Ray (Kazan, Majid Sadigh) 

Swapnil Parve (Kazan) 

210

CALENDAR 

MAY CALENDAR 

May 1: Dr. Bulat Ziganshin presented “Unraveling 

the Genetics of Thoracic Aortic Disease: Can a Global 

Approach Help?” at Danbury Hospital’s Department of 

Medicine Medical Grand Rounds. 

May 9: Dr. Tho and Dr. Scholand presented a poster 

titled “Clinical Features of Streptococcus Suis Infection 

in a Major Urban Hospital, Ho Chi Minh City, Vietnam 

2014-2017.” 

May 9: Dr. Sadigh arrived to Russia for administrative 

and teaching responsibilities. 

May 10: Dr. Sadigh met with Professor Marat 

Mukhamedyarov, the Head of the International Office 

at KSMU to discuss the current and future direction of 

the Global Health Program. 

May 10: Dr. Sadigh led the first of several orientation 

sessions with the four residents and junior faculty 

selected for the global health elective in Uganda and 

the Dominican Republic. 

211

May 10: Dr. Sadigh, Professor Marat Mukhamedyarov, 

and Dr. Swapnil Parve met with Rector Sozinov to 

update him on the evolution of WCHN to Nuvance 

Health and the new potential horizons ahead. 

May 10: Mary Shah and Laura Smith of WCHN 

attended the Third Annual International Nurse’s Day at 

the United Nations. 

May 11: Dr. Sadigh, Professor Marat Mukhamedyarov, 

and Global Health Scholar alumnus Dr. Rafael Khalitov 

traveled to Chelny to pay their respects to the grave of 

Dr. Rinat Sabirov. 

May 13: Dr. Sadigh held the second orientation session 

with Global Health Program participants from KSMU. 

May 13: Dr. Sadigh held the first session on the 

architecture of clinical research with four PhD students 

and residents. 

May 13: AUC students Seth Perry and Stefanie Rulli 

traveled to the Dominican Republic for the global health 

elective, and Iyabo Akinsanmi and Matthew Myrick to 

Uganda. 

May 13: Dr. Sadigh spoke about global health to a 

diverse audience. 

May 14: Dr. Swapnil Parve presented two posters on 

the evolution of tropical medicine and evidence-based 

medicine courses at the sixth International Educational 

Conference on Medical Education. 

212

May 14: Dr. Sadigh spoke about student mistreatment at the sixth International Educational Conference on 

Medical Education. 

Above photo: Dr. Sadigh speaking at the International 

Educational Conference. 

May 14: Dr. Sadigh handed out certificates of scholarship 

to the 2019 Global Health Program participants at a 

ceremonial meeting of the KSMU Academic Council. 

May 14: A ceremonial meeting of the KSMU Academic 

Council was held during which Tropical Medicine 101, 

published in English and Russian, was nominated as 

the best book of the year. 

213

May 15: Dr. Sadigh held another orientation session with Global Health Program participants and delivered the 

seconad session of the biostatistics course as well as the architecture of clinical research course to PhD students. 

May 15: Dr. Sadigh presented “How to Support PhD Students and Residents On Their Research Project” during 

KSMU’s International Scientific Board meeting. 

May 15: Dr. Sadigh presented “The Historical Perspective of the KSMU-WCHN partnership,” dedicated to Dr. Rinat 

Sabirov, to more than one-hundred attendees. 

Global Health Alumni: 

Top to bottom, left to right: Maksim Kuznetsov, third-year PhD student, Department of Medical Biology and Genetics; Isa 

Ngbede. second-year resident, Department of Internal Medicine; Rafael Khalitov, MD, Internal Medicine; Arseniy Pichugin, 

MD, PhD, Neurosurgeon; Mavlieva Aisylu, Endocrinologist and second-year resident of the Department of Obstetrics and 

Gynecology; Elena Belousova, Assistant of the Department of Internal Medicine; Elina Mukhametshina, second-year 

resident in the Psychiatry Department; Alina Valeeva, Allergist-Immunologist, Assistant of the Department of Clinical 

Immunology and Allergology; Zhanna Zavgorodneva, OB/GYN specialist 

214

May 16: Dr. Sadigh received the Most Distinguished 

Recognition Award for the contribution of the Global 

Health Program to public health and close cooperation 

with the medical community of the Republic of 

Tatarstan from the Cabinet of Ministers of the Republic 

of Tatarstan, signed by Prime Minister Aleksey Pesoshin 

and delivered by the Minister of Health, Marat Sadykov. 

May 16: Dr. Sadigh held the third orientation session 

with selected Global Health Program participants. 

May 16: Dr. Sadigh held the third session on the 

architecture of clinical research with PhD students. 

May 16: Dr. Sadigh conducted the first session of 

Journal Club with faculty and residents from KSMU’s 

Department of Clinical Epidemiology and Biostatist 

May 17: Dr. Sadigh held the final orientation session 

with the 2019 Global Health Program participants as 

well as the final session of the architecture of clinical 

research course with PhD students. 

May 17: Dr. Sadigh delivered a lecture on antimicrobial 

resistance to a group of students, residents, and faculty. 

May 17: Dr. Sadigh held a meeting with the recent 

Global Health Scholars alumni. 

Dr. Sadigh with PhD students 

May 18: Dr. Sadigh conducted the second Journal 

Club session with faculty and residents of the 

Department of Clinical Epidemiology and Biostatistics. 

215

PHOTO NEWS 

Dr. Sadigh with Diana Abdulganieva, Chairperson of Medicine, 

and Gulshat Khasanova, Director of the Department 

of Clinical Epidemiology and Biostatistics, both Global 

Health Scholars 

Dr. Sadigh with Professor Anokhin 

Dr. Sadigh with International Scientific Board members 

Dr. Sadigh with Gulshat Khasanova (left), Global Health 

Scholar and Director of the Department of Clinical Epidemiology 

and Biostatistics, and Saida (right), faculty 

member 

Dr. Sadigh with Dr. Jeffrey Wong and Global Health Program 

participant Elina Mukhametshina in the Dominican 

Republic 

216

Dr. Sadigh with Nikita Yakovlev, Global Health Scholar and 

Associate Chair of the OB/GYN Department at KSMU 

Dr. Sadigh with Professor Anokhin 

With faculty and residents from the Department of Clinical Epidemiology and Biostatistics 

Global Health Scholars at KSMU 

Dr. Sadigh with Professor Ayrat Ziganshin and 

Professor Lilia Ziganshina 

217

Orientation session with the 2019 Global Health Program 

participants from KSMU 

KSMU (smaller building in the back) 

2019 Global Health Program participants 

218

RESOURCES 





Ebola book 















Publications 





219

July 2019 

Special Issue 

WESTERN CONNECTICUT HEALTH NETWORK AND THE 

UNIVERSITY OF VERMONT LARNER COLLEGE OF MEDICINE INAUGURAL 

Global Health Program Conference 

A Celebration In Honor of 

Dr. John Murphy, the CEO of Nuvance Health 

June 3-5, 2019 

“People With Passion Can Change The World” 

- Steve Jobs 



220

“Our program is strong because of the passionate strength held in 

the individuals with whom we work and the communities in which 

we move.” 

Dr. Majid Sadigh, Director of the WCHN/UVMLCOM Global Health Program and 

Christian J. Trefz Family Endowed Chair in Global Health at WCHN 

Dr. John Murphy, CEO of Nuvance Health and recipient of the Path to Excellence Award 

221

PERSPECTIVE 

Mitra Sadigh 

Editor and Writer, UVMLCOM/WCHN 

The first annual WCHN Global Health Program Conference was held in 

celebration of the UVMLCOM/WCHN Global Health Program’s seventh year, 

and dedicated to Dr. John M. Murphy, CEO of Nuvance Health, for his tireless 

support and pivotal role in advancing the program to what it is today. The 

event provided a meaningful scaffold on which domestic and international 

partners - well-seasoned and new - could meet, network, and collaborate with 

the goal of creating a new consortium in global health devoted to medical 

education. The event was also a celebration of our new partnerships with 

Linde and Health Quest, as well as an opportunity to introduce global health 

to a wider community. 

It was incredibly powerful to see representatives from each of our partners under one roof. These included our 

existent international partners - Universidad Iboamericana (UNIBE) in the Dominican Republic; Kazan State 

Medical University (KSMU) in Russia; the African Community Center for Social Sustainability (ACCESS), Saint 

Francis Naggalama Hospital, Saint Stephen’s Hospital, Makerere College of Public Health in Uganda; and University 

of Zimbabwe College of Health Sciences in Zimbabwe - and domestic partners, University of Vermont Larner 

College of Medicine, Sacred Heart University Global Education Initiative and School of Nursing, and Western 

Connecticut Health Network. Together, we welcomed our new international partners Dalian Municipal Central 

Hospital in China, Datta Meghe Institute of Medical Sciences (DMIMS) in India, Walailak University School of 

Medicine in Thailand, and Makerere University School of Public Health in Uganda, as well as our new potential 

domestic partners Chiricahua Community Health Centers representing Global Health at Home in Arizona, Linde, 

and Health Quest. 

With such staggering programmatic growth over the last few years, this event reminded all of us to take a moment 

to recognize our remarkable expansion and accomplishments while reflecting on potential areas of improvement 

and methods of working toward sustainability. By conversing and learning one another’s strengths and talents, 

members were able to discover new collaborative possibilities. I watched in awe as we revealed unique skills, 

expertise, and passion to ourselves and one another, with those we already knew and those we had just met. 

I was moved by the ease with which our partners old and new instantly melded, connected by a deeply shared 

vision: equal access to healthcare for everyone, everywhere through true multidimensional partnerships founded 

in trust and capacity building in medical education. We were all stunned to discover the immense potential 

contained within each of us, within each potential collaboration, and together as a collective, and returned to our 

work spaces in our respective corners of the world with a resurge of creativity and commitment. I hope we can 

render this unbridled potential energy held in our global health family kinetic 

222

MESSAGES 

Message from Senator Christopher S. Murphy: 

223

A MESSAGE FROM PROFESSOR ALEXEY SOZINOV, RECTOR OF KAZAN 

STATE MEDICAL UNIVERSITY 

Dear Dr. John Murphy, 

Please accept these warm greetings from the 

community of Kazan State Medical University and health 

professionals in the Republic of Tatarstan. We cordially 

congratulate you, the administration, students, faculty, 

and health workers at Western Connecticut Health 

Network/ Nuvance Health and University of Vermont 

Larner College of Medicine for the seventh year 

anniversary of the Global Health Program. 

We would like to cordially thank you for your kind 

support, including in continuing the collaboration with 

our institution and hosting our faculty and residents at 

your home sites. The program has greatly contributed 

to the development of medical education and training 

of health professionals in Kazan, and we appreciate it 

very much. 

Kazan State Medical University is proud to be the first 

overseas site established within WCHN/UVMLCOM 

Global Health Program. The seven-year period was 

marked by productive collaboration in global health between our institutions. This cooperation not only expands 

horizons for the parties in the global health arena, but also enriches clinical and intercultural knowledge of 

participants. 

Due to the WCHN global health initiative, KSMU developed first in Russia and later in Europe six-week global 

health electives offering extensive clinical rotations, basic and applied research projects, and unique sociocultural 

curriculum for international medical students. Over the years, KSMU has welcomed many talented and highly 

motivated medical students from partnering medical schools while selected young KSMU faculty members and 

residents underwent clinical clerkships at WCHN. 

KSMU highly appreciates the Global Health Program partnership for its beautiful and valuable experience in 

exchanging views and ideas, as well as its contribution to medical education development. We recognize that the 

program has made, in only a few years, an outstanding contribution to the training of health professionals around 

the world while making strides in influencing population health in a global way. Today, the Global Health Program 

has a tremendous opportunity to make our world a better place. 

With best wishes, 

Alexey Sozinov 

Rector of Kazan State Medical University 

224

SPEECHES 

OPENING SPEECH: SENSE OF COMMUNITY 

IS WHAT UGANDA HAS GIVEN ME 

Grace Herrick, Founder of Grace’s Promise 

My dad is from California and my mom is Portuguese born in 

Mozambique. My mom’s stories always piqued my curiosity about 

the continent of Africa, a curiosity that continued to grow through 

high school as I frequently attended the WCHN global health 

evening sessions. In the summer of 2015, I had the opportunity 

to go to Uganda for two weeks during which I shadowed doctors 

and nurses, visited an orphanage, and went to ACCESS in Nakaseke 

where I learned about the activities of this amazing organization and 

community. 

I was particularly moved by the work ACCESS does with children 

and orphans. During one of our home visits, an elderly woman sang 

a beautiful and haunting song. I didn’t understand the words, but 

the emotions I felt were powerful. I felt fully present that day. There 

existed a feeling of community, connectedness with one another in 

the villages we visited that is difficult to describe. In the U.S., we do 

not often see communities in which everyone treats one another with 

dignity and respect. I felt that I was witness to something important. 

I left ACCESS feeling like I had to be a part of that community in a 

permanent way. I started brainstorming about what I could offer that 

could have lasting impact. After speaking with Dr. Robert Kalyesubula 

and Estherloy Katali, President and Co-Founders of ACCESS, we 

came up with the idea of a preschool program, as that was something the community needed that I could work 

on remotely. We created a curriculum and opened a preschool program that started during my junior year of 

high school.To help illustrate why Nakaseke made such an impression on me, let me tell you about my return 

to Uganda in July 2018. The morning we drove to visit the school during my next visit in 2018, we stopped at a 

street shop in Kampala to purchase candy for the children. 

The shop was small, packed with odd foods and nicknacks and one cashier crammed into the corner because 

space was so tight. The street was loud and bustling with people and cars, equally packed in, and I was with 

my sister and her friend. I stepped onto the street with feelings both familiar and strange. Shops and streets 

in the midst of people hustling about, just like midtown Manhattan. It was in the midst of this familiarity that I 

felt strange. Here I was with my sister and her friend, three American girls so out of place in a sea of people as 

to cause them to stop in their tracks to stare at us. How could something seemingly so familiar feel so strange? 

When I visit Boston or New York City, I feel like a stranger among strangers, and somehow that feels comfortable 

because no one cares. But in Kampala, I feel like a stranger among friends and neighbors, and it makes me feel 

alone – like a real stranger – while also feeling envious of a sense of community that doesn’t exist in any city in 

225

the US, not even in my home Newtown. It is this irony of feeling like a stranger among friends in Uganda but a 

friend among strangers in the US that is so alienating. 

Later, I arrived at ACCESS expecting that we would visit the school program and greet the children with the 

treats. Instead, they came running to greet us in their bright, electric colored polo shirts chanting “Welcome to 

ACCESS Preschool.” Their warmth, giggles, and bright eyes filled me with so much love that I burst into tears. We 

were then greeted by many other people, some familiar like Dr. Robert and Estherloy, and some new. Embracing 

them felt like coming home. We picked up exactly where we left off when I was sixteen. 

There is something about the way Ugandans greet you that makes you feel immediately welcomed and cared 

for. They extend both their hands to shake yours, then hold your hand in theirs in a warm embrace while talking 

to you. They focus their eyes and attention on you as if you are the only person on the planet. It makes you feel 

safe and connected, like the bond is as strong as family. Never have I been greeted with such strong feelings. It 

is disarming. 

The children continued running around us giggling, tugging on my dress and requesting my attention. Two 

grabbed my hands, one on either side, and walked me with Dr. Robert to a Welcome Brunch. As we went around 

the large table introducing ourselves, I was struck by the passion and dedication with which community members 

help the preschool to run. Afterwards, we walked to a tent set up with tiny brightly colored chairs where the 

children put on a show, full of life and infectious laughter. The end performance was a dance similar to the conga 

line dance where the little ones lined up and danced their way around. Eventually everyone joined in, including 

Dr. Robert. It was a moment I wish I could have frozen in time. I spoke with parents about their day-to-day lives, 

their families, and their friends. They shared the impact the school has had, and the aspirations they have for 

their children. The stories they shared were intimate and moving with the familiarity of a friend. 

Let me end by talking about Susan Byekwaso, the Coordinator of the International Office at Makerere University 

College of Health Sciences, as she perfectly represents what Uganda means to me. By my side throughout most 

of my days in Uganda, she refers to me as her daughter and herself as my African Mama. I am blessed to have 

another mother across the world. She plans our days precisely, but is there to make it work when I want to go off 

the schedule. She is tough in the best way possible, even saying no to me, like, “No Grace, you cannot stick your 

head outside the van in the middle of Kampala with the streets filled like this!” Susan does this purely from her 

heart, her love of people, and her love of her home. And her home is not just her house, and not just the country, 

but the entire global health contingent who call upon her when visiting. 

I decided to create my own individualized major in global health at the University of Connecticut. One of the 

first papers I wrote on the subject was an attempt to understand why the US has undergone a reversal in life 

expectancy for the first time in its history when compared to other Global North nations. A group of Princeton 

economists noted that the reversal is largely due to three factors: opiate overdoses, cirrhosis of the liver, and 

suicide. They coined the term “deaths of despair” to describe this triad. As rich as we are in material goods, we 

are very poor in community. Uganda, on the other hand, is rich in this most important commodity that comes 

freely. And a sense of community is what Uganda has given me. 

226

AN OPPORTUNITY FOR EXCHANGE AND 

INSPIRATION 

Dr. Naomi Hodde, Department of Medicine 

Faculty at UVMLCOM 

It was a sight for sore eyes and slightly discouraged souls. In a time 

when so much of our energy is directed at exploring efficiency, payment 

models, or physician burnout, the Western Connecticut Network 

Global Health conference provided an opportunity for inspiration and 

rejuvenation. For three days in early June, 140 members from China, the 

Dominican Republic, India, Russia, Thailand, Uganda, Vietnam, as well 

as domestic partners in Connecticut, Vermont, and border communities 

in Arizona had an opportunity to share ideas and visions for future work 

in global health education, healthcare delivery, and cultural exchange. 

On Monday June 3rd, we heard from panelists detailing new partnerships 

at global health sites around the world. Dressed in a traditional Thai 

lavender garment with a broad and warm smile, Dr. Prachyapan “Menn” Petchuay’s enthusiasm for the emerging 

educational experience at Walailak University School of Medicine was infectious. Next, Dr. Swapnil Parve shared 

many details of their growing educational program at Datta Meghe Institute of Medical Sciences. Finally, Dr. 

Jonathan Melk discussed the history and current scope of Chiricahua Community Health Centers in Douglas, 

Arizona. Their model is innovative in its approach to interdisciplinary care to adults and children providing a 

broad range of services including medical, dental, and behavioral healthcare in southeastern Arizona. Their motto 

“Health For All” speaks volumes. The health system serves 28,000 patients of all ages in nine sites - through 

brick-and-mortar clinics as well as mobile health centers in buses in a catchment area the size of Connecticut and 

Rhode Island combined. His dedication to the project’s mission was palpable. The potential for future exchange at 

this site made it clear that global health is a philosophy of learning that can be translated into action domestically 

as well as abroad. 

Later in the afternoon, conference attendees were treated to shared reflections from the field. Presentations 

included topical lectures on sexual harassment and gender equity, diversity and inclusion in global health, and 

means of mitigating harm to host institutions and members during global health electives. Topics in medical 

education included Dr. Moore discussing her curriculum for simulation and pre-departure training designed for 

learners and a session on evaluation and feedback. The afternoon concluded with an engaging discussion using 

case studies detailing “Ethical Challenges in Short-Term Global Health Clinical Experiences.” 

A dinner and awards ceremony at the Ethan Allen Hotel was a time for conversation and exchange among 

participants. Additionally, we were grateful to hear several performances from acclaimed soprano Alexis Rodda. 

Among the honorees that evening were Grace Herrick, founder of Grace’s Promise; Amanda Wallace, Multimedia 

Specialist at WCHN; Mitra Sadigh, Writer, Editor, and Researcher at the Global Health Program; Dr. S. Javed 

Shahid, Section Chief of Neurosurgery, Danbury Hospital; and Dr. John M. Murphy, CEO of Nuvance Health. It was 

a lovely opportunity to highlight the achievements of this talented group and the generous local support being 

directed to the important work of partners in a shared global health mission. 

The next morning, Global Health Program leadership traveled to Danbury Hospital for Grand Rounds, delivered by 

Dr. John Murphy who detailed the newly designed partnership with Nuvance Health and his continued commitment 

to the hybrid model of this health network including community health care, academic medical education, and 

227

productive research. Dr. Murphy conveyed his vision and perspective. Several posters displayed scholarships 

resulting from collaborations at global health partner sites including Uganda and Russia. 

Later that morning, the true work began. In a conference room at Linde Corporation, Dr. Mariah McNamara lead 35 

members of the leadership team from twelve sites across the globe in a strategic session to explore the mission, 

vision, and values of the WCHN global health collaborative. Members exchanged ideas on strengths, weaknesses, 

and opportunities for improvement at individual sites. The ultimate goal, however, was to come together as one 

community and detail our vision for the future of this collaborative. All remain committed to a mission steeped in 

mutual respect in the spirit of cultural exchange, medical education,and bi-directional opportunities for growth. 

The group identified the need for a multi-site leadership and steering committee as well as a communications 

committee to ensure adequate exchange of ideas across sites in an efficient and reliable network. Finally, there 

was consensus on the need for regular future meetings in the form of a yearly conference. The hope is that the 

location of this meeting can vary among sites in the Global North and South, and that a conference planning 

committee will be formed. 

The session was filled with hope for a strong and sustainable collaboration to be headed by our current partners, 

but one that will grow and change over the coming years. The morning was productive and inspiring. Members 

left the session ready to work toward a shared goal in the model conceived by the program director and embraced 

by all in our growing Global Health Institute. 

Dr. Swapnil Parve 

Global Health Program Site Director at Datta Meghe Institute of Medical Sciences (DMIMS), India 

One of the key outcomes of the first WCHN Global Health Conference was the 

adoption of a resolution to form a consortium of our partners in global health 

and launch a unique program “Linde Global Health Educators Beyond Borders.” 

Scheduled to launch in 2020, this novel program will select academically 

promising international colleagues for training at Nuvance Health and Linde 

Headquarters in Danbury to become an army of health educators around 

the world. In order to maintain their certifications every five years, program 

graduates will be required to conduct academic or scientific activities in 

global health in their own home country as well as in other countries in the 

global south. 

DR. PRACHYAPAN “MENN” PETCHUAY, DEAN OF WALAILAK 

UNIVERSITY SCHOOL OF MEDICINE 

Arriving at Danbury’s Ethan Allen Hotel at 10 p.m., after more than 24 hours of travelling from my home in 

southern Thailand, I was exhausted and jetlagged, too tired to think of anything. On the last leg of the journey 

from New York City’s JFK airport, I was delighted to be in the company of Dr. Hoang Phuong Lann and Dr. 

Tran Hahn Uyen from Cho Ray Hospital in Vietnam. But as someone attending the meeting for the first time, 

228

epresenting Walailak University’s School of Medicine as the newest member of the global health family, I could 

not help feeling a little apprehensive. Checking into my hotel room, however, I was overwhelmed by a big box 

of souvenirs that was waiting for me. Before getting ready for bed and some much needed sleep, I just had to 

check it out and what I found - the welcoming postcard, books, some amenities, and a bit of this, and a bit of that 

- made me feel right at home. But the most important package, especially as the hotel kitchen was closed, was 

a delicious nutrition bar. With that keeping my stomach happy, I was ready for my first sweet night in the USA. 

I have to confess that before attending the conference, my view towards global health was not totally clear. I 

had researched its work in several articles that contained differing points of view, such as whether this might be 

another science in the medical world, a new subject, or merely a new medical practice in a global perspective. 

However, I had concluded that this particular conference would clarify these issues for me and any queries I might 

have about global health would be resolved. I accepted that I was a new and unknown person in this arena. 

Meeting everyone for the first time at the welcome party, I was nervous. It was the fear of the unknown which 

I’m sure we all feel when we attend any function for the first time. But on seeing the familiar faces I had met in 

Thailand, Dr. Stephen Scholand followed by Dr. Majid Sadigh and Mitra Sadigh, my nervousness evaporated. The 

warmth of the welcome, with everyone greeting each other with smiles and acknowledgment indicated that we 

were all happy to be there; we were the same family and we shared the same values. Experiencing the warmth 

of that greeting, I readily accepted that I too would be one of the global health family. 

Standing in front of everyone during the first conference session, I was even more nervous as I had to speak in 

English which is of course not my native tongue. Afraid of the misuse of some vocabulary or misunderstanding 

what someone might ask me, I was quickly reassured by the support that I could see and sense from other 

229

attendees. My confidence grew as everyone seemed to be enthusiastically listening to me. I knew then that 

whatever our vocabulary, whatever words we used, we were speaking the same language: the language of care. 

All of us in that room were linked by common beliefs, and any dissimilarities were soon resolved. 

Throughout the sessions, we were all participating. We discussed different topics from different points of view. 

Travelling from different points of departure we nonetheless shared the same value and the same destination. 

The destination where our medical care will be under the hands of good doctors. The destination where we 

teachers can nurture our students to become the doctors we have dreamed of. 

I understand now more about global health, a project to shape both our students and staff to be global doctors 

who instinctively understand not only the workings of the clinic where they will ultimately practice but also well 

beyond that – out into the communities where their patients reside. 


Dalia Martinez 

I’m a former journalist-turned content strategist. I 

help companies get noticed by mapping out how they 

can promote their brand and I write their promotional 

content. In terms of my experience in healthcare, I work 

with doctors who specialize in finding the root cause of 

disease and support stronger legislation in the U.S. to 

protect food supply, water, and environmental health. 

What interests me the most about social justice work is the 

opportunity to learn from people who come from all walks 

of life with hundreds of stories, and of course, making 

a difference. I am involved in social justice work in the 

U.S. for prison reform, voter rights, and environmental 

causes. 

Currently, I’m adding on user experience design (UXD) to 

my content strategy portfolio with the hope of utilizing it 

in the non-profit and policy think tank circuit. 

230

Abraham Lincoln Walks at Midnight 

By Vachel Lindsay (In Springfield, Illinois) 

It is portentous, and a thing of state 

That here at midnight, in our little town 

A mourning figure walks, and will not rest, 

Near the old court-house pacing up and down. 

Or by his homestead, or in shadowed yards 

He lingers where his children used to play, 

Or through the market, on the well-worn stones 

He stalks until the dawn-stars burn away. 

A bronzed, lank man! His suit of ancient black, 

A famous high top-hat and plain worn shawl 

Make him the quaint great figure that men love, 

The prairie-lawyer, master of us all. 

He cannot sleep upon his hillside now. 

He is among us:—as in times before! 

And we who toss and lie awake for long 

Breathe deep, and start, to see him pass the door. 

His head is bowed. He thinks on men and kings. 

Yea, when the sick world cries, how can he sleep? 

Too many peasants fight, they know not why, 

Too many homesteads in black terror weep. 

The sins of all the war-lords burn his heart. 

He sees the dreadnaughts scouring every main. 

He carries on his shawl-wrapped shoulders now 

The bitterness, the folly and the pain. 

He cannot rest until a spirit-dawn 

Shall come;—the shining hope of Europe free; 

The league of sober folk, the Workers’ Earth, 

Bringing long peace to Cornland, Alp and Sea. 

It breaks his heart that kings must murder still, 

That all his hours of travail here for men 

Seem yet in vain. And who will bring white peace 

That he may sleep upon his hill again? 

Click here for audio of Dalia reciting the poem >> 

231

Keyvan Behpour 

President of Kvon Photography 

What led you to pursue photography? 

I have been fascinated with the still image since I was eight years 

old, spending my childhood memories looking through the National 

Geographic Magazine which we used to receive in Iran. My father 

gave me his old camera and light meter, sending me off “looking” 

and “seeing,” and I never stopped. 

What subject material are you most passionate about capturing and 

why? 

I love all aspects of photography: architectural, scenic, advertising, 

lifestyle… but what fascinates me the most is people. It’s my belief 

that when a camera is pointed at a person, it triggers something in 

them to put up a front such that the real person behind it cannot 

be revealed. I feel that a photographer’s inner personality comes 

into play at this critical moment. If the photographer can establish a 

connection with the person or the group of people and get through 

that barrier, the real person behind it is so much more beautiful and interesting, with a fascinating life story that 

would not have been revealed otherwise. That is where my passion lives. 

What has been your involvement in human rights and social justice issues? 

I have been an outspoken advocate in this area for as long as I can remember. I continually read, research, and 

share the issues as broadly as I can, trying to inform and educate whoever might listen. As we all know right now, 

the current geopolitical atmosphere makes this task harder, and hence we must try that much harder. 

What do you see as the value of art as a means for advocacy? 

I get requests from various NGO’s and other organizations asking for a $20 donation to feed people or help with 

the tragedies that have befallen them. My response is always this: I can give you $20 for a meal, or you can get 

me to where the problem is, and I can capture the essence, depth, and urgency of the situation, bring the images 

back, and get hundreds of thousands of dollars instead from newly informed and passionate people after they 

have seen and felt the problem. 

What are your hopes for your future work and career involvements? 

My hopes are a just world, and a peaceful one at that, while this seems like such a distant goal, it will be even 

further away if I don’t try. I hope to continue my advocacy work by bringing out the truth and helping as many 

unfortunate people as possible while making a living, to support my family as well. 

What was your impression of the Global Health Conference, and what are your thoughts on the Global 

Health Program’s mission? 

I have been totally fascinated with the Global Health Program and its vision. I knew nothing about global health 

until one night when I was photographing an event for Norwalk Hospital and heard the Program Director talking 

about global health. It was like the clouds parting as a beam of light came down from the sky. I thought, now 

this is something that finally makes sense, the big picture: get everyone involved since it’s not just us and them, 

but about all of us. 

232

Photographing the latest congregation of all these amazing, talented, accomplished, and caring humans for three 

days was so powerful in my mind. Just looking across the room, making friends with all of them and listening to 

distant nations passionately discussing common goals, remedies, and possibilities was inspiring. It gave me hope 

that we might just be able to do this on a worldwide basis. 

I feel that one of the most important aspects of global health is sending medical students from one country to 

another so they can see and develop compassion for others and realize the problems and shortcomings that they 

had no idea even existed. The exchange of ideas and solutions is also a key factor. 

We all need to burst out of our safe, comfortable, and local bubble and become involved with the wider world 

to realize that at the end of the day, we are all humans. We all need peace, love, understanding, compassion, a 

place to rest and be. 

Sean Nuremberg 

Multimedia Intern at WCHN 

What is your role at WCHN, and how did you become involved 

with the Global Health Conference? 

I’m currently a volunteer for Danbury Hospital’s multimedia 

department. Over the six months of my volunteer work, I have 

learned more and more about the Global Health Program. It was 

through Dr. Sadigh regularly visiting the multimedia department 

for editing and advice on global health-related media that we met, 

and I wound up having the opportunity to film the Global Health 

Conference. 

What was your experience filming the Global Health 

Conference? What did you think of the event? 

My experience at the global health conference was fantastic! Filming 

an event like this one was exciting, especially after meeting so many 

of the wonderful people involved. Seeing how important this event 

was to everyone really motivated me to capture the best footage I 

could. Even though I was behind the camera, being there in person was eye-opening. I learned so much about 

different healthcare efforts around the world. I saw how the people in that conference room were giving it their 

all to make the world a better place. The progress this program has made is inspiring and the world couldn’t ask 

for a more passionate group of people. 

What is your background in media, and what has led you to pursue it? 

I’ve always loved technology since I was young. I got a cheap digital camera for my twelfth birthday, and recorded 

countless memories with my friends throughout high school. As I grew older, I found myself thinking about what 

I wanted to do for a career. At first, media didn’t even click in my head. I didn’t believe that something so fun 

and enjoyable to me could be a career - it sounded too good to be true! Since that realization, I’ve been pursuing 

videography and trying my best to get as much hands-on experience as I can. 

233

What are your hopes for your future work? 

I’m still relatively new to this, and am currently looking for my niche in videography. I really love working with 

people and hearing about their experiences. I enjoy filming interviews with individuals and capturing large events. 

My favorite parts are the stages of preparation and the fast-paced work when it all unfolds. I also enjoy editing 

the footage just as much as filming it. I’m a detail-oriented person and I do everything I can to make the footage 

flow and look its best. At the end of the day, I want to help people learn about things from unique perspectives. 

Everyone has a story to tell and a goal to reach, and I’d love to help share those with the world. 

Alexis Rodda 

Soprano 

Alexis Rodda is a classically-trained soprano described by New York 

Classical Review as having “a lovely voice, full of color and body 

in every register.” She attended Princeton University (BA), Mannes 

College (MM), and currently attends CUNY Graduate Center as a Five- 

Year Fellowship recipient and doctoral candidate. In March 2019, she 

was chosen as a Fulbright Scholar to travel to Vienna and conduct 

research in the exil.arte Zentrum (The Exiled Art Center.) In 2018, 

she won a grant, the Elebash Award, to travel to Munich and explore 

the works of exiled Austrian composer, Egon Lustgarten, at the Lahr 

von Leitis Archive. A strong proponent of new music, she premiered 

four new works in the past two years including the leading role in a 

full length opera, A Taste of Damnation, by Avner Finberg and has developed a new operatic libretto with bestselling 

author Cari Luna based on her award-winning novel, The Revolution of Every Day. At Princeton, she was 

a Lewis Center for the Arts grant winner to create and sing a new opera by composer Maxwell Mamon, Rosaleen, 

which had its premiere in Richardson Auditorium. She was a 2013 Boston Metropolitan Opera National Council 

District Winner and Regional Finalist, a 2014 NYC Metropolitan Opera National Council Encouragement Award 

Winner, and a 2014 and 2018 Elebash Grant Winner. She was a 2016 Serge & Olga Koussevitsky Young Artist 

Award Finalist and a 2016 Violetta DuPont Competition Encouragement Award Winner. Additionally, she is a 

professional singer at St. Patrick’s Cathedral in New York City. Alexis also teaches a number of students voice and 

piano lessons in the New York City area. 


Dr. Gagandeep Kaur 

Pathology Resident at Danbury Hospital 

Having worked in rural India with limited resources and bearing witness to a wide array of dilemmas - from 

favoring treatment to males to delivering biased treatment based on financial aid - ethical dilemmas are the big 

concern while caring for patients in any respect, in the Global North and South alike. 

234

The WCHN Global Health Conference provided a meaningful 

platform for all attendees. The “Ethical Dilemmas in Global 

Health” panel stuck out to me as particularly thoughtprovoking. 

Among the cases discussed was one of a 

traveling physician offering to give financial support to 

a patient that couldn’t otherwise afford the treatment, 

thinking this would solve the issue of lack of funds. However, 

the local physician discouraged this, stating that there are 

many more patients that require financial aid and funding 

one single patient does not solve the universal issue. 

Meanwhile, the traveling physician felt it was ethical to 

provide the best possible care to the patient at his capacity. 

Although it is the responsibility of a physician to care for 

the patient, decisions should not be driven by emotions. 

Healthcare institutions, hospital management, alternative 

funding sources, and community members willing to make 

a financial contribution can play a vital role in providing 

assistance to patients that need it most. 

The other topic on this panel that caught my attention was in regard to gender-biased treatment. This practice 

should be strongly discouraged, and may be prevented by offering awareness to patients, families, and healthcare 

providers through seminars and educational programs. Doing so may gradually open the community to new ideas 

and practices. 

The ethical dilemmas panel provided perspectives from different geographies including the United States, Uganda, 

and Vietnam, as well as insights and questions from conference attendees from around the world, providing me 

with the opportunity to hear varying voices while also expressing my own. What I took away is this: before 

concluding whether a healthcare decision is right or wrong, one must seek to understand the perspective behind 

the decision and its impact on patient outcomes. 

Ritesh Vidhun 

High School Student 

The Global Health Conference this past June was interesting and eye-opening, 

to say the least. It was intimidating yet inspiring to be part of such a diverse 

group of people from all parts of the world who are experts in their fields as 

they discussed important healthcare issues. Being the only high school student 

presenting a poster made me incredibly nervous at first, but the collaboration 

among everyone was highly encouraging. Global health has given me the opportunity 

to pursue my interests through research while discovering an area of 

healthcare that I am very much interested in. Through meeting new people, 

conducting research, and discussing various topics in healthcare, I now have a 

better understanding of global health and the significance of this program. 

Ritesh Vidhun 

235

The program and symposium were energizing and well-executed. Capping it with Dr. John Murphy’s grand rounds 

and Dean Page’s heartfelt words put an exclamation point to all that was said. 

Dr. Jonathan Fine 

Former Designated Institution Official at WCHN 

Dear Global Health Team; 

Thank you for inviting me to attend this wonderful event and visit Danbury Hospital for a month. 

It was a great pleasure to meet excellent people from different fields and areas of expertise. The Global Health 

Program has established an international exchange platform based on the premise that all humans deserve the 

same rights to healthcare. 

My hospital is affiliated with Dalian Medical University. There are 2000 in-patient beds, but we are not yet the 

best training site for students and residents, and do not have fellowship program. Our level of healthcare also 

needs to improve greatly. We need to pay attention to basic skills besides advanced technology. It is a new 

and important mission to make more of our doctors aware of these differences and start to make changes and 

improvements. 

I am excited to be a part of this exceptional group. 

Warm regards, 

Peishi Yan 

Hello Ms. Lisa Esneault, 

I want to express my gratitude to you and other Linde leadership for their generous support of the Global 

Health Program at Western Connect Health Network and Linde Health Educators Without Borders. The Global 

Health Conference was a great success thanks to your valuable endorsement. It was a wonderful and rare opportunity 

for all of our partners, Linde included, to gather in one space. 

But beyond your substantial financial support of our program and events, we deeply appreciate the time and 

participation of Linde members, including Todd’s speech at the dinner as well as your opening remarks during 

the brainstorming session. We also deeply appreciate you hosting the global health leadership at the Linde 

headquarters. We were all moved by the warm welcome given by all Linde representatives. 

We are truly grateful for this new partnership and excited for the growth that your support has allowed us to 

pursue in the coming years. Thank you for standing by us, in both financial backing and mission. 

Sincerely, 

Majid Sadigh 

236

Dear Dean Page, 

I want to thank you for taking time out of your busy schedule to attend the global health dinner and grand rounds. 

Your presence and insights made a tangible historical influence on the future direction of the UVMLCOM/WCHN Global 

Health Program, for which I am personally thankful. 

Warm regards, 

Majid 

It was my great pleasure. I also enjoyed reading the materials you gave me. 

Best wishes, 

Richard L. Page, M.D. 

Dean, The Robert Larner M.D. College of Medicine 

The University of Vermont 

Dear Carole, 

I owe you a debt of gratitude for being so generous in sharing your energy and wisdom with me and other members 

of the global health leadership during so many critical moments over the past 7 years. 

You have been an inspirational role model to me and many others. 

Warm regards, 

Majid 

Thanks to you for being such an inspiring mentor and leader! It was wonderful to see so many international leaders 

come together for planning and celebrating. The conference was an enormous success from where I sit, and I am 

very excited to see where the river of ideas takes us next! 

Thank you for all you have done for all involved with global health, 

Carole Whitaker 

Congratulations on the program success with the Global Health Conference! Beautiful photos. 

Thanks, 

Rafael Khalitov 

237

Hi Dr. Sadigh, Dr. Robert, and Joann, 

I felt so embarrassed receiving an award for something so simple as to start a preschool program! I’m extremely 

fortunate to have amazing people, like all of you, supporting me in our shared journey of making the 

world a better place. Thank you for your kind words. I don’t deserve them. I promise to continue to work hard 

to one day earn the praises you shower me with. 

Much love to all of you, 

Grace 

Dear eMagazine team, 

Hello. It’s an honor for me to read about and see the Global Health Program’s amazing work and success as 

demonstrated by the conference. It is my wish to join this conference one day. My greatest congratulations to 

you for these great achievements and accomplishments. The humanistic mission of the program is really inspiring. 

I am sure that the program has inspired many young people like myself around the world. It makes me proud 

to be a member of this community. The program’s accomplishments and fast growth are demonstrative of the 

fact that good things come to those who are willing to sacrifice for a worthwhile goal. Words can’t express how 

happy and proud I am. Like many others, I am celebrating the dedication of so many members of this program 

who are selflessly investing their energy and talents toward humanistic goals. 

I hope all the best for you and wish the program to reach the highest of success. I send my heartfelt congratulations 

to all members, and wish many more successes. 

Best wishes, 

Elnaz 

Dr. Sadigh, 

I regret that I did not have the chance to speak with you yesterday. I unfortunately had to run back to the hospital 

immediately following the panel discussion. 

Thank you for the opportunity. It was great fun and I received wonderful personal feedback from those in 

attendance. 

All the best, 

Patrick Zimmerman, DO 

Resident Surgeon, General Surgery 

Danbury Hospital, University of Vermont 

238

Hi Drs. Murphy and Sadigh, 

My name is Sanjay and I am one of the general surgeons at Vassar – Just wanted to reach and tell you that I had 

the pleasure of attending part of the conf/sessions yesterday and the Grand Rounds today. I was truly inspired 

and it was a breath of fresh air to listen to both of you who were sharing your visions/passions for global health! 

Global health has always been a passion of mine and I am actually heading to Africa next week to perform 

surgery. Please let me know how we can bring Global Health awareness to this HQMP like you have both done 

at WCHN. 

Sanjay Thomas, MD, FACS 

Attending General Surgeon 

Core Faculty General Surgery Residency 

Program Director of Transitional Year Residency Program 

Hi Dr. Sadigh, 

I hope you had a chance to relax a little today. The parts of the conference I attended were so well run! 

I wanted to say thank you again for your mentorship and giving me the opportunity to do things most people 

could only dream about! 

Take care and safe travels to China, 

Grace 

Dear Majid, 

During the conference I met with so impressive group of local and international Global Health Program members. 

I have learned so much more, and over and over again the Global Health Program impresses me with the span 

of knowledge in so many fields. It is visionary in this world where help is needed. 

Warm regards, 

Eva Landegger 

Dear Majid, 

Congratulations on what seems to have been a very successful global health conference June 2-4th. The 

awards were fantastic. 

Best, 

Nelson Sewankambo 

239

Thank you very much for the beautiful conference and this meeting with plenty of great people. It inspired so 

many committed people. Our collective global health initiative expanding very well. Congratulations! I am sure 

that Linde Health Educators also has a great future. 

Cordially, 

Marat Mukhamedyarov 

Thank you Majid. It was a wonderful conference and opportunity to see old friends, make new friends, and 

establish new contacts and programs. Thanks to you and the many people at your side who made this work so 

seamless. 

Steve Winter 

It was a great pleasure to meet each of you! Thank you for your warm welcome. I hope to collaborate with your 

programs more in the future. 

Sincerely, 


Chief Executive Officer/Chief Medical Officer 

Chiricahua Community Health Centers, Inc. 

Just arriving home. Thanks to the WCHN team for organizing this wonderful event. Thanks to the program 

leadership. I am, like so many others, so proud of being a part of this exceptional group. We have in our hands 

a big task of contributing, from our different fields of expertise, to help to make this world more equal and fair. 

I am so proud to have met people like you and want all our efforts from each site to bring hope and light to the 

undeserved and unprotected populations around the world. 

Warm regards to everyone. 

Dr. Marcos Nunez 


I have just arrived back in Zimbabwe. The journey was great though tiring. It was pleasing to meet all the other 

people involved in global health. The discussions were rich, inspiring, futuristic, and full of encouragement. 

We look forward to continued growth and prosperity of the organisation. I wish you all great success in your 

current duties. 

Prof. R. Masanganise (Dean UZCHS) 

240

Dear Everyone! 

Thank you very much for opening my world to opportunities to learn something new, and for empowering me and 

giving me inspiration to improve my work. 

To join the gang, I realise that there will be several things I have to do when I am back to my work. First of all, 

to get ready for my first group of students who will be with me for six weeks. 

The conference was superb... Thank you for your hard work. Thank you to everyone who was the force behind 

the conference. 

At this stage, I would like to promise that cooperation between my site and the Global Health Program will be a 

more fruitful, prosperous and productive one. 

Thank you again, 

Menn Petchuay 

Dear All, 

It was great meeting you all. I would like to thank the members of Western Connecticut Health Network for 

bringing us all together. Looking forward to a very fruitful relationship with all of you. 


Swapnil 

Dear All, 

I sincerely appreciate the opportunity offered me to join the Global Health Conference and all the participation 

therein. I learned a lot and was greatly inspired by the strategic direction the global health partnership is taking. 

It was a moment of international exposure and exchange of ideas. We are open to the network and development 

henceforth. 

Be blessed, 


It was a great pleasure to meet everyone! I am leaving tomorrow and go back to work next week. I believe 

what I learned here will improve my work and benefit patients. I hope to collaborate with your programs more 


Best regards, 

Peishi Yan 

241

Dear All, 

I agree with everyone’s sentiments – this was a wonderful conference! I greatly enjoyed spending time with 

this amazing group of lovely, inspiring people. This is a very special program. I returned to Vermont with a renewed 

sense of deep gratitude for having the opportunity to be a part of it. I look forward to continuing to work 

with you all in the future! 

Warmest regards, 

Audree 

Dear Global Health Team, 

Thank you so much for the opportunity to participate in the incredible Global Health Conference! It was so wonderful 

to meet so many of our friends and partners, talk to everyone, and identify areas that we can strengthen 

our collaborations. This conference was a great learning opportunity for me personally and an inspiration for 

further development. 

Thank you very much for making this conference happen! 


Bulat 

Dear Majid – 

After being inspired by the WCHN Global Health Conference, I finished the faculty development piece which will 

be useful for the network and the consortium. 

Best wishes, 

Jeff Wong 

Dear Team. 

We had a wonderful time and are very happy to have met old and new colleagues. 

Robert Kalyesubula 

Dear All, 

It was so insightful to interact as the so-called United Nations, and wonderful knowing that all of us were there 

for one cause: to cultivate a world of global citizens. 

Katali Estherloy 

242


I am back at work. 

First of all, I’d like to thank the global health team for making my trip to the U.S. such a wonderful one. I 

appreciate your hospitality. 

My thanks go to all of you – my new colleagues - for sharing your thoughts and experiences through conference 

presentations and discussions. 

I believe that this event has brought us closer together. It is also an effective way to increase engagement with 


Again, thank you very much. 

Best regards, 

Lan Phuong, 

Choray hospital, Vietnam 

Thank you for sharing this wonderful photo of such a wonderful group! It was so lovely to see old friends and 

make new ones, and I’m very much looking forward to working (and playing!) with you all in the year ahead! 

Warmest wishes for safe return home for all the internationals! 

Carole Whitaker 


Thank you for sharing the photos. Thank you especially for the opportunity to participate in the excellent 

conference—a great opportunity for networking and creating more partnerships with your teams! 

Rhoda 

The pictures are beautiful. Thank you so much. 

Best wishes, 

Prof Masanganise 

Thank you for sharing the beautiful photos. 

Robert 

Thank you so much for the beautiful photos. 

Dr. Lan Phuong and Dr. Uyen 

243

PHOTO GALLERY 

Photos courtesy of Kvon photography 

DAY 1: SUNDAY INTRODUCTORY DINNER AT THE ETHAN ALLEN HOTEL 

The introductory dinner provided an opportunity for everyone to meet members from each domestic and 

international site and learn about their respective strengths. Delegates from each partner institution were called 

upon and introduced, followed by a summary of that site’s unique qualities and characteristics. As members 

looked around the room, many were matching faces to names they had heard or seen in their email inboxes. 

Global Health Program members at the Ethan Allen Hotel courtyard 

244

Dr. Majid Sadigh introducing members at the introductory 

dinner 

Dr. Rangairira Masanganise, Dean of the University of 

Zimbabwe College of Health Sciences (left) and Dr. Rhoda 

Wanyenze, Dean of the Makerere University School of 

Public Health (right) 

Eva Landegger, a friend of the Global Health Program 

(left) and Sister Jane Frances Nakafeero, Director of 

Saint Francis Naggalama Hospital (right) 

Dr. Marcos Nunez, Dean of UNIBE (left) and Dr. Jeffrey 

Wong, Associate Dean of Medical Education at the 

Pennsylvania State University College of Medicine (right) 

Dr. Jonathan Melk, CEO of Chiricahua Community Health 

Centers (left) and Dr. Peishi Yan, Global Health Program 

Site Director at Dalian Municipal Central Hospital (right) 

(left to right) Dr. Marcos Nunez, Dean of UNIBE; Dr. Robert 

Jarrett, Founder of Hearts Around the World; and Dean 

Prachyapan “Menn” Petchuay, Dean of Walailak University 


245

MONDAY MORNING: DAY 2: SMALL GROUP MEETINGS 

The introductory dinner provided an opportunity for everyone to meet members from each domestic and 

international site and learn about their respective strengths. Delegates from each partner institution were called 

upon and introduced, followed by a summary of that site’s unique qualities and characteristics. As members 

looked around the room, many were matching faces to names they had heard or seen in their email inboxes. 

LUNCHEON 

More guests joined from UVMLCOM, AUC, RUSM, and SHU for the conference after lunch. 

MONDAY CONFERENCE: 

Photos courtesy of Sean Nuremberg 

Keynote speaker: Grace Herrick: “ Sense of Community, 

What Uganda Gave Me” 

Global Health Program members at the WCHN Global 

Health Conference panel sessions 

Dr. Stephen Winter, Senior Advisor for the Global Health Program; Dr. Randi Diamond, Global Health Program Site Co- 

Director at Saint Francis Naggalama Hospital; and Sister Jane Frances Nakafeero, Director of Saint Francis Naggalama 

Hospital 

246

Dr. Robert Kalyesubula, Co-Founder of the African 

Community Center for Social Sustainability (ACCESS) 

Dr. Anne Dougherty, Director of the Global Women’s 

Health Program at UVMLCOM, speaking about gender 

inequalities in global health 

Dr. Margaret Tandoh, Associate Dean for Diversity & 

Inclusion, and Assistant Professor of Surgery at UVMLCOM 

Dr. Robyn Scatena, Associate Director of Global Health 

at Norwalk Hospital speaking about sexual harassment in 

global health 

Dr. Molly Moore, Director of Global Health at the 

UVMLCOM Department of Pediatrics 

Dr. Swapnil Parve, Global Health Program Site Director at 

Datta Meghe Institute of Medical Sciences (DMIMS), India 

247

Photos courtesy of Kvon photography 

Eva and Christian J. Trefz, donors of the Christian J. Trefz Family Endowed Chair in Global Health at WCHN 

248

COCKTAIL HOUR: 

This gave new invitees a chance to socialize with domestic and international partners. Among the invitees was 

the Trefz family and many other generous donors, the Western Connecticut Health Network Foundation, and 

representatives from the University of Vermont Larner College of Medicine, Health Quest, Western Connecticut 

Health Network, Sacred Heart University, American University of the Caribbean, ROSS University School of 

Medicine, and Linde. 

Global Health Program members mingling and networking 

during Cocktail Hour 

Trefz family members with Dr. Stephen Winter, Senior 

Advisor for the Global Health Program 

Dr. John M. Murphy, CEO of Nuvance Health (left) with Dr. 

Jonathan Fine, former Designated Institution Official at 

WCHN 

Dr. Catherine Kwagala, Medical Director at St. Stephen’s 

Hospital; Dr. Peishi Yan, Global Health Program Site 

Director at Site Director of Dalian Municipal Central 

Hospital; and Dr. Mariah McNamara, Associate Director of 

Global Health at UVMLCOM 

Dr. Richard L. Page, Dean of UVMLCOM (left) with Dr. Katie 

Wells, MPH, Emergency Medicine Physician at UVMLCOM 

Dr. Peishi Yan, Global Health Program Site Director at 

Dalian Municipal Central Hospital; Dr. John M. Murphy, 

CEO of Nuvance; Dr. Robert Jarrett, Co-Founder of Hearts 

Around the World; Dr. Marcos Nunez, Dean of UNIBE; Mrs. 

Minoo Jarrett, Co-Founder of Hearts Around the World; 

and Dr. Marat Mukhamedyarov, Vice Rector of KSMU 

249

Dr. Bulat Ziganshin, Director of Global Health at AUC/RUSM; Mrs. Minoo Jarrett and Dr. Robert Jarrett, Co-Founders of 

Hearts Around the World; Dr. Marat Mukhamedyarov, Vice Rector of KSMU; Dr. Peishi Yan, Global Health Program Site 

Director at Dalian Municipal Central Hospital; Dr. Marcos Nunez, Dean of UNIBE; Dr. Ziganishin and Dr. Ziganshina; Dr. 

Swapnil Parve, Global Health Program Site Director at DMIMS; Dr. Catherine Kwagala, Medical Director of St. Stephen’s 

Hospital; and Dr. Jeffrey Wong, Associate Dean of Medical Education at the Pennsylvania State College of Medicine 

(left to right) Dr. Paul Wright, Assistant Vice President 

of Neurosciences at Health Quest Medical Practice 

Division of Neurosciences; Dr. Chris Stenberg, Designated 

Institution Official and Vice President of Graduate Medical 

Education at Health Quest; and Dr. Jonathan Rosen, 

UVMLCOM Associate Dean of the WCHN Clinical Campus 

(left to right) Mr. Martin Scholand, Dr. Stephen Scholand, 

Global Health Program Site Director in Thailand, Vietnam, 

and Zimbabwe; Mrs. Connie Scholand, and Mr. Truong 

Nguyen, a lifelong friend of the Scholand family 

250

(left to right) Christian J. Trefz, donor of the Christian J. 

Trefz Family Endowed Chair in Global Health at WCHN; Dr. 

Howard Eison, Global Health Program Site Co-Director at 

Saint Francis Naggalama Hospital; and 

Grace Linhard, Chief Development Officer at WCHN 

Dr. Aparna Oltikar, Chair of the Department of Medicine 

at Danbury Hospital (left) with Dr. Jonathan Melk, CEO of 

Chiricahua Community Health Centers (right) 

OPENING DINNER: 

Jo and John Luicci, donors of the Jo and John Luicci 

Endowed Chair in Emergency Medicine at Danbury 

Hospital 

Invitees settling in for the dinner and awards ceremony 

(left to right) Dr. Jay and Patricia Weiner, members of the 

Global Health Program; Dr. Swapnil Parve, Global Health 

Program Site Director at DMIMS; and Dr. Robert Jarrett, Co 

Founder of Hearts Around the World 

Mitra Sadigh, Writer, Editor, and Researcher at the Global 

Health Program reciting “The World of the Global Health” 

251

OPENING REMARKS: 

Dr. John M. Murphy, CEO of Nuvance 

Health 

Dr. Richard L. Page, Dean of 

UVMLCOM 

Mr. Todd Skare, Chief Technology 

Officer at Linde speaking about Linde’s 

role in global medical technology and 

healthcare delivery 

Dr. Mariah McNamara, Associate Director of Global 

Health at UVMLCOM, speaking at the dinner 

Dr. Majid Sadigh, Christian J. Trefz Family Endowed Chair 

in Global Health at WCHN and Director of Global Health at 

UVMLCOM addressing the attendees at dinner 

252

AWARDS: 

Sister Jane Frances Award 

This award recognizes a student who observes tragedies in underserved communities, but overcomes the initial 

transient anger or frustration to find a creative solution and implements it with hard work and dedication. 

(left to right) Sister Jane Frances Nakafeero, Director of Saint Frances Naggalama Hospital presenting the award to Ms. 

Grace Herrick, Founder of Grace’s Promise 

Recipient of the 

Linde Excellence In 

Mentoring Award: 

Dr. Javed Shahid, 

Neurosurgeon at WCHN 

The Linde Excellence in Mentoring 

Award recognizes a community 

physician or faculty member who has 

excelled at mentoring Global Health 

Scholars in achieving their career 

objectives through moral, social, and 

intellectual support. 

Todd Skare, Technology Officer at Linde (left) presenting the award to Dr. 

Javed Shahid, neurosurgeon at WCHN (right) 

253

Recipients of the John M. Murphy, MD Leadership Award: Amanda 

Wallace, Multimedia Specialist at WCHN, and Mitra Sadigh, Writer, 

Editor, and Researcher at the Global Health Program 

John M. Murphy, MD Leadership Award: This award recognizes a member of the global health family at WCHN 

who demonstrates innovative, initiative driven leadership impacting the program and beyond. 


Health Program (left) and Carole Whitaker, Associate 

Dean of Communications at UVMLCOM (right) 

Amanda Wallace, Multimedia Specialist at WCHN (left) 

and Lauri Lennon, Director of Business Operations, 

Medical Education, Research and Innovation at WCHN 

(right) 

Dr. Majid Sadigh dedicating “Sequences of Light and 

Dark,” a book about the 2014 Ebola epidemic in Liberia, 

to Dr. John M. Murphy 

Ms. Dalia Martinez reciting “Abraham Lincoln Walks at 

Midnight” by Vachel Lindsay 

254

Recipient of the Path to Excellence Award: Dr. John M. Murphy 

Professor Marat Mukhamedyarov, Vice Rector of KSMU, 

delivering Rector Sozinov’s gift to Dr. John M. Murphy 

Professor Marat Mukhamedyarov, Vice Rector of KSMU 

delivering Rector Sozinov’s message to Dr. John M. Murphy 

Christian J. Trefz and Dr. Majid Sadigh, the Christian J. 

Trefz Family Endowed Chair in Global Health at WCHN 

255

TUESDAY: MEDICAL GRAND ROUNDS 

Tuesday morning, Dr. John M. Murphy, CEO of Nuvance Health, delivered his talk about the history of the Global 

Health Program and his methods of adhering to the mission early on despite the lack of programmatic and 

financial support. 

Dr. John M. Murphy, CEO of Nuvance Health delivering the 

Grand Rounds presentation 

Richard L. Page, Dean of UVMLCOM, delivering remarks 

about Dr. John M. Murphy’s, CEO of Nuvance Health, 

grand rounds presentation 

Grand Rounds attendees attentively listening to 

Dr. John M. Murphy’s, CEO of Nuvance Health, 

presentation 

Grand Rounds attendees attentively listening to Dr. John 

M. Murphy’s, CEO of Nuvance Health, presentation 

256

POSTER, REFLECTION, AND PHOTO EXHIBITION 

Global Health Program members at the Photo and Poster Exhibition hosted at Danbury Hospital 

Dr. Marcos Nunez, Dean of UNIBE, with Sister Jane Frances 

Nakafeero, Director of Saint Francis Naggalama Hospital 

Global Health Program members mingling and admiring 

posters 

Sister Jane Frances Nakafeero, Director of Saint 

Francis Naggalama Hospital (left) with Dr. Damanjeet 

Chaubey, Medical Director of Palliative Care and Denial 

Management at WCHN and Andrew Cruz Endowed Chair in 

Palliative Care (right) 

257

LINDE HEADQUARTERS 

Global Health Program leadership moved to Linde for a brainstorming session geared toward identifying one 

theme for multinational and domestic partnerships for future collaborations. Lisa Esneault, Vice President of Global 

Communications and Public Relations at Linde, opened the session. We are grateful to Linde for their hospitality 

and for providing such a wonderful space. 

On the way to Linde Headquarters 

Lisa Esneault, Vice President of Global Communications 

and Public Relations at Linde speaking with Dr. Hoang 

Lan Phuong, Director of the International Office at Cho 

Ray Hospital, and Tran Hahn Uyen, Director of the Training 

Center at Cho Ray Hospital 


and Public Relations at Linde, with Dr. Majid Sadigh, 

Christian J. Trefz Family Endowed Chair in Global Health 

at WCHN and Director of Global Health at UVMLCOM 

258


and Public Relations at Linde, 

(left to right) Nina Caraluzzi, MBA, Communications 

Manager at Linde; Kai-Lin Garrison, Global Giving 

Manager at Linde; 

and Dr. Majid Sadigh, Christian J. Trefz Family Endowed 

Chair in Global Health at WCHN and Director of 

Global Health at UVMLCOM 

Audree Frey, Global Health Program Coordinator at 

UVMLCOM, taking notes for the brainstorming session 

Dr. Benjamin Clements, Director of Global Health at 

the UVMLCOM Family Medicine Department making a 

comment at the brainstorming session facilitated by Dr. 

Mariah McNamara, Associate Director of Global Health at 

UVMLCOM 

(left to right) Christa Maria Zehle, Interim Senior Associate 

Dean for Medical Education; Lauri Lennon, Director of 

Business Operations, Medical Education, Research and 

Innovation at WCHN; Ms. Dalia Martinez, Global Health 

Conference volunteer; and Dr. Stephen Scholand, Founder 

of Rabies Free World and Global Health Program Site 

Director in Thailand, Vietnam, and Zimbabwe 

259


Health Program; Dr. Naomi Hodde, Internal Medicine 

Faculty at UVMLCOM; Dr. Sheila Chamberlin, Orthoptist 

at UVM Medical Center; and Dr. Rangairira Masanganise, 

Dean of the University of Zimbabwe College of Health 

Sciences 

(left to right) Christa Maria Zehle, Interim Senior Associate 

Dean for Medical Education;Mary Shah, Medical Librarian 

and Archivist at WCHN; and Dr. Tran Hahn Uyen, Global 

Health Program Coordinator at the Cho Ray Hospital 

Training Center 

(left to right) Dr. Jonathan Melk, Director of Global Health 

at Home at Chiricahua Community Health Centers; Dr. 

Marcos Nunez, Dean of UNIBE; Dr. Swapnil Parve, Global 

Health Program Site Director at DMIMS; and Dr. Marat 

Mukhamedyarov, Vice Rector of KSMU 

(left to right) Dr. Margaret Tandoh, Associate Dean for 

Diversity & Inclusion, and Assistant Professor of Surgery 

at UVMLCOM; Carole Whitaker, Associate Dean of 

Communications at UVMLCOM; Dr. Catherine Kwagala, 

Medical Director at 

Saint Stephen’s Hospital; Audree Frey, Global Health 

Program Coordinator at UVMLCOM; and Laura Smith, 

Global Health Program Coordinator at WCHN 

(left to right) Mrs. Estherloy Katali, Global Health 

Coordinator at the African Community Center for Social 

Sustainability (ACCESS); Professor Rhoda Wanyenze, 

Director of the Makerere University School of Public 

Health; and Sister Jane Frances Nakafeero, Director of 

Saint Francis Naggalama Hospital 

Dr. Tran Hahn Uyen, Global Health Program Coordinator 

at the Cho Ray Hospital Training Center, and Dr. Petchuay 

Prachyapan, Dean of Walailak University School of 

Medicine 

260

TUESDAY EVENING: 

International guests and WCHN delegates enjoyed a celebratory goodbye dinner, during which Lisa Esneault, 

Vice President of Global Communications and Public Relations at Linde, thanked our domestic and international 

partners for attending the event and wished them well on their journeys and future endeavors. 

Farewell dinner with Global Health Program leaders 

With deepest gratitude we express our sincere appreciation to Linde for their generous support of the Global 

Health Program at Nuvance Health by creating the “Linde Health Educators Without Borders.” The Global Health 

Conference was a great success thanks to Linde’s valuable endorsement and commitment to our mission. It was 

a wonderful and rare opportunity for international healthcare leaders from across the globe to share their vision 

and experiences of the impact they’re making caring for the underserved throughout the world. 

But beyond Linde’s substantial financial support of our program and events, we deeply appreciate the time and 

participation for sharing in our vision to make an impact in the lives of so many throughout the globe. We are 

grateful for the personal commitments and interest Linde has shown in hosting our global health conference this 

year! 

We are truly thrilled for this new partnership and excited for the growth that Linde’s support has allowed us to 

pursue in the coming years. Thank you for standing by us, in both financial backing and mission and believing in 

the important and vital work we are doing for the global community. 

261

AFTER THE GLOBAL HEALTH PROGRAM CELEBRATION 

Dr. Stephen Scholand, Global Health Program Site Director in Thailand, Vietnam, and Zimbabwe, and Dr. Prachyapan 

“Menn” Petchuay, Dean of Walailak University School of Medicine hiking in Connecticut 

262

Click here to make a donation >> 

263

RESOURCES 





Ebola book 















Publications 





Global Health Conference 2019 Photos 

Global Health Conference 2019 Videos 

Two UVM Docs Combat Ebola in Liberia (Article) 

Majid Sadigh, MD Interview Regarding Ebola in Liberia (Video) 

My Heart Burns: Three Words Form a Memoir (Video) 

Words of Encouragement 

AUC/RUSM Annual Report 2018 

Cases and Reflections from Mulago 

264

July 2019 Volume 7 



“Behind the cloud the sun is still shining.” 

-Abraham Lincoln 



265


THE INAUGURAL GLOBAL HEALTH CONFERENCE, HONORING DR. 

JOHN MURPHY, THE CEO OF NUVANCE HEALTH, 

JUNE 3-5, 2019 

“The program and the symposium were energizing and well-executed. Capping it with Dr.John Murphy’s grand 

rounds and Dean Page’s heartfelt words put an exclamation point to all that was said.” 

-Dr. Jonathan Fine, former Designated Institution Official at WCHN 

CELEBRATING GLOBAL HEALTH WEEK 

Written by Mary Shah 

Medical Librarian and Archivist at WCHN 

Watch for a special eMagazine issue on this event in early July 

As the Global Health Program of WCHN enters its eighth year under the 

leadership of Dr. Majid Sadigh, Director of the WCHN Global Health Program and 

the Christian J. Trefz Family Endowed Chair of Global Health, and support of Dr. 

John Murphy, CEO of Nuvance Health, it continues to expand its global footprint 

with a sustainable vision. 

On June 2nd, Dr. Sadigh welcomed representatives of our global health partners from nine countries and 

numerous states to the WCHN Global Health Conference. Our domestic partners present for the event included 

the University of Vermont Larner College of Medicine, Sacred Heart University, Pennsylvania State University 

College of Medicine, Chiricahua Health Centers in Douglas, Arizona, WCHN, Health Quest (HQ), and the American 

University of the Caribbean School of Medicine. Meanwhile, our international partners included members from 

Dalian Municipal Central Hospital in China, Universidad Iboamericana in the Dominican Republic, Walailak 

University School of Medicine in Thailand, Kazan State Medical University in Russia; University of Zimbabwe 

College of Health Sciences in Zimbabwe, Cho Ray Hospital in Vietnam, and Makerere University College of Health 

Sciences, Makerere University School of Public Health, Naggalama Hospital, St. Stephen’s Hospital, and the 

African Community Center for Social Sustainability (ACCESS) in Uganda. 

Informal meetings, networking opportunities, and discussions on future projects took place, followed by thoughtprovoking 

panel sessions addressing “Building Blocks for our Partnership,” “Reflections from the Field,” “Hot Topics 

in Medical Education” and “Ethical Challenges in Short-term Global Health Clinical Experiences.” 

International and domestic partners joined WCHN and HQ members as well as donors and supporters for a dinner, 

underwritten by Linde, which preceded an evening of awards, entertainment, and celebration. Dr. John Murphy 

delivered welcoming remarks followed by Dr. Richard L. Page, Dean of the University of Vermont Larner College of 

266

Medicine, and Todd Skare, CTO of Linde Corporation. Global health testimonials were given and the group enjoyed 

interludes of song and celebration. 

Global Health Program members at the Ethan Allen Hotel courtyard 

Following dinner, the following special awards were 

presented: 

• Sister Jane Frances Award to Grace Herrick, 

Founder of Grace’s Promise, for establishing a 

preschool program in Nakaseke, Uganda 

• The Linde Excellence in Mentoring Award to Dr. S. 

Javed Shahid, neurosurgeon at WCHN 

• The John M. Murphy, MD Leadership Award to Mitra 

Sadigh, Writer/Editor at the Global Health Program, 

and Amanda Wallace, Multimedia Specialist at 

WCHN, for their innovative work on promoting 

and disseminating the work of the Global Health 

Program 

Recipient of the Path to Excellence Award: 

Dr. John Murphy, CEO of Nuvance Health 

• The Path to Excellence Award to Dr. John Murphy, 

CEO of Nuvance Health, presented by Mr. Christian 

J. Trefz 

267

Dr. John Murphy and Dr. Richard L. Page delivering welcoming remarks at the dinner hosted at Ethan Allen Hotel, 

Danbury, CT 

On June 4th, Dr. Murphy spoke on his perspective of leadership and global health as the CEO of Nuvance Health. 

Photos, posters and reflections were on display in the Robilotti Conference Center and engaging discussions, 

brainstorming sessions, and video interviews with international leaders took place at the Linde Corporate 

Headquarters in Danbury. The conference concluded with a farewell dinner sponsored by the WCHN Foundation. 

Global Health Program leadership at Linde Headquarters, Danbury, CT 

268

DR. SADIGH’S ONE-WEEK SITE-VISIT TO DALIAN, CHINA, JUNE 8-15 

Dr. Majid Sadigh with members of Dalian General Municipal 

Hospital 

During a debriefing session with Dr. Fan Wang, the 

following projects were discussed: 

Dr. Sadigh made a one-week site-visit to Dalian, 

China to learn more about the medical education and 

healthcare delivery systems at Dalian General Municipal 

Hospital (DGMH). During this visit, he met with the 

leadership of medical education including Dr. Fan Wang, 

CEO of DGMH and Mr. Qin Yue, Director of Information 

Technology at DGMH as well as chief of speciality 

departments and fellows, residents, and students. 

Meanwhile, Dr. Sadigh delivered many lectures on 

global health, tropical medicine, evidence-based 

medicine, and biostatistics as well as the American 

medical education and healthcare delivery systems. He 

also conducted bedside rounds in neurology, cardiology, 

renal medicine, surgery, and MICU, and was consulted 

in reference to multiple patients. 

1. Establishing an annual medical education 

conference in Dalian to introduce new medical 

education methods to a broad audience from all 

over Dalian and northern China. The date of this 

one to two-day conference is projected for early 

June. 

2. Building a new medical residency program modeled 

after the American program. 

3. Selecting and inviting two nurses and two faculty 

from Dalian to Nuvance Health for a month 

of training in medical and nursing education. 

These four individuals were selected following an 

interview session. 

4. Sending faculty and residents from UVMLCOM, 

Nuvance Health, Sacred Heart University, ROSS 

University School of Medicine, and American 

University of the Caribbean to Dalian Central 

Municipal Hospital. In the future, this group will be 

instrumental in building the new residency program 

in medicine. 

269

Dr. Sadigh was welcomed by Mr. Qin Yue, Director of 

Dalian Municipal Central Hospital, on June 8th. The next 

day, Mr. Qin Que accompanied him through sightseeing 

of Dalian harbor and nearby surroundings. 

Outpatient Clinic in Dalian, China 

On June 10th, Dr. Sadigh held a three-hour session 

with the leaders of medical education at Dalian 

Municipal Central Hospital (DMCH) about the structure 

and function of the WCHN Global health program. Later 

that afternoon he held an interactive session about 

the undergraduate and graduate medical education 

systems in the U.S., during which the strengths and 

improvement areas of the Dalian medical education and 

American medical education systems were discussed. 

Outpatient Clinic in Dalian, China 

In late afternoon, Dr. Sadigh had a dinner meeting with 

Dr. Wang, CEO of DMCH, and Mr. Qin Yue, Director of 

DMCH. 

Dr. Fan Wang, CEO of DMCH (left) and Mr. Qin Yue, Director 

of DMCH (right) 

Dr. Sadigh spent four hours on June 11th in the neurology department conducting bedside rounds and discussing 

puzzling cases with neurological findings. He also discussed clinical training in the U.S. with the medical education 

leadership of this section. That afternoon, he held an interactive session with selected medical educators about 

hot topics in tropical medicine. 

270

Dr. Sadigh spent four hours on June 11th in the neurology department conducting bedside rounds and discussing 

puzzling cases with neurological findings. He also discussed clinical training in the U.S. with the medical education 

leadership of this section. That afternoon, he held an interactive session with selected medical educators about 

hot topics in tropical medicine. 

Dr. Sadigh spent the morning of June 12th in the surgery department with DMCH leadership and faculty conducting 

bedside rounds and discussing challenges in medical education and clinical practice. 

271

That afternoon, he held a session on evidence-based medicine, biostatistics, and creation of a journal club with 

selected faculty and PhD students. 

Dr. Sadigh spent the morning of June 13th in the cardiology ward rounding with students, residents, and faculty, 

and holding a discussion about clinical medicine in the U.S. 

272

He later met with selected residents and students to become more familiar with the structure of medical education 

in China. 

Dr. Sadigh spent the morning of June 14th in the 

Department of Nephrology and Hemodialysis where he 

conducted bedside rounds and held a discussion about 

a patient with fever of Unknown Origin (FUO) and met 

with a group of students and residents to become more 

familiar with medical education in China. 

That afternoon, he had a debriefing session with Dr. Fan 

Wang, CEO of DMCH; Mr. Qin Yue, Director of DMCH; 

and several members from the medical education 

department to discuss the essential elements of the 

collaboration between DMCH and the UVMLCOM/WCHN 


He later interviewed and selected two nursing staff and 

two faculty members to come to WCHN for a month 

of training in medical and nursing education while 

familiarizing with the U.S. healthcare system. 

273

(left to right) Mr. Qin Yue, Director of DMCH; Dr. Fan Wang, CEO of DMCH; Dr. Sadigh, and nurses and doctors selected for training 

in medical education and healthcare delivery systems at WCHN 

BOOT CAMP AT UVMLCOM 

This report has been prepared by Audree Frey 

UVMLCOM Global Health Coordinator 

On June 22, the UVMLCOM Global Health Leadership 

Team held the annual pre-departure Boot Camp Day, 

which occurs at the culmination of the bi-weekly Global 

Health Elective course that runs January through June 

for first-year medical students accepted into the Global 

Health Program. Boot Camp Day is an intensive oneday 

course held one week prior to the start of the 

students’ electives abroad, and is the final step in their 

pre-departure preparation and training. This year’s 

course was held for ten first-year UVMLCOM students 

who will be departing for their electives on July 1. 

The first half of the day included a cultural humility 

active learning exercise, safety vignettes, and case 

discussions with global health faculty. Students then 

had the opportunity to have lunch with senior students 

who have previously participated in the elective, during 

which they reviewed and discussed the Participant and 

Safety Guides for their respective sites. 

274

The afternoon consisted of three simulation cases 

using volunteer standardized patients and physicians, 

designed to give students a realistic picture of what 

taking care of patients might look like at our partner 

sites. The day concluded with an in-depth debrief 

of the cases and time for students to ask their lastminute 

logistical questions. After preparing over the 

past six months and completing their Boot Camp Day, 

the students are very excited to embark on their first 

global health elective! We look forward to reading their 

reflections as they progress through their rotations. 

First-year UVMLCOM students participating in a simulation 

activity at UVMLCOM Boot Camp Day in preparation for 

their global health elective 

PERSPECTIVES 


Sexual- and gender-based harassment and violence are gradually emerging from tabooed obscurity and entering 

the global consciousness. What were once accepted as facts of life are slowly being called into question as 

overturnable systems of oppression. It is pertinent that we demonstrate our commitment to gender equality 

and safety for all human beings by using this momentum to create platforms for further investigation. Over the 

next few months, we hope to create one here for our global health community. We encourage our members, 

particularly those from the Global South, to join the discussion by sending us their thoughts and insights in the 

form of perspective pieces. 

Written by Katrin Sadigh, MD 

Global Health Fogarty Fellow, Brigham and Women’s Hospital Boston/Botswana Harvard 

Partnership 

There is no other way to discuss the topic of sexual harassment but to 

begin bluntly—sexual harassment happens almost everywhere and with 

great frequency. An online survey performed by Stop Street Harassment, 

a nonprofit based in the United States, reported in February 2018 that 

81% of women and 43% of men have experienced some form of sexual 

harassment. Additionally, 66% of women reported that this harassment 

occurred in public spaces, while 38% reported it at the workplace.1 Based 

on WHO reports, 75% of the world’s 2.7 billion women aged 18 and older 

have experienced sexual harassment.2 

Recently there have been increasing efforts to counter the culture 

of tolerance of sexual harassment, to dispel the shroud of silence that 

surrounds it, and to protect those who come forward to report perpetrators. 

UN Women reports that roughly 144 countries have passed laws on 

275

There is no other way to discuss the topic of sexual harassment but to begin bluntly—sexual harassment happens 

almost everywhere and with great frequency. An online survey performed by Stop Street Harassment, a nonprofit 

based in the United States, reported in February 2018 that 81% of women and 43% of men have experienced 

some form of sexual harassment. Additionally, 66% of women reported that this harassment occurred in public 

spaces, while 38% reported it at the workplace.1 Based on WHO reports, 75% of the world’s 2.7 billion women 

aged 18 and older have experienced sexual harassment.2 

Recently there have been increasing efforts to counter the culture of tolerance of sexual harassment, to dispel the 

shroud of silence that surrounds it, and to protect those who come forward to report perpetrators. UN Women 

reports that roughly 144 countries have passed laws on domestic violence while 154 countries have laws on 

sexual harassment (though these laws may not comply with international standards or be implemented). Last 

year, a new position was created at UN Women to focus specifically on addressing sexual harassment both within 

the United Nations and worldwide.3 This process was jump-started and accelerated by the Me Too movement, 

founded by activist Tarana Burke in 2006 in the United States, which she has stated “is part of a collective vision to 

see a world free of sexual violence… a movement about one in four girls and the one in six boys who are sexually 

abused every year, and who carry those wounds into adulthood.”4 The viral hashtag #MeToo transformed the 

movement into a sweeping global phenomenon after the Harvey Weinstein sexual abuse allegations, providing 

the passion and infrastructure of a widespread grassroots movement with measurable impact as far as Sweden, 

Egypt, and South Korea.5 

#MeToo has also fueled other campaigns worldwide, including #NotYourHabibti (“Not your sweetheart”) in the 

Palestinian territories,6 #NiUnaMenos (“Not one [woman] less”) in Argentina7 and #MosqueMeToo, which focuses 

on sexual abuse that occurs during the pilgrimage to Meccan,8 among many others. Unfortunately, as farreaching 

as the global conversation has become regarding sexual harassment and other more aggressive forms 

of gender-based inequity, not all of these movements have gained traction in many countries including throughout 

sub-Saharan Africa, China, and Russia,9 and some have actually had the opposite effect. After women in Japan 

proclaiming #MeToo were targeted and shamed, a variant #WeToo was created in an effort to display a united 

front. Yet even this herculean effort can have limited impact in a country like Japan where sexual harassment is 

not a criminal offense,10 or in Russia where the terms “harassment” or “sexual harassment” do not even have a 

place in legislation.11 

While the reasons for why the Me Too movement has spread like wildfire in some areas and fizzled out in others 

are myriad and complex, it is important to note that it did not arise spontaneously. Rather, it arose through a 

culmination of well-defined and highly organized preludes advocating for and demanding equal rights for women 

in the backdrop of a country that fought hard for civil rights in the 1950s and 1960s and for women’s rights 

in the 1960s through 1980s. This is not to say that countries more impervious to the influence of the #MeToo 

movement have not attempted to redefine the societal measure of women or to address gender-based offenses. 

Indeed, even prior to #MeToo, other activist movements have taken on issues from sexual violence to bans on 

dress codes across the continent of Africa and elsewhere.12 Yet despite these efforts, many women worldwide 

continue to fight for their rights, with many odds against them, with neither the resources nor the protections in 

place to address sexual harassment and other forms of violence against women. 

articipants of global health programs, particularly women, often note an increase in unwanted attention, sexual 

politics, and other more nefarious forms of harassment when living and working in the host country. One reason for 

this is relatively straightforward, and relates to being in a new environment. We cannot rely on the same defense 

mechanisms and other modifications to our daily behavior that we had implemented in our home countries to 

minimize our risk of confronting sexual harassment and other threatening behavior. Perhaps more importantly, 

when working in a foreign setting, we lack the deep understanding of the social and cultural intricacies defining 

276

ehavior, mannerisms, and both nonverbal and verbal communication. We also are unaware of the laws governing 

sexual equity and the avenues for recourse, both institutional or otherwise. Thus we may be burdened not only 

by the weight of sexual harassment that we experience on the streets or in our professional lives, but also by the 

inability to effectively address, or in some cases even understand it. 

In these situations, there is no resource more valuable than our trusted friends and colleagues in the host 

countries. They can serve as good listeners. They can provide essential context in more ambiguous scenarios, and 

suggest a method or approach to handling particularly difficult situations. They can help us navigate reporting 

mechanisms if such exist. They can offer empathy and recount their own experiences with sexual harassment or 

that of their family members or friends. 

And this may prove to be our greatest challenge—not the harassment that we personally encounter, but bearing 

witness to forms of sexual harassment, both flagrant and subtle, by our friends, colleagues, and even those 

unknown to us, in the host countries. Ultimately, as difficult as incidents of sexual harassment or aggression may 

be for us, we can rely on the support and resources of both our host and home institutions. We can return to our 

home countries where we can find some comfort in the turning of the tide on issues of gender equity, where the 

threat of sexual harassment as a public health issue has finally been given the attention it deserves.13 This is 

more than most can say in the countries we may be working. 

As members of the global health community, it is our responsibility to stand by others confronting such harassment, 

and to push for intolerance of sexual- and gender-based violence. We must not be satisfied until all communities 

of the world begin to engage in serious discussion on these issues, and all women can expect a safe living and 

working environment. But we must proceed with patience and a recognition of the deeply rooted cultural and 

institutional mechanisms within which gender inequality and misogyny have bred. This week alone, despite all 

of the progress made towards securing the safety and security of women, the United Nations was forced to 

compromise on its most recent resolution on the reproductive and health rights of survivors of sexual violence.14 

We cannot remain ambivalent, nor can we let down our guard. 

1. http://www.stopstreetharassment.org/resources/2018-national-sexual-abuse-report/ 

2. http://www.globalissues.org/news/2018/02/01/23899 

3. http://www.unwomen.org/en/news/stories/2018/7/take-five-purna-sen 

4. https://www.bbc.com/news/world-46393369 

5. https://foreignpolicy.com/2019/03/07/metooglobalimpactinternationalwomens-day/ 

6. https://www.pri.org/stories/2018-02-02/she-started-notyourhabibti-shine-light-sexual-harassmentpalestinian-territories 

7. https://www.pri.org/stories/2017-11-03/dangers-reporting-femicide-argentina 

8. https://www.pri.org/stories/2018-03-14/muslim-women-are-speaking-out-against-abuse-mosquemetoo 

9. https://www.washingtonpost.com/world/a-year-after-it-began-has-metoo-become-a-globalmovement/2018/10/05/1fc0929e-c71a-11e8-9c0f-2ffaf6d422aa_story.html?utm_term=.806ad9c77fbf 

10. https://www.pri.org/stories/2018-11-08/japan-sexual-harassment-isn-t-crime-women-who-say-metoo-aretargets 

11. https://www.themoscowtimes.com/2018/04/04/harassment-of-women-in-russia-has-to-end-op-ed-a60976 

12. https://africasacountry.com/2018/07/metoo-africa-and-the-politics-of-transnational-activism 

13. O’Neil A, Sojo V, Fileborn B, Scovelle AJ, Milner A. The #MeToo movement: an opportunity in public health? 

Lancet 2018; 391:2587-2589. 

14. https://www.theguardian.com/global-development/2019/apr/23/un-resolution-passes-trump-us-vetothreat-abortion-language-removed 

277

Written by Jeffrey Wong, MD 

Associate Dean of Medical Education and Professor of Medicine at Pennsylvania State College of 

Medicine 

Dr. Wong is an active member of the UVMLCOM/WCHN Global Health Program, where he has frequently traveled 

to our partner sites to supervise medical students as well trained our faculty in the Stanford Faculty Development 

Program. We are grateful that he attended the WCHN Global Health Conference and hope he will continue sharing 

his insights by teaching at the Global Health Academy. 

The Western Connecticut Health Network / University of Vermont 

Larner College of Medicine Global Health program is arguably one 

of the better organized and more effective global health programs 

presently in existence. Recently, an Inaugural International 

Conference celebrating the successes of the program was 

hosted in Danbury, CT where program members from China, the 

Dominican Republic, India, Russia, Thailand, Uganda, Vietnam, 

Zimbabwe, and various U.S. states were present. The conference 

was extremely successful as a plethora of amazing projects 

ongoing throughout the world were reported in plenary sessions. 

In between formal presentations, tremendous opportunities for 

networking with the conference attendees was encouraged. 

I was extremely fortunate to be invited to this gathering, not as an expert in global health but as someone 

with international experience in the realm of faculty development and helping teachers become more effective 

teachers of medical learners. A primary driver of all the global health efforts in this rapidly developing consortium 

is to foster active engagement of young physician-trainees - both within medical school as well as in residencies 

- as they perform their work within host countries. The physician-teachers assigned to supervise these learners 

are frequently busy clinicians who, while knowledgeable about their discipline and generous with their time and 

efforts, may not have ever been trained in the art of teaching. As a result, the effectiveness of the educational 

experiences that learners report can be highly variable. 

This situation - busy clinicians teaching with underdeveloped teaching skills - was the norm in the United States 

through the end of the twentieth century. By the early 1980s, several medical educators were recognizing 

deficiencies within the medical education system and began studying the problem. One such educator, Dr. Kelley 

Skeff, completed his internal medicine residency at Stanford University and then went on to complete a PhD in 

education. As part of his doctoral thesis, through qualitative research methodologies, he developed and analyzed 

an educational framework of teaching behaviors that were related to effectiveness in clinical teaching settings. He 

and a colleague in cognitive psychology, Georgette Stratos, PhD, developed what has now become internationally 

known as the Stanford Faculty Development Program (SFDP) model of faculty development. Over the past forty 

years or so, Drs. Skeff and Stratos have trained teachers as facilitators of this model and it has been widely 

studied, validated, and accepted throughout the world as an effective tool for helping busy clinicians become 

more effective teachers for medical learners. 

The SFDC Faculty Development program for Medical Teachers concentrates on the process of clinical teaching. 

The program identifies specific behaviors (techniques) that teachers can use to help them become more effective 

for a wide variety of learners in a multitude of teaching venues and situations. These behaviors may be used in all 

types of teaching settings and without regard to the specific topic of interest. Graduates of the program feel that 

278

these techniques are fully applicable to the patient care setting as well. By concentrating on specific low-inference 

behaviors, the process of teaching can better be discussed, analyzed, and subsequently improved. 

I trained in the SFDP model in 1992 and quickly became involved with resident and faculty teaching in several 

academic institutions in the United States. In 2000, through the mentorship of Dr. Majid Sadigh, I presented 

the faculty development workshops to four Kazan State Medical University (KSMU) faculty members who were 

visiting in the United States. This led to an invitation in 2001 to travel to Kazan to teach Russian faculty members 

this educational model that was culturally different than the more traditional Russian fashion of teaching, and 

that engages learners in a vibrant and inclusive manner. Over the past eighteen years, I have continued to work 

with the KSMU faculty and to date have trained, in some fashion, over 140 faculty members, residents, and 

medical students. I have also been fortunate enough to present similar workshops at several other international 

medical universities including Claude Bernard Universite in Lyon, France; Universidad de Navarra in Pamplona, 

Spain; ZheJiang University in Hangzhou, China; National University of Singapore and SingHealth in Singapore; 

American International University in St. Lucia, WI; University of Tokyo, Kyoto University, Hokkaido University and 

Kyushu University in Japan; and most recently, Universidad Iboamericana (UNIBE) in Santo Domingo, Dominican 

Republic. 

This faculty development work takes a successful educational model (the SFDP model) and attempts to transport 

that model, educationally and culturally, from the U.S. to the host country. While much of the work has been 

done in the English language, adaptations into Russian and Japanese already exist and plans are underway for 

the development of a Spanish adaptation as well. The purpose of creating these adaptations and customizations 

is to build and develop the human resource capacity within home institutions to carry on this necessary faculty 

development work into the future. 

If the various partners within the UVMLCOM/WCHN Global Health Program discover a need for faculty development 

and “teach the teacher” training, the SFDP model could prove to be a useful place to start. If anyone is interested 

or would like to discuss things further, I would be pleased to offer whatever help or assistance I can. Please feel 

free to contact me through email at jwong2@pennstatehealth.psu.edu. 

Selected References: 

1. Skeff KM, Stratos GA, Campbell M, Cooke M, Jones HW. Evaluation of the seminar method to improve clinical teaching. J Gen Intern Med 

1986; 1:315-322. 

2. Litzelman DK, Stratos GA, Marriott DJ, Skeff KM. Factorial Validation of a widely disseminated educational framework for evaluating clinical 

teachers. Acad Med 1998; 73(6): 688-695. 

3. Skeff KM, Stratos GA, Berman J, Bergen MR. Improving Clinical Teaching – Evaluation of a national dissemination program. Arch Intern 

Med 1992; 152:1156-1161. 

4. Litzelman DK, Westmoreland GR, Skeff KM, Stratos GA. Factorial validation of an educational framework using residents’ evaluations of 

clinician-educators. Acad Med 1999; 74(10 Suppl): S25-S27. 

5. ohansson J, Skeff K, Stratos, G. Clinical Teaching Improvement: The Transportability of the Stanford Faculty Development Program. 

Medical Teacher 2009; 31: e377-e382. 

6. Wong JG, Agisheva K. Cross-Cultural Faculty Development: Initial Report of an American/Russian Experience. Teach Learn Med 2004; 

16(4): 376-380. UI: 15582876 

7. Wong JG, Agisheva K. Developing Teaching Skills for Medical Educators in Russia: A Cross-Cultural Faculty Development Project. Medical 

Education 2007; 41:318-324. UI: 17316218 

8. Wong JG, Yu F. Improving clinical teaching in China: A multi-hospital pilot faculty development effort. Teach Learn Med 2012; 24(4): 

355-360. UI: 23036004 

9. Son D, Gunshin M, Wong JG. Improving Resident Teaching Through Clinical Case Conferences in Japan. Am J Med Sci 2016; 352(5): 

531-532. UI: 27865302 

10. Wong JG, Son D, Miura W. Cross-cultural Inter-professional Faculty Development in Japan: Results of an Integrated Workshop for Clinical 

Teachers. Am J Med Sci 2017; 354(6): 597-602. UI: 29208257 

279

Written by Dr. Stacey Sassaman 

Medical Simulation Teaching Assistant, RUSM 

I volunteered in mission trips in high school, and later to help those with 

less resources in urban Philadelphia during my college career. I did not 

simply want to become a physician; I wanted my career to be a tool to 

help those less fortunate. During the medical school application process, I 

sought out schools with opportunities that aligned with these goals. This led 

me to Ross University whose Salybia Mission Project is markedly unique. A 

non-profit organization founded and run by Ross students, it provides free 

health screenings to the last remaining indigenous tribe of the Caribbean. 

I became involved with Salybia Mission Project from the beginning of my 

didactic years in Dominica. The island itself is already a resource-limited, 

impoverished nation, and yet the Kalinago people - the native tribes people 

of the island - are always the last to receive these limited resources. For 

example, nine months following widespread devastation from Hurricane 

Maria, 75% of Dominica was still without electricity, and the Kalinago 

territory was the last to have restoration of power. I was drawn to help this 

vulnerable population through several positions while in Dominica through 

health education and clinic coordination. 

Experiences with the Salybia Mission Project 

A particular stand-out moment from this experience was during a special women’s health clinic where I recruited 

an OB/GYN to perform pelvic exams and wet mounts for the Kalinago women. I was shocked to find out that a 

majority of women in their thirties and forties had never had a pelvic exam or pap smear. Meanwhile, those who 

had a pap test likely did not follow up for their results because they did not have transportation to carry them 

through the hours-long travel to the capital city hospital. It seemed so unfair to me that we have been able to 

significantly decrease the rate of cervical cancer in the Global North due to simple, affordable, accessible screening 

tests, yet these tests were unaffordable or even unheard of in this less fortunate nation. I knew bringing an OB/ 

GYN to the clinic for one day would not solve this issue, but maybe it could cause a small ripple of awareness that 

could eventually lead to improved screening. 

At this clinic, we saw a patient in her early thirties who had never had a pelvic exam but complained of a 

malodorous discharge for the past few months. Suspicious of bacterial vaginosis, we prepared for a pelvic exam 

and wet mount. As the doctor inserted the speculum, I was surprised when I did not see a smooth, textbook 

cervix, but instead a highly irregular surface. I knew something was not right, but it was like nothing I had ever 

seen in my studies. The doctor urged the patient to go to the main hospital for a pap test and follow-up care, 

sharing his thought process to a fellow student and I afterwards. He explained how such advanced irregularity 

was likely cervical cancer, and that we were unlikely to see anything like it again in our schooling or careers due 

to the excellence of screening and care in the US and Canada. 

This all seemed too unfair to me. If there were women out there who did not have the means or resources to 

prevent cervical cancer as we do in the Global North, why not make an effort to bridge that gap and provide 

greater screening and prevention globally? In this moment I knew I would not be meeting my full potential as 

a physician if I were to focus only on providing positive outcomes for my patients in the U.S., but that I had a 

280

passion for providing better outcomes for patients everywhere, and needed to dedicate parts of my career to this 

goal. Following this, I stayed highly involved in Salybia Mission Project, even after leaving Dominica. I was then 

inspired to complete a global health rotation and pursue a residency program with a global health focus. 

The Global Health Elective in Uganda 

My global health rotation at Kiruddu and Kawempe Hospitals in Uganda was one of the greatest experiences 

of my life, both personally and professionally. In those six weeks, I cycled through a rollercoaster of emotions: 

overjoyed, sad, inspired, frustrated, shocked, overwhelmed, and loved. I witnessed some of the most shocking 

events and conditions, some I never imagined I would see in my lifetime. Yet I found profound support and 

guidance from people who were previously strangers. The Ugandan people, especially my host family and those 

I worked with in the hospital, were some of the kindest people I have ever met. They taught me that when you 

peel away the layers of culture, language, upbringing, experience, and status, all people possess the same core 

human qualities and emotions. It was amazing how quickly I could form solid bonds with others who were a world 

away by simply approaching the experience with an open heart and mind. 

The experience was especially enhanced by my host family experience. Uprooting and traveling alone to Uganda, 

when never having been to the African continent, was a scary experience. But the moment I met my host parents, 

they greeted me with a warm embrace. They included me in their New Year’s Day festivities, and I knew I had a 

new home away from home. From preparing g-nuts and jackfruit with my host brother to riding matatus (taxis) to 

the market with my host sisters, I was completely immersed in Ugandan culture. My host father, Dr. Sam Luboga, 

is a retired surgeon who is an MD, PhD, and retired Anglican priest. Despite being retired, he works tirelessly 

to improve medical school education locally, to build his farm, and to create new leadership opportunities in the 

community, all while being a loving neighbor, father, and grandfather. 

His wife Christine is just as hardworking, intelligent, and motivated. She was head of the chemistry department, 

and is now running a tailoring business that encourages her employees to gain leadership and entrepreneurial 

skills. My host parents are a prime example of how hard work and dedication can make a positive impact on 

lives, a principle that is applicable anywhere in the world. My host parents were not only inspirational, but were 

always comforting and supportive. In my time in Uganda, I witnessed the saddest events I had ever witnessed in 

a hospital setting, with some days sadder and more frustrating than others. Despite this sadness, I always had 

loving, understanding host parents to debrief and talk out my emotions with. Whether it was a handhold and chat 

over tea or a lighthearted fable to cheer me up, my host family was always there for me. 

In the hospital setting, I was also treated with such kindness and respect. The midwives would take me by the 

hand and say, “You’re going to deliver this baby,” as they wanted us to have the best hands-on experience. The 

OR nurses would pull me aside to share their rice and beans for lunch, or to have a mini dance party. The medical 

students and residents immediately integrated me into their lectures and rounds. This welcoming, communityminded 

attitude both in and out of the hospital has inspired me to be more community-minded in my own life and 

practice. In American culture, we tend to hold so many boundaries and shut others out. Yet I think we could all 

benefit by being more inviting like the Ugandan people. 

Professionally, I learned a new appreciation for all the technology and resources we have in the Global North. So 

often I have seen U.S. physicians become frustrated over not having access to the instrument they prefer, yet 

in over half of the cesarean sections I scrubbed in on in Uganda we did not have a blade holder for the scalpel, 

let alone easy access to X-ray, MRI, or CT scanning. We had to make due with what we had. I had never before 

seen such excellent physical examination skills until I completed the infectious disease portion of my rotation. I 

remember in particular needing to perform a pleuracentesis on a patient in respiratory distress. Her family could 

281

not afford X-rays, so we had to rely solely on a physical exam and percussion to estimate how much fluid was 

in each lung and how much needed to be drained. In the labor and delivery portion of my rotation, the majority 

of patients did not have prenatal care or ultrasounds, and there were no dopplers to detect fetal heart rate. This 

led us to rely on Leopold maneuvers and auscultation with a fetoscope while assessing our laboring patients. These 

experiences led me to improve my hands-on assessment skills, and helped me rely less heavily on technology in 

future rotations. I now feel better-equipped to perform thorough assessments and management in the absence of 

the luxury of technology. 

Plans for the Future 

I have recently graduated from Ross University School of Medicine and am now employed at Ross as a Medical 

Simulation Teaching Assistant. We are wrapping up our first semester of Internal Medicine Foundations now, 

which is an eight-week session for incoming third-year medical students to hone in on their interview and physical 

exam skills as well as learning skills such as IV insertion, ultrasound, and pelvic exams. We are also teaching 

high-fidelity simulation and using it as a means to emphasize the importance of communication and teamwork in 

medicine. I will be teaching medical students for the year while applying for obstetrics and gynecology residency 

for the 2020 match. 

Meanwhile, I will be making an effort to stay involved with global health, particularly global women’s health 

through various projects. I also plan to match in a residency program that allows me to remain involved in global 

health, as it is a vital part of my future career. In the future, I hope to practice as an OB/GYN generalist at a 

teaching hospital. I must work somewhere with a global health program, so if there is not already one in place I 

would want to start one at my future place of employment. Although I plan to live in the U.S., likely back on the 

East coast, I do plan to practice, teach, and learn abroad several times per year. 

DR. PEISHI YAN’S EXPERIENCE AT DANBURY HOSPITAL 

By Menoo Jarrett 

The Western Connecticut Global Health Program and the University of Vermont, in conjunction with Hearts Around 

the World, welcomed our first global scholar from Dalian Municipal Hospital in Dalian, China. Dr. Peishi Yan, a 

clinical cardiologist on staff at Dalian Municipal Hospital for more than ten years, arrived at Danbury Hospital 

on May 11, 2019. She was welcomed by Menoo Afkari Jarrett and Dr. Robert M. Jarrett, MD, FACC, Executive 

Director and President of Hearts Around the World, respectively, and Dr. Jishu Motta, medical resident at Danbury 

Hospital. Immediately after settling in, Dr. Peishi Yan planned out her schedule for the next five weeks while 

dining at the Jarrett home. 

Her daily activities included morning cardiology report, daily rounds with the cardiology teaching service, attendance 

at all cardiology conferences, and afternoons seeing outpatients in the clinic. Overall, Dr. Yan expressed that it 

was a personally and professionally rewarding experience for her. 

At the completion of her visit, Dr. Yan expressed tremendous enthusiasm for the global health experience. She 

specifically commented on the differences between cardiovascular practice in China and in the U.S. These included 

the more significant involvement of nurses in our patient care; the greater amount of time that physicians, 

including attendings and residents, spend at the bedside with patients (both by attendings and residents); the 

greater reliance on evidence-based medicine and clinical judgment rather than the utilization of technology; and 

the closer relationships developed between patients and physicians. 

282

We are delighted that Dr. Yan enjoyed her experience with us, and that she will recommend this training to her 

colleagues in Dalian, China after her return home. We wish her well and hope to see her soon during our future 

visits to her institution. 

(left to right) Mrs. Menoo Jarrett, Executive Director of Hearts Around the World; Dr. Peishi Yan, Global Health Scholar 

from China; and Dr. (left to right) Mrs. Menoo Jarrett, Executive Director of Hearts Around the World; Dr. Peishi Yan, Global 

Health Scholar from China; and Dr. Robert Jarrett, President of Hearts Around the World 

SEXUAL HARASSMENT AND VIOLENCE 

ACROSS GLOBAL CONTEXTS 


programs often experience and report such abuses while undergoing international electives. Proper guidance 

and support must be provided so that these individuals can effectively recover and that the source of abuse be 

rectified. The framework for understanding sexual harassment and abuse has fundamentally changed with the 

widespread #MeToo movement that has shaken the historic tolerance of sexual harassment, leading to both 

discourse and action of global impact. In this vein, it is the responsibility of the global health community to 




283


Dear Doctor Sadigh, 

Hello. Thank you for sharing the program’s great successes and achievements with me. 

It is a great honour to read about the rapid progress of the WCHN global health program, as well as that of Kazan 

State Medical University and Datta Meghe Medical University, among many other esteemed institutions with 

whom this program is partnered. 

Best regards, 

Elnaz 

Thank you for hosting me at WCHN, and for the opportunity to experience 

global health on a whole new level. The time I spent with the health workers 

was extremely worthwhile. The compassionate patient- and family-centered care 

and yet attention to the tiniest details was inspiring. I loved the family-centered 

rounds. 

I was privileged to spend time with medical educators like Dr. First and Dr. Raska 

(voted best teacher on several occasions). Those few moments spent with them 

made me feel empowered to be a better teacher by keeping students engaged 

and interested, giving constructive feedback, and helping them achieve their 

objectives. 

I was also happy to sit in on the quality improvement committee meetings in 

Vermont. I learned that “things can go wrong” in the U.S. but it does not have to 

be the norm. I observed all the principles of quality improvement at play. I was 

also impressed by the enthusiasm and motivation of the team members. 

The interaction I had with the infection control manager was informative, and the grand rounds were remarkable. 

I learned a lot and was stimulated to read more. Meanwhile, the connections and friendships I made with 

exceptional people with a shared vision will be long lasting. I believe the results will make this world a better 

place. 

I am sorry I did not have time to meet with you again before I left. I would have loved to thank you in person and 

discuss more global health issues, such as how to improve student education and patient care at St. Stephens, 

the most urgent need being a chemistry analyser and hematology analyser. 

Thank you once again for the opportunity, inspiration and kindness. 

Cathy Nakibuule 

Global Health Site Director at St. Stephen’s Hospital, Kampala, Uganda 

284

Thank you for inviting me to attend this wonderful event and 

month-long visit to Danbury Hospital. Thank you also for your 

warm welcome. I hope to collaborate with your programs more 


It was a great pleasure to meet excellent people from different 

fields and areas of expertise at the conference. The Global Health 

Program has established a meaningful international exchange 

platform based on the premise that humans deserve the same 

rights to health care. 

My hospital is affiliated with Dalian Medical University where 

there are 2000 in-patient beds. However, we are not an ideal 

training site for students as residents, as we do not have a 

fellowship program. Our level of healthcare also needs great 

improvements, with greater attention on basic skills rather than 

advanced technology. It is our new and important mission to 

make our doctors more aware of these differences and start 

making needed changes and improvements. 

I would like to be part of this exceptional group. 

Warm regards, 

Peishi Yan 

Global Health Program Site Director at Dalian 

Municipal Central Hospital 

Dear Professor Majid and Dr. Jarrett, 

It has been a while since we last communicated but I am always grateful for having met you and all that you 

offered me. I hope that you are fine. 

I am about to complete my cardiology fellowship program come July this year. I am so excited and grateful 

because it all started with you. I also wanted to let you know that the global health exposure I received drove me 

to love a greater love for global health. As such, I applied to join the Global Health Equity Scholars Program and 

was offered a position. 

I will thus be travelling to the U.S. tomorrow June 28th, to attend the induction course at Bethesda. 

I cannot thank you enough and will always keep you in my prayers. Kindly send my greetings to the entire family 

that made me feel at home while at Danbury. 

Kind regards, 

Charles Musoke 

Specialist Physician/Cardiology fellow at Mulago National Referral Hospital 

and Uganda Heart Institute 

285

Dr. Sadigh, 

I know it has been quite a while since you last heard from me. However, I have to say that you keep on sending 

the most interesting reads. When I saw the inspirational words on the picture on the first page of June 2019 issue, 

it inspired me to write a piece. I hope it is worth your while. 

This piece will be posted soon. 


Assistant Lecturer at Makerere University 

A Note from Dr. Rhoda Wanyenze 

Professor and Dean, School of Public Health College of Health Sciences, Makerere University 

The reported Ebola cases in Uganda were at the border district with DRC. I believe we will quickly contain the 

Ebola epidemic in Uganda like we have done with previous ones. With the exception of the first epidemic in 

northern Uganda many years ago, we often get these controlled very quickly. 

We are monitoring the situation too and today we have a meeting of the national taskforce to review the response 

and next steps. Unfortunately I have another school event and will miss it, but we have a representative on the 

committee who will update me. I will also update you as we go along. 

A Follow-Up Note from Dr. Rhoda Wanyenze, June 23rd 

The Ebola epidemic is fully contained—no new cases and none in the isolation center. I am informed by the 

Director of the EOC that the follow-up period for the few contacts that were under follow-up will end next week. 

REFLECTIONS FROM 

THE FIELD 

I felt very much like part of the team. For the first time, when something started to go wrong during induction, 

I didn’t start internally panicking. I knew what was wrong, and knew how to fix it, just like the rest of the team. 

While everyone else was becoming increasingly anxious around us, we all remained calm, and the problem 

was solved. I’m at the point where I’m starting to problem solve independently in those “heat of the moment” 

situations, which is really exciting. I’m feeling more and more comfortable in my own skin in this specialty. 

286

Working with the same resident and attending all week has helped me cultivate that skill. 

Whether it’s setting up and preparing for the process of induction, putting in IVs, bagging, or intubating, I am 

very much involved in the care of the patient. I’ve also been helping the resident teach the Ugandan medical 

students some anesthesia topics during the cases. It is very apparent that I’m a valued member of the team, 

which makes the learning so much easier and more valuable. 

Jayne Manigrasso, UVMLCOM student in Uganda 

Last week we had the distinct privilege of being transported to the outskirts of town to meet with natural healers 

in the area. We first visited the home of a natural birth attendant, who had been delivering babies in her district for 

over fifty years. She graciously discussed with us her path leading up to her career, her training passed on by her 

mother and the ritual surrounding her practices. We learned about how her biggest struggle was having patients 

who didn’t have the means to present themselves early enough, clean themselves or bring the necessary supplies 

to their deliveries. She discussed with us the decline of her birthing rates because of the increased incidence of 

women with HIV, whom she sends to the local hospital. Though culturally quite interesting, I was concerned to 

hear that the attendant had felt she never had a birth or pediatric complication in her career. In having a general 

sense of the incidence of birthing complications, I couldn’t help but be curious about how many conditions had 

come and gone through her doors that we would have intervened on medically. It reminded me of being in the ICU 

in Zimbabwe and in Uganda, where many of the patients suffered and died from obstetric complications. I wonder 

further about the infants and whether there are ever complications of infections, asphyxia or cerebral palsy later 

down the line. Though I am partial to westernized medicine, I found it quite useful and enlightening to attempt to 

understand where so many patients were previously being cared for. 

Amber Messervey 

UVMLCOM student in Uganda 

I love the new hospital, a charity hospital named Instituto Nacional de la Diabetes (INDEN). It’s a beautiful 

hospital with very modern decor and facilities that take insured patients as well as those who have no ability to 

pay. Before coming here, I had in my mind what a diabetic should look like and read about it plenty of times as 

it’s a classic test question. Walking in, I had to remind myself that 90% of these patients have diabetes or were 

prediabetic. These patients didn’t look like they had diabetes, and didn’t even look sick, honestly. Our first day 

was consults or what we would refer to as a triage section. The physician was responsible for not only the full HPI 

but personal information like address, insurance, and telephone contacts. 

During this visit, the patient receives a card if entering the healthcare system. The card states that they are a 

diabetic and is signed and dated for each appointment. Some patients were referred, and others knew they were 

diabetics but wanted to establish care at this hospital. They provide all services related to the complications of 

diabetes including nephrology, gastroenterology, cardiology, ophthalmology, and an ICU. One of the other things 

specific to this hospital was the diabetic foot center. The building is comparable with some of the centers in the 

U.S. and possibly better organized. At the entrance there is a wound care and washing center specifically to treat 

ulcers. Upstairs the wards are set up by insured versus uninsured with the large private rooms for those who can 

afford it. 

287

This disease is so prevalent in this country that there is a specific specialty you can train in called Diabetology 

that is a four-year residency program within internal medicine that details how to manage diabetic patients at 

their most critical points. 

Antonia Ngozi Nwankwo 

RUSM student in the Dominican Republic 


FOR THE THIRD TIME, W.H.O. DECLINES TO DECLARE THE EBOLA 

OUTBREAK AN EMERGENCY 

“For the third time, the World Health 

Organization declined on Friday to 

declare the Ebola outbreak in the 

Democratic Republic of Congo a 

public health emergency, though 

the outbreak spread this week into 

neighboring Uganda and ranks as the 

second deadliest in history. 

An expert panel advising the W.H.O. 

advised against it because the risk 

of the disease spreading beyond the 

region remained low and declaring 

an emergency could have backfired. 

Other countries might have reacted 

by stopping flights to the region, 

closing borders or restricting travel, 

steps that could have damaged 

Congo’s economy.” 


Health workers at the Mpondwe Health Screening Facility, on Uganda’s 

border with the Democratic Republic of Congo. The outbreak that began in 

Congo has defied expectations. Credit; Isaac Kasamani/Agence France- 

Presse — Getty Images 

288


Dr. Pamela Gorejena, University of Zimbabwe 

HIV activist Joshua W. Robbins once said “HIV is a virus, 

stigma is the deadly disease.’’ 

People with HIV may feel isolated or choose to isolate 

themselves for various reasons. Some still believe in the 

notion that a diagnosis of HIV is equivalent to a death 

penalty. This may ultimately lead to the emergence of 

mental illnesses such as depression or anxiety disorders 

which contribute further to the stigmatization. Some feel 

embarrassed to seek medical attention because they 

assume their disease is perceived to be associated with 

reckless sexual behaviours or infidelity. 

My first encounter with Alice* was when she was referred 

to me after having undergone two weeks of treatment for 

Pneumocystis jirovecii pneumonia. She had suspected 

her HIV status for a long time, but only agreed to an HIV 

screen three months prior to her visit to my room. 

By the time she agreed to see a practitioner, she had been short of breath and was coughing for close to three 

months. A month before that, she had noticed purple spots on her face and chest, as well as a plaque on the roof 

of her mouth but thought nothing of them. 

When I examined her, she had deteriorated beyond recognition: pale, with florid oral candidiasis. She had 

generalised lymphadenopathy as well as facial and bilateral leg edema. She had multiple violaceous skin lesions 

on her face, anterior chest, and palate in keeping with Kaposi’s sarcoma. Her feet were both covered in bandages 

and she couldn’t wear open shoes. Her chest examination was significant for bilateral diffuse wheezes suggesting 

the presence of endobronchial Kaposi’s Sarcoma. She also had tender peri-anal ulcers, suggestive of concomitant 

local Herpes simplex infection. Her CD4+ count was 30, a confirmation of the severity of her immunosuppression. 

She was in the company of her sister, the only individual whom she allowed to visit her in the hospital while she 

received treatment. She was successful in her own right; educated, affluent, and able to pay for her own medical 

bills. 

She presented with an AIDS-defining illness in an era when there is greater awareness about the disease, 

widespread drug availability, and ease of access to antiretroviral therapy. Not only did she have the means to 

access treatment, but she was probably aware of her status for a while but delayed accessing treatment for 

reasons unknown. I can only speculate that fear of the stigma and discrimination associated with HIV was one 

of them. She only had one regular visitor during her stay in the hospital. She often spoke fondly about her 

only daughter who was away in boarding school. She never spoke of her daughter’s father from whom she was 

289

separated. It was clear she had a lot of unresolved issues about their relationship and possessed a lot of anger 

towards him. 

There have been great strides in transforming the treatment and face of HIV over the years. Due to the 

advancements made in HIV medicine, patients who believed they were destined to die within months of diagnosis 

can now live normal, healthy lives. There has also been significant progress in preventing maternal-to-child HIV 

transmission and transmission in discordant couples. However, it has taken significantly longer to change the 

public’s mindset regarding the implications of an HIV diagnosis. Stigmatization of people living with HIV is still 

prevalent in resource-rich as well as resource-limited settings. A greater awareness of the advancements in HIV 

through education of communities will aid in addressing fears and ultimately changing attitudes towards people 

living with HIV. On a national level, more should be done in advancing anti-discrimination laws. Programs that 

emphasize the rights of people with HIV as well as empower those living with the virus would go a long way 

in fighting the barriers that prevent early access to treatment. A greater focus on fighting this disease called 

“stigma” would save the lives of people just like Alice. 

*Named changed to maintain anonymity 

GLOBAL HEALTH 

AND THE ARTS 



What led you to pursue a career in music? 

I have always loved music and started piano lessons at age five. I 

began pursuing music - especially classical music - more seriously 

during my undergraduate career, and worked in marketing at the 

Metropolitan Opera on graduating. By attending multiple opera 

productions every week through this position, I realized I wanted to 

be part of music on a deeper level. 

How did you first become involved in your research? 

I first became involved with my research back in 2012 while 

performing in a summer festival with Elysium Between Continents, 

an artistic organization run by Michael Lahr and Gregorij von Leitis. 

290

These two extraordinary gentlemen made it their life’s mission to promote music and literature lost to history 

because of the rise of the Nazis. They repeatedly mentioned a man named Egon Lustgarten, a Viennese-Jewish 

scholar and composer who had incredible operatic and vocal literature sitting idly in an archive due to the 

complete disruption of his life by the Nazis. Years later when I was admitted to a doctoral program, I knew he 

was the person I wanted to research. 

What do you see as the relationship between music, advocacy, and social justice? 

Though historical, my work relates to today’s sociopolitical atmosphere in that while the events of the Holocaust 

and Nazi oppression are becoming more removed from our modern society, the hatred and discrimination that 

spurred those historical events are still present. It is important to me that art fight against that hatred, and 

that those responsible for said oppression and violence do not “win” in the end by silencing the voice of Egon 

Lustgarten or other artists like him. Additionally, we are losing the voices and artistic output of many populations 

due to their need for basic survival, such as the art and music of refugees currently coming to this country or, 

more often, being rejected by this country. Additionally, xenophobic attitudes do not allow immigrants to integrate 

into society and contribute fully to their communities, and I hope that art can cultivate empathy that will enable 

people to be more accepting of each other’s differences. 

How do you feel your work relates to today’s sociopolitical atmosphere, and why is it important? 

The music and artistic output of any society has always been an indication of the events and emotions most heavily 

affecting that population of people. Music is historical in that it can reflect political or sociological movements. 

Overall, though, it helps audiences have a shared sense of empathy, and to move them to emotion or action. 

Art is also an opportunity to share important stories with a greater audience, including stories that may have 

been untold or unfairly repressed. I believe music can advocate for those stories while helping reach audience 

members on a deeper and more profound level, thus spurring them to action. 

What are your hopes for your future endeavors? 

I hope to continue much of the research I am conducting, either in a university-level faculty position or at any 

organization that supports this kind of work. I also hope to continue my performance career, both in art song and 

opera. It is my goal to unite historical research and discovery with performance, which sometimes can have a 

more immediate influence on those listening or watching. 

What advice do you have for artists trying to make an impact? 

My advice for artists trying to make an impact is that there is no need to wait for someone else to create an 

opportunity for you. You are empowered to create art, even on a small level, that advocates for issues that are 

important to you. With social media and other platforms that can be easily shared with others, the ability to have 

a greater impact worldwide is more rife with opportunity than ever. 

Learn more about Alexis Rodda’s work and listen to some of her music. 

291

ANNOUNCEMENTS 

Linde Healthcare Educators Without Borders has been established. 

The Rudy Ruggles Global Mental Health Scholarship supporting psychiatry residents at Makerere University College 

of Health Sciences has been established. 

The Global Women’s and Children’s Health Program has been funded and is underway. 

The Memorandum of Understanding with Botswana University School of Medicine has been approved by the 

WCHN Legal Office. It is currently under review by Botswana University. 

The second annual Global Health Program “Climb For a Cause” will be held this July. Three members of the Sadigh 

family are climbing Kilimanjaro. 

292


Congratulations to Dr. Tendai Machingdaize, Associate Site Director of Global Health in Zimbabwe, for graduating 

with honors from Privolzhsky Research Medical University. 

CALENDAR 

JUNE CALENDAR 

June 2-4: UVMLCOM leadership and staff attended the inaugural WCHN Global Health Conference at Ethan Allen 

Hotel in Danbury, CT. 

June 4-15: Dr. Catherine Nakibuule visited the UVMLCOM. 

June 8-15: Dr. Sadigh site-visited Dalian Central Municipal Hospital in Dalian, China. 

June 10: A Global Health Leadership Team meeting was held at UVMLCOM. 

293

June 20: A meeting was held with the UVMLCOM communications 

team to discuss Global Health Program website updates. 

June 21: Dr. Sadigh spoke about the structure and function of 

the Global Health Program to the new house staff at Danbury 

Hospital. 

June 22: Global Health Elective Pre-Departure Boot Camp Day 

was held at UVMLCOM. 

June 24: A Global Health Leadership Team meeting was held at 

UVMLCOM. 

June 25: The first meeting of the task force committee on the 

2019 Climb For a Cause was held. 

June 25: The first annual Endowed Chair 

Dinner was held at Bernard’s in Ridgefield, CT. 

During the opening remarks, Dr. John Murphy, 

the CEO of the Nuvance Health, underlined 

the significance of innovative basic and clinical 

sciences research as well as global health 

program. 

Mr. Christian and Eva Trefz with Grace Lindhard, Chief 

Development Officer at WCHN (center) 

Dr. John Murphy, CEO of Nuvance Health, delivering 

opening remarks at the dinner 

June 28: Dr. Sandra Mini travels to St. Stephen’s Hospital, Uganda. 

294

JULY CALENDAR 

July 1-12: Dr. Benjamin Clements accompanies UVMLCOM students in the Dominican Republic. 

July 2: Dr. Stephen Scholand accompanies UVMLCOM students and Norwalk IM Resident to Thailand. 

July 8: A Global Health Leadership Team meeting is held at UVMLCOM. 

July 8-26: Dr. Naomi Hodde accompanies UVMLCOM students in Naggalama, Uganda. 

July 13: Dr. Sandra Mini returns from Uganda. 

July 16: Dr. Majid Sadigh begins visiting every international partner site to solidify themes from the brainstorming 

session toward starting a consortium in medical education. 

July 17: Dr. Sadigh site-visits Cho Ray Hospital and the University of Medicine and Pharmacology in Ho Chi Minh 

City, Vietnam. 

July 20-24: Dr. Sadigh site-visits University of Botswana School of Medicine. 

July 24-26: Dr. Sadigh site-visits University of Zimbabwe College of Health Sciences. 

July 27-August 3: The 2019 Climb for a Cause takes place on Mount Kilimanjaro. 

August 4-10: Dr. Sadigh site-visits University of MakCHS, St. Stephen’s Hospital, ACCESS, and St. Francis 

Naggalama Hospital in Uganda. 

August 4-10: Dr. Linus Chuang, Chairman of the department of OB/GYN at WCHN site-visits MakCHS and 

Uganda Cancer Institute. 

July 21-August 4: Dr. Mariah McNamara accompanies UVMLCOM students at St. Stephen’s Hospital in Kampala, 


July 22: A Global Health Leadership Team meeting is held at UVMLCOM. 

295

GLOBAL HEALTH 

PARTICIPANTS IN THE FIELD 

SUMMER 2019 

Participant 

Affiliation 

Status 

Host Site 

Travel Date 

to Site 

Travel Date 

to Home 

Seth Perry 

AUC 

MS4 


May 13 

June 21 

Stefanie Rulli 

AUC 

MS4 


May 13 

June 21 

Iyabo Akinsanmi 

AUC 

MS4 

Naggalama, Uganda 

May 13 

June 21 

Matthew Myrick 

AUC 

MS4 


May 13 

June 21 

Shamili Vemulapalli 

AUC 

MS4 

ACCESS, Uganda 

June 24 

August 2 

Lilian Ameh 

AUC 

MS4 


June 24 

August 2 

Luke Gray 

AUC 

MS4 


June 24 

August 2 

Maria Frost 

AUC 

MS4 


June 24 

August 2 

Dr. Sandra Mini 

Danbury 

Hospital 

Faculty 

St. Stephen’s, 

Uganda 

June 29 

July 13 

Prasanna Kumar 

UVMLCOM 

MS1 


July 1 

August 2 

Jose Calderon 

UVMLCOM 

MS1 


July 1 

August 2 

Dr. Benjamin Clements 

UVMLCOM 

Faculty 


July 1 

July 12 

Amelia Anderson 

UVMLCOM 

MS1 

St. Stephen’s, Uganda 

July 2 

August 8 

Irene Sue 

UVMLCOM 

MS1 


July 2 

August 8 

Gregory Davis 

UVMLCOM 

MS1 


July 2 

July 6 

Elena Martel 

UVMLCOM 

MS1 


July 2 

July 6 

Kathleen O’Hara 

UVMLCOM 

MS1 


July 2 

July 6 

Andrew Pham 

UVMLCOM 

MS4 


July 2 

July 26 

Ray Mak 

UVMLCOM 

MS1 

Thailand 

July 2 

August 8 

Isaac de La Bruere 

UVMLCOM 

MS1 


July 2 

August 8 

Collin Montgomery 

UVMLCOM 

MS1 


July 2 

August 8 

Dr. Zhou ‘Wendy’ Li 

Norwalk 

Hospital 

Resident 


July 2 

August 8 

Dr. Stephen Scholand 

WCHN 

Faculty 


July 2 

August 11 

Kalin Gregory-Davis 

UVMLCOM 

MS1 


July 6 

August 8 

Elena Martel 

UVMLCOM 

MS1 


July 6 

August 8 


UVMLCOM 

MS1 


July 6 

August 8 

Dr. Naomi Hodde 

UVMLCOM 

Faculty 


July 9 

July 26 

Dr. Pamela Chidawanyika 

UZCHS 

Faculty 

Danbury Hospital 

July 15 

September 6 

Dr. Majid Sadigh 

WCHN 

Faculty 

All international sites 

July 16 

August 5 

Dr. Mariah McNamara 

UVMLCOM 

Faculty 


July 22 

August 4 

296


PHOTO CONTEST 

Talk to Me (Kvon Photography) 

Paypal (Dalian, China); Majid Sadigh 

Dancing Girls in the Wind of Sea 

(Dalian Harbor); Majid Sadigh 

297

Captives (Dalian, China); Majid Sadigh 

Sea Market (Dalian, China) 

PHOTO NEWS 

Dr. Robert Jarrett, Founder and President of Hearts Around the World and Dr. 

Peishi Yan, Global Health Scholar from Dalian, China 

Training of global health students in the 

Simulation Lab during the Global Health 

Boot Camp at UVMLCOM 

298

RESOURCES 







Ebola book 















Publications 







Two UVM Docs Combat Ebola in Liberia (Video) 


AUC/Ross Annual Report 2018 

299

August 2019 Volume 8 





300


DR. MAJID SADIGH’S SITE-VISIT TO CHO RAY HOSPITAL AND THE 

UNIVERSITY OF MEDICINE AND PHARMACY, HO CHI MINH, VIETNAM 

Dr. Majid Sadigh traveled to Ho Chi Minh, Vietnam from June 15-19 to meet with the leadership of the University 

of Medicine and Pharmacy as well as help select a director for the newly established partnership. He toured the 

medical and pharmacology schools as well as the anatomy division which features more than fifty cadavers. 

He also site-visited three pediatric hospitals, after which Pediatric Hospital No. 2, a 1400-bed facility with 

subspeciality wards for all specific diseases, was selected as the primary pediatric hospital for Global Health 

Program participants interested in pediatric global health. Interestingly, all residents and seventy-five percent 

of students in this hospital speak fluent English, due in part to a new government ordinance. Dr. Sadigh then 

searched for appropriate accommodation in a safe neighborhood for potential global health participants. 

During his trip, Dr. Sadigh also met with the leadership of Cho Ray Hospital where he attended numerous 

administrative meetings discussing the future direction of the partnership with a focus on establishing a consortium 

of universities and annual conference centered on medical education. He also delivered lectures on several topics 

including how to write a scientific manuscript, how to analyze a scientific paper, and the structure and function of 

the UVMLCOM/WCHN Global Health Program. 

Dr. Majid Sadigh with the leadership of Cho Ray Hospital, Ho Chi Minh, Vietnam 

301

Left to right: Dr. Duy Khoa Duong, Global Health Scholar 

from Vietnam; Dr. Tomai Xuan-Hong, PhD, Head of the 

Department of International Relations; Dr. Majid Sadigh; 

and Dr. Huỳnh Kim Hiệu, PhD., faculty at the Department 

of International Relations 

Dr. Sadigh in front of Pediatric Hospital No.2, 

Ho Chi Minh City, Vietnam 

ESTABLISHING A PARTNERSHIP WITH THE UNIVERSITY OF MEDICINE 

AND PHARMACOLOGY IN HO CHI MINH, VIETNAM 

We were searching for a new hospital to send medical 

and physician assistant students, residents, faculty 

and nurses for pediatric and OB/GYN experience 

as a part of Women’s and Children’s Health, a newly 

established program supported by a generous grant 

by an anonymous donor. Dr. Sadigh site visited a 

2000-bed children’s hospital in Ho Chi Minh, where 

he observed small children walking hand-in-hand with 

their parents in the garden surrounding the hospital. 

Below are photos from sections of this hospital complex 

which is home to all pediatric specialties, with the 

infectious diseases ward holding over 200 beds. We 

are currently finalizing the next steps toward sending a 

group of students, residents, nurses, and faculty to this 

institution to conduct a report before opening the site to 

global health participants. 

One of several sections of Pediatric Hospital No. 2 

Children’s Hospital No. 2 is located at the center of Ho 

Chi Minh City, in District 1. Accommodation is located 

a twenty-minute walk away from the hospital in a safe 

community. Rooms are clean and equipped with air 

conditioning and a kitchenette. Laundry and cleaning 

are included in rent (230 USD/month + electricity). The 

facility has four rental rooms in a family house of nine 

rooms. 

A cafe across from the accommodation site 

302

Accommodation close to Pediatric Hospital No. 2. 

Children Hospital No.2 (CH2), located on a small hill in 

the city center, is an integral part of the city’s history. 

Established in June 1978, the facility belongs to the 

Department of Health of Ho Chi Minh City and treats 

all children under sixteen years of age. As one of the 

nation’s few pediatric hospitals, it has 1400 beds on 

a spacious 8.6 hectare area with greenery, shade, a 

playground, and a child-friendly environment. CH2 

serves as the teaching hospital for three medical schools 

including the University of Medicine and Pharmacy in 

Ho Chi Minh City, as well as partner for many national 

and international research institutions. It has ten facility 

and 35 clinical and paraclinical departments. Notably, it 

is well-known for boasting the only pediatric neurosurgery department in Vietnam, in addition to physiotherapy, 

psychotherapy, and healthy children departments. The outpatient department receives 5,000 to 6,000 patients 

a day. 

Below is a brief history: 

• 1862: Was a Military hospital (Hôpital militaire) during the French regime. 

• 1891: Albert Calmette founded here the first Pasteur institute outside of France. 

• 1925: The name changed to Hopital Grall (to honor Dr Charles Grall). 

• 1956: The hospital remained under the French Embassy during the Saigon regime. 

• 1976: The hospital transferred to the Socialist Republic of Vietnam’s control. 

• 1978: Became Children’s Hospital No. 2. 

303

UNIVERSITY OF BOTSWANA SITE- 

VISIT, JULY 26TH, 2019 

Written by Professor 

Lynnette T. Kyokunda 

Head of the Department of Pathology 

Dr. Majid Sadigh site-visited the University of Botswana in Gaborone, Botswana from July 21-23 to follow up the 

initiation of signing a Memorandum of Understanding and to identify key faculty for the collaboration. He met 

the institution’s key faculty including Head of the Department of Pathology, Professor Lynnette T. Kyokunda, who 

organized meetings with full support of the Acting Director of the Office of International Education and Partnerships, 

Professor Musa W. Dube. Five meetings were held to discuss these important topics, with attendees including 

Professor Lynnette T. Kyokunda; Professor Oatlhokwa Nkomazana, Acting Deputy Vice Chancellor of Academic 

Affairs (DVCAA); and Dr. Katrin Sadigh, Global Health Fellow at Harvard University. Professor Nkomazana greatly 

welcomed the collaboration and advised that the team see the Acting Dean of the Faculty of Medicine and Head 

of Medical Education to discuss the collaboration’s contributions to patient-centered care, medical education, 

mentorship, and research. 

Dr. Sadigh with the University of Botswana leadership 

304

Left to Right: Dr. Katrin Sara Sadigh, Global Health Fellow 

at Harvard University; Professor Lynnette Kyokunda, Head 

of the Department of Pathology; Professor Oathlokwa 

Nkomazana, Acting Deputy and Vice Chancellor of 

Academic Affairs; and Matshidiso Zungu, Executive 

Assistant in the Office of the Deputy Vice Chancellor of 

Academic Affairs 

Right to Left: Dr. Japhter Masunge, Deputy Dean and 

Associate Program Director Faculty of Medicine; Dr. Katrin 

Sara Sadigh, Global Health Fellow at Harvard University; 

Professor Lynnette Kyokunda; and Dr. Detlef Richard 

Prozesky Head, Department of Medical Education 

After members introduced themselves, Dr. Majid Sadigh 

articulated his philosophy and that of the University of 

Vermont and Western Connecticut Health Network on 

the concept of global health. He outlined the history of 

the Global Health Program and its evolution through 

the passion and commitment of its partner members. 

Administrative and departmental leadership had the 

opportunity to find clarification on a number of issues 

while laying groundwork for potential collaboration 

between the two universities. 

Photo above: Dr. Majid Sadigh; Professor Lynnette 

Kyokunda, Head of the Department of Pathology; 

Professor Musa W. Dude, Acting Director, Office of 

International Education and Partnerships; Dr. Vincent 

Setlhare, Senior Lecturer and Head of the Department 

of Family Medicine; Professor Motshedisi Sabone, Deputy 

Dean, Faculty of Health Sciences; Professor Caleb 

Othieno, Head of the Department of Psychiatry; Dr. 

Zakir Patel, Department of Pediatrics; Dr. John Wright, 

Department of Biomedical Sciences; and Dr. Mercy N. 

Nassali, Senior Lecturer and Acting Head of Obstetrics 

and Gynaecology 

Overall, there was great enthusiasm in the prospects 

of partnership and a readiness to move forward with 

next steps. It was decided for Professor Kyokunda 

to organize a follow-up meeting with departmental 

members and administrative leadership as they work 

together to draft a Memorandum of Understanding; for 

Dr. Majid Sadigh to link interested faculty with global 

health leaders at UVM and WCHN to initiate discussions 

around potential projects; and for a small delegation of 

leaders from UB to organize a one-week visit to UVM 

and WCHN in October 2019. 

Read the full report here >> 

305

UNIVERSITY OF ZIMBABWE SITE-VISIT, JULY 

24-26, 2019 

Written by Professor 

Ndhlovu Chiratidzo Ellen 

Director of Global Health at University of Zimbabwe 

Dr. Majid Sadigh made an administrative site-visit to the University of 

Zimbabwe College of Health Sciences (UZCHS) where he met with institutional 

and departmental leadership including meeting with Dean Masanganise, 

Deputy Dean Jephat Chifamba, and Mrs. Rachel Gandara, Administrative 

Assistant for the Global Health Program at UZCHS. Several topics were 

discussed over the course of numerous meetings, including Dr. Pamela 

Gorejena-Chidawanyika’s current visit to Danbury Hospital, practical considerations such as accommodations 

and the impact of hyperinflation on global health participants, the reopening of the UZCHS global health site, the 

sending of specialized faculty from UVM to UZCHS, the participation of a UVM member as a guest speaker at the 

2020 Annual Health Professions Education Conference held in Zimbabwe, and the establishment of a regional 

center for medical education. 

Dr. Sadigh also gave UZCHS members a summary of Linde Health Educators Without Borders, after which the 

interest of two UZCHS faculty members, biostatician and community medicine specialist Mr. Vasco Chikwasha 

and rehabilitation specialist Mrs. Farayi Kaseke, was discussed. In alignment with program standards, trainees 

would travel to UVM for five months for the training, upon which they would receive a joint certification by UVM 

(Left to right): Mrs. Rachel Gandara, Dr. Majid Sadigh, Professor Ndhlovu Chiratidzo Ellen, Dean Masanganise, and 

Deputy Dean Jephor Chifamba 

306

and UZCHS with recertification every five years. Applications are expected to open in September for the January 

intake, in addition to another round of applications in January for the July intake. 

New UZCHS initiatives were discussed including creation of an ethics module for faculty, improvement of 

community-based education, the potential for UZCHS members to participate in the Global Mental Health Program 

in Uganda, and further utilization of the Simulation Lab, which could be based in part on the UVM Simulation 

Model. Lastly, Dr. Majid Sadigh presented three lectures to UZCHS MMed students. 

Dr. Majid Sadigh with Professor Ndhlovu Chiratidzo Ellen 

and Dr. Walter Mangez, Chairperson of the Department of 

Health Professional Education 

Dr. Majid Sadigh with Professor Margaret Borok (left) and 

Professor Ndhlovu Chiratidzo Ellen (right) 

Dr. Majid Sadigh with Dr. Shalote Chipamaunga, Global 

Health Scholar 

Left to right: Mrs. Farayi Kaseke, Dr. Shalote Chipamaunga, 

Mr. Vasco Chikwasha, and Professor Ndhlovu Chiratidzo 

Ellen 


307

INAUGURAL GLOBAL HEALTH ROTATION AT 

WALAILAK UNIVERSITY, THAILAND 

Written by Dr. Stephen Scholand 

Global Health Program Site Director in Thailand, Vietnam, and 

Zimbabwe 

The rat snake (Ptyas korros) struck with such a ferocious velocity it jolted 

me wide awake from my jet-lag induced haze. Fortunately, I was separated 

by a solid cement wall from the snake handler and the serpentine creature, 

awesome yet strangely beautiful. As a non-venomous snake, it did not 

pose a risk to humans, unlike some of the other amazing snakes on display 

at the Thai Red Cross snake farm in Bangkok. We observed live demonstrations of several of the most deadly 

snakes, all kept for anti-venom production at the institute. We were within spitting distance of cobras (Naja 

kaouthia), Malayan pit vipers (Calloselasma rhodostoma), Malayan kraits (Bungarus candidus) and Russell’s 

viper (Daboia siamensis). This was our first official leg of the new global health elective site in Thailand, where 

we learned in depth about the neglected tropical disease “Snakebite Envenomation,” a new WHO priority. Thus 

we were initiated into our journey. 

We traveled farther into the rural reaches of Thailand, arriving at Walailak University in Nakhon Si Thammarat, 

an ancient kingdom of Thailand. Dr. “Menn” Petchuan Petchuay, the dean of the medical school greeted us and 

reviewed the fantastic rotation he had arranged for us. Of course, it all started by sharing a delicious Thai dinner 

with our hosts. Smells of fragrant herbs and chili wafted from the kitchen. Admittedly, this was an important 

aspect to the rotation – that mouth-watering Thai food would enhance the experience. 

We started on-site with a couple days of clinic-based activities including “bread and butter” medical cases in 

diabetes, hypertension, and cardiovascular disease. We graduated on to a nearby community hospital, Tha Sala, 

consisting of approximately 150 beds. Here participants focused learning activities on an individualized basis, 

including Pediatrics, Surgery, Emergency Medicine, Psychiatry and Medical Intensive Care Unit. The teaching 

was augmented with didactic sessions on tuberculosis, zoonotic diseases, rabies, and global health perspectives 

as well as useful bedside reviews of the cardiovascular exam, X-ray reading, and understanding EKGs. Tha 

Sala showcased community medicine, and several excursions into the community were carried out to provide 

care in a global health framework. Important health topics addressed included cost, access to care, education/ 

understanding, and environmental and cultural perspectives on healthcare. Throughout, our participants were 

exposed to traditional Thai medicine, which seemed integrated into Thai concepts of healing. In fact, Tha Sala 

even had a special wing of the hospital dedicated to medical Thai massage, aromatherapy, acupuncture, and even 

cupping. 

A significant highlight of the rotation was a sojourn to the Phud Hong Leper Foundation. Here, it was brought into 

sharp focus how a horrific disease could be well-managed with determination and vision. Instead of rotting limbs 

and rampant suffering, here was a place of healing and empowerment. A veritable global health success story! 

Finally, the group rotated through Maharaj hospital, a 1000-bed teaching hospital in the heart of Nakhon Si 

Thammarat city. This clinical site included smart and supportive Thai medical students who were fluent in English. 

Faculty were interesting and engaged, and provided didactic teaching and led bedside rounds. In addition, noon 

conferences in English augmented the excellent educational experience here. Our global health participants 

agreed wholeheartedly that this was a comprehensive and satisfying rotation. 

308

As a finale, our group provided some of our own pearls and perspectives in global health, each giving a fifteenminute 

presentation to our Thai faculty leaders. Fortunately, our teachers had asked us from the beginning to call 

them Pee which meant “big brother” or “big sister,” so it was not stressful to present to them. Instead, we felt a 

certain nostalgia to leave after such a wonderful time. According to Buddhist philosophy, however, we knew that 

things would continue on, as this was the natural order of the universe. 

Thank you, or ขอบคุณครับ, to our Thai global health family. I feel that our partnership has just begun. 


Group dinner, from far left counter clockwise: Dr. “Mee” 

Apichai Wattanapisit, Dr. “Menn” Petchuan Petchuay, 

Dean of the Walailak University School of Medicine; Dr. 

Stephen Scholand, Global Health Program Site Director 

in Thailand, Vietnam, and Zimbabwe; Isaac de La Bruere 

MSII, Dr. David, Collin Montgomery MSII, Wendy Li PGY III, 

and Ray Mak MSII 

Left to right: Collin Montgomery MS II, Dr. Wendy Li PGY 

III, Isaac de La Bruere MS II, Ray Mak MS II, Yupin Waree, 

and Dr. Stephen Scholand with very large Burmese python 

(Python bivittatus) at Queen Saovabha Memorial Institute 

Snake farm 

Elephant kiss. Don’t be jealous! Isaac de La Bruere MSII 

and a loving Asian elephant (Elephas maximus) 

Walailak University core medical faculty demonstrating a 

double “mini heart” sign. Left to right: Dr. “Mee” Apichai 

Wattanapisit, Dr. Stephen Scholand Site Director, 

Ray Mak MS II, Dr. “Frank” Chaiwat Rerkswattavorn, 

Collin Montgomery MS II, Dr. Wendy Li, and 

Isaac de La Bruere MSII 

Left to right: Dr. Stephen Scholand, Dr. Deer, and Dr. “Mee” 

Apichai Wattanapisit 

Amazing sunset over Walailak University park, Nakhon Si 

Thammarat, Thailand 

309

PERSPECTIVES 

SEXUAL HARASSMENT AND VIOLENCE ACROSS GLOBAL CONTEXTS: 

PART 2 

Sexual- and gender-based harassment and violence are gradually emerging from tabooed obscurity and entering 

the global consciousness. What were once accepted as facts of life are slowly being called into question as 

overturnable systems of oppression. It is pertinent that we demonstrate our commitment to gender equality 

and safety for all human beings by using this momentum to create platforms for further investigation. Over the 

next few months, we hope to create one here for our global health community. We encourage our members, 

particularly those from the Global South, to join the discussion by sending us their thoughts and insights in the 

form of perspective pieces. - Mitra Sadigh 

“KSS KSS SISTA”: #METOO IN A ZIMBABWEAN CONTEXT 

Written by by Tendai Machingaidze 

The issue of sexual harassment was, is, and will continue to be one of 

the world’s most confounding dilemmas. Logically, it seems like it should 

be a straightforward problem to solve if the right protocols and systems 

are put into place to punish those who violate others. In fact, this is quite 

often the way it has been handled decade after decade around the world. 

However, history clearly shows that the complexity of preventing sexual 

harassment goes beyond programs, manuals, and training videos. Why? 

Because sexual harassment is inextricably linked to gender inequality, 

and gender is indissolubly bound to culture, and the logic of a culture is 

itself governed by that culture. 

The #MeToo movement in the United States has given birth to a renewed 

worldwide mobilization against sexual harassment. #MeToo supports 

women’s voices and empowers them to speak up and share their stories 

of sexual harassment and assault. In so doing, #MeToo, as with many other notable movements in history, aims 

to change the culture of tolerance towards sexual misconduct and to authorize women to demand justice and 

lasting change. As much as #MeToo is to be applauded and given wings to fly across the globe, it is an inherently 

Western movement that cannot be fully translated and realized in all cultures and contexts without adjustments. 

Here, we take the Zimbabwean context into consideration, particularly the question: Can a global health student 

from America exercise #MeToo if they experience sexual harassment or assault in Zimbabwe? 

Despite the fact that Zimbabwean cultures are inherently patriarchal, great advances have been made in the 

education of the girl child. This has resulted in women being able to work and get paid on par with their male 

counterparts. In medicine, it is commonplace, for example, for women to work not only as nurses and midwives, 

as has been traditionally acceptable for generations, but also as doctors, medical faculty members, and leaders 

in health policy. Such education of women is principally tied to the upsurge of women’s rights and the promotion 

of gender equality. 

310

However, culturally, and in many cases religiously as well, the dynamics between Zimbabwean men and women 

still places men “above” women in all spheres of life. The male perspective demands and dominates, and this has 

been, and in most cases still is, accepted as the norm. Within such a male-controlled environment, it is therefore 

not surprising that it is men who tend to govern sexual interactions between the two genders. Often, within the 

Zimbabwean context, persistence and aggressiveness in a male suitor are applauded despite rejection from the 

female object of his affection. Especially if a woman is single and without children, a man has every “right” to 

pursue her. It is not uncommon for leering shouts of “kss kss sista,” or some other version of catcalling, to be 

heard in the streets directed towards a woman who is simply going about her day. Nor is it uncommon for verbal 

harassment to turn into physical advances and in tragic cases, sexual assault. 

Though still shadowed by stigma and shame in some places, sexual abuse in the form of rape, is unacceptable 

in Zimbabwe, and many avenues exist to report and prosecute perpetrators if a woman is brave enough to 

speak out. However, when it comes to sexual harassment that is verbal or behavioral, the lines in Zimbabwe are 

dreadfully undefined. Women are expected to be silent and submissive recipients of unwanted advances as “it is 

in men’s nature to behave like that.” In many African societies including Zimbabwe, women rarely discuss their 

own sexuality among women, let alone in the public arena in relation to male sexuality. Fear of stigmatization is a 

very real concern that often leads to crippling passivity. Speaking out against sexual harassment and abuse often 

leads to being blamed yourself, being labeled a “loose woman,” being ostracized from your family and friends, 

losing your job, and worse. As such, “sexual harassment of female students by their lecturers has become a 

serious social problem in schools and institutions of higher education in Zimbabwe.” 

According to a 2017 article by R. Matsikidze in the Zimbabwe Electronic Law Journal, “The University of Zimbabwe 

Code of Conduct defines sexual harassment as unwarranted conduct of a sexual nature that affects the dignity of 

men and women at work. It includes physical, verbal and non-verbal conduct that is sexually coloured, offensive, 

intrusive, degrading or intimidating. The definition…is inadequate in that the content of the definition itself is 

insufficient and it does not include the mechanisms to detect and resolve the cases of sexual harassment, for 

example the boards of inquiry, counselling services, (or) post-harassment support centre(s).” Matsikidze goes on 

to note that, “The University of Zimbabwe Students’ Charter comprehensively provides for the combat of sexual 

harassment but what is needed still is to transform those noble intentions into satisfactory regulations.” 

In a study titled “Sexual Harassment Among Female Students at a Zimbabwean Institution of Higher Learning,” 

Dhlomo et. al found that “31% of the students acknowledged having been sexually harassed. About 69% of the 

students appeared not to recognize sexual harassment that may have occurred to them. Only a minority of the 

students (7%) reported the harassment.” How then is a female student visiting Zimbabwe from America who 

embraces and supports #MeToo supposed to step up and speak out against sexual harassment within this context? 

Should she follow the pervasive attitude of timidity and tolerance when harassed by an unrelenting suitor while 

in Zimbabwe? What is considered an overreaction in Zimbabwean culture? Should her comfort with the opposite 

sex take a back seat because she is in a different part of the world? Will speaking out make a difference? 

The unequivocal answer is “Yes! Speaking out will make a difference.” How should this be done? 

• Seek advice from strong female Zimbabwean medical personnel who have undoubtedly had to deal with 

sexual harassment in one form or another. Ask them about the informal and formal ways to deal with sexual 

harassment in Zimbabwe. 

• Though the system may be flawed, make an official complaint! 

311

• After you make a report, do not expect the same reaction/process to occur as in the United States. It is a 

work in progress that continues to evolve with each official complaint that is registered. 

• 

• Do not isolate yourself. In sharing your experience with your Zimbabwean counterparts, you will likely find 

that you have a lot in common, despite your differences in culture. Such bidirectional exchanges are the key 

to empowering each other to make a stand against injustice to women in whatever culture it occurs. 

• 

• A balanced approach is key. Despite your justified anger and hurt, do not throw out the proverbial baby 

with the bathwater. Try not to dismiss an entire culture because of one particular issue. There are countless 

lovely and noteworthy aspects of Zimbabwean culture, gender relations, and family dynamics, that the world 

could learn a lot from. #MeToo must be contextualized so as not to dismiss or obliterate these aspects of 

Zimbabwean culture through unchecked westernization. The goal should be to inform Zimbabwean culture to 

be a better version of itself, not to make it more American. 

The temper of the times is changing in Zimbabwe, albeit much slower than in the United States. Global health 

participants from the United States may not immediately see this in comparison to the pace of the culture they 

are used to, but women in Africa are rising up as well. Female revulsion to sexual harassment transcends culture, 

be it silent, quiet, or loud. Only together can we find solutions that uplift the beauty, dignity, and pride of the 

female gender, in all its multifaceted cultural manifestations around the globe. 

“What women are saying worldwide is: you don’t listen to us, you don’t believe us, your reporting systems don’t 

work for us, investigations are not independent, and it takes too long to get an outcome. We certainly have to 

improve; but these issues are ultimately procedural expressions of a culture that devalues women. I don’t think 

that we will see lasting change unless we change the cultural expressions of tolerance to male sexual entitlement 

over women’s bodies.” 

-Purna Sen (UN Women’s Director of Policy Division) 

1 

Almon Shumba & Antony Erinas Masiki Matina (2002). “Sexual Harassment of College Students by Lecturers in 

Zimbabwe.” Sex Education, 2:1, 45-59. 

2 

Matsikidze, R. (2017). “Strengthening legislations as a way to combat sexual harassment at workplace and in 

universities in Zimbabwe.” The Zimbabwe Electronic Law Journal, 2(1), 57-63, 62. 

3 

Matsikidze, R. (2017). “Strengthening legislations as a way to combat sexual harassment at workplace and in 

universities in Zimbabwe.” The Zimbabwe Electronic Law Journal, 2(1), 57-63, 62. 

4 

Thelma Dhlomo, Rose M. Mugweni, Gwen Shoniwa, Levison Maunganidze & Tholene Sodi (2012). “Perceived 

Sexual Harassment Among Female Students at a Zimbabwean Institution of Higher Learning.” Journal of Psychology 

in Africa, 22:2, 269-272. 

UPDATE ON EBOLA SITUATION IN UGANDA 

Written by Professor Rhoda Wanyenze 

Generally, Uganda has done well in stemming off the Ebola epidemic. The contacts that were being followed 

previously were cleared. Contacts of the latest case of an individual who tested positive that came into Uganda 

but eventually admitted in Congo were tracked quickly and vaccinated. I would say we are safe for now, and I will 

let you know if any other issues emerge. 

312



programs often experience and report such abuses while undergoing international electives. Proper guidance 

and support must be provided so that these individuals can effectively recover and that the source of abuse be 

rectified. The framework for understanding sexual harassment and abuse has fundamentally changed with the 

widespread #MeToo movement that has shaken the historic tolerance of sexual harassment, leading to both 

discourse and action of global impact. In this vein, it is the responsibility of the global health community to 





2019 WCHN/UVMLCOM GLOBAL HEALTH INTERNS 

Written by Dylan Ochoa 

Coordinator of the WCHN Global Health 

The Western Connecticut Health Network/University of Vermont Larner College of Medicine (WCHN/UVMLCOM) 

Global Health Program continues to be actively involved in conducting outreach initiatives with multiple countries 

and communities from around the world. For the previous seven years, we have sent medical students, faculty, 

and administration overseas to engage in global health. This year was a first for WCHN/UVMLCOM Global Health 

Program as we excitedly accepted three pre-professional students for an internship at Danbury Hospital. These 

individuals have a shared interest in global health and specifically sought out Dr. Sadigh for his professional 

guidance to learn more about global health. 

The three interns are Ritesh Vidhun, Sarah Cordisco and Jack Mix. Since May 2019, each student has met with Dr. 

Sadigh on a weekly basis to discuss the fundamentals of global health, including biostatistics, medical literature 

reviews, and the healthcare profession. They also had the opportunity to meet with Global Health Scholars and 

faculty from different countries, and to learn about their unique experiences. 

The interns created modules based on their interests. Entering the University of North Carolina in Wilmington 

this fall where he plans to follow a pre-med track and major in biology, Jack created a global health module that 

incorporates the basic tools for teaching global health to future interns. A sophomore nursing student at the 

University of Vermont, Sarah Cordisco is currently developing a Women’s Global Health module, as well as a 

manuscript on the role of nursing in global health. A high school senior at Chase Collegiate School in Waterbury, 

Connecticut, Ritesh Vidhun previously completed a research project on the healthcare system in Uganda and 

presented a poster at the 2019 WCHN Global Health Conference. He is expanding his research to compare and 

contrast Zimbabwe’s and the United States’ medical education and healthcare systems. 

313

Left to right: Jack Mix, Dylan Ochoa, Ritesh Vidhun, Dr. Stephen Scholand, Sarah Cordisco 

All three students have the exceptional capabilities to continue on their path and to make their own mark in 

global health. The WCHN/UVMLCOM Global Health Program is proud to have played a role in providing them with 

a greater awareness of global health. As their short but meaningful internship with us comes to a close, we wish 

all three academic success and the assurance that the WCHN/UVMLCOM Global Health Department will remain a 

steadfast supporter in establishing future global health peers. Due to the success of our first year pre-professional 

interns, we look forward to the opportunity to influence and inspire prospective interns. 

“I am interested in global health because of its impact and significance across the world. It reaches all types of 

communities with one main goal: to help others in need. I decided to pursue an internship with the WCHN/UVM- 

LCOM Global Health Department in order to gain more exposure to and experience with this field before deciding 

what to study in college.” 

– Ritesh Vidhun 

314

REFLECTIONS 

Dr. Li Zhou, Medical Resident at Norwalk Hospital 

Due to a shortage of doctors and large patient volume, the MDs here are wellrounded 

with superb hands-on skills in all procedures. Even senior medical 

students in their sixth (final) year - called “externs” - regularly handle procedures 

that are usually designated to specialists in North America, such as endotracheal 

intubation, and even perform simple surgeries such as Cesarean sections or 

appendectomies as the only surgeon, as opposed to the first assistant! Not 

surprisingly, hematologists perform their own bone marrow biopsies and 

nephrologists put in hemodialysis catheters for their patients. Interventional 

radiologists do not work here! In fact, I am not sure if they exist in Thailand. 

Coming from the United States where all specialties are becoming increasingly 

sub-specialized and internists are rather hands-off while most invasive procedures 

are taken over by interventional radiologists, I actually wish I could train and work in Thailand in order to hone my 

procedural skills and become as capable as the Thai MDs or older generation of American physicians. 

One thing I know for sure is that I cannot help but feel ashamed when a Thai medical student, anesthetic nurse, or 

paramedic can intubate while I cannot. How can I be a doctor when I have never had the opportunity or training 

for procedures such as intubation, lumbar puncture, or thoracentesis? These are just a few of the procedures I 

never had a chance to learn or practice enough to be good at. 

To be honest, I know most of my fellow residents do not know how to put in peripheral IVs. Skills like these are 

simply lost when our nurses take care of them, and when they cannot, they come not to us but to the resource 

nurses. When the resource nurses also fail, we simply order 

peripherally inserted central catheter (PICC) lines to be done 

by an interventional radiologist. Similar is getting arterialblood 

gas analyses (ABGs) and managing ventilators. With 

respiratory therapists in North America, we MDs don’t have 

to do these seemingly mechanical tasks anymore. But for 

Thai doctors, after they intubate their patients, they are the 

ones setting up the ventilator and later adjusting the settings. 

Dr. Li Zhou with the Global Health Program 

participants and Thai faculty 

The last time I performed an ABG was probably a year ago, 

and I only got to do it because the respiratory therapist took 

a long time to show up to the patient’s bedside. Fortunately, 

I knew how to get an ABG, but again I know many of my 

colleagues do not or are not good at it. I think there will be 

situations in which this loss of hands-on skills by many of 

us in the U.S. due to overwhelmingly good auxiliary support 

system or birth of numerous other health-related specialties 

may actually hurt patient care. 

315

I clearly remember, as a medical student rotating in the U.S., witnessing a resuscitation where the patient did not 

have a peripheral IV. Nobody at the scene was able to put one in, so they proceeded to attempt a central line blind 

in the middle of the code. This was when I realized even seemingly simple skills such as peripheral IV access is 

important, despite everyone telling me it’s a useless skill if I end up working in the U.S. 

This is one of the main reasons I am interested in global health. I yearn for the opportunity to learn intubation, 

to run ventilators on my own, to learn everything that a Western medical education and training, despite its 

greatness, failed to teach me. 


It has been a while now since I returned home, and I have been able to settle 

in well. My experience in the United States has been very valuable since I got 

back. It has totally changed my perspective in both the practice of medicine and 

teaching of students. With the knowledge I acquired, I now find myself in a better 

position to help patient care while trying my best to pass it on to my colleagues 

and the residents, especially as new equipment has been brought to the Mulago 

ICU. Thank you very much for the opportunity you offered me. 

Moses Othim 

Global Health Scholar from Uganda 

Dear Noeline, 

I’m writing to let you know that the idea you initiated - supporting psychiatry residents in Uganda - has been 

funded by a generous gift from Mr. Ruddy Ruggles! 

Dr. Mariah McNamara, who you met with about a year ago and who oversees the Global Health Program at the 

UVM College of Medicine, will be coming to Kampala in two weeks and would like to meet with you. She and I 

have a series of questions for you to orient us to the department and the residency program so that we can get 

the planning underway. I’m cc’ing Mariah above so that you and she can find a time to meet. Dr. Sadigh will also 

be in Kampala in early August to meet with the Provost of the University and the Dean of the medical school to 

obtain their support for this initiative. 

This is indeed exciting! 

All my best, 

Judy Lewis 

Director of the Psychiatry Residency Training Program at UVMLCOM 

316

Dear Mariah, 

I let the department know of this great opportunity, Ruggles Scholars in Global Mental Health, for the incoming 

students and they are all very excited about it. They send appreciation by the team that made this happen. When 

you come over Thursday afternoon, the 25th is a good time as well as the whole of the 26th Friday and the 30th 

Tuesday morning. 

Kind regards 

Noeline Nakasujja, MBChB, MMed. Psych, PhD 

Associate Professor of Psychiatry 

Chair, Department of Psychiatry, School of Medicine, 

Makerere University College of Health Sciences 

Dear Dr. Sadigh, 

Reading through the Special Issue of the eMagazine, I had a thought that one day a documentary or short film 

will be born from any one or all of these stories. Each of them provokes a powerful feeling of humanity, truly 

reminding us that we are one humanity. One is just lucky or unlucky to be born in a certain location, family, 

or circumstances, none of which we chose but it just happened: as such it is important to embrace empathy. 

This is being achieved through global health, since everyone in the world is entitled to good health as a human 

right. Thank you to all for reminding us. My prayer is that this program expands and expands.... 

Jamidah Nakato, PhD 


Dear Doctor Sadigh , 

It is great to see an article about sexual harassment in eMagazine. This is a worldwide problem for women in 

any society on a daily basis. Thank you so much for posting my email in the July eMagazine. Flipping through 

it has opened my eyes to much bigger societal problems in addition to inspiration and strength to be more 

resilient and industrious to shape the future into a better world for everyone. 

Best regards, 

Elnaz 

Hello All: 

The special issue looks great, nice design work......I hope it’ll get the message out there :-) 

Thanks, 

Kvon 

317

Dear Dr. Nazarius, 

I wanted to thank you for receiving us Thursday afternoon. You and your team were very welcoming. It was 

very interesting to see the Makerere University School of Public Health, learn about your ongoing projects and 

partnership with different institutions through the Africa Resilience Network. I hope we continue to communicate, 

learn from each other and work together. And, thanks for the ride in your car!!! 

Best, 

Sandra Mini, MD 

My daughters are doing great! They go to Sanyu Babies every day, and I to St. Stephen’s Hospital, except 

when I visited the Makerere University School of Public Health with UVM students. We came to Murchison Park 

this weekend. Tomorrow students that go to Naggalama depart. I will go Monday with students to St. Stephens. 

Incredible. 

Thanks, 

Sandra Mini, MD 

New Nursing Platform! 

It is a big world! All of us at WCHN are watching the 

organization grow again through the union of Western 

Connecticut Healthcare Network (WCHN) with Health Quest 

to create a new integrated health system, Nuvance Health. 

Concurrently, the Global Health Program is growing as well! 

WCHN, which has been a branch campus for Larner College of 

Medicine at the University of Vermont, is also expanding with 

new clinical partnerships and additions to the global medical 

team with our experienced nursing colleagues at WCHN! 

Having established a Nursing Platform on the eMagazine, 

we invite our experienced nurses to participate in dialogue 

about global health issues and in the development of 

innovative nursing education programs around the world. 

These programs, both domestic and abroad, will benefit from 

the clinical expertise and wisdom of knowledgeable nurses 

Catherine G. Winkler, PhD, MPH, APRN-BC 

in our network who can provide the perspective and nsight 

needed to enhance nursing education and patient care delivery in underserved populations. The goal is to offer 

consistent, coordinated, and efficient nursing knowledge through global health in a way that makes sense and is 

doable for the international organizations and nurses we work with, taking into consideration the culture, people, 

and environment. 

Global health started as a program to advance the education of medical students while providing clinical support 

and medical education and research at international sites. The program has expanded to include specialty rotations 

318

of experienced physicians and additional domestic clinical sites. Now, as global health grows, experienced nurses 

are essential as partners in global health initiatives to better guide the development of education and research 

programs and the delivery of patient care. Accordingly, nurses are needed to share their perspectives, assist in 

the formulation of novel ideas and solutions, and join with our medical colleagues in a team-based approach 

which in turn can be used as a model that supports patient-centered care in healthcare systems that are often 

faced with many challenges. We currently have Sacred Heart University as a partner with nursing students 

volunteering at sites as part of their clinical rotation with faculty advisement on curriculum development. The 

addition of the experienced nurse is fundamental to the program’s operations in the communities served by global 

health to share best practices, advance knowledge, and collaborate across all disciplines and organizations. 

We look forward to hearing from our nursing colleagues, learning from experienced nurses, and growing in 

collaborative practice. Please contact Catherine Winkler at Catherine.winkler@wchn.org to publish your comments 

on this nursing platform, become involved in important work, and discuss future directions in the Global Health 

Program. 

All the best, 


GLOBAL HEALTH 

AND THE ARTS 

Written by Tendai Machingaidze 


“HOLD YOUR BREATH” 

An Interview with Artist-Activist Paulina Siniatkina 

Growing up in Zimbabwe, the burden of disease from tuberculosis is 

one that I am all too familiar with. Coupled with the HIV/AIDS epidemic, 

tuberculosis has a firm grip on many African countries, and has ravaged 

families and communities for centuries. 

Though I was well aware that the problem extended around the world, 

living in Russia for the past six years I have been astounded by the strong 

parallels between what patients in Zimbabwe and Russia experience. 

Despite the stark differences in culture and access to adequate medical 

care in the two countries, stigma is a common thread that ties the 

experiences of those who have suffered from tuberculosis together. 

319

I recently had the opportunity to engage with Paulina Siniatkina, age 29, about her experience as a tuberculosis 

patient in Russia. Since 2016, Paulina considers herself an “artist-activist” in the field of global health. My interview 

with her reveals why. 


PS: Paulina Siniatkina 

TM: Could you please describe your personal experience with TB and with being a patient in a TB 

hospital in Russia? 

PS: In 2015, I spent six months and seventeen days in a tuberculosis hospital in Moscow. When I heard my 

diagnosis, I was not afraid because I had never really heard about TB in my life. While in the hospital, I learned 

many things: that it is a very dangerous disease, that millions of people are dying because of it; and that there is 

a stigma over this decease. People who are not infected react aggressively, blaming or avoiding communications 

with infected people, and as a result, sick people are afraid to speak out. They hide or lie about what is actually 

happening to them. In my personal experience, my doctor told me not to tell anyone about my diagnosis, 

otherwise I would be branded for life. 

TM: How did your experience with TB inspire your work “Hold Your Breath”? 

PS: I think that stigma is the main reason why humanity still cannot beat tuberculosis. As long as people are 

afraid to talk about it, the disease will continue to spread. I realized that I want to fight it and the only weapon I 

am able to use is art. 

I started to paint while I was in the hospital. I 

painted the reality of hospital life. I asked permission 

from my chamber mates if I could paint them. To 

my surprise, lots of people agreed to pose for me, 

because they wanted to break through the taboo. 

They were afraid to do it alone, but together we 

could do it. However, many other people didn’t 

want to pose for me because they were afraid that 

somebody would recognize them in a painting. 

Don’t Speak! Tempera on canvas from the project “Hold your 

breath” , a series of artworks by Paulina Siniatkina, made 

during her 6 months of treatment in a Moscow TB clinic 

I left the hospital cured and with a series of artwork. 

Thankfully, because of the StopTB Partnership, I 

had an opening of my first exhibition “Hold Your 

Breath” on March 24 in Moscow for World TB Day. 

My work became my confession, and not only mine, 

but of the people in my paintings too. Together, we 

say to everyone that we are not afraid to speak out. 

We also want to inspire other people to break the 

silence so that TB patients share their experiences 

without fear of being stigmatized. 

320

TM: What impact has “Hold Your Breath” had in Russia? 

PS: “Hold Your Breath” was shown in Moscow, Saint Petersburg, Voronezh, Ekaterinburg, and Ivanovo. I saw 

different reactions from viewers. Mostly, there were good reactions, but some people were afraid to even watch 

the exhibition. People were shocked. They had never thought that TB was something that could happen to them. 

Many young viewers were so impressed that the first thing they did after seeing the paintings was to get X-rays 

to check their health status. This was my purpose in the beginning. I knew that people would be shocked. TB 

could never be associated with someone like me. I hope I broke the stereotype. No one is safe, and I hope my 

audience got this message. 

TM: How did the World Health Organization (WHO) come to know of your work? 

PS: Stop TB Partnership supported my first exhibition. They realized back then that nothing like this had ever 

been done before. They brought my exhibition to Geneva and Bratislava – that’s how more people in the medical 

world got to know me. I also started to work with Elli Lilly Partnership on my new project in 2016 – a brochure for 

patients written by patients called “Tuberculosis and You.” That’s how WHO Russia got to know me and we started 

to work together. WHO featured my story on their website in 2017 and my exhibition was shown at the WHO 

Ministerial Conference on TB in Moscow. Additionally, in 2017, posters of my works were displayed in Geneva, 

Switzerland for World TB Day. 

TM: What impact has “Hold Your Breath” had on the rest of the world through your association with 

WHO? 

PS: I have around 9500 followers on Instagram (@paulina_siniatkina) and many of them came from WHO 

features. I constantly receive messages from different TB patients around the world. They write to me of how 

much they are inspired by what I do. Some of them say that they are not afraid to speak out anymore, and for 

me it is the most important thing. I don’t allow myself to give up on what I’m doing after I read these messages. 

TM: Could you please describe your new work “You Don’t Want to Know This”? 

I am working on it now and am going to make a big solo exhibition in MMOMA (Moscow Museum of Modern Art). 

The concept is simple. It is going to be my manifesto. I want to tell the world that our main enemy is stigma. We 

have everything to beat most infectious diseases, and still they kill millions of people every year. New medicines 

may beat the rising drug resistance and offer even more effective treatments, but that won’t matter if people feel 

the need to hide their disease. Diseases will always win; bacteria will always become smarter. So it is STIGMA 

that we need to fight first. Stigma is in the mind. It is a mentality that is very hard to change. It may be scary, 

but if we want to change it, we need to face the truth. 

TM: Why did you choose art as your means of expression and commentary on health issues? Why is 

the relationship between health and the arts important? 

PS: I have done art all my life and I can’t imagine myself not doing it. I think it was always in my character to be 

a fighter. When I got TB and faced all the awful truth about it, I realized I wanted to fight the system and that art 

was my only tool, but a very strong one. 

TM: What are your plans for the future? 

PS: I want to change the world. 

Paulina studied at the Moscow State Academic Art Institute named after Surikov (2007-2013), and she has taken 

workshops at the Moscow Modern Art Museum. She currently lives in Moscow and Amsterdam. 

321

Find out more about Paulina Siniatkina and her work as 

an artist-activist at: 

https://www.youtube.com/watch?v=vFmRhvTTpFk&t=39s 

https://www.paulinarts.com/ 

https://www.who.int/features/2016/russia-tuberculosis/ 

en/ 

Tendai gets the point about treating the spirit as well as 

the physical malady. The art is intriguing and I wish we 

could acquire some of it (or even a high-quality reproduction) 

for our global health offices. 

Jonathan Fine 

ANNOUNCEMENTS 

NEW INITIATIVES FUNDED BY GENEROUS 

DONORS 

Ruggles Scholars in Global Mental Health 

“It was often a monumental challenge to present 

schizophrenia, bipolar, or epilepsy as anything 

other than possession” 

Brian Rosen 

A carved tribal wooden figure from Nigeria, about 

eight inches tall, depicting in its quintessential, 

primitive way an eerie embodiment of the inner 

torment of a mental illness (Courtesy of Mr. 

Rudy Ruggles) 

322

PROPOSAL FOR COLLABORATION AND SUPPORT OF PSYCHIATRY RESIDENTS AND 

TRAINING SCHOLARS IN GLOBAL MENTAL HEALTH IN UGANDA AND BEYOND 

Western Connecticut Health Network (WCHN) 

& University of Vermont Larner College of Medicine (LCOM) 

Background 

Uganda has over 40 million citizens and only 30-40 psychiatrists, which is a ratio of about 1 psychiatrist per one 

million of its population. The country’s mental health needs are great, with as many as 35% of its citizens having 

a mental disorder and up to 15% needing treatment (1). This high prevalence rate is a result of a combination of 

factors including widespread PTSD from the bloody dictatorship of Idi Amin 1971-79, a high poverty rate (27% 

in 2017), a high birth rate (5.5 births per woman in 2017), and a high rate of AIDS (~13% of all deaths in 2017) 

(2) . According to a 2006 WHO study, the country spends only 1% of its total healthcare dollars on mental health 

such that an estimate of 90% of mentally ill in the country do not receive treatment (3). In addition, there is 

great cultural stigma against psychiatric diseases, with a high percentage of the population believing that spirits 

or witchcraft cause the disorders. Epilepsy is considered a psychiatric condition in Uganda because of both stigma 

- as it is believed to be caused by a curse, not a neurologic disorder - and the lack of neurologists in the country. 

Patients with epilepsy take up many of the psychiatric resources because of high rates (estimated at 2-5 per 

1,000) due to the prevalence of infectious diseases and the frequency of birth trauma from unattended births 

(4). Children with epilepsy are thought to have a contagious illness and are often abandoned by their families, 

however there are few specialty facilities or training programs for child and adolescent psychiatry in the country. 

Whereas internationally, an average of 15% of medical students report an interest in the specialty of psychiatry 

and 3% choose the field (5), interest in Uganda is around 4% and less than 1% of medical students choose it (3). 

This is likely due to multiple factors. Stigma against psychiatry is strong and exists within medicine itself, due in 

part to a widely-held belief that those who treat mental illness are themselves afflicted. In addition, psychiatric 

careers do not pay as well as other fields due to low reimbursement rates and low demand for private clinics. The 

cost of training further pushes interested students towards more lucrative specialties in which trainees can make 

up for any debt they accrue during training. Only 1% of the medical doctors in Uganda are psychiatrists, and the 

ratio of psychiatrists per bed in psychiatric facilities is 2 per 100 patients (3). Uganda is not alone in this problem. 

The World Psychiatric Association (WPA) included recruitment to psychiatry as a major part of its 2008–2011 

Action Plan (5). 

Medical school in Uganda spans five years, after which graduates work for two years as a medical officer. Subsequently, 

physicians can enroll in a three-year psychiatry residency called a Masters in Medical Psychiatry (MiMP). 

The purpose of Makerere University’s MiMP program is “to produce competent psychiatrists” who will: 

• Provide clinical psychiatric and psychotherapeutic care to those who will present with both common as well 

as the more unfamiliar psychiatric disorders in Uganda. 

• Conduct and/or supervise research in psychiatry and mental health problems. 

• Assume a leadership role in the field of mental health. 

• Build capacity in mental healthcare. 

• Provide consultation services in mental health to other health institutions in the country (6). 

The program has capacity for six residents per year, but is rarely fully subscribed. Residents in training at Makerere 

University College of Health Sciences have two main clinical sites: Mulago National Referral Hospital in Kam- 

323

pala, one of the largest hospitals in East Africa, and Butabika Hospital, a 400-bed psychiatric hospital located 16 

km outside of Kampala serving all of Uganda. 

Proposal 

An intervention that would have a significant and sustainable impact on the mental health of Ugandans could be 

aimed at ameliorating the international recruitment crisis in psychiatry (5). Makerere University’s residency training 

program is ideally suited to train specialized physicians who can take on leadership roles, shape policy, and 

guide the country in the provision of mental healthcare, as well as model excellent and humane mental healthcare 

for their students. The program, headed by Dr. Noeline Nakasujja, could use our financial help to recruit talented 

young physicians into their residency program. 

We envision creating a scholarship to financially support three residency slots across three years of training such 

that in the third year, there would be a steady state of nine scholarship residents in training at any one time. 

During their residency, Ugandan residents would have the opportunity to visit the University of Vermont Medical 

Center for two months or longer to shadow inpatient psychiatrists and residents and to learn about policies and 

provision of care. At the beginning of their second year, we would pair Ugandan residents with the second year 

UVMMC residents who currently elect to travel to Uganda for a month-long Global Mental Health rotation each 

year, a program that has been in place for three years. We envision these resident pairs developing a mutually 

beneficial collaboration, sharing materials, research ideas, and forming joint scholarly projects that focus on the 

advancement of mental health care in Uganda. In addition, the UVMMC residency would share our curriculum, 

creating audio PowerPoints or learning modules from our extensive lecture series that includes four years of 

didactic training and a weekly Grand Rounds series featuring nationally known speakers. In addition, Ugandan 

residents would spend an additional two months at Western Connecticut Health Network to learn research skills 

and teaching techniques. The goal would be to train expert clinicians, teachers, and researchers, some of whom 

will join Makerere’s faculty to teach and shape the next generation of medical school graduates and psychiatrists. 

We envision that these scholarships would be highly sought after, and that they would raise both the profile and 

status of the field of psychiatry within the medical school community. To our knowledge, this would be the first 

program of its kind, and could serve as a model for a sustainable financial and educational partnership elsewhere 

in Uganda and other low-resource countries. 

In addition, we propose an annual conference in mental health at MakCHS to address the challenges of this field 

in Uganda and to increase the level of interest among the medical students and others, crucial steps in attracting 

medical school graduates to psychiatry as a specialty. 

The advantages to our residents would be: 

1. Increased collegial interaction across the two residency programs, both at the residency and faculty level 

2. Collaborative research opportunities in Global Mental Health 

3. Collaborative educational opportunities (e.g. sharing curriculum across sites) 

4. Enhanced education on the social determinants of health and cross-cultural psychiatry from visiting residents 

and faculty from Makerere 

5. Increased longitudinal commitment from Makerere faculty r.e. teaching/supervising our residents and students 

(given the reciprocity of us supporting and teaching their trainees) 

6. Reduced experiences of guilt over “medical tourism” when our students and residents visit Uganda 

7. Enhanced recruitment of U.S. college students (to UVMLCOM) and medical students (to UVMMC psychiatry 

residency program) who are interested in practicing Global Mental Health 

324

What Global Health Participants Learn: 

• Soft Skills 

• Humility 

• Cultural sensitivity, appreciation, and competence 

• Cultural relativity vs. ethnocentrism 

• Communication skills 

• Perspective taking 

• Broad worldview 

• Apprenticing of problems before offering solutions 

• Building of a comprehensive framework for future medical practice 

Awareness of: 

• Resource allocation 

• Multi-factored, deep-rooted problems without simple solutions 

• Negative and false stereotyping and the need for narrative justice 

• Different ways of life 

• Traditional medicine and how it supports/opposes modern medicine 

• Socioeconomic determinants of health 

• Religious beliefs and how they affect healthcare 

• Sociocultural and political awareness 

• Effects of colonialism on healthcare today 

• Different approaches/non-Western frameworks of medical practice 

• The co-dependent nature of healthcare and education in Global South countries 

• Historical and present North-South dynamics 

Clinical Skills 

• The art of the physical exam and history taking 

• Thoughtfulness around which medical technologies to use and when 

• Wider exposure to diseases and conditions 

• Creativity around diagnosis and treatment 

• Tailoring clinical skills/practice to different cultural/religious contexts 

• How to handle loss of lives due to broken/inadequate medical systems 

Steps Toward Establishing Ruggles Scholars in Global Mental Health: 

1. To put together an executive committee including a member of the Ruggles family to write the mission and 

vision of the program, craft the blueprint, design the curricula, establish milestones and metrics, monitor and 

measure outcomes, and oversee the process (by July 15). 

2. To discuss the proposal with the MakCHS educational and executive leadership and acquire their approval 

(by August 15). 

3. To make moves toward implementing the program 

4. To frequently review the program and modify the blueprint based on the evaluation process 

5. To move forward toward a joint certificate in global mental health between WCHN/UVMLCOM and MakCHS 

(by September 2021) 

325

References 

1. Ndyanabangi S, Basangwa D, Lutakome J et al, (2004) Uganda Mental Health Country Profile. International 

Review of Psychiatry, 16, 52-62. 

2. Data from World Bank and Bureau of Statistics 2016-17 https://data.worldbank.org/country/uganda 

3. WHO-AIMS Report on Mental Health System in Uganda, WHO and Ministry of Health, Kampala, Uganda, 

2006. 

4. Bishara, Delia: Improving Health Care in Uganda, The Pharmaceutical Journal Dec 16, 2008 

5. Farooq K, Lydall GJ, Malik A, Ndetei DM, and Bhugra D, Why medical students choose psychiatry - a 20 country 

cross-sectional survey BMC Medical Education 2014, 14:12 

6. Website Makerere University Graduate programs, retrieved May 2019 from https://courses.mak.ac.ug/programmes/master-medicine-psychiatry-0 

LINDE HEALTH EDUCATORS WITHOUT BORDERS 

Written by Mitra Sadigh 

Writer/Editor/Researcher at the UVMLCOM/WCHN Global Health Program 

Science and humanism, values shared by healthcare practitioners across the board, mark healthcare education as 

one of the world’s most transnational enterprises. Despite its collaborative nature, the current system for meeting 

the burgeoning needs for more healthcare professionals, estimated by the World Health Organization to reach 

12.9 million by 2035, is insufficient. This deficit is especially felt in training workers to provide services in places 

of access scarcity. Therefore, we propose the creation of a carefully managed academy of healthcare educators 

that, by way of capacity building through teaching, can amplify the global healthcare workforce while broadening 

the extent of its reach - a replicable model that could grow to worldwide scale. As far as we know, the concept of 

Healthcare Educators Without Borders has never before been conceived or founded. 

326

Unlike other international healthcare organizations that are unidirectionally streamlined by Global North providers 

working in the Global South, or Global South providers training in the Global North before returning home, Health 

Care Educators Without Borders would be entirely inclusive and connective in nature. It would be predicated 

on the movement of healthcare educators from everywhere to anywhere on the globe: Global South to North, 

North to South, North to North, and South to South. Instead of emerging exclusively during times of crisis, this 

innovative organization would nurture foundational structures within communities by members themselves within 

a constantly growing network. We envision a collective body of well-trained health care educators that can be 

mobilized at any time to any point on the globe, to collaborate with health care educators on-the-ground toward 

developing the skills needed to build functional faculties within their own institutions. 

Though this body would initially be comprised of promising, accomplished junior or senior faculty from our 

international partner sites, it would eventually expand to include promising faculty from any medical or nursing 

school - or other healthcare education institution - around the world. Our program would be well-advertised to 

attract applicants who would pass through a selection committee comprised of members drawn from the WCHN 

(HQ) Global Health Institute, Division of Nursing Education, and to-be-formed Teaching Academy; Sacred Heart 

University College of Health Professions; and Linde representatives. Linde, a global industry leader that has 

expressed strong interest in supporting the WCHN Global Health Institute, would be sought as a major program 

funder. We would offer comprehensive training in clinical medicine and research, healthcare education, evidencebased 

medicine, and biostatistics, in addition to familiarization with the healthcare education and delivery systems 

in the United States. A competitive scholarship offered to select Global South applicants would cover expenses for 

transportation, meals, and daily living, as well as programmed social and cultural excursions. 

Termed “Linde Healthcare Educators Without Borders,” participants would arrive in two five-month cycles in 

January and July. Their training would occur at Western Connecticut Health Network, Sacred Heart University 

College of Health Professions, and Linde sites. On receiving certificates of completion, they would return to their 

home institutions to impart their newly- acquired knowledge to colleagues and students while supervising the 

327

training and research projects of our global health participants assigned to those partner sites. As the program 

gains momentum, reputation, and human power, these Linde Healthcare Educators would be sent to implement 

changes in healthcare education where needed. Familiar with the terrain, Global South educators are often better 

equipped to teach in other Global South sites than Global North educators. Such allocation of involvement would 

be an advantage of our inclusive, connected model. 

In terms of human resources, we would need a director and robust selection committee in addition to a management 

and coordination system for organizing visas, flights, housing, social support, and other necessities. In terms of 

communications, we would need a professional, user-friendly website through which interested parties can learn 

about the program and find ways of becoming involved; an eJournal to serve as a platform for publishing our 

own research as well as that of the greater community; an eJournal Editor-In-Chief to push the program forward 

through academic editing, assembling, and networking; an Editorial Board to peer-review eJournal submissions; 

and a blog through which to share participant experiences and spread our vision. 

Though its own independent entity, Healthcare Educators Without Borders would overlap with the WCHN (HQ) 

Global Health Program within the WCHN (HQ) Global Health Institute in a complementary twin model. Junior 

faculty, senior residents, and fellows anywhere in the United States would be able to apply for a global health 

elective scholarship focused on teaching and faculty development alongside Linde Healthcare Educator alumni. 

The organization would also partner with the Teaching Academy that should form within the new network, funded 

in part by the Endowed Chairs Fund, with the function of training Linde Healthcare Educators in medical education 

and research skills. 

In summary, we propose the building of an international army of healthcare educators that can mobilize in the 

direction of need, with the Global Health Institute at WCHN serving as our headquarters. Emulating the global 

health model, Healthcare Educators Without Borders would be created with the vision of an inclusive, multiconnected 

web of talented participants and mission of capacity building on-the-ground within an ever-growing 

network. With the support of Linde, Healthcare Educators Without Borders would be unparalleled in potential 

scope and impact. 

328

A CRITICAL SAFETY RAMP OVER NGUYEN THANH TUAN STREET HAS 

BEEN CONSTRUCTED 

Now, global health participants in Ho Chi Minh, Vietnam, can avoid crossing the busy street between Cho Ray 

Hospital and Rainbow Hotel by using the newly constructed ramp. 

The newly constructed ramp over Nguyen Thanh Tuan Street connects Cho 

Ray Hospital to Rainbow Hotel 

Busy Nguyen Thanh Tuan Street between 

Cho Ray Hospital and Rainbow Hotel 


PHYSICIAN BURNOUT: A GLOBAL CRISIS 

Commentary by Catherine Winkler, PhD, MPH, APRN 

The editorial in the Lancet (Vol 394; July 13, 2019) highlighted the concern of physician burnout on a global scale 

and suggested the need for healthcare reform at the “systemic and institutional level” in the context of workplace 

ethics, culture, specialty, gender, and I would add physician age as well as the demographics of the community 

served. I agree that this problem needs to be addressed as soon as possible, before another generation of 

physicians enters the healthcare system unprepared or experienced physicians exit the profession too soon - no 

matter the location in the world. 

In May of this year, “burnout was included in the 11th revision of the ICD as an occupational phenomena related 

to feelings of energy depletion, mental distance from one’s job or negative feelings about the job, with reduced 

professional efficacy”, (WHO, July 22, 2019). Since physician burnout is considered an occupational occurrence, it 

is incumbent on the stakeholders to solve it using a “systems” approach where the focus is not only on outcomes 

of care but processes of care. Some of the stakeholders depending on the country and the context would 

329

involve the educational institutions, the healthcare delivery 

organizations (hospitals, community centers, etc.), the patients 

and their families, colleagues, insurance ndustry, government, 

and the employers. 

Specifically, in the U.S. I worry that sometimes the outcome 

measurements that relate to a hospital stay or use of electronic 

medical record miss the point of the value of the care itself and 

the essence of medicine. Physicians are educated for over ten 

years to become experts in their field and care for people as 

independent decision makers, which in turn drives the quality 

of the care. Now, once in the workplace they are often not 

independent decision makers but hourly workers who are not 

only responsible for the quality of a patient’s care but also 

for fulfilling a RVU goal related to numbers of patients seen 

along with the complicated documentation procedures, coding 

and billing components of the additional work that exists to 

standardize care and ensures reimbursement for services. 

Taken all together, the work-related processes not only changes 

their work principles, but extends their days by many hours and 

contributes to a reduced quality of life. 

If we think of these work-related or system stressors that are not only felt in the U.S. but on a global level, it 

would be important to consider some of the ways that this phenomena of burnout could be reduced. Although 

there isn’t much data on the topic of physician burnout overall and even less in low- and middle-income countries, 

one way I have seen that works well and think would have application worldwide is to promote global health 

immersion for all physicians, new and experienced. 

Both educational institutions such as the University of Vermont and healthcare delivery systems such as Western 

Connecticut Healthcare Network have come together to promote medical education, nursing education, hospital 

administration, and public health. This partnership that supports global health though physician visits working 

abroad does many things to include the promotion of medical education and population health, the insight 

into culture and medical ethics, the development of new interpersonal and institutional relationships, and most 

importantly, perhaps a renewal of the spirit and sense of personal accomplishment. 

Accordingly, physicians have the opportunity to visit abroad come away with a newly-informed understanding 

that is priceless, whether they are new to the profession in protecting them from the problems associated with 

a narrow world view, or experienced in promoting a new sense of meaning and work satisfaction. In keeping 

with Dr. Majid Sadigh’s thoughts, we should consider the potential but critical role of global health in mitigation 

of this tragedy. I believe through experiencing healthcare systems that are different from their own, and being 

welcomed to a new environment where their expertise and knowledge is embraced, and where in return they gain 

awareness of their significant contributions, there will be a reduction in physician burnout. 

Promoting clinical connections across the world and fostering opportunities for new and experienced physicians to 

travel abroad to make contributions in hosting countries will allow for improvements in global health and the lives 

of our physicians. Global health is well-positioned to be part of the solution in combating occupational physician 

burnout. 


330

COMMENTARY 

NUMBER OF AUC/RUSM APPLICANTS FOR GLOBAL HEALTH ELECTIVES 

IN 2020 

On July 1, 2019 the WCHN/UVMLCOM Global Health Program closed 

the application season for students from the American University of 

the Caribbean (AUC) and Ross University School of Medicine (RUSM) 

who have been applying for the global health elective during the 

calendar year 2020. There are 29 applications from AUC students and 

47 applications from RUSM students for 48 global health elective slots 

(24 slots per medical school) in 2020. All student-applicants are (or will 

be as of 2020), fourth-year medical students who have completed all 

of their core rotations. 

In order to narrow down the pool of applicants to those who are likely 

to benefit from this global health elective opportunity the most, we will 

be employing a new three step selection procedure. This will include, 

first, internal student evaluation performed at the student’s respective 

medical school; second, review of application documents (application 

form, curriculum vitae, motivation letter/statement); and third, videoconferencing 

interview with each student. The selection process is 

designed with an emphasis on assessing the main competencies in 

global health (published in LoPiccolo MK and Sadigh M. Med Sci Educ. 

2016). Final selection decisions will be sent to students and AUC and 

RUSM administrators during the first week of September 2019. 

Bulat A. Ziganshin, MD, PhD 

Director, Global Health Electives Program for AUC/RUSM 

WCHN/UVMLCOM Global Health Program 

Dilyara F. Nurkhametova, MD 

Coordinator, Global Health Electives Program for AUC/RUSM 

WCHN/UVMLCOM Global Health Program 

331

REFLECTIONS FROM 

THE FIELD 

My upcoming global health trip to Southern Thailand brought back fond memories from eight years ago when I 

volunteered in Kenya before starting medical school. I completed an observership in the HIV/AIDS department of 

a district hospital and also helped out at an elementary school attended by children from a slum. I remembered 

how systematic the HIV department ran and remembered all labels reading “USAID” on the antiretrovirals provided 

free to patients - they were all manufactured in India and donated by the U.S. Kudos to the U.S. government! 

I also remembered feeding all the school children multivitamin syrup, giving them antihelminthic pills, rubbing 

antifungal creams onto the ringworms on their scalp, and cooking for them in the makeshift school kitchen. Those 

were the good old days! I really enjoyed this volunteer experience in Kenya. 

Though I know it is different in many aspects, I’m hoping that my global health experience in Thailand will mirror 

this previous experience. For one thing, I’m no longer a student, but a mature health professional now. In fact I’m 

responsible for three medical students. Teaching and supervising will be two of my top responsibilities for this trip. 

Dr. Li Zhou, Medical Resident at Norwalk Hospital 

I wasn’t sure what to expect to find in Kampala. People can tell you the details of their experiences, but there is 

always something that can’t be captured by facts alone. I knew that there would be chaotic traffic, red dirt, and 

lush plants, and was excited but unsurprised to find these things. The one thing I hadn’t envisioned though was 

the number of people you see regardless of where you are in the city. The street we live on is a great example 

of this. On one end, the street dead-ends in a busy intersection with trucks and boda bodas racing by impossibly 

close to each other. On the other end, the street turns into a rural landscape. There are goats, chickens, and cows 

roaming around handbuilt homes with corrugated metal roofs. 

Everywhere you go, though, there are people. It’s common to see people doing yard work or cooking outdoors 

all hours of the day, and the streets are flooded with children when the schools get out for the afternoon. Coming 

from sparsely-populated Vermont, the sheer number of moving bodies is overwhelming. For me, this has been 

the most defining feature of the city: the population density combined with the fact that everyone is so young. I 

was told that 70% of the population is under 30 years old, a fact that seems fundamental in making Kampala the 

city that it is. There is energy and chaos everywhere you go. It’s thrilling to move through the city, taking in the 

sensory overload. I expect I will get used to it, with the noise and movement becoming normal. This leaves me 

wondering how Vermont will feel in comparison. 

Amelia Anderson, UVMLCOM Class of 2022 

My main experience with the local people has been through medical home visits. We do this mainly for the elderly 

and those who physically can’t make it to the community clinic. I’ve met with Clara, an 87-year-old patient who 

suffers from malnutrition. Yet despite her fragile body and apparent weakness, she does everything on her own. 

She cooks, cleans, and takes care of all household responsibilities with a smile on her face. I’ve also met with 

332

Miguela, an 85-year-old patient who had what appeared to be woody edema on her legs, who is struggling to walk 

around the house (which led to many falls), and has had occasional depressive episodes. Despite it all, as soon as 

we walked in the house she received us with a bright smile. There was this positive aura about her that made me 

feel an instant connection with her. Maybe she reminded me of my own grandma, who despite her own personal 

medical issues is a constant source of positive energy for the entire family. 

Jose Calderon, UVMLCOM Class of 2022 


ABDOMINAL TUBERCULOSIS 

Samit Joshi, DO, MPH 

Medical Director 

Global Clinical Research, Virology 

BMS 

A.T. is a 42-year-old man with unknown serostatus presenting to the gastroenterology service with an acute 

on chronic abdominal pain. He has had persistent diffuse abdominal discomfort described as an “aching.” This 

has been slightly progressive over the past six months. He also admits to having diarrhea and malaria [note: 

malaria is often used to describe fever]. He denies any nausea or vomiting. A family friend believes he has lost 

a significant amount of weight in the past four months. He has not had any sick contacts and has not traveled 

anywhere recently. He is employed as a market vendor. 

On physical examination, his vitals are: T 37 °C, BP 100/80, P 115, RR 25. Generally he is laying in bed and 

appears uncomfortable. HINT: no scleral icterus or lymphadenopathy is noted. Cor: RRR with a 2/6 systolic 

murmur heard equally throughout. Pulm:decreased BS at Right base. Abdomen: BS x 4 (diminished) with a 

doughy sensation. No hepatomegaly appreciated. Extremities: negative for edema or rash. 

What is your differential diagnosis? 

A reasonable differential diagnosis of this patient’s non-specific subacute abdominal complaints is led by abdominal 

tuberculosis and lymphoma. Other entities include malabsorption from tropical sprue or inflammatory bowel 

disease, amebiasis, and malignancy from a variety of solid gastrointestinal sources should be considered. 

What is Abdominal Tuberculosis? 

Abdominal Tuberculosis is the sixth most common extrapulmonary source of infection and can affect any aspect 

of the gastrointestinal tract including solid organs, peritoneum, lymph nodes. A higher prevalence of infection 

exists in patients infected with HIV. The four major mechanisms involved in acquisition are hematogenous spread 

from primary lung infection, spread from lymphatics, ingestion of bacilli, or direct spread from other organs (2). 

Concomitant pulmonary Tuberculosis is present in less than half of patients (4). 

333

The presentation may present in either an acute or chronic fashion depending on the location within the 

gastrointestinal tract and the patient’s immune system (often impacted by HIV infection, age, nutrition, diabetes, 

alcohol intake). For example, a chronic infection within the small intestine may present as malnutrition from 

diarrhea versus an acute small bowel obstruction, perforation, hemorrhage or peritonitis. The most commonly 

infected site is the ileocecal region: varying from a mass or obstruction to fever and gastrointestinal bleeding. The 

proposed pathophysiology for increased infection in the ileocecal region is increased stasis, increased lymphoid 

tissue, and increased absorption (4). Patients often have nonspecific symptoms of fever, weight loss, abdominal 

pain, distention, and diarrhea, and anorexia. 

The clinician must also consider atypical presentations such as peptic ulcerative disease, fistulas in the anorectal 

area, fever of unknown origin, and ascites (1). The physical exam may mirror the patient’s presentation: 

tenderness, hepatosplenomegaly, or mass; a “doughy abdomen” is a classic but infrequent finding (4). 

His lab values reveal: WBC count is 12, HgB 9, Platelet 100. His albumin is 3. An ultrasound shows diffuse small 

bowel lymphadenopathy and thickening of the ileocecal valve. 

What are the methodologies employed in the diagnosis of Abdominal Tuberculosis? 

In a patient population with high prevalence of HIV, distinguishing between lymphoma and reactive 

lymphadenopathy from tuberculosis is difficult. The challenging diagnosis rests in a combination of the patient’s 

clinical picture, radiographic studies, and microbiological evidence. Where available, molecular techniques (ie. 

PCR) have proven useful in aiding the diagnosis. 

Plain abdominal imaging often reveals sequelae of infection: obstruction or perforation. A chest x-ray consistent 

with Tuberculosis can support the diagnosis although the radiograph may be normal in 50-60% of patients 

(3). Finally, ultrasound or CT can suggest the diagnosis if it reveals lymphadenopathy; these tools can also aid 

in guided biopsy. In a resource limited setting (which shares a disproportionate burden of disease) the use of 

ultrasound is very important. The ileocecal area often has concentric bowel wall or loop thickening, ulceration, and 

ascites (3). Important features of lymphadenopathy range from an increase in number or size of nodes; nodes 

circular or ovoid in shape from 12-40 mm (mean 20 mm); nodes that range from being well defined to matted; 

finally lymph nodes may have central hypoechoic areas (3). 

Laboratory values are often nonspecific: leukocytosis 

(increased neutrophil or lymphocyte predominance), 

hepatocellular liver injury, and an elevated ESR. If 

paracentesis is performed, the fluid is often a cloudy 

yellow or straw colored and may have an elevated 

leukocyte count (4). Additionally, a serum to ascites 

albumin gradient < 1.1 can support the diagnosis; 

an Adenosine Deaminase (ADA) > 33 U/L has a 97% 

sensitivity and 100% specificity in a non-cirrhotic 

patient population (the prevalence of Abdominal 

Tuberculosis was not reported) (2). 

Gross examination through endoscopy or operative 

laparotomy does not aid in narrowing the diagnosis 

to Abdominal Tuberculosis. Histology shows caseating 

Ileocecal tuberculosis is demonstrated by uniform and concentric 

thickening of the wall of terminal ileum (3). 

334

granuloma formulation with central necrosis, fibrinolysis, and calcifications (1). Microbiological evidence of acidfast 

bacilli within lymphatic tissue or ascitic fluid is the gold standard (the latter having a lower yield). The team 

suspects abdominal tuberculosis. 

What are the management options? 

Standard four drug therapy (for a goal of six months, minimum) can be both therapeutic and diagnostic (if 

microbiological/histological evidence is unavailable or inconclusive). Surgery is indicated in the management of 

an acute abdomen or complications of infection such as stricture, obstruction, massive bleed, or perforation (1,4). 

The mortality remains high at 5-10% (1). Several risk factors for higher mortality include liver disease, HIV, and 

malignancy. 

References: 

1. Kapoor, VK. Abdominal Tuberculosis. Medicine. 2003:112-114. 

2. Lazarus A. and Thilagar B. Abdominal Tuberculosis. Dis. Mon. 2007. 53:32-38. 

3. Pereira, J. et. al. Abdominal Tuberculosis: Imaging Features. Eur. J. Rad. 2005. 55:173-180. 

4. Sheer, T. and Coyle W. Gastrointestinal Tuberculosis. Curr Gastro Rep. 2003. 5: 273-8. 


Big congratulations to the Emergency Medicine residents at MakCHS who all passed the last semester of 

examinations and are now officially second-year residents. 

Second-Year Emergency Medicine Residents 

335

PHOTO 

QUIZ 

Editor: Stephen 

Scholand 

Right: A female teacher in South 

Africa with a chronic non-healing 

ulcer on lower left leg (Michael Lee) 

Left:When you are not protected by 

long sleeves and deet in Thailand’s 

forests 

What is the differential diagnosis? 

What are the potential consequences? 

Stephen Scholand (South Thailand) 

PHOTO CONTEST 

Art Gallery, Village, Gaborone, Botswana (Majid 

Sadigh) 

Iran (Parvin Sadigh) 

336

Nicaragua (Kvon photography) 

Nicaragua (Kvon photography) 

Batabut Kantora, Gambia 

(Ana Perez Bartolome, Radiology Resident at Hospital Clinico San Carlos, Madrid, Spain) 

337

PHOTO NEWS 

HOME 

Dr. Stephen Scholand, Global 

Health Program Site Director 

in Thailand, Vietnam, and 

Zimbabwe; Dr. Pamela Gorejena- 

Chidawanyika, Global Health 

Scholar from Zimbabwe, and Ms. 

Lauri Lennon, Director of Business 

Operations at WCHN 

INTERNATIONAL SITES 

Botswana 

338


Mr. Danny Capellan, coordinator of student visitors at UNIBE with Monica Rogers, a senior student from UVM 

339

340 

Global Health Program participants and 

leadership in Santo Domingo

Left to right: Dr. Jomar Florenzan, Dr. Zufar Safiullov, Jose 

Calderon, Prasanna Kumar, Ramil Gabdulkhaev, and Dean 

Marcos Nunez 

341


Midnight dinner in Bangkok 

Global Health Program participants in Thailand with Dr. 


A Global Health Program participant in Thailand 

Global Health Program participants, including UVM 

students, introduce themselves and teach English to 

school children at Nawaporn School, Banasan Thailand. 

Left to right: Collin Montgomery, Dr. Stephen Scholand, 

Ray Mak, Dr. Wendy (Zhou) Li, Issac de La Bruere 

Global Health Program Participants in Thailand with Dr. 


342

Global Health Program participants on their way to 

Khamin Cave in Thailand 

Right to left: Global Health Program participants Collin 

Montgomery, Ray Mak and Isaac de La Bruerereceive 

blessings for an auspicious educational experience from 

a 101-year-old monk. Aajaan (spiritual master) Phisan 

Khunapon of Wat (temple) Apaikettaram, Banasan 


Welcome dinner with Dr. Menn, Dean of Walailak Medical 

School 

A giant spider in Khamin Cave 

Holy snakes in a cave in Thailand 

Front row, left to right: Dr. Mee Apichai, Dr. Menn 

Prachyapan Petchuay, Ray Mak, Orrawee Scholand, Henry 

Scholand, Dr. Wendy (Zhou) Li, and Pee Sow. Back row, left 

to right: Issac de La Bruere, Dr. Stephen Scholand, and 

Collin Montgomery 

343


Dr. Mariah McNamara and Dr. Naomi Hodde with Professor 

Noeline Nakasujja, Chairperson of Department of 

Psychiatry, MakCHS 

Global Health Program participants with Professor 

Nazarius Mbona Tumwesigye 

Dr. Scovia Mbalinda, Head of the Nursing Department; Dr. 

McNamara, Associate Director of Global Health at UVMLCOM; 

Ms. Susan Byekwaso, Coordinator of the MakCHS International 

Office; and Lydia Kabiri, International Coordinator of the 

Nursing Department 

Global Health Program participants in Sanyu Babies 

Orphanage in Kampala, UgandaMakCHS 

Russian residents Anna Vaiman and Dilyara Khastieva and 

their friends on the way to a cultural dance show 

Dr. Lily Horng, Global Health Program alumnus, and 

Jamidah Nakato, PhD, Assistant Lecturer at MakCHS, in 


344

UVM EM Global health members visiting the main office of 

the MakCHS EM Residency Program 

Dr. Naomi Hodde, Professor Nazarius Mbona Tumwesigye, and Dr. 

Mariah McNamara 

Vietnam 

Dr. Majid Sadigh with the leadership of Cho Ray Hospital, 

Ho Chi Minh, Vietnam 

Dr. Majid Sadigh with the leadership of Cho Ray Hospital, 

Ho Chi Minh, Vietnam 

Dr. Majid Sadigh with the leadership and Global Health Scholars at Cho Ray Hospital, Ho Chi Minh, Vietnam 

345

Infectious Disease Scholars 

Dr. Majid Sadigh presenting at Journal Club 


Dr. Majid Sadigh with Infectious Disease Scholars 

Dr. Majid Sadigh the leadership of Cho Ray Hospital 

346

A 2000-bed Pediatric Hospital, the new global health 

elective site in Ho Chi Minh City 

Zimbabwe 

Mrs. Rachel Gandara 

Administrative Assistant for the 

WCHN/UVMLCOM Global Health 

Program 

Mrs. Rachel Gandara 

Administrative Assistant for the 

WCHN/UVMLCOM Global Health 

Program 

Dr. Majid Sadigh with medical residents attending lectures 

With Dr. Shalote Chipamanuga, Global Health Scholar 

347

CALENDAR 

JULY CALENDAR 

July 1: Ten UVMLCOM medical students departed for their summer electives in the Dominican Republic, Thailand, 

and Uganda. 

July 1-12: Dr. Benjamin Clements accompanied UVMLCOM students in the Dominican Republic. 

July 1-August 23: UVMLCOM students Jose Calderon and Prasanna started the global health elective in 

theDominican Republic 

July 2: Dr. Sadigh held a follow-up orientation meeting with Dr. Harold Cedeno, a medical resident at Danbury 

Hospital who will be going to Uganda in 2020. 

July 2: Dr. Sadigh held a meeting with Dr. and Mrs. Weiner to discuss a fundraising classic music event. 

July 3: Dr. Sadigh held a meeting with the global health leadership of SHU including Dr. Voytek (Wojciech) 

Wloch, Executive Director of Global Affairs, to discuss steps toward signing a MoU between SHU and WCHN, as 

well as with Christina Gunther, Cima Sedigh, and Mis. Molly Higbie whereby work on the MoU went underway, 

the personnel on the Executive Committee was decided, the eMagazine was decided to circulate through various 

listerserves, and SHU has its own page in the eMagazine. 

July 7-24: Monica Rogers begins the global health elective in the Dominican Republic. 

July 8: Global Health Leadership Team meeting was held at at UVMLCOM. 

July 8-26: Dr. Naomi Hodde accompanied UVMLCOM students in Naggalama, Uganda. 

July 8: Dr. Sadigh made a monthly administrative trip to UVMLCOM during which he met with Dr. Judith Lewis, 

the Director of the Psychiatry Residency Program to discuss the details of Ruggles Scholars in Global Mental 

Health, as well as Dr. Mariah McNamara, Dr. Molly Moore, Carole Whitaker, and Audrey Frey. During this visit, he 

participated in the global health leadership meeting during which many agendas were discussed. 

July 10: Dr. Sadigh and WCHN Global Health Program Coordinator Dylan Ochoa had a meeting with Dr. Oltikar, 

Chairperson of the Department of Medicine, to discuss the Global Health at Home project and the hosting of Dr. 

Pamela Gorejena-Chidawanyika, Global Health Scholar from Zimbabwe. 

July 10: Dr. Sadigh and Dr. Robyn Scatena had a meeting with Norwalk Hospital foundation representatives to 

discuss the details of a recently named donation to address pulmonary diseases in Global South nations. 

July 11: Dr. Sadigh and Mr. Dylan Ochoa had a meeting with Dr. Damanjeet Chaubey, Director of Palliative Care 

at WCHN, to discuss the educational activities of Dr. Pamela Gorejena-Chidawanyika, Global Health Scholar from 

Zimbabwe. 

348

July 15: The arrival of University of Zimbabwe faculty member Dr. Pamela Gorejena-Chidawanyika to Danbury 

Hospital for six weeks of training in palliative care and cancer medicine. 

July 15-19: Dr. Sadigh conducted a site-visit in Vietnam. 

July 16- August 27: Dr. Zufar Safiullov, Global Health Scholar from Russia, underwent his elective in Dominican 

Republic 

July 23-August 23: Dr. Ramil Gabdulkhaev, Global Health Scholar from Russia, underwent the global health 

elective in the Dominican Republic. 

July 18: Dr. Sadigh held a meeting with the leadership of Cho Ray Hospital where he discussed the details of 

networking with other collaborators around the world. 

July 20: Dr. Sadigh had a second meeting with Tomai Xuan-Hong, MD, PhD, Associate Professor of Obstetrics and 

Gynecology and Senior Lecturer - Department of Obstetrics and Gynecology, Head - Department of International 

Relations, University of Medicine and Pharmacy in Ho Chi Minh City, Vietnam, to discuss the expansion of the 

partnership to OB/GYN departments. Linde Health Educators Without Borders and Women’s and Children’s Health 

Program were also discussed. Dr. Tomai Xuan Hong will identify nominees for both of these positions in addition 

to finding a director for collaboration. 

July 21-August 4: Dr. Mariah McNamara accompanied UVMLCOM students to St. Stephens Hospital in Kampala, 


July 22: A Global Health Leadership Team meeting was at UVMLCOM. 

July 22: Dr. Sadigh and Dr. Katrin Sara Sadigh had an introductory meeting with Professor Lynnette Kyokunda 

to discuss the agenda for multiple meetings with the leadership of medical education at Botswana University. 

July 22-24: Dr. Majid Sadigh, Dr. Katrin Sara Sadigh, and Professor Lynnette Kyokunda had multiple meetings 

with the Botswana University leadership toward establishing a new multidisciplinary partnership. 

July 24-26: Dr. Sadigh site-visited the University of Zimbabwe. 

July 25: Dr. Stephen Scholand met with Mr. Dylan Ochoa and WCHN Global Health Interns Sarah Cordisco, Jack 

Mix, and Ritesh Vidhun to discuss their projects, challenges of getting into American medical school, and various 

global health concepts. 

July 27- August 3: The Sadigh Family Climb For a Cause took place. 

July 29: Dr. Tran Hoang Long, a Cardiologist at ChoRay Hospital, arrive in Danbury for three months of training 

with Dr. Robert Jarret and his cardiology team. 

July 30: Dr. Pamela Gorejena-Chidawanyika met with Mr. Dylan Ochoa and the WCHN Global Health Interns to 

educate them on women’s health and medical education in Zimbabwe. 

349

AUGUST CALENDAR 

August 3: Dr. Sadigh returns from Mount Kilimanjaro. 

August 4: Professor Linus Chuang arrives in Uganda. 

August 4: Dr. Sadigh arrives to Uganda. 

August 5: Dr. Sadigh meets with Susan Byekwaso, Coordinator of the MakCHs International Office; Rhoda 

Wanyenze, the Dean of MakSPH; and Russian participants in global health, and attends a dinner with Professor 

Linus Chuang at Professor Sam Luboga’s home where medical students from UVM, and UVM ED nurses and 

faculty are staying. 

August 5 - September 13: Ajja Steele (RUSM) and Ribao Kaysha (AUC) start their elective in Nakaseke, 


August 8-9: Second-year UVMLCOM students return from international sites. 

August 13: Dr. Sadigh returns to the USA. 

August 13: Dr. Aparna Oltikar and Dr. Cristina Mihu arrive in Douglas, Arizona to collaborate with Dr. Jonathan 

Melk and visit the Chiricahua site. 

August 14: Dr. Sadigh travels to Burlington to attend the Dean’s welcome reception for the new first-year 

medical students. 

August 15: Dr. Aparna Oltikar and Dr. Cristina Mihu return from Douglas, Arizona. 

August 15: Global Health Committee Meeting was held. 

August 18: Dr. Simon Otim arrives to Danbury Hospital for three weeks to familiarize with the medical education 

and administration as well as healthcare delivery systems in the USA. He will additionally focus on infertility, 

simulation lab, and laparoscopic surgery during his rotation. 

August 20: WCHN Global Health Interns complete their internship and receive their certificate of completion. 

350

RESOURCES 







Ebola book 















Publications 










351

September 2019 Volume 9 

NUVANCE HEALTH 


What lies behind us 

and what lies before us 

are tiny matters 

compared to what lies within us. 

-Ralph Waldo Emerson 



Cover Photo: Kvon Photography 

352


KILIMANJARO 

2019 CLIMB FOR A CAUSE 

The 2019 Climb for a Cause in support of nursing 

staff interested in global health was successfully 

completed on August 3rd. 

Read the daily reports here >> 

Majid Sadigh and Mitra Sadigh at Uhuru Peak with The 

Support Group 

Katrin Sara Sadigh, Majid Sadigh and Mitra Sadigh in front of Rebmann Glaciers near Uhuru peak, Kilimanjaro’s summit 

353

TOWARD ESTABLISHING A GLOBAL HEALTH PROGRAM AT HOME 


Chief Executive Officer/ 

Chief Medical Officer 

Chiricahua Community Health had the honor of receiving 

Drs. Aparna Oltikar and Anamaria Cristina Mihu from the 

Western Connecticut Health Network from August 13- 

16. We had the opportunity to share our global health 

projects and programs taking place on and near the rural 

US/Mexico borderlands of southeastern Arizona. Both 

parties are optimistic to form an impactful and mutually 

beneficial relationship in the future. 

REPORTS 

MEETING SUMMARY AT THE UNIVERSITY OF MEDICINE AND 

PHARMACOLOGY 

Written by the Associate Professor To Mai Xuan Hong 

Director of the International Relations Office and Senior Lecturer at the Department of Obstetrics 

and Gynecology, University of Medicine and Pharmacy, Ho Chi Minh City 

I am currently the Director of the International Relations Office 

at the University of Medicine and Pharmacy (UMP) in Ho Chi 

Minh, and also work as a faculty member in the Department of 

Obstetrics and Gynecology in UMP and UMP’s affiliated maternity 

hospitals, Hung Vuong Hospital and University Medical Center - 

Branch 2. I had the opportunity to meet Dr. Majid Sadigh on July 

16th, 2019 in the UMP International Office and was interested 

in what he shared about the Global Health Program’s philosophy 

and the purpose of Linde Healthcare Educators Without Borders: 

to educate and train faculty members to become global doctors 

who not only work in hospitals or clinical units, but also apply 

their enthusiasm to improving healthcare in communities 

worldwide. I was impressed to learn that children in the United 

States receive early diagnosis and specialized care. I hope the 

Vietnamese healthcare system enhances its quality in such a way 

in the near future. 

354

Dr. Sadigh spent his time visiting and learning more about the daily activities at Children’s Hospital No. 2 and 

discussing potential collaborative opportunities towards developing a model for “training the trainer.” Working 

in two roles, one as a lecturer in the Faculty of Medicine and the other as a doctor in Ho Chi Minh’s maternity 

hospitals, I am faced every day with the struggles of pregnant women and infants in the outpatient and inpatient 

departments. My colleagues and I try our best to help them overcome their health problems in spite of the 

lack of time for careful consultation and treatment equipment including medication, nutrition, and hygiene. 

Though medical students and future doctors find opportunities to improve their clinical skills in this context, 

they lack opportunities to communicate with and express their sympathy to poor patients and their families. 

We as healthcare staff distinctly recognize the need for a national program that screens fetal abnormalities and 

pregnancy-induced disorders toward preventing these complications as early as possible. 

However, the most important thing is for healthcare staff to be well-trained and empathetic toward patients. 

Though Vietnam has implemented a new program based on primary care that educates medical students and 

trains healthcare staff in community health, the training is neither integrated nor of sufficient quality to impact 

the nation’s high healthcare demands. Additionally, we are now living in the “flat world,” and as such, we would 

love to cooperate with foreign experts toward conducting detailed and useful activities that help poor patients 

and healthcare workers in rural areas. In this context, the Global Health Program and Linde Healthcare Educators 

Without Borders have opened a new opportunity for us, Vietnamese doctors and faculty members, to join hands 

in working with you toward improving healthcare quality in communities worldwide. We hope that after attending 

the intensive training course, Vietnamese doctors will become further involved in global health and devote their 

enthusiasm, confidence, and compassion to the well-being of patients. 

REPORT ON DR. MAJID SADIGH’S VISIT OF CHO RAY HOSPITAL, 

JULY 17-20, 2019 

Written by Dr. Lan Phuong 

Dr. Sadigh during a short visit met with the leadership of 

the Cho Ray Hospital and the global health scholars and 

gave a series of talks about global health and analytical 

review of scientific articles. 

Read the report here >> 

355

AUGUST 8: MEETING WITH THE LEADERSHIP OF THE MAKERERE 

UNIVERSITY SCHOOL OF PUBLIC HEALTH 

Written by Susan Byekwaso 

Left to Right: Professor Rhoda Wanyenze, Dr. Majid Sadigh, Professor Joan Eron 

Mutyoba, Professor Nazarius Tumwesigye, and Ms. Susan Byekwaso 

Dr. Sadigh had a meeting with Professor Rhoda Wanyeze, Dean School of Public Health, Prof. Nazarus Mbona 

Lecturer, Department of Epidemiology and Biostatistics, Dr. Joan Nakya Mutyaba Lecturer, Department of 

Epidemiology and Biostatistics, and Susan Nassaka B International Coordinator, MakCHS 


6/8/2019: MEETING WITH THE LEADERSHIP OF THE MAKCHS SCHOOL 

OF NURSING 

Written by Susan Byekwaso 

Dr. Majid Sadigh visited the MakCHS Department of 

Nursing with the objective of forming a collaboration 

between this department and the Nursing Division of 

the UVMLCOM/WCHN Global Health Program. This 

educational collaboration is aimed at improving nursing 

education toward benefiting underserved communities. 

Makerere University Department of Nursing should be 

in control and drive the partnership, thereby serving as 

a model institution in this collaboration. 


Dr. Majid Sadigh; Thomas Ngabirano, Associate Head of 

the Nursing Department; Susan Byekwaso, Coordinator 

of the MakCHS International Office; and Lydia Kabiri, 

International Coordinator of the MakCHS Nursing 

Department 

356

Meeting with the 

MakCHS Psychiatry 

Department, August 8, 

2019 

Written by Susan 

Byekwaso 


Left to right: Dr. Majid Sadigh; Dr. Akena 

Dickens, Director of graduate students; 

Professor Noeline Nakasujja, Head of the 

Psychiatry Department; Susan Byekwaso, 

International Coordinator; and Dr. Joyce 

Nalugya, a child psychiatrist 

MY FIRST WEEK AT WCHN 

Written by Dr. Simon Otim 

a Global Health Scholar and the Program Site Director at St. Francis 

Naggalama Hospital, Uganda 

Dr. Simon Otin (left) with Dr. Joshua Hurwitz 

Day 0 (Sunday): I arrived on Sunday 18th of 

August, 2019 at about 7:00 AM ET at JFK airport. 

The security check went smoothly and in thirty 

minutes I was done. It took me about an hour to 

connect with the driver who then drove me to Dr. 

Sadigh’s home. Along the way, I was treated to 

beautiful and unique scenarios of fast cars, wide 

roads, many road signs and of course the fact that 

motorists drive on the right-hand side of the road. 

As we went through the woods and tall trees on a 

slick tarmac, the driver made a gentle turn and said 

“we are here”. I went to the front door with my small 

luggage and rang the doorbell. I was welcomed 

by Dr. Sadigh himself with a big strong hug and 

a lot of excitement and laughter. Finally, I saw a 

familiar face in this strange land. After exchanging 

pleasantries with his wife and another visiting guest 

from India named Abhinav, we sat as he made us a 

big delicious breakfast. 

357

After about a one and a half-hour of rest we took a drive to New Haven where Dr. Sadigh gave Abhinav and I a 

guided tour of the Yale University Campus. Notably, we were shown the old and new campuses; the Yale Sterling 

Memorial Library, The Women’s Table, The Cathedral of Knowledge, Yale Beinecke Rare Books and Manuscript 

Library, Mory’s Club, Yale Law, the Music schools, Amistad Memorial Site (Make Us Free) in front of New Haven 

Town Hall and many more sites. We continued the tour more places in Woodbridge, Watertown, Morris, Litchfield, 

Bethlehem, the Shrine of Lourdes in Litchfield, his sister’s home and garden and many more amazing sites. On 

our way back at about 4:00 PM, we picked up very delicious Chinese food. We had dinner with Dr. Sadigh’s family 

and then I took a shower and went to bed while Dr. Sadigh dropped off Abhinav to the train station. 

Day 1 (Monday): I woke up at 1:00 AM and then stayed awake till morning. After breakfast we set off at about 

5:00 AM to go to Danbury hospital. At the hospital, Dr. Sadigh showed me several landmarks to help me find my 

way around including where to find meals. 

After dropping my luggage at my assigned room, we met Dr. Joshua Hurwitz at 6:45 AM. A very wonderful, 

cheerful, amazing gentleman with a great sense of humor and an amazing teacher. He took me to his private 

practice for fertility treatment in Danbury where I met the rest of the team, who were very wonderful people. 

The day was packed with very interesting cases and mind-blowing procedures. That afternoon we returned to 

the Danbury Hospital where we joined a high-risk obstetric review meeting where cases were presented and 

reviewed. After this, we joined the Department of OB/GYN business meeting and I was introduced to the rest of 

the members by Chairman Professor Linus Chuang. 

Day 2 (Tuesday): I linked up with Professor Linus Chuang and joined him in the theatre to observe the surgeries 

and I saw how well organized and coordinated the team was together with amazing machines that are used for 

the procedures. 

Day 3 (Wednesday): I was picked up by Dr. Hurwitz at 6:45 AM and went to his private practice at Danbury. We 

went through several cases. Dr. Hurwitz taught me amazing skills and we shared a bit about our personal lives 

as well as compared OB/GYN in different parts of the globe handling different populations with different medical 

conditions and needs. 

Day 4 (Thursday): I was taken to a section of Maternal and Fetal Medicine where I was under watch by 

another excellent academician, Dr. Zimmerman (commonly referred to as Dr. Z ) where we shared about highrisk 

obstetrics. I saw state of the art equipment used in the management of the patients. It was amazing. I later 

caught up with the team at the Global Health office; Lauri Lennon, Laura Smith and the coordinator of program, 

Dylan Ochoa who later took me around to Danbury Fair Mall where I bought a few personal items. 

Day 5 (Friday): I was picked up by Dr. Sadigh around 5:45 AM and we drove to Norwalk to meet up with Dr. 

Joshua Hurwitz at yet another one of his fertility clinics. Once there, we met and quickly got down to business. 

He is a very busy man whose clients and staff love him. He treated me to a quick tour of the premises and 

behold...the place looked like a sci-fi lab on another planet.The team was so welcoming and we quickly learned 

and started calling each other by first names. We saw clients, attended procedures, had a wonderful lunch and a 

baby shower too for one of the staff members. At 4:00 PM Dr. Sadigh was again sharp on time to pick me up to 

return to Danbury Hospital. Overall, it’s been a wonderful first week. I am still trying to wrap my head around all 

that I saw in one week and yet, I have only seen one department of the entire hospital. It has been a beautiful 

once in a lifetime experience. 

358

REFLECTIONS 

From Rt to Left; Kaysha Lynne Ribao, Martha and her mother, Ahja Steele, and Fred, ACCESS, Nakaseke, Uganda 

Kaysha Lynne Ribao 

Global Health Uganda 

August – September 2019 

Martha—one of the many girls who unjustly faces the inequities of poverty and gender, but was born with fighting 

power! 

My colleague and I were chatting away and getting ready for bed. Fred, a nurse, came knocking on our door at 

9:30pm --- a 25 year old female was in labor. We raced to the theater, the size of a small bedroom. She was 

walking naked and barefoot on the beige floors. The exam table with plastic covering half its size was on a wooden 

crate. She firmly said, “I want a boy,” as if there was no other option. She had two daughters with a husband who 

resides in Kampala, the capital. Was it the expectation of her husband to have a boy? Or society? I have learned 

Uganda women are expected to be soft spoken, gentle in spirit, and most importantly obedient to men. Upon 

greeting, a woman respectfully kneels down to any man, elderly, and educated person. 

359

I walked with her and did squats to further descend the baby. After drinking four cups of Ugandan black tea, she 

went to the corner of the room where there was a drain to ease herself. She then continued to walk around the 

room. Something was wrong. Labor began at eight in the morning and yet her contractions were inconsistent. 

Although we broke her water, contractions slowed and baby wasn’t moving. No fetal heart monitoring or ultrasound 

was insight. The mom was restless, sitting on the floor of the theater, crying and begging to go home. I felt 

helpless! She finally agreed to Pitocin. As things started to move along, the lights went out for a minute or so 

(Thank God it was not longer!). Black outs are a regular occurrence in this part of the world and they are quite 

unpredictable. 

The mom was pushing and the head was out. Cord was around the neck twice and baby’s face was blue. The body 

was not sliding out despite Fred’s efforts to manipulate the head. It was shoulder dystocia, in which the baby’s 

shoulder is caught behind the mom’s pubic bone. Mom had mentioned in passing this baby seemed larger than 

the others. At that moment, I was filled with fear. Was death near? At that moment, I realized the gravity and 

responsibility of being a physician. We truly have the power to impact and essentially save a life. Life is precious 

regardless of who you are, where you come from, rich or poor. Once it’s taken away, it’s gone forever. 

My colleague and I had a mutual understanding that something needed to be done. We decided to do the 

McRoberts maneuver with suprapubic pressure while Fred did the Wood’s corkscrew maneuver. I literally put my 

full weight onto the mom’s abdomen three times and the baby finally came out. She was limp, blue, and not 

crying. As my colleague used the bulb suction, I was rubbing her vigorously and Fred was tying the umbilical 

cord. Through it, I prayed. It took at least five minutes to hear a slight cry. As my colleague revived the baby, I 

delivered the mom’s placenta by twirling the umbilical cord around my finger because there was no clamp. There 

was meconium, blood, and mom’s feces on the exam table, floor, and even my shoes…. Essentially everywhere. 

I’ll never forget the mom’s face when she realized the baby was a girl- disappointment, sadness, and eventually 

apathy. I washed the mom with a bucket of water over the same drain that drained all the other fluids. She then 

walked into the waiting room without her baby. 

I believe women are invaluable. They are the foundations of many families, working and sometimes sacrificing 

their dreams to care for their family while some experience domestic abuse, poverty, venereal diseases, and 

infidelities of their husbands. I see absolute resilience. Yet, women throughout the world do not receive the 

recognition or respect they rightfully deserve. That’s why I believe it is important for girls and women to be 

empowered by each other and given opportunities to open doors. That is why my journey of becoming a woman 

of color physician is so important. I want to be an example for women. We are strong, brilliant, important, have a 

voice, and have a right to dream. ACCESS (African Community center for Social Sustainability) has been part of 

this journey of change through their various programs of Dream Girls, Orphans and other Vulnerable Children, the 

Nursing School, and family planning outreach. I am glad to be part of this and hope other students will continue 

to participate in ACCESS’ mission. We saw Martha, the baby a week after her birth and she was healthy and mom 

was happy, giving her full love and attention to another strong and beautiful girl. 

This experience taught me the significance of teamwork. This baby would not have been delivered safely if we all 

did not do our part—my colleague attending to the baby, me to the mom, and Fred working on both mom and 

baby. We had a mutual understanding of the situation and agreed on the plan. There are many hopes I have for 

the future mothers and babies of Uganda. I hope mortality rates will decrease by improving prenatal care. Every 

pregnant woman should be provided free check ups that includes basic screening tests, education of pregnancy 

complications, and how to reduce it. In the United States, once a woman is pregnant, they start their prenatal 

check ups a few couple of months and eventually monthly. During their care, women are screened for infectious 

diseases and genetic abnormalities, counseled on diet and exercise, and tested for gestational diabetes and 

360

hypertension. If there are any complications, the mom and baby are monitored closely with non-stress tests, fetal 

ultrasounds, and at times referred to a specialist. If a baby is larger, Cesarean section is usually offered. In this 

case, Martha’s mother did not have these options—instead the delivery was prolonged and painful. Lastly, I want 

babies and moms to have access to life saving equipment such as oxygen, vital signs monitoring, and a warmer. 

I want girls such as Martha to grow up into self driven, educated, and leading women who will work in addressing 

socioeconomic and gender disparities that exist in Ugandan society. 

HEALTHCARE EDUCATORS 

WITHOUT BORDERS 

Tendai Machingaidze 

Associate Site Director of the UVMLCOM/WCHN Global Health 

Program in Zimbabwe 

A cholera outbreak was declared in Harare by the Ministry of Health and 

Child Care (MoHCC) of Zimbabwe on September 6, 2018. This is not 

the first, nor will it likely be the last crisis related to the pathogen Vibrio 

cholera in Zimbabwe. Historically, organizations such as the WHO, 

UNICEF, Global Outbreak and Response Network (GOARN), Oxfam, 

Mercy Corps, Welthungerhilfe (WHH), and Christian Care, to name but a 

few, have taken the lead and stepped in to aid in managing such crises. 

It must, however, not be overlooked that over the decades, Zimbabwean 

doctors, nurses, and community health workers have become experts 

adept at dealing with cholera outbreaks despite their low-resource 

settings. Within the indigenous experience of these Zimbabwean health 

workers lies a wealth of knowledge and expertise that is perhaps incomparable and irreplaceable with regards to 

dealing with cholera in an underdeveloped setting. 

Imagine, then, that there is a cholera outbreak in Uganda. Aren’t these Zimbabwean health workers uniquely 

equipped to educate their counterparts in East Africa on how to deal with such a crisis? 

Many of the existing structures of global healthcare are built on the framework of the superiority of developed 

countries in the “Global North” in relation to underdeveloped communities in the “Global South.” The essence 

of colonialism still lingers in much of how the Global North relates with less privileged nations in terms of 

international aid. When a crisis arises in healthcare, education, economics, or politics, it is assumed that the 

Global North has the best answer. As such, these countries travel across oceans to solve problems and teach from 

a position of presumed authority. 

The problem, however, with such a model is that it overlooks the monumental role that context plays in such 

situations. For example, in Zimbabwe there are the mapostori, a religious sect whose beliefs forbid its people 

361

from seeking medical treatment. A community health worker from Zimbabwe who has dealt with the challenges 

of trying to administer treatment among the mapostori during an epidemic is far better equipped to educate 

health workers in a similar context in Uganda or Vietnam on how to handle this situation than an aid worker from 

the Global North who has never encountered such cultural and religious customs. 

The fault, however, does not lie only with countries in the Global North. The Global South has also retained a 

so-called “colonial mentality.” Rather than pooling its own resources to find indigenous and sustainable solutions 

to its dilemmas, the Global South far too often waits for handouts from the Global North. Despite the fact that 

great strides have been made in healthcare and education in these countries over the years, the Global South 

undervalues its experience and expertise, and hence tragically forfeits its place on the global stage. 

Médecins Sans Frontières (MSF) was founded in 1971 in Paris by a group of journalists and doctors in the wake 

of war and famine in Biafra, Nigeria. Their aim was to establish an independent organization aimed at delivering 

emergency medical aid effectively. Now, they have become a worldwide movement of more than 45,000 people 

that provide medical assistance to people around the globe. Much of the MSF staff is hired locally and regionally, 

and then teams are supplemented by field assignments from abroad. 

Medicine and education are two sides of the same coin. Both are fundamental human rights, and the success 

of one is largely dependent on the success of the other. Indeed if there is a cholera outbreak in Uganda, the 

medical personnel and logistical support provided by an organization such as MSF is crucial. But what of medical 

education? There are, of course, aid organizations that have medical education as part of their mission, but it is 

not enough. There is a glaring need for institutions that focus solely on medical education in the sphere of global 

healthcare. 

The Western Connecticut Health Network/University of Vermont Larner College of Medicine (WCHN/UVMLCOM) 

Global Health program has developed global health sites in several countries around the world. Imagine for a 

moment that colleagues in these seven countries (and counting) formed a team of medical educators. Each 

scholar on the team would offer expertise according to his/her particular context and experiences. From updating 

a medical school curriculum to responding to a health crisis, the Global North and Global South would stand 

together to address the vast array of medical education needs around the world. 

The mammoth task of global health necessitates collaborations between the Global North and Global South 

whose foundations are capacity building and sustainability. Unity rather than further divisions should be the 

guiding theme if we are to accomplish work in healthcare that is truly “global.” 

It is time for the Global North and Global South to rise up together. It is time for medical educators around the 

world to unite and mobilize their knowledge and expertise to solve the health dilemmas we face together as 

humans. It is time for the Global North and the Global South to form “A United Nations of Medical Educators 

without Borders!” 

362


Dear Prof. Sadigh, 

It seems there is more interest at Botswana University in partnership with the WCHN Global Health Program. 

I have been asked to make a presentation at the Faculty Executive Meeting. 

Thank you. 

Professor Lynnette Kyokunda 

Head, Department of Pathology 

PERSPECTIVES 


Sexual harassment and other forms of sexual and gender based violence are ubiquitous. Participants of global 

health programs often experience and report such abuses while living and working in low-to-middle-income 

countries. Efforts should be made to provide guidance and support so that these individuals can effectively cope 

with these situations. However, the framework for understanding sexual harassment and abuse has fundamentally 

changed with the #MeToo movement. This widespread grassroots movement has shaken the historic tolerance of 

sexual harassment, and has led to both discourse and action of global impact. The global health community must 

now educate its members, from trainees to faculty and researchers, on how to advocate for one’s own rights and 

the rights of others in the face of sexual harassment and abuse in the era of the #MeToo movement. 

SEXUAL HARASSMENT ON THE STREETS OF 

UGANDA 

Written by Jamidah Nakato, PhD 


While sexual harassment is described as the bullying or coercion of a 

sexual nature and the unwelcome or inappropriate promise of rewards in 

exchange for sexual favors, the coining of this concept is relatively new 

to many in Uganda. Sexual harassment includes a range of actions from 

mild transgressions such as looks or touch to sexual abuse or assault. 

Harassment can occur in many different social settings such as on the 

363

street, and the harassers or victims may be of either gender. On the streets of Uganda, sexual harassment 

largely encompasses transgressions of a milder form as opposed to sexual abuse. Often times, it is expected that 

women, especially young and attractive ones, walking down the streets of Kampala will hold the attention of men. 

It is a common scenario for young and working women, such as bank employees. However, this is rarely seen as 

sexual harassment. Even if it were, it would be difficult to prove to the public and in the court of law. Meanwhile, 

some women may appreciate this attention as it may boost their self-confidence by reasserting the belief that 

they are attractive, while other women may find it intrusive and even offensive. 

There are also instances in which women are touched while walking on the streets of Kampala, especially by 

taxi touts and conductors who compete for clients at slow hours of the day. In these situations, these men may 

believe that by touching a woman, they can convince her to get into the standby taxi as a passenger. Though 

this is unwanted physical contact, it is not necessarily seen as sexual harassment. However, on crowded streets, 

women will get unwanted touches without any other intention. 

In most cultures in Uganda, the term sexual harassment is rarely used because there can be a thin line between 

sexual harassment and dating or showing interest in someone. Also, in most of our cultures, sexual advances 

are rarely on public display and would be seen as completely improper. Therefore these instances are rarely 

confronted on the street. In addition, sexual harassment is a humiliating situation that is commonly ignored 

except in cases in which the victim has the courage and means to report the incident. In fact, what one might 

view as bullying or hounding, another might view as persistence, which may be an acceptable trait in a serious 

partner. After all, the general understanding is that men know their role to include making advances on women, 

while women also expect advances from men. 

It is important to note that the harassers are mostly men and rarely women because of the Uganda’s culture. 

All in all, sexual harassment is a complicated issue. Its definition may vary from setting to setting and from 

person to person. If sexual harassment is to be defined as above, “bullying or coercion of a sexual nature and 

the unwelcome or inappropriate promise of rewards in exchange for sexual favors,” few instances of sexual 

harassment exist on the streets of Uganda. However, when such incidents exist, they are commonly ignored and 

rarely reported for fear of humiliation or retribution due to the fact that it is difficult to prove, and Uganda is a 

predominantly male-centered society. 

The following list describes specific actions one can undertake to avoid or counter sexual harassment while in 

Uganda: 

• Wear modest clothing and avoid provocative dress (e.g. leggings, miniskirts, short shorts, etc) while walking 

on the streets. 

• Learn to say a firm and unfriendly “No” to the harasser. 

• Avoid oversocialization with strangers. They may consider this attention as interest. 

• Be prudent with whom personal contact information is shared. When in doubt, choose not to share this 

information. 

• Have a buddy who is familiar with the local customs as a resource and guide when confronting more difficult 

issues. 

364

SAFETY IN GLOBAL HEALTH 

DON’T BE BLINDED 

Written by Stephen J Scholand, MD 

Associate Director of Global Health 

It was quite late in the evening, and I was walking alone in a crowded urban 

market. It wasn’t the best area of town, but I needed to do some last minute 

souvenir shopping for my loved ones at home. I thought of their interest 

and enjoyment in receiving some beautiful and unique handicrafts from local 

artisans. 

Admittedly my focus was elsewhere. I headed towards a pedicab, a bicycle 

powered contraption with sidecar, enveloped in a tough vinyl shell. As I entered, 

I heard a shrill whistle, which sprung me from my shopping revere. I was 

weighed down with a few shopping bags, but now as I slid into the pedicab, I 

realized in essence I was ‘trapped’ by a sinewy looking passenger who blocked 

my only exit. The whistle was to alert some unknown and unseen accomplices 

in the crime that was unfolding. Adrenaline shot through my circulation. “Give 

me your wallet” the man said in broken English. I could not go forward, I could 

not go backwards, I could not get out. I was trapped! I pretended I didn’t understand what he was saying, so I 

asked him to repeat – “what”? It gave me a few milliseconds more to think. ‘What if he pulled a knife’, ‘what if he 

took my cell phone’, ‘what about all these gifts I just bought for my family and friends’? 

The man hissed again, “Give me your wallet” My mind raced, but my body was trapped in the pedicab ‘how can 

I escape’, ‘should I fight’, ‘what if he resorts to violence’? Realizing the futility of the situation, I handed over my 

wallet. He withdrew all the cash and handed it back to me, before he slipped out the door. Before I could breathe 

a sigh of relief, a hand snaked back and snatched the glasses off my face– effectively blinding me and ensuring 

his successful escape. I could not run after him, not that I would want to given my situation. 

I was very relieved not to have been a more hapless victim… In fact, I still held onto my priceless cell phone, and 

a sack full of souvenirs. Most importantly I was physically unharmed, it might have been different… 

Looking back, I realized I violated several cardinal rules of safety: 

1 – never travel alone 

2 – be careful going out at night 

3 – maintain critical awareness of your surroundings 

Attention to these basic principles is important, and our Global Health program takes safety extremely seriously. 

Make sure to think about your own safety and review safety protocols prior to your global health experiences. 

365


CONCEPTUALIZING MEDICAL HUMANITIES PROGRAMS IN LOW- 

RESOURCE SETTINGS IN AFRICA 

Eichbaum, Quentin MD, PhD, MPH, MFA, MMHC; Reid, Steve MBChB, MMed, PhD; Coly, Ayo PhD; 

Naidu, Thirusha PhD; Omaswa, Francis MBChB, MMed 

Academic Medicine: August 2019 - Volume 94 - Issue 8 - p 1108–1114 

The role of the humanities in medical education remains a topic of dynamic debate in medical schools of highincome 

countries. However, in most low- and middle-income countries, the medical humanities are less topical 

and rarely even have a place in the curriculum. Reasons for this dearth include inadequate resources to support 

such programs coupled with misapprehension of the role and significance of the humanities in medical education. 

In this article, the authors argue that the humanities have a vital role to play in the low-resource settings of 

African medical education. They discuss the complexities of the continent’s sociohistorical legacies, in particular 

the impact of colonization, to provide contexts for conceptualizing humanities programs in African schools. They 

outline the challenges to developing and implementing such programs in the continent’s under-resourced medical 

schools and present these as four specific conundrums to be addressed. As a general guide, the authors then 

suggest four non-prescriptive content domains that African medical schools might consider in establishing medical 

humanities programs. 

The goal is to jump-start a crucial and timely discussion that will open the way for the feasible implementation 

of contextually congruent humanities programs in the continent’s medical schools, leading to the enhanced 

education, training, and professional development of its graduating physicians. 


NURSING PLATFORM 

GLOBAL HEALTH COMES TO NUVANCE! 

In follow up to last month’s e-magazine article, Global Health is expanding and invites our nurses to become 

involved in the many international opportunities to partner with colleagues around the world. 

We have visitors coming from Dalian, China around October 15, 2019. Four colleagues, 2 physicians and 2 

nurses will spend one month with us learning about our healthcare delivery system, the processes of care, and 

medical and nursing education. We, in turn will have the opportunity to learn about them and together advance 

knowledge which will benefit patient care no matter the location! 

366

A Grand Rounds is planned for the end of October. Please stay posted 

for the date, time and location. There will be opportunities to listen 

in if attendance isn’t possible. An overview of Global Health will be 

presented as well as future initiatives. Our guest speaker will be Dr. 

Majid Sadigh, The director of the global health program with added 

presentations by Jo Richie, Director of Nursing Professional Practice, 

and Catherine Winkler, PhD, MPH, APRN-BC, Director of Nursing 

Division at Global Health Program – WCHN). 

We look forward to seeing you at Grand Rounds and having you join 

the global team! For additional information - please contact Catherine 

G. Winkler at Catherine.winkler@wchn.org. 


ANNOUNCEMENTS 

WCHN MICROBIOLOGY LAB IN ST. FRANCIS NAGGALAMA HOSPITAL IS 

FULLY OPERATIONAL (A REPORT WILL BE FOLLOWING SOON) 

Left to right: Dr. Anna Vaiman, Dr. Simon Othim, Dr. Dilyara Khastieva, and lab technicians in front of the WCHN 

Microbiology lab 

367

NUVANCE HEALTH GLOBAL HEALTH INFORMATION CENTER 

Joseph Kalanzi, Dr. Majid Sadigh, and Dr. Annet Kutesa, Senior Lecturer at the Department of Dentistry in front of the 

Nuvance Global Health Information Center 

The Nuvance Health Global Health Information Center will be fully functional by September 2019 in Makerere 

University Main Campus 

A NEW HOMESTAY IN KAMPALA: THE HOME OF DR. JOSEPH KALANZI, 

CHIEF RESIDENT OF THE MAKCHS EMERGENCY DEPARTMENT 

RESIDENCY PROGRAM 

The apartment is located in Bukoto, 

a safe and quiet suburb within 

eight kilometers of the city center 

and five kilometers from Mulago 

Hospital. It is within walking 

distance of the Kabira Country 

Club, Ndere Cultural Center, 

supermarkets, and entertainment 

spots, and is accessible by public 

transport. The apartment comes 

with services including meals, 

laundry, cleaning, airport pickup, 

and transport within Kampala. 

Living Room 

368

Dr. Joseph Kalanzi (the first from Rt.) and Makerere University Emergency Medicine Residents 

THE GLOBAL HEALTH PROGRAM TABLE AT THE STUDENT RESOURCE 

FAIR AT UVMLCOM 

The Global Health Program table at the student resource fair 

369

PHOTO QUIZ 

Editor: Stephen Scholand 

A female teacher in South Africa with a chronic non-healing ulcer on 

lower left leg (Michael Lee) 

Answer: Idiopathic Pyoderma Gangrenosum 

She was treated with steroids. 

When you are not protected by long sleeves and deet in Thailand’s 

forests 


What are the potential consequences? 

Stephen Scholand (South Thailand) 

Answers: 

Mosquito bites 

Malaria 

Japanese Encephalitis 

Elephantiasis 

370

PHOTO CONTEST 

A family of Ugandan green monkeys at Mulago Guest House (Majid Sadigh) 

African tulip tree flowers at ACCESS 


Aristolochia Trilobata (Dutchman’s 

Pipe) at ACCESS (Majid Sadigh) 

A resting moth in Mulago Guest House 


371


Written by Zufar Safiullov, M.D. PhD 

Zufar Safiullov, M.D. PhD, a participant in global health elective in Dominican Republic from KSMU 

This week was busy at Hospital General Plaza 

de la Salud. Dengue fever is characterized by 

a high temperature up to 40 degrees celsius 

and bone-breaking pain in joints, back, head, 

and eyes. It is a serious condition that results 

in a patient being able to do little more than 

staying in bed and being quiet. I observed a 

23-year-old patient with Dengue fever who 

spoke English. Even despite his temperature 

and pain, he was glad to engage with me. I 

wondered how he could find the energy to 

speak and describe his condition. Compared 

with other febrile patients I have encountered, 

he was friendly and nearly always smiled 

while sharing his disease history. I think he 

understood that this information was very 

important, and so described it in great detail. 

He played a big role in helping me understand 

the manifestation of Dengue, playing 

simultaneously the role of patient and teacher. 

When he asked if I would help him. I explained 

that there is standard therapy and a vaccine 

in the clinical stage of development. Here in 

the Dominican Republic, everybody knows 

about Dengue fever, and in case of high fever 

Zufar Safiullov, M.D. PhD searching for petechiae on patient’s hand. 

Fortunately, the patient didn’t have petechiae. 

the first medication given is paracetamol. I later asked other patients and parents of children with Dengue about 

the disease, and they all remarked that they have known about it since childhood. My patient spent a week in 

the hospital, and we had a pleasant conversation every day. Though he was steadily recovering, trombocitopenia 

remained. Only after the sixth day did the number of plaques grow. 

At the end of his hospital stay, he wished me good luck in becoming a tropical diseases specialist. Though my 

Dengue lesson lasted only one week, I will remember it much longer than any Dengue lessons I was given in 

university, which involved mainly reading about the disease and discussing it with a professor. 

372

PHOTO NEWS 

KILIMANJARO TO UGANDA 

Returning from Kilimanjaro to the hotel in Moshi by bus 

Flying from Kilimanjaro Airport to Nairobi Airport 

Kilimanjaro with Mawenzi peak in right, Kibo in center, and 

Shira to the left 

INTERNATIONAL SITES 


The Principal of MckCHS 

Professor Charles Ibingira, Principal of MakCHS 

Dr. Sadigh with Professor Charles Ibingira, the Principal of 

the MakCHS 

373

Dr. Majid Sadigh with Professor Charles Ibingira, Principal of 

MakCHS 

Dr. Majid Sadigh with Professor Isaac Okullu, Deputy 

Principal and Director of the International Office 

MakSPH 

Left to right: Professor Nazarius Tumwesigye, Professor 

Joan Eron Mutyoba, and Professor Edith Nakku Joloba 

Professor Nazarius Tumwesigye, Dr. Majid Sadigh, and 

Professor Joan Eron Mutyoba 

Professor Nazarius Tumwesigye, Dr. Majid Sadigh, and Ms. 

Susan Bekwaso 

374

Right to left: Professor Linus Chuang, Mrs. Christine 

Luboga, Professor Samuel Luboga, Dr. Anna Vaiman, Dr. 

Dilyara Khastieva, and Dr. Majid Sadigh 

Professor Linus Chuang (right) and Dr. Majid Sadigh (left) 

Left to right: Professor Linus Chuang, Dr. Anna 

Vaiman, Dr. Dilyara Khastieva, and Dr. Majid 

Sadigh 

Global Health Program participants at Mrs. Christine and Professor 

Samuel Loboga’s home 

Dr. Majid Sadigh with Dr. Anna Vaiman 

(left) and Dr. Dilyara Khastieva (right) 

Dr. Majid Sadigh with Professor 

Moses Kamya, Dean of the MakCHS 


Dr. Majid Sadigh with Professor Pauline 

Byakika, the new Chairperson of 

the MakCHS Department of Medicine 

375

ACCESS, Nakaseke 

Dr. Majid Sadigh with Kaysha (left) and Ahja (right) 

Left to right: Dr. Alex Kayongo, Global Health Program 

alumnus; Ahja Dominique Steele, Estherloy Katali, Global 

Health Coordinator at ACCESS, Kaysha Lynne Ribao, 

Justus Ibrahim, and Dr. Majid Sadigh 

Dr. Majid Sadigh with Justus Ibrahim 

Ahja Dominique Steele, Estherloy Katali, Kaysha Lynne 

Ribao, Justus Ibrahim, and Dr. Majid Sadigh 

Right to left: Fred Kyanzi; the airport driver at ACCESS; 

Ahja Dominique Steele (RUSM); Justus Ibrahim, Coordinator 

of International Programs Engagements at ACCESS; and 

Kaysha Lynne Ribao (AUC) 

Kaysha Lynne Ribao (Rt) and Ahja Steele (Lt) 

376

Left to right: Dr. Majid Sadigh, Estherloy Katali, Ahja Dominique Steel, Kaysha Lynne Ribao, Justus Ibrahim, 

and Alex Kayongo 

Naggalama 

Global Health Participants from UVM and KSMU with St. 

Francis/Naggalama Hospital Leadership 

Left to right: Dr. Anna Vaiman, Dr. Dilyara Khastieva, and 


377

Global Health Program participants from Russia and 

UVMLCOM with St. Francis Hospital leadership 

Left to right: Dr. Simon Otim, Dr. Anna Vaiman, Dr. Dilyara 

Khastieva, Sister Jane Frances, 

and Dr. Majid Sadigh 

A painting on the wall of the Ob/Gynecology Ward 

Nests of weaver birds; St. Francis, Naggalama Hospital 

A painting on the wall of the Pediatric Ward 

Adult Wards 

The Pediatric Ward 

378

Dr. Majid Sadigh with Jamidah Nakato, PhD 

Left to right: Professor Chuang, Dr. Dilyara Khastieva, Dr. 

Anna Vaiman, (Russian Global Health Program participants), 

Ms. Stella Nyange Businge (HVO), and Dr. Majid Sadigh at 

Khana Khazana Indian Restaurant for dinner 

Left to right: Professor Linus Chuang, Dr. Dilyara 

Khastieva, and Ms. Nyange Stella, Coordinator of Health 

Volunteers Overseas, Uganda 

Professor Noeline Nakasujja, Head of the Department of 

Psychiatry 

Dr. Majid Sadigh with Professor Moses Kamya (left) and 

Professor Demalie Nakanjako (right), the new Dean of the 

MakCHS Medical School 

379

Dr. Anthony Okoth and Professor Linus Chuang 

Dr. Dilyara Khastieva and Dr. Anna Vaiman at Dr. and Mrs. 

Okullo’s home 

Mrs. Anna Okullo and Dr. Dilyara Khastieva 

The New Home welcoming the participants in global health in 

Kampala 

Kitchen 

380

Bathroom 

Bedroom 


Global Health Program participants dining in Bangkok before returning to the USA 

381

Home 

Dean’s Dinner with first-year medical students at UVM 

Dr. Otim at Yale’s Old Manuscript Library 

Dr. Otim in front of the oldest church on the New Haven Green 

Dr. Otim on the Yale University Campus 

Global Health: New Generation 

Alazia and Hamzah 

Dr. Alex Kayongo, Global Health Program alumnus with his 

daughter Lauren 

382

Dr. Majid Sadigh with 

Lauren Kayongo 

Dr. Majid Sadigh with Leon 

and Lindsay Kalyesubula 

Dr. Majid Sadigh with 

Lindsay Kalyesubula 

Dr. Stephen Scholand with his son 

Henry 


Saint Francis/Naggalama Hospital has been 

awarded a certificate for good performance 

at the Accounts Symposium. This award 

was given to the top 20 of 2000 Partners 

in Health. 

Sister Jane Frances, the CEO of St. Francis 

Naggalama Hospital, Uganda 

383

CALENDAR 

AUGUST CALENDAR 

August 3: The end of the 2019 Kilimanjaro Climb for a Cause 

The Kilimanjaro Team at Mweka Gate (Exit Gate) 

August 4: Professor Linus Chuang arrived in Uganda. 

August 4-12: Dr. Sadigh site-visited Uganda. 

August 5: Dr. Sadigh met with Susan Byekwaso, Coordinator of the Global Health Program and MakCHS 

International Office August 5: Dr. Sadigh met with the leadership of the MakSPH. 

August 5: Dr. Sadigh met with Russian Global Health Program participants 

August 5: Dr. Sadigh met with the leadership of the MakSPH. 

August 5: Dr. Sadigh met with Russian Global Health Program participants 

Ms. Susan Byekwaso, Coordinator 

of Global Health at MakCHS 

August 7: A meeting moderated by Jo Ritchi Director of Nursing Professional 

Practice and attended by Cathy Winkler, APRN, WCMG, Director of the 

Nursing Division at the WCHN Global Health Program and Sandy Swiatek, 

Peri-Operative Educator at WCHN pulled together a group of key stakeholders 

representing nursing leadership, midlevel providers for the medical group and 

experienced global health nurses to discuss the establishment of a nursing 

division in global health. These initiatives are bidirectional and in the fall, 

Norwalk Hospital will host two nurses from China. 

384

August 13: Dr. Majid Sadigh made an administrative trip to UVMLCOM. 

August 13: Dr. Sadigh, Dr. Mariah McNamara, and Audree Frey attended the Dean’s Dinner with first-year 

medical students in Burlington. 

Left to right: Dr. Anna Vaiman 

and Dr. Dilyara Khastieva, Global 

Health Program participants from 

KSMU 

Right: Dean’s Dinner at UVM with first-year medical students 

August 13 - 16: 

August 14: Dr. Majid Sadigh met with Dr. Mariah 

McNamara, Carole Whitaker, Dr. Molly Rideout, Dr. 

Deepak Gupta, Dr. Danielle Ehret, and Audree Frey 

to discuss the future of the Global Health Program, 

the establishment of a global health site in Nepal, 

initiation of a site for those interested in a neurology 

elective in India, the details of a fellowship program in 

preneonatalogy, and for debriefing, respectively. 

August 15: Majid Sadigh Visited Rudy L. Ruggles 

Biomedical Research Institute in Danbury with Thomas 

Gray and Dylan Ochoa 

August 15: A Global Health Program Committee 

Meeting was held. 

August 15: Dr. Majid Sadigh met Ritesh Vidhun, the 

global health intern and Dr. Long, a Global Health 

Scholar from Vietnam. 

August 18: Dr. Otim, Global Health Site Director at 

Naggalama/St. Francis Hospital, arrived in Connecticut 

for a three-week administrative visit. 

Members of the Global Health Committee 

385

August 18: Dr. Otim toured the Yale University campus 

and a few other places including the town of Lichfield. 

August 19: Dr. Sadigh had a debriefing meeting with 

Dr. Pamela Gorejena, a Global Health Scholar from 

Zimbabwe 

Dr. Otim in Yale Sterling Library 

August 20: Dr. Sadigh had a debriefing meeting with 

Dr. Zhou Li at Norwalk Hospital about her experience 

in Thailand. 

Dr. Pamela Gorejena 

August 20: Ritesh Vidhun received a certificate on successful completion of the global health internship. 

August 21: Dr. Sadigh had a debriefing meeting with Dr. Tran Huang Long, Global Health Scholar from Vietnam. 

Dylan Ochoa, Coordinator of the Global Health Program at WCHN and Mr. 

Ritesh Vidhun, a global health summer intern 

386

August 22: The first meeting of 

the Linde Health Educators Without 

Borders Executive Committee 

discussed the details of how to start 

Linde Health Educators Without 

Borders at Danbury Hospital. 

August 23: Dr. Simon Otim finished 

a week-long rotation in the OB/GYN 

Department. 

Left to Right: Majid Sadigh, Richard Galiette, Lisa Esneault, Mary Shah, Lauri 

Lenon, and Dylan Ochoa 

August 26: Majid Sadigh had a meeting with Catherine Winkeler, The 

Director of Nursing Division in global health regarding Makerere Nursing 

Department, ACCESS School of Nursing, Nursing visitors from Dalian, 

E-magazine, Global Health Grand Rounds for nurses, and Global Health 

Academy. 

Read the minutes from the meeting here >> 

August 26: Majid Sadigh had a meeting with Mary Shah about finding 

resources in support of the University of Zimbabwe’s Library. 

August 26: Majid Sadigh had an information session with the global health 

scholars when he discussed the structure and the function of the global 

health eMagazine as well as the global health at Nuvance Health. This was 

the first of the 4 sessions designed to introduce the concept of the global 

health and analytical review of the literature to the scholars. 

August 27: Dr. Sadigh had the second session on how to read a scientific 

article critically with the scholars in global health. 

Dr. Simon Otim in front of Reproductive 

Medicine Associates of Connecticut 

(RMACT) in Norwalk 

August 27: Dr. Sadigh had a phone conversation with foundation in preparation for a meeting with a potential 

donor. 

August 28: Dr. Sadigh had the third session on how to read a scientific article critically with the scholars in global 

health. 

August 28: Dr. Sadigh, Dr. Scatena had a phone conversation with a member of foundation and a potential 

donor. 

387

August 28: Dr. Sadigh and Mr. Dylan Ochoa met with 

Dr. Oltikar and Dr. Mihu to follow-up on their Arizona 

site visit. 

August 29: Dr. Sadigh had the fourth session on how 

to read a scientific article critically with the scholars in 

global health. 

August 29: Dr. Pamala Gorejena received the 

certificate of finishing successfully a 7 weeks of training 

in Palliative care, oncology and medicine from Dr. 

Damanjeet Chaubey, the Medical Director of Palliative 

Care and Denial Management at WCHN. 

Global health scholars and Dylan Ochoa during a session 

on how to read a scientific article critically 

August 30: Dr. Sadigh visited UVMLCOM to meet 

with Dean Morin and Dean Page and other medical 

education leadership to discuss the future direction of 

global health program. 

SEPTEMBER CALENDAR 

September 3: Dr. Tran Long and Simon Otim will 

attend the Library Orientation with Mary Shah 

September 5: Dr. Sadigh will meet with Dr. Petrini to 

discuss the Linde Health Educators without Borders 

Executive Committee and Global Health Academy. 

Dr. Pamala Gorejena received the certificate from Dr. 

Damanjeet Chaubey, 

September 6: Dr. Pamela Gorejena-Chidawanyika will return back to Zimbabwe. 

September 11: Dr. Simon Otim will return back to Uganda. 

September 11: Dr. Sadigh will give a lecture on the current status of Ebola in the Republic of Congo at Danbury 

Hospital Department of Medicine Grand Rounds. 

September 12: Dr. Nguyen Tai My, a Vietnamese cardiologist from Cho Ray Hospital will arrive at Danbury 

Hospital. 

September 23: Dr. Sadigh will talk about Global Health Program at Nuvance Health at Norwalk Hospital. 

September 23-25: Dr. Jonathan Melk and Dr. Darlene Melk will visit UVMLCOM. During this visit they will meet 

with medical school leadership and the global health interest group. 

September 24: Dr. Sadigh will fly to Ho Chi Minh City, Vietnam with Mr. Ron Nair to visit Cho Ray Hospital. 

388

GLOBAL HEALTH 


Participant 

Affiliation Status Host Site 

Travel Date 

to Site 

Travel Date 

to Home 

Shamili Krishna Vemulapalli 

RUSM 

MS4 


24-Jun 

24-Jul 

Jose Calderon 

UVMLCOM 

MS2 


1-Jul 

10-Aug 

Monica Rodgers 

UVMLCOM 

MS4 


7-Jul 

24-Jul 

Maria Dara Frost 

AUC 

MS4 


24-Jun 

2-Aug 

Dr. Mariah McNamara 

UVMLCOM 

Faculty 

St. Stephens, Uganda 

22-Jul 

4-Aug 

Dr. Benjamin Clements 

UVMLCOM 

Faculty 


1-Jul 

12-Jul 

Prassanna Kumar 

UVMLCOM 

MS2 


1-Jul 

10-Aug 

Irene Sue 

UVMLCOM 

MS2 


2-Jul 

8-Aug 

Ray Mak 

UVMLCOM 

MS2 


2-Jul 

8-Aug 

Elena Martel 

UVMLCOM 

MS2 


7-Jul 

8-Aug 


UVMLCOM 

MS2 


7-Jul 

8-Aug 

Dr. Zhou “Wendy’ Li 

Norwalk 

Hospital 

Resident 


July 2 

Aug-19 

Lilian Enyojo Ameh 

AUC 

MS4 


24-Jun 

14-Aug 

Luke Michael Gray 

AUC 

MS4 


24-Jun 

14-Aug 

Ameilia Anderson 

UVMLCOM 

MS2 


2-Jul 

16-Aug 

Kalin Gregory-Davis 

UVMLCOM 

MS2 


7-Jul 

16-Aug 

Dr. Pamela Chidawanyika 

UZCHS 

Faculty 


15-Jul 

6-Sep 


WCHN 

Faculty 

All international sites 

15-Jul 

6-Sep 

Dr. Simon Otim 

Naggalama 

Hospital 

Faculty 


17-Aug 

11-Sep 


AUC 

MS4 


3-Aug 

14-Sep 

Ahja Dominique Steele 

RUSM 

MS4 


3-Aug 

14-Sep 

Colee Michelle Mitchell 

RUSM 

MS4 


16-Sep 

25-Oct 

Oludolapo Oyetola Ilori 

RUSM 

MS4 


16-Sep 

25-Oct 

Jula Flum-Stockwell 

RUSM 

MS4 


16-Sep 

25-Oct 

Andrea Louise Green 

RUSM 

MS4 


16-Sep 

25-Oct 

Shaheen Lashani 

AUC 

MS4 

Cho Ray Hospital, Vietnam 

16-Sep 

25-Oct 

Danash Raja 

AUC 

MS4 


16-Sep 

25-Oct 

William James Leach 

AUC 

MS4 


16-Sep 

25-Oct 

Dr. Tran Long 

CRH 

Faculty 


29-Jul 

29-Oct 

Anna Vaiman 

KSMU 

Resident 


16-Jul 

25-Aug 

Dilyara Khastieva 

KSMU 

Resident 


16-Jul 

25-Aug 

Zufar Safiullov 

KSMU 

Resident 


16-Jul 

27-Aug 

Ramil Gabdulkheav 

KSMU 

Resident 


23-Jul 

23-Aug 

389

RESOURCES 







Ebola book 















Publications 










390

October 2019 Volume 10 

NUVANCE HEALTH 


I can do things you cannot. You can 

do things I cannot. Together we can 

do great things.. 

-Mother Teresa 



Cover Photo: Majid Sadigh, MD 

391


DR. SADIGH’S SHORT VISIT TO VIETNAM AND THAILAND, SEPTEMBER 22-28 

Right to left: Dr. Hoang lan Phuong, Dr. Majid Sadigh, Professor Nguyen Van Khoi, Vice Director of Cho Ray Hospital; and 

, Mr. Lam Dinh Tuan Hai, Vice Head of the Training Center at Cho Ray Hospital, Ho Chi Minh City, Vietnam 

Vietnam 

In Ho Chi Minh City, Vietnam, Dr. Sadigh met with the 

leadership of Cho Ray Hospital and University of Medicine 

and Pharmacy where he discussed the details of Linde 

HealthCare Educators Without Borders (LHCEWB) as well 

as Scholars in Pulmonary Medicine. Meanwhile at Cho 

Ray Hospital, he interviewed six of eleven candidates for 

LHCEWB and held a debriefing session with three AUC 

medical students undergoing the global health elective. Dr. 

Uyen agreed to serve as a member of the LHCEWB selection 

committee. 

Left to right: Dr. Khoa, Dr. Sadigh, Dr. To Mai Xuan 

Hong, Director of the International Cooperation Office 

and Dr. Hieu Huynh (Huỳnh Kim Hiệu), Officer at 

the International Cooperation Office 

Dr. Sadigh also met with and moderated a journal club 

session for Global Health Scholars at UMP where Dr. Khao was 

selected as the first Scholar in Global Pulmonary Medicine, 

and To Mai Xuan Hong agreed to serve as a member of the 

LHCWB selection committee. During this visit, Dr. Sadigh 

was introduced to the leadership of Children’s Hospital 

Number 2, and spent time speaking with the hospital’s 

medical students, residents, and faculty. 

392


On arrival to Thasala City on September 26, Dr. Sadigh had a debriefing dinner meeting with Dr. Prachyapan 

Petchuay (Menn), Dean of Walailak University (WU) School of Medicine, and other leadership to discuss 

future curriculum for global health participants based on lessons learned from the first group of participants 

who underwent the elective this past summer, as well as other curriculum-related matters. It was decided 

that participants will only be assigned to Thasala Community Hospital, which has 270 beds including fifty 

pediatric inpatient and ten neonatal beds. This hospital is close to the WU campus and has a combined 

medical surgical ICU with twelve beds. The annual delivery rate is close to 1600, with a Cesarean section 

rate of forty percent. 

Dr. Sadigh found the leadership and faculty of Thasala Community Hospital enthusiastic and welcoming to 

new educational ideas. 

Dr. Sadigh with Dean Prachyapan Petchuay and Walailak 

University School of Medicine Faculty 

The Pediatric Ward at Thasala Community Hospital 

DR. JONATHAN MELK’S VISIT TO 

UVMLCOM 

Written by Audrey Frey 

Global Health Coordinator at UVMLCOM 

Dr. Jonathan Melk, CEO and CMO of Chiricahua Community Health 

Centers in Arizona, visited UVMLCOM from September 23-25. While 

he was here, Dr. Melk gave grand rounds talks for both Family 

Medicine and Pediatrics titled “Global Health on the US/Mexico 

Border.” He also participated in a panel discussion with Naomi 

Wolcott-MacCausland, Migrant Health Coordinator at Bridges to 

Health at the UVM Extension, where the topic was “Migrant Healthcare on Both the Northern and Southern 

US Borders.” All three events were well-attended and many people expressed interest in learning more about 

Chiricahua and the work Dr. Melk and his team are doing there. Dr. Melk also had the opportunity to meet with 

many medical students and residents interested in undergoing global health rotations at Chiricahua, as well as 

393

with members of the medical education and global health leadership teams to discuss the program and begin 

working on logistics for these upcoming rotations. It was a pleasure to host Dr. Melk, and we are all very much 

looking forward to developing our new partnership! 

PERSPECTIVES 

REMEMBERING OUR LOVED ONES 

Written by By Dr. Stephen Scholand 

In Southern Thailand, the Festival of the Tenth Lunar Month or Ngan Boon 

Duan Sib (ประเพณีสารทเดือนสิบ) is very important. It’s a traditional Buddhist 

festival celebrated in Nakhon Si Thammarat, the home of Walailak University, 

every September or October when the tenth moon is on the wane. At this 

time, Thais remember their close relatives and friends who passed away, 

and make merit or do good deeds for the benefit of their souls. It is thought 

that unless someone is a saint and goes directly to heaven, that person’s 

spirit will initially pass into a type of hell and experience suffering. These 

spirits may assume forms of giant ghosts with small mouths that are always 

hungry. Then, at this special time when living relatives make merit in honor 

of their deceased, that person’s soul may be released to ascend into heaven. Part of the merit-making involves 

providing provisions for the Buddhist monks to endure the rainy season. There are five special desserts or sweets 

394

associated with the festival: khanom pong which is a puffed pastry symbolizing a raft for the spirits to float to the 

nether world, khanom la symbolizes clothing, khanom dee sam symbolizes money, khanom ba symbolizes good 

times, and khanom gong symbolizes ornaments. A small portion of these and other foods are offered to the spirits 

that are thought to be present at this time. A small candle is lit for the spirit to see, and the food is presented 

on a banana leaf in a sacred temple area or near a large sacred tree. Styrofoam is not allowed! For those spirit 

relatives that were forgotten about, their suffering is magnified because they cannot have the offerings for 

others, but can only lick the leftover banana leaves of the other spirits! 

In Thai culture, it is very important to honor, respect, and love one’s elders and family, even beyond this life. This 

festival is a special time to help them in their spiritual journey. Making merit in their honor might include donating 

money to a temple, releasing a captive animal, planting a tree, or even feeding some fish. Of course it’s also an 

excellent time to celebrate life in the Thai way with elaborate costumes, dance, delicious food, and community 

activities. Let’s remember our departed loved ones! 

395

KEEP GOOD TIME: A SOLUTION TO HEALTHCARE 

IN UGANDA 

Written by Hamidah Babirye Nsereko 

Assistant Director / Contracts Management and Monitoring Unit, 

Office of the Principal, Makerere University Business School 

My child woke up complaining of tooth pain. I gave her a pain killer and we 

were able to sleep without further incident. In the morning, we decided to 

visit the newly opened Dental Hospital and School at Makerere University. 

We were quite early and while we were waiting, we witnessed some students 

and doctors making preparations to receive patients including dressing up in 

shrubs and gloves. After about thirty minutes, a student arrived on a boda 

boda (scooter) rushing to get to class. The Professor then banned her from entering the class. She tried to 

explain her reasons for arriving late in a hushed tones, to deaf ears. I realized then that this could be one of the 

contributors to the degeneration of this current era. 

Coming late in Uganda and other African countries is taken lightly, and we use any excuse including “killing our 

own parents” to justify this vice. Maybe it’s because we are not paid per hour for our professional output, as is the 

case in developed nations. In Uganda, most professionals are in gainful employment and earn a monthly salary. 

Therefore, time is not valued. The professor who stopped the student from entering the class is actually trying to 

inculcate values including time management in the student. Unfortunately this is seen as old fashioned, yet it is 

exactly what is needed to revamp this generation. 

In Uganda, one of the biggest challenges that people face is lack of access to healthcare, and that is precisely why 

we are known to have high mortality rates, for example in maternity or infants. This could be attributed to the 

actual time lost by medical personnel arriving late and leaving early, especially in remote areas. Imagine a doctor 

paid monthly to provide care eight hours a day under public service rules. The doctor being available for four 

hours a day means that only half the patients for the day will be catered for. Computer that for the entire nation 

and find out the total loss. It is immense. I therefore commend all those teachers out there that make efforts to 

ensure that their students come in time and adopt good time-keeping habits. 

396

SEXUAL HARASSMENT AND VIOLENCE 

ACROSS CULTURAL CONTEXTS 

Sexual harassment and other forms of sexual- and gender-based violence are ubiquitous. Participants of global 

health programs often experience and report such abuses while living and working in low-to-middle-income 

countries. Efforts should be made to provide guidance and support so that these individuals can effectively cope 

with these situations. However, the framework for understanding sexual harassment and abuse has fundamentally 

changed with the #MeToo movement. This widespread grassroots movement has shaken the historic tolerance of 

sexual harassment, and has led to both discourse and action of global impact. The global health community must 

now educate its members, from trainees to faculty and researchers, on how to advocate for one’s own rights and 

the rights of others in the face of sexual harassment and abuse in the era of the #MeToo movement. 

WRITTEN ANONYMOUSLY 

During a hotel stay in a crowded urban city, a global health participant encountered a foreign tourist while 

swimming in the pool of the hotel. The tourist initially asked this global health participant to help him take a photo 

of himself. Afterward, the two engaged in a conversation. The tourist subsequently asked the participant for her 

social media information, to which she declined to disclose. When the participant got out of the pool, the tourist 

followed her to her floor and made further advances by asking if he could enter her room. After she declined his 

request again, he left but only to return later to knock on her door. She was cautious enough not to answer the 

door but was disturbed at a later time by a phone call to her hotel room from this tourist using the hotel phone. In 

order not to be disturbed by him again that night, she reluctantly accepted his friend request on social media but 

immediately declined, for the third time, his invitation for a night out on the town before she was able to finally 

retire for a quiet and peaceful night. 

As a female who is only vaguely aware of the sex tourism industry and the culture in some big urban cities around 

the world, this participant was very taken aback, alarmed, and shocked by the aggressive behavior of this tourist. 

She hopes to make other global health participants aware of and prepared to deal with potentially hazardous 

situations like this one. After all, safety is everyone’s top priority! 

SEXUAL HARASSMENT IN RUSSIA 

Written by Anna Ziganshina 

Endocrinology Fellow at Albany Medical Center 

While sexual harassment in Russia has been present for centuries, the term itself 

is still not widely known. Given the unique characteristics of work and street 

harassment, it is worth discussing them separately. Although both women and 

men can be subjects of sexual harassment, harassment of males is practically 

nonexistent in Russia. 

Work or school-related harassment is a large and daunting subject to discuss. There are currently no strict or 

precise regulations in place that define appropriate behavior between employees/students and their superiors. 

Traditionally, Russia was and mostly still is a patriarchal society. It is more common for men to hold key positions 

397

across different sectors, from finance to education to healthcare industries. Meanwhile women’s roles are largely 

that of assistant to men, even at relatively high positions in the social ladder. 

Unfortunately, some men in Russia also lack a sense of courtesy towards their female colleagues or students. 

These factors combine to form an environment in which sexual harassment can occur. It is important to point 

out that in the majority of known instances, work- and school-related harassment is verbal. While other forms of 

harassment certainly occur, it is difficult to speculate on their exact nature or frequency. Thus, various inappropriate 

comments directed at females are seen frequently in Russia, though more aggressive forms of harassment are 

relatively uncommon. Many women will perceive such behavior as incredibly offensive and bothersome. 

One group of researchers investigated the prevalence of sexual harassment in the workplace. In one smallscale 

survey, they found that nearly 30% of working women experience sexual harassment at their workplace,1 

although this is likely an underestimation due to underreporting. While sexual harassment does run rampant in 

the workplace, it appears that the ice is slowly starting to break. Recently there has been a number of high-profile 

scandals in Russia involving politicians and media moguls accused of various forms of sexual harassment. 2,3 

Though rarely penalized, such cases negatively impact the perpetrators’ careers and personal lives, and force a 

more open national discussion on the issue. 

Street harassment in Russia seems to be less of an issue for multiple reasons. First, Russians, like many northern 

cultures, share certain characteristics of “colder”-appearing people. For instance, it is quite unusual for men to 

shout out remarks or approach women on the streets. However, this is not to say that frankly revealing clothing 

or specific social contexts such as bars or nightclubs would not potentially result in harassment. Secondly, the 

situation is more favorable towards tourists, particularly due to the significant language and culture barrier 

that maintain distance. Furthermore, a specialized police division called “Tourist Police” was recently established 

specifically geared towards ensuring safety of local and international tourists. 

Overall, sexual harassment is an important issue in modern Russian society with rapidly growing public awareness 

of its existence. However, much work remains to be done to change the existing culture particularly in work and 

school settings. 

1. https://daily.afisha.ru/relationship/4836-chto-takoe-harassment-i-kak-zaschitit-sebya-ot-nego/ [Russian] 

2. https://yandex.ru/turbo?text=https%3A%2F%2Fwww.gazeta. 

ru%2Flifestyle%2Fstyle%2F2018%2F11%2Fa_12052873.shtml [Russian] 

3. https://meduza.io/feature/2018/02/24/zhurnalistki-obvinili-deputata-gosdumy-leonida-slutskogo-vdomogatelstvah-on-vse-otritsaet-glavnoe 

[Russian] 

398

CHALLENGING MOMENTS 

IN GLOBAL HEALTH 

During a hotel stay in a crowded urban city, a global health participant notices that an older man, presumably 

a tourist, is in persistent pursuit of the receptionist who is a young female. Each time the participant enters the 

lobby, she sees the tourist making inappropriate advances toward the receptionist despite her clear yet polite 

discomfort. 

One particularly late and quiet night, the participant notices that the receptionist is working alone in the lobby, 

and the tourist is getting noticeably close. The participant considers asking the receptionist, in private, whether 

she is uncomfortable, but the tourist is so persistent that she is unable to encounter the receptionist alone. 





NURSING PLATFORM 

GLOBAL HEALTH PROGRAMS 

IT’S A SMALL WORLD! 

As the world continues to become increasingly interconnected with not 

only social, political and cultural integration, economic health dependent 

on the “health of a nation” becomes a greater factor with the need to 

expand policies and work beyond borders and to cooperatively decide on 

public health initiatives. 

Editor: Catherine G 

Winkler, PhD, MPH, 

APRN-BC 

In an editorial by Martin and colleagues (2014), the authors state 

that there needs to be a “recognition of health as a major engine of 

economic growth and for commensurate investment in public health”. 

Additionally, the authors contend that although it is understood that with 

a better gross domestic product or GDP comes better health, so too, 

they postulate that the improvements in the health of a given population 

promote the growth of a country’s economy. 

Further, most Americans would agree that we need to be engaged in global health issues as a matter of “doing 

what’s right” to alleviate the human suffering associated with communicable diseases, lack of healthcare 

resources, clean water, clean air and the like, however, there continues to be large scale problems with collective 

399

decision-making on the right course of action. In contrast, the Global Health Program at Nuvance Health has 

taken action with their academic partners for the past 7 years to improve patient care and medical education 

through partnerships and an exchange of ideas. Taken together, the global health program at Nuvance Health 

continues to expand its network to facilitate collaboration with colleagues around the world in patient care, 

research, leadership and healthcare administration and education. 

Accordingly, physicians, nurses and all members of the healthcare team can support action on a global initiatives 

through multiple venues to include their academic or health delivery organizations, from professional societies 

and through independent inquiry into opportunities. Moreover, often one can transfer skills easily from a local 

level to a worldwide platform with a few adjustments. At Nuvance Health with our academic partners, our global 

health program is growing. Please contact us to get involved. In the next issue, we will report on the progress of 

global health programs within our state. 

Catherine G. Winkler PhD, MPH, APRN-BC 

GLOBAL HEALTH 

IN THE ARTS 

Editor: Tendai Machingaidze 

“BEAUTY IN IMPERFECTION”: 

PALLIATIVE CARE INNOVATION IN INDIA 

Written by Tendai Machingaidze 

Wabi Sabi Health (WSH) is a foundation that delivers holistic palliative care to developing countries by coupling 

medical and psychosocial therapy. WSH uses expressive arts to act as a bridge to palliative care. In 2018, I 

attended a presentation by Dr. Preeya Desh, Founder and CEO of WSH, titled “Palliative Care Innovation: Coupling 

Music, Art, and Traditional Counseling Therapy to Program Development” at the Global Health & Innovation 

Conference. The WSH approach was one of the finalist pitches for the coveted Innovation Prize. In the following 

interview, Dr. Desh further articulates how WSH is using the arts to bypass social and cultural barriers in palliative 

care in India. 


PD: Preeya Desh 

TM: What does “Wabi Sabi” mean? 

PD: Wabi Sabi is a Japanese philosophy that means “beauty in imperfection, the natural cycle of life and death.” 

We chose [the name] because in palliative medicine, which is the medical care of the terminally ill and dying 

400

patient, the natural tendency is to find ugliness and injustice in the journey 

of illness. With this concept, we acknowledge pain and suffering, but look 

to the idea of beauty in the impermanence of life and the inherent dignity 

in life and death. 

TM: What is the inspiration behind the WSH Foundation? When 

was it started? Where does it operate? 

PD: When I first started working with palliative care patients in India 

a few years ago, I noticed a gap in the delivery of services. Palliative 

Care is a holistic approach to medical care that encompasses body, mind 

and spirit. It functions as an interdisciplinary team of doctors, nurses, 

social workers, chaplains and other psychosocial clinicians. Though there 

have been lots of efforts recently to make it more available, only 1% of 

Indians have access to it. Those that receive palliative services mostly 

get medical treatment with pharmacotherapy to manage pain and other 

symptoms. They do not receive psychosocial care, which is an integral 

part of palliative medicine. With that gap in mind, we set out to create a 

training program for medical teams across India that would incorporate 

medical and psychosocial care simultaneously. We have partnered with 

two hospitals - CanCare Foundation in Chennai and Sharon Palliative Care 

Hospital in Salem. In the future, we will be in other parts of India and 

hopefully in other developing countries. 

TM: Please comment on the need for holistic palliative care in 

India and developing countries? What cultural barriers exist to 

mental health care in India? 

PD: Because of the culture of medicine based on paternalism and the 

mistrust of doctors, patients often seek homeopathic and ayurvedic 

treatment options in place of allopathic care. This tells me that doctors 

are not listening to the needs of their patients, which is a desire to 

incorporate a strategy for health that involves body, mind and spirit. 

Medical professionals are quick to prescribe medicine without really seeing 

the patient. Wabi Sabi Health equips medical professionals to provide 

holistic care. 

One big barrier related to the patients themselves is the stigma with 

mental health. It is perhaps counter culture to see a doctor for depression, 

anxiety or mental illness or to talk to a psychotherapist. We recognized 

this barrier immediately and worked to creatively overcome it. 

TM: How does WSH integrate art and music into mental health 

care? Why is this important? How do you assess outcomes of your 

methodology? 

PD: Wabi Sabi Health uses art, music and expressive therapy to work 

around the stigma. We are currently exposing our students to expressive 

401

arts therapy where they participate in monthly sessions. This gives these young nurses and psychosocial workers 

who work at the bedside of dying patients the tools to manage their own emotional distress as well learning how 

to use it for patients. It was profound to see how well they’ve responded and enjoyed the group sessions. No 

one had ever been concerned about their emotional response to patient care and they felt safe and free to share 

their experiences. 

We are working with medical students from the University of Miami who will be evaluating our model using 

Edmonton Symptom Assessment Scales and the Distress Thermometer to measure the effectiveness of our 

intervention. 

We also have a music therapist on our advisory board who has worked extensively in India who will bring music 

therapists to do on site work in the hospital and the patient’s homes. 

TM: Please share a success story of a patient treated using the WSH model. 

PD: Home visits are an amazing thing. Patients are given the medical support to be comfortable at home. The 

nurses do weekly visits and provide bedside medical care. Usually this is medical care- either pharmaceutical 

or interventional care. On one visit, I watched one of the nurses we are training use what she learned in her 

Expressive Art therapy session while she spoke to the daughter of a sixty-year-old female with terminal ovarian 

cancer. The daughter was asked to draw a picture of how she perceived her mother’s suffering using colored 

markers. The daughter was happy to participate and this led to a more open discussion. The daughter was 

relieved that somebody asked how she was coping with her mother’s suffering and was eager to talk about her 

“mental health.” Because we use music and art, which are non-threatening and universal, the potential for use 

is profound. We will be offering art and music therapy sessions by licensed expressive art therapists to patients 

soon. 

Dr. Desh is a Pediatric Hematology/Oncology physician from West Palm Beach, Florida. She completed medical 

school at Sri Ramachandra Medical University in Porur, India, residency at Jersey Shore University Medical Center, 

and a fellowship in Pediatric Hematology Oncology at Brown University. 

Find out more about Wabi Sabi Health and their innovative use of the arts in palliative health care at: 

http://www.wabisabihealth.org/ 

402

CLINICAL CASE 

Editor: Dr. Stephen Scholand 

SCHISTOSOMIASIS (S. MANSONI) 

Written by Jennifer Edelman and Harriet Mayanja 

From collection of cases and reflections from Mulago Hospital, Kampala, Uganda 

A 32-year-old fisherman who lives near Lake Victoria presents with several months of abdominal discomfort with 

increased abdominal girth, occasional dark stool, and increased fatigue. The review of symptoms is notable for 

nonproductive cough for several weeks. He denies having any prior medical problems and does not take any 

medications. He lives with his brother and drinks alcohol on occasion. His family history is significant, for his sister 

died from AIDS-related complications. 

On physical exam, he is afebrile with HR 80, BP 105/80, RR 12. General: thin, pleasant, cooperative gentleman 

appearing as stated age in NAD. HEENT: no scleral icterus, pale conjunctiva, no LAD. Cor: regular S1, S2 without 

m/r/g. Pulm: CTAB. Abdomen: soft, slightly distended, hepatomegaly with liver edge ~6 cm below costal margin, 

no splenomegaly appreciated, normoactive bowel sounds. Extremities: trace edema, warm with strong distal 

pulses. Rectal: no gross blood, normal tone, no masses. His laboratory values reveal a normal WBC, HCT 35, and 

PLT 120. Additional studies include normal liver function tests, hepatitis serologies, AFP, and HIV serology. 


The patient is presenting with a chronic history of gastrointestinal complaints with associated hepatomegaly. The 

possible causes include chronic viral hepatitis with potential sequale of cirrhosis or hepatocellular carcinoma. Also 

possible is gastrointestinal or military tuberculosis, visceral leishmaniasis, or schistosomiasis. Given the patient’s 

occupational exposure, schistosomiasis should be high on one’s differential diagnosis. 

Schistosomiasis results from an infection with a flatworm, an organism with a cylindrical body, two terminal 

suckers, a digestive tract, and reproductive organs. These trematodes feed on blood and globulins of the human. 

While there are many species of trematodes, there are several Schistosome species of varying geographic 

distribution carrying major importance involved in human infection: Schistosoma haematobium, Schistosoma 

mansoni, and Schistosoma japonicum. 

Describe the life cycle of a Schistosome. 

Resting in the males’ gynecophoric channel, females produce hundreds of eggs each day that use proteolytic 

enzymes to migrate to either the bladder (S. haematobium) or liver and gastrointestinal tract (S. mansoni, S. 

japonicum). Once the eggs are excreted, ciliated miracidium larva hatch and infect a freshwater snail. Once inside 

the snail, asexual reproduction allows them to become sporocytes and eventually cercarial larvae. 

The cercarial larvae then leave the snail and can survive in fresh water for up to 72 hours. Once a host is found 

(commonly in warm slow moving water), the cercarie penetrate the skin and migrate to the lungs and liver; inside 

403

the liver the cercarie transform into schistosomulae by forming a heptalaminate membrane. Within the portal 

vein schistosomulae mature and mate, the eggs then migrate to other organ systems, including the bladder or 

gastrointestinal tract, to begin the cycle again. 

What are the clinical manifestations of Schistosomiasis? 

Patients in endemic areas present after recurrent infection and demonstrate signs and symptoms of chronic 

infection from high egg burden. The migration of eggs to the bladder, lungs, liver, gastrointestinal tract, and 

central nervous system result in local inflammation (including granuloma formation) followed by fibrosis. In 

chronic infections: 1) antibody production and involvement by eosinophils allow for some resistance to reinfection 

and 2) alterations in the hypersensitivity response result in decreased granuloma formation and intensity of 

fibrosis. 

Migration of S. haematobium to the bladder causes inflammation and ulceration clinically manifesting as 

hematuria; other manifestations include fibrosis, obstructive uropathy, hydronephrosis, and acute kidney injury. 

Patients may also have a subclinical glomerulonephritis secondary to immune complex deposition disease. Finally, 

in combination with other carcinogens, bladder squamous cell carcinoma may be seen. 

Ova within the pulmonary capillary beds causes endarteritis obliterans and pulmonary hypertension. Genital tract 

disease (from S. mansoni, and S. haematobium) may appear as hypertrophic and ulcerative lesions and may 

facilitate the transmission of HIV and STI’s; 

Additionally, manifestations of irregular bleeding, pelvic pain, infertility, and in males- hemospermia may develop. 

S. mansoni, and S. haematobium can cause transverse myelitis; S. japonicum can cause a meningoencephalitis, 

focal paralysis, or seizure from granulomatous lesions. 

Intestinal involvement from granulomatous inflammation may present with colicky abdominal pain, anorexia, and 

bloody diarrhea. Lesions ranging from pseudopolyps, ulceration, and bleeding are within the large intestine. Long 

standing complications include chronic Salmonellosis, contractures of colon, and intussusception. 

Within the liver, the eggs of S. mansoni and S. japonicum cause hepatomegaly and granuloma formation. Fibrosis 

occurs 5-15 years after initial infection with S. mansoni; the time interval is shorter with S. japonicum. The 

classic location is within the periportal spaces leading to Symmers’ pipe stem fibrosis. Sequelae from chronic liver 

disease ensues particularly in those with preexisting cirrhosis or co-infection with Hepatitis C or B. 

In contrast to chronic infection, Katayama fever (often seen in returning travelers) is an acute manifestation 2-8 

weeks after infection classically seen with S. japonicum and S. mansoni. The syndrome is a reaction to migrating 

schistosomulae and is characterized by a pruritic maculopapular eruption in the region of cercarial penetration 

followed by cough, abdominal pain, fever, fatigue, hepatosplenomegaly, pulmonary infiltrates, and eosinophilia. 

How is the diagnosis of Schistosomiasis made? 

Ultimately, the diagnosis is based upon the patient’s history and clinical feature. Supportive evidence from 

examination of stool or urine for schistosome eggs remains the most useful test to perform. The major species 

can be differentiated by the location of their spine: S. mansoni are oval with a lateral spine, S. haematobium are 

oval with a terminal spine, and S. japonium are globular without a spine. Anti-Schistosomal antibodies may be 

used to confirm the diagnosis; however, serology can not differentiate past from active infections and are not 

available in resource-limited settings. 

404

The team seeks to further evaluate for the possibility of 

schistosomiasis and undertake an examination of the stool as well 

as an abdominal ultrasound that reveal: oval eggs with lateral spine 

present and a “bull’s eye” lesion with fibrosis, respectively (see 

below). 

Courtesy Omongot Samson 

In this patient, the “Bulls Eye” lesion (representing liver fibrosis 

around the central venous structures in the presinusodal region 

does not alter hepatocyte function and therefore results in normal 

liver function tests. These findings and the characteristic eggs on 

stool examination are consistent with Schistosomiasis. 

How do HIV and Schistosomiasis interact? 

Patients with HIV are more susceptible to schistosomiasis and its consequences due to less effective excretion 

of eggs, impaired granuloma formation, and decreased immune response to antigen exposure. On the other 

hand, schistosomiasis may lead to increased transmission and progression of HIV due to egg deposition induced 

ulceration and nodularity within the female genital tract. 

How is Schistosomiasis treated? 

The drug of choice is praziquantel. This kills adult worms by affecting membrane permeability through calcium 

ion channel inhibition within the central nervous system. The drug kills 65-90% of adult worms but not 

immature forms or eggs so a repeat course of therapy may be necessary 4-6 weeks after the initial treatment. 

Mild Side effects (headache, dizziness, abdominal discomfort, fever) are due to dying worms. The use of 

Praziquantel in neuroschistosomiasis must be carefully monitored. Finally, steroids may be used as an adjunct in 

neuroschistosomiasis and Katayma fever. 

How is Schistosomiasis prevented? 

Avoiding contact with contaminated water and/or wearing protective clothing decreases the risk of transmission. 

Praziquantel has a half-life of 1 – 1.5 hours and is not effective against eggs or cercarial larvae. Conversely, 

Artemether has activity against immature schistosomulae as demonstrated in laboratory and clinical trials. The 

dosing is higher than That given for malaria (6 mg/kg) but given every 2 weeks (S. japonicum), 3 weeks (S. 

mansoni), or 4 weeks (S. haematobium). Although not demonstrated in mouse models of malaria, theoretically 

indiscriminant use of Artemether may result in resistant Plasmodial species. (9) 

References: 

1. World Health Organization. Schistosomiasis and Soil-Transmitted Helminth Infections- Preliminary Estimates 

of the Number of Children Treated with Albendazole or Mebendazole. Weekly Epidemiological Record. 2006. 

16: 145-164. 

2. Kolaczinski, JH. Neglected Tropical Diseases and their Control in Uganda: situational anaylsis and needs 

assessment. 4/2006. 

3. Despommier, DD, Gwadz RW, Hotez PJ, Knirsch CA. Parasitic Diseases. Apple Trees Productions, LLC. New 

York, NY. 2000 

4. Gryseels, B, Polman, K, Clerinx, J, Kestens, L. Human Schistosomiasis. The Lancet. 2006; 368: 1106-18. 

405

5. Secor, WE. Interactions between schistosomiasis and infection with HIV-1. Parasite Immunology. 2006; 28: 

597-603. 

6. Ross, AGP, et al. Schistosomiasis. NEJM. 2002; 346(16): 1212-1220. 

7. Maguire J. Trematodes (Schistosomes and Other Flukes). In: Mandell G., Bennett J., and Dolin R. eds. 

Principles and Practice of Infectious Diseases. 6th Ed. Philadelphia: Elsevier. 2005. 3276. 

8. Shuhua X., et. al. Recent Investigations of Artemether, a Novel Agent for the Prevention of Schistosomiasis 

japonica, mansoni, and haematobia. Acta Tropica. 2002. 82: 175-181. 

Read more cases here >> 

ANNOUNCEMENTS 

DIRECTOR AND ASSOCIATE DIRECTOR OF LINDE 

HEALTHCARE EDUCATORS WITHOUT BORDERS 

Jamidah Nakato holds a PhD in Business Management from Nelson Mandela 

University in South Africa, a Bachelor of Arts in Education and a Master of Business 

Administration from Makerere University. 

She is a contributing author to the UVMLCOM/WCHN eMagazine and Global Health 

Diaries. 

Director: Jamidah 

Nakato, PhD, 

Assistant Lecturer 

at Makerere 

University 

She is currently an Assistant Lecturer at Makerere University College of Business 

and Management Sciences. 

Hamidah Babirye Nsereko was born in Kampala, Uganda, in 1982. She received 

the B.A. degree from Makerere University, Kampala in 2006, and the Master of 

Business Administration in Finance and Accounting from Makerere University, 

Kampala in 2009. Currently, she is pursuing a PhD in Business Management from 

the Nelson Mandela University in Port Elizabeth, South Africa. In 2006, she joined 

the Office of the Dean of Students at Makerere University Business School as 

an Administrative Assistant, and in 2009, she was promoted to the position of 

Administrator. She was also the pioneer person in charge of the Accounts of the 

Dean of Students department of Makerere University Business School, a position 

she held for 2 years. 

Associate Director: 

Hamidah Babirye 

Nsereko 

In 2011, she was promoted to Senior Administrator in the Office of the Dean of 

Students of Makerere University Business School and in 2014, she was promoted 

to the position of Assistant Director in the Office of the Principal in Makerere 

University Business School. When the new Contracts Management and Monitoring 

Office was established in the Office of the Principal, she was appointed Assistant 

Director in charge of the same office, a position she has held to date. Since 2014, 

she has also been the person in charge of the new Health and Safety Unit under 

406

the Office of the Principal of Makerere University Business School. In addition, she is the managing editor and 

supervisor of the Makerere University Business School Publications Unit and the supervising director of the 

Makerere University Business School Alumni Office. She is the Manager of the Contracts Management and 

Monitoring Office in Makerere University Business School. 

She has a Postgraduate Certificate in Project Monitoring and Evaluation from the College of Business and 

Management Sciences at Makerere University, and another postgraduate certificate in Project Planning and 

Management from the Institute of Statistics and Applied Economics of Makerere University. Other trainings 

include Accounting and Finance for non- finance executives, Public Speaking, Occupational Safety and Health, 

Strategic Planning, Effective Communication Skills, Effective Co- Counselling, Gender Student Peer Training and 

Peer Education. 

Dr. Tendai Machingaidze has been assigned as the Nuvance Global Health Site Director for partnership with 

University of Zimbabwe College of Health Sciences. 

Dr. Pamela Gorejena has been assigned as the Assistant Director of the Global Health Program at the University 

of Zimbabwe. 

Dr. Rati Ndhlovu from University of Zimbabwe College of Health Sciences, Dr. Pauline Byakika from MakCHS, Dr. 

To Mai Xuan Hong from UMP in Ho Chi Minh City and Dr. Uyen from Cho Ray Hospital have accepted membership 

on the LHCEWB selection committee. 

REFLECTIONS 


Global Health Program participant from KSMU, Russia 

“There is a kind of magic about going far away and 

then coming back all changed,” Kate Douglas Wiggin 

once said - the quotation I stumbled upon shortly 

before my internship in Uganda. Coming back home 

after six weeks, I felt like a completely new person and 

could feel the true meaning of the quote. Six weeks 

in Kampala went in one breath, but in a breath that 

changed me. Uganda taught me several lessons during 

my internship, lessons I can bring to my professional 

and personal life. I found out that indeed, “words can 

heal.” I heard this phrase many times but only Uganda 

made me truly understand it. Lack of resources, 

medical supplies, and medical equipment makes words 

407

and simple verbal assurances a powerful and sometimes only remedy. “There is only one shot and it has to hit the 

target” – a phrase the doctors I’ve met in the hospital taught me. For most patients, even a simple examination 

is a huge expense and sacrifice from their family budget. Therefore, doctors need to choose one, most precise 

diagnostic method and make their decision fast. The price for the smallest mistake or prolongation can be 

patient’s life. It is admirable how medical staff in Kirruddu Hospital were able to diagnose patients with such 

precision in such a short period of time. 

After long work days in the hospital, I would meet with students from all over the world including Ugandans, 

Americans, Italians, Chinese, and Belgians. We shared our experiences, interesting clinical cases, and impressions. 

This discussion made me realize that our huge modern world is in some sense quite small, and all of us more alike 

than different. We live in different countries and speak different languages, but we all read the same books, watch 

the same movies, sing the same songs, and, share the same experiences here in Uganda. On the weekends, I 

got to travel around the country and meet a lot of people. Even during these short trips, Uganda prepared some 

lessons for me. 

While dancing with the indigenous people of Uganda on a small island in the middle of Lake Bunyoni, I learned 

that sometimes, a small piece of land can be the whole world. While racing on the motorcycles, boda bodas, that 

were banned for foreign students on the streets of the provincial town of Kabale, I learned that sometimes it is 

worth it to take a risk and break a few rules. While having dinner with an African family and listening to stories of 

their lives, I learned just how much I miss my family and became convinced that the family is the most important 

thing for me. The hugs I gave them at the airport upon my return after six weeks so far away never were tighter. 

As I said goodbye at the airport to my friends I met in Uganda, the Beatles song “All You Need Is Love” was 

playing in my head. I memorized for life the smiles and bright moments associated with my new friends. Indeed, 

loving people around you, places you visit, and your own profession makes life brighter and more meaningful. If 

someone asks me what the main gem of Uganda is, I will not hesitate to answer: it is the people, full of kindness 

and love for everything that surrounds them. 


Amelia Anderson ‘22 and Kalin Gregory Davis ‘22 

Amelia Anderson ‘22 and Kalin Gregory Davis ‘22, rising second-year medical students from UVMLCOM, headed 

to Tanzania to climb Mount Kilimanjaro after completing the global health elective in Naggalama, Uganda. Below 

is Amelia Anderson’s reflection about the climb, while Kalin Gregory Davis’ piece will be featured in next month’s 

edition. 

Amelia Anderson, UVMLCOM Class of 2022 

I wanted to climb Kilimanjaro because it is a spectacular cultural and geological feature of Africa. I was excited by 

the physical and mental challenge, and ready to have an adventure before the start of the second year. We took 

the Lemosho Route, a six-day ascent for a total seven-day trip. Neither of us trained specifically for Kilimanjaro, 

but we were both in good shape to begin with. I ran the Boston Marathon earlier this year and had been doing a 

408

lot of hiking and cycling. I tried to maintain fitness the best I could in 

Kampala for the six weeks before the trip, but that mostly consisted 

of at-home workouts. 

We both took Diamox and experienced symptoms at almost the 

exact same time. I got neuropathy in my hands and feet after two 

days that came and went for the rest of the trip. In general, the 

neuropathy wasn’t too bad and was only painful when we stopped 

after a few hours of hiking. I also experienced some loss of appetite 

and fatigue but I’m not sure if that was the Diamox, altitude, or 

early morning wake-ups. I lost my appetite after 11,000 feet but 

didn’t have any nausea or discomfort. I thought I didn’t want to 

eat because they were feeding us so much and didn’t realize I 

was ravenous until we got back to the hotel on our final day. I did 

experience severe exhaustion when we got to base camp at 15,000 

feet but that resolved after resting for a few hours. 

Summit day went perfectly. I was cold but felt completely fine, 

though this was definitely subjective because I have blue lips and 

Amelia Anderson (right) and Kalin Gregory 

Davis (left) 

look pretty out of it in the summit pictures. I feel extremely lucky for 

not having any problems with the altitude. We were reminded daily 

of the dangers of high altitude. As early as the third day we saw a porter with high altitude pulmonary edema 

(HAPE), who our guide strongly encouraged to descend. After that, we saw helicopter evacuations almost daily. 

Even as we started our ascent to the summit, we had to step aside as a man was carried down on a stretcher. His 

group had camped at about 16,000 feet and it looked like he developed HAPE that evening. As we continued up, 

we could see droplets of blood on the rocks from where he likely had been coughing. 

Kalin and I were the only members of our group, and were accompanied by one guide, one assistant guide, one 

server, one cook, and several porters. We summited alongside our guide and assistant guide, both of whom we 

got to know pretty well. The oldest on the mountain at the age of 63, our guide was nicknamed “Papa Joe.” He 

has been a guide for many decades, and even lead Jimmy Carter to the summit in the 80’s. The assistant guide 

Faraja is 34 years old and has been a porter for several years. He told us that he doesn’t like the job; it’s hard 

work and he doesn’t like hiking. He does it to make income, but he would rather have gone to school. That being 

said, he is planning on taking over Papa Joe’s role when he retires next year. I was glad to see that our money 

went directly to Tanzanians, but I wish there were other job opportunities in the area so that people didn’t feel 

forced to work on Kilimanjaro. The job is brutal and comes with significant danger. It seemed absurd for so many 

people to be carrying pounds of gear up the mountain so that we can camp in luxury. We could have done without 

three-course meals, chairs, and a toilet tent (an accidental purchase). 

I would climb Kilimanjaro again, although I know we both have our eyes set on a few other mountains in the area 

including Elgon, Meru, and Mount Kenya. Kilimanjaro was a wonderful experience but I’m interested in exploring 

some of the more rugged summits. 

The most challenging part of the hike was the uncertainty of how we would react to higher elevations. Each day 

closer to the summit came with the fear of developing acute mountain sickness. I had never been higher than 

13,000 feet and was extremely nervous about how the additional 6,000 feet would affect me. Additionally, I found 

it hard to go the slow pace that is required for acclimatization. The mantra of each day was pole pole, or “slowly 

409

slowly” in Swahili. It helped to know that fitness doesn’t improve your ability to acclimatize and that the people 

who most often have problems are those that hike quickly. 

My favorite part of the trip was summit day. We got up at 10:30 pm and were hiking just after 11. We were one 

of the first groups on the trail and the full moon lit our way. We made it to the summit just as dawn was breaking 

and could look out at the moon on our left and the sun on our right. The trip down back down was extremely fun. 

We took the porters’ path and glissaded down several thousand vertical feet on sand and scree fields. I was elated 

by the successful summit and happy to break our pole pole pace. 

PASSPORTS AND PRIVILEGE: ACCESS DENIED 

COMMENTARY BY DYLAN OCHOA 

The foundational belief of global health is the breaking down of barriers and 

borders to deliver healthcare to everyone across the globe. Agreeing with this 

statement and believing in this statement are entirely different things. The UK 

recently announced last month that they were going to invest £50 million to 

combat the ongoing Ebola outbreak, but when the professionals on the front 

lines come to speak about this issue, they aren’t even allowed to enter the 

country. “African applicants are over twice as likely to be refused a UK visa 

than applicants from any other part of the world. Researchers from Africa and 

Asia were three to four times more likely to experience visa-related challenges 

compared to their European and North American counterparts.” The fact that 

the UK is willing to invest so much money into helping these Global South 

countries but discriminates against these researchers shows that we still 

have much work to do to change the average Global North citizen’s mindset 

and prejudice behind closed doors. This is not a good look for the UK and 

undermines the very belief of global 

health. The UK and other Global North 

countries must not just simply agree 

with assisting global health issues, 

but truly believe in the collaboration, 

starting from politicians all the way 

down to immigration officers and 

citizens. The Elsevier Journal calls 

on the UK government to change its 

policy on short-term visas, but it is 

our responsibility as global health 

advocates to continue working on 

convincing everyone of the value of 

true healthcare for all, and not just 

politicians and medical professionals. 

Read More Here>> 

410


Thank you for sending this magazine. It is touching to read about what is out there in the world, with the world 

in crisis. From Dengue Fever and Ebola to Cholera. Seriously, the world is in need of healthcare workers. It is 

interesting that this magazine brings to life the interdisciplinary approach to global health. We get to see the 

various players in the field and how global health is everyone’s problem with diseases and healthcare workers 

moving beyond physical borders. All in all, this magazine is a provocative read. Thank you for sharing. Have a 

great day and keep them coming. 


Dear Doctor Sadigh, 

Hello. It’s great to climb up Mount Kilimanjaro, the highest mountain in Africa. Watching the view of glaciers and 

galaxies is everybody’s desire. Reaching the summit can prove that human beings are just a small part of this big 

world, like an organ in the human body in which every organ its task and functions in a correct manner. According 

to the big bang theory, everything happens in an organized manner. 

The view of Mawenzi peak and the starry night are spectacular, reminding us to think deeply about the beauty 

that surrounds us. It is a great experience and unforgettable memory to walk in a mountainous area and conquer 

the summit of a mountain. 

I hope you and dear Mitra and dear Katrin all enjoyed this journey. I felt very sad that Mitra got a migraine at the 

highest point. I hope she felt better after coming descending. 

Visiting the MakCHS Psychiatry Department, Cho Ray Hospital, and Makerere University is an excellent way to 

exchange knowledge among Global Health Program members. African tulip tree flowers are amazing to look at, 

demonstrating solidarity and unity like the different organs in the body united together and complementing each 

other to function and live a life. 

Thank you for sharing these beautiful memories and details with us readers. 

Sincerely, 

Elnaz Arabpour 

I want to express my sincere gratitude to you and the Global Health Program. I cannot thank you and the Global 

Health Program enough for giving me this chance to explore the world and enhance my professional and personal 

growth. It was just six weeks, but six weeks full of experiences, emotions, and events; six weeks where I made 

each second count. 


Global Health Scholar from KSMU 

411

Our medical rotation experience in the Dominican Republic this summer was an unforgettable one. With another 

medical student, also from the University of Vermont, we had the opportunity to shadow in a variety of clinics and 

hospitals across Santo Domingo. Through the experience, we not only learned how care can differ across various 

healthcare settings (primary clinic versus hospital), but also about health conditions that are common in the 

region. In addition, we were able to conduct house visits with the healthcare providers, a memorable experience 

wherein we were simultaneously immersed in both the healthcare system and culture of the Dominican Republic. 

After returning to the United States with this incredible experience, I hope to integrate the cultural, medical, and 

linguistic skills that I gained into my future practice. 

Kind Regards, 

Prasanna Kumar 

Uvmlcom Class Of 2022 

You are so lucky to be with Vietnamese Scholars. Please tell them all (including those who are not in photo like 

Tho, Long, Thu, Chau, Cuong, and Thanh) that I say hello and send my love and affection. Our Vietnamese 

scholars have a special place in my heart and I will never forget how much pleasure and happiness they have 

brought to me. 

Steve Winter 

412

REPORTS 

REPORT ON DR. SADIGH’S SECOND VISIT TO 

UMP 

Written by Dr. To Mai Xuan Hong 

Director of the International Cooperation Office 

After the first meeting with Dr. Majid Sadigh in UMP in July 2019, I gave my 

commitment to work with the Global Health Program. This collaboration is 

aimed toward building a network of UMP doctors who are eager to share their 

knowledge and enthusiasm and join hands with international professional 

healthcare staff to improve healthcare delivery, especially that of women and 

children, in Vietnam and other developing countries through activities such 

as training of the trainer, supporting medical students and junior doctors, and 

conducting collaborative research projects. 

To help move this collaboration forward, I had a second meeting with Dr. Sadigh on Monday, September 23rd 

in the UMP International Relations Office. During this discussion, we focused (1) on the recruitment of potential 

candidates for “Linde Health Care Educator Without Borders” five for months at at Nuvance Health, (2) the 

search for one excellent candidate for “Global Pulmonary Medicine Scholars” with main focus on prevention and 

treatment of Chronic Obstructive Pulmonary Diseases (COPD) and Emphysema (3) Dr. Sadigh’s official visit to 

Children’s Hospital No. 2 toward familiarizing with the medical education for sixth-year medical students and 

residents in this hospital and (4) the planning for my first short visit to Connecticut and Vermont in 2020. 

Toward the first objective, I have identified five excellent UMP lecturers with proficient English who are willing to 

apply to Linde HealthCare Educators Without Borders with the goal of returning to Vietnam to share their new 

knowledge and skills with students and young doctors. I have already submitted their CVs. Per the second point, 

I strongly recommend Dr. DUONG Duy Khoa, a Global Health Pulmonary Medicine Scholar who is familiar with the 

Nuvance Global Health Program and has shown interest in pulmonary medicine as well as expanding into COPD 

and emphysema. He is currently working in this field and is ready to again be a part of the pulmonary team at 

Norwalk Hospital. I am sure he will return to Vietnam to establish efficient protocols and initiate projects toward 

improving the prevention and treatment of COPD and emphysema in the community. 

Per the third point, I am glad that Dr. Sadigh enjoyed his visit at Children’s Hospital No. 2, became fully familiar 

with clinical medical education, and was able to witness day-to-day activities in the inpatient department as well 

as speak with students, residents, nursing staff, and faculty. Our students and residents are enthusiastic about 

participating in a bidirectional learning and teaching experience with Nuvance Health. Concerning the final point, 

I would love to visit the leadership of the Nuvance/UVMLCOM Global Health Program from April 12-18 2020 if this 

period works for all involved parties. 

413

DR. SADIGH’S SHORT VISIT TO CHO RAY 

HOSPITAL, CHILDREN’S HOSPITAL NUMBER2, 

AND UNIVERSITY OF MEDICINE AND 

PHARMACY IN HO CHI MINH CITY 

Written by Dr. Khoa Duong 

Faculty at the University of Medicine and Pharmacy in Ho Chi 

Minh city, and a Global Health Program alumnus 

Dr. Sadigh landed in HCMC on Sunday night. After arriving at the hotel, he had a short meeting with me to 

prepare for another meeting the following day with Dr Hong To, the head of the International Cooperation Office 

of the University of Medicine and Pharmacy at Ho Chi Minh city (UMP-HCM), the latest Global Health Program 

partner site. 

On Monday morning, Dr. Sadigh met the Director of the Board as well as many doctors from the Training Center 

and Cho Ray Hospital’s International Affairs Office including Dr. Phuong Hoang (Hoang Lan Phuong) and Dr. Uyen 

Tran (Tran Hanh Uyen). In the afternoon, Dr. Sadigh met Dr. Hong To (To Mai Xuan Hong) in the afternoon to 

discuss the partnership with the University of Children and Women’s Health and hosting of Dr. Hong To in the U.S., 

the Scholars in Global Pulmonary Medicine, and Linde Health Educators Without Borders. He then met the current 

AUC medical students undergoing the global health elective at Cho Ray Hospital. 

On Tuesday morning, Dr. Sadigh met many Global Health Program alumni who are ICU and pulmonary doctors 

at Cho Ray Hospital. He commented on many changes and quality improvements made in clinical services and 

medical education inspired by their experiences in WCHN hospitals. He also discussed the prospect of publishing 

those works. He then received a greeting from Professor Dr. Khoi Nguyen (Nguyen Van Khoi), MD, PhD, Vice 

Director of Cho Ray Hospital with whom he had a brief discussion about the five-year bilateral partnership as well 

as the Linde Scholarship. He and I then traveled to Children’s Hospital No. 2 at the city center where we were 

greeted by Dr. Tin Pham (Pham Xuan Tin), MD, a young lecturer for the Pediatrics Department at UMP-HCM who 

will become the contact person at Children’s Hospital No. 2. He was very hospitable and helpful, and guided us 

through the clinical Respiratory Department and then the Training Center of the Pediatrics Department at UMP- 

HCM. 

Dr. Sadigh observed the outpouring of children patients and their parents packed in rooms and alleys. He took 

notes of the circumstances, environment, and conditions of the clinical training setting. He also met with many 

fifth- and sixth-year UMP-HCM medical students who were delighted to speak with him about differences in 

medical education, children’s healthcare systems, and anti-vaccination movements in the two countries. The 

Vietnamese medical students showed admirable confidence when speaking English after the first few moments 

of shyness. Dr. Sadigh then returned to Cho Ray Hospital to attend the ICU resident lunch conference, inspired by 

the model at Norwalk Hospital and attended by Vietnamese residents and young doctors as well as international 

students from the Global Health Program, among others. 

In the afternoon, Dr. Sadigh helped Global Health Program alumni organized their first Journal Club, during which 

the National Lung Cancer Screening Trial paper in NEJM was discussed under Dr. Sadigh’s guidance. The global 

health students were also present, and enjoyed different learning experiences as Dr. Nam T. Nguyen discussed 

the relevance of Lung Cancer Screening with CT-scan in the context of Vietnam. Dr. Sadigh said goodbye to 

everyone before leaving for Thailand early Wednesday morning. 

414

DR. SADIGH’S SHORT VISIT TO CHO RAY 

HOSPITAL 

Written by Dr. Uyen 

Coordinator of the Global Health Program at Cho Ray Hospital 

During this short visit, Dr. Sadigh had a meeting with the leadership of 

Cho Ray Hospital and the Training Center. The site-visit of a donor willing 

to sponsor HCW with an interest in COPD and emphysema was discussed. 

Dr. Sadigh announced the Linde Healthcare Educators Without Borders 

program, which will be sponsored by Linde. He interviewed 6/11 potential candidates. During the interview, 

Professor Sadigh summarized the contents of the program before asking candidates’ opinions and their reasons 

for applying to the program. In addition to the clinical content of the curriculum, scholars will learn how to conduct 

clinical or educational research, how to design and review the curriculum, and how to teach, all within five months 

of training. 

Lastly, Dr. Sadigh met with three global health students from the U.S. rotating at Cho Ray Hospital. The students 

expressed satisfaction with the program and shared their experiences in the Tropical Medicine/Infectious Disease 

and Emergency Departments. He encouraged students to see more patients, have more clinical experiences, ask 

their supervisors about the difference in treatments, and share their stories and experiences with others in the 

Global Health Program eMagazine. 

ST FRANCIS NAGGALAMA HOSPITAL LABORATORY REPORT 

AUGUST 2019 

Written by Sr. Jane Frances 

CEO of St. Francis Naggalama Hospital, Uganda 

Special emphasis is given to the Laboratory because of the recent upgrade to include a Microbiology Unit which 

was sponsored by Prof Majid Sadigh - Director of Global Health for Western Connecticut Health Network in 

Danbury, Connecticut. Setting up the Microbiology Unit was much more expensive than expected but eventually 

we are now able to start with some tests which we were sending out to Kampala Laboratories. Here below is how 

the Laboratory has been performing over the years: 

Table 1: Trend of Laboratory Testing Workload in the Period 2012/13 to 2019/19 

2012/13 

2013/14 

2014/15 

2015/16 

2016/17 

2017/18 

2018/19 

10,189 

9,079 

10,686 

14,293 

14,837 

14,676 

15,283 

12,357 

11,013 

39,825 

42,338 

22,656 

26,554 

39,043 

3,412 

3,247 

3,514 

3,104 

689 

972 

1,579 

3,279 

3,564 

3,271 

10,497 

12,796 

20,365 

27,637 

3,898 

3,609 

5,312 

6,837 

6,001 

7,264 

11,398 

3,343 

3,068 

5,314 

5,415 

4,624 

2,473 

4,673 

0 

0 

0 

0 

0 

0 

0 

36,478 

33,580 

79,719 

82,484 

61,303 

72,304 

99,613 

7 

8 

9 

9 

10 

10 

10 

5,212 

4,198 

8,858 

9,165 

6,130 

7,230 

9,961 

415

Graph 1: Laboratory Tests Done During FY2018/19 

20,000 

Laboratory Tests for the FY 2018/19 

18,000 

17,397 

16,000 

14,931 

Number of Tests 

14,000 

12,000 

10,000 

8,000 

7,411 

8,523 

9,272 

7,054 7,249 

8,589 

8,021 

11,236 

8,456 

12,686 

6,000 

4,000 

2,000 

0 

JulyA ug Sept OctN ov DecJ an Feb Mar AprilM ay June 

Note: The FY 2018/19 saw fluctuating numbers of tests worked upon in the Laboratory per month depending on 

seasonality and availability of reagents. However, it is clear that that the 4th Quarter showed a steady increase 

in volume of work. 

It is clear that the volume of work in the laboratory increased in 2018-2019. However, some tests of histopathology, 

cytology and fertility were referred to Lancet laboratories. For the future year 2019-2020, the department has 

acquired a fully-equipped microbiology section that will reduce the number of tests referred out. Coupled with 

the increasing volume of tests handled in the laboratory, this has necessitated us to increase the staff by three 

members. The graph below shows the particular tests that were sent to Lancet Laboratories in Kampala because 

we had not yet put up the unit or the equipment. 

Graph 2: Microbiology Tests Sent to Lancet in Kampala, 2018-2019 

Graph 2 above is an example of some microbiology tests that could not be done at St. Francis Naggalama 

Hospital, but were sent instead to Kampala for identification of microorganisms, thereby leading to an effective 

and accurate diagnosis. Today, we have managed to purchase some consumables e.g. media and antibiotics for 

culture and sensitivity including: HVs, pus swab, urethral swab, ear swab, throat swab, urine, CSF analysis and 

semen analysis. An analysis will be carried out by the end of 2019 to ascertain the impact. 

The laboratory has a dedicated and committed team that will ensure the lab is effectively managed and utilised. 

However, the challenge remains that the consumables are expensive, and this can hamper progress as the unit 

starts to perform. 

Compiled by Sister Jude Mary, Laboratory Technologist; Julie Wanfuko, Microbiology Incharge; and Eddy Kalyango, 

Records Officer. Submitted by Sister Jane Frances Nakafeero. 

416

CONGRATULATIONS/WELCOMING 

Right to left: Dr. Nguyen Hoang Tai My, Majid Sadigh, and Dylan 

Ochoa 

Welcoming Dr. Nguyen Hoang Tai My, Global Health Scholar 

from Cho Ray Hospital, Vietnam 

Professor Alexey Sozinov re-elected as the Rector 

Professor Alexey Sozinov has been re-elected as 

the Rector (Chancellor) of Kazan State Medical 

University for a further term of five years. We 

would also like to share that Professor Sozinov 

has won another election as a Member of 

Parliament (State Council) of Tatarstan Republic 

earlier this Month. We heartily congratulate him 

and wish him success for his new terms in both 

offices. 

417

PHOTO NEWS 

HOME 


Dr. Tran Long fishing off the coast of 

Connecticut 

Dr. Simon Otim on the Batman Roller 

Coaster at Six Flags New England in 

Agawam, Massachusetts 

Dr. Pamela Gorejena-Chidawanyika at 

Niagara Falls 

University of Vermont Robert Larner MD 

College of Medicine 

Simon Otim and Laura Smith at Danbury 

Hospital 

Dr. Jonathan Melk speaks to the global health interest group at UVMLCOM 

418


Vietnam 

Dr. Mariah McNamara with Russian residents from KSMU 

Left to right: Dr. Lan Phuong, Dr. Majid Sadigh, and 

Dr. Uyen Tran at Cho Ray Hospital in Ho Chi Minh 

City, Vietnam 

Medical Students at Children’s Hospital Number 2, Ho Chi Minh 

City, Vietnam 

Right: Dr. Majid Sadigh with Dr. Tomai Xuan-Hong, Director of 

the Office of International Relations, University of Medicine 

and Pharmacy in Ho Chi Minh City, Vietnam 

419


Dr. Majid Sadigh with Dr. Prachyapan Petchuay, Dean of Walailak University School of Medicine in Bangkok Airport 

Respiratory Rehabilitation Center at 

Thasala Community Hospital 

Thasala Community Hospital Traditional Medicine Center 

420

Herbal medications at Thasala 

Community Hospital Traditional Medicine 

Center 

Medical and Surgical ICU at Thasala Community Hospital 

Festival of the Tenth Lunar Month in Nakhon Si Thammarat, Thailand 

421

Global Health Family 

Huynh Mai Anh (Anna), daughter of Dr. 

QuangDai Huynh, Global Health Scholar 

from Pulmonary/ICU Division of Cho Ray 

Hospital, Ho Chi Minh City, Vietnam 

Henry and Steve Scholand in Phuket 

Island, Thailand 

Majid Sadigh and Henry Scholand in Banasan, 


422

CALENDAR OF EVENTS 

SEPTEMBER CALENDAR 

September 3: Dr. Sadigh met with Dr. Joann Petrini to discuss establishing the Global Health Teaching Academy. 

September 4: Dr. Sadigh met with Dr. Patricia Tietjen. 

September 5: Dr. Sadigh met with Dr. Sanjay Thomas to discuss the introduction of global health into Nuvance 

Health and possibly exploring potential expansion of the Global Health Program to the Department of Surgery. 

September 9: Dr. Otim had a meeting with Dr. Howard Eison at Danbury Hospital. 

September 10: Dr. Tran Long and Dr. Simon Otim went 

to Linde to meet with Nina Caraluzzi to be interviewed 

for Linde’s compilation video of all of the Global Health 

Scholars who come to visit Danbury. 

September 10: Dr. Otim received his certificate of 

training from Dr. Sadigh. 

Dr. Sadigh withDr. Simon Otim and Dr. Howard Eison 

Dr. Sadigh with Dr. Simon Otim, Dr.Long and Dylan Ochoa 

September 11: Dr. Sadigh gave Grand Rounds lecture 

on the current status of Ebola in the Democratic Republic 

of Congo under the title of “Ebola Viral Diseases, Then 

and Now, an Update.” 

September 11: Dr. Simon Otim left Danbury Hospital 

to return home to Naggalama, Uganda. 

September 12: Dr. Sadigh met with Ramin Ahmadi to 

discuss a AAMC-related issues. 

Dr. Sadigh with Dr. Nguyen Hoang Tai My 

and Dylan Ochoa 

September 16: Dr. “Mark” Nguyen Hoang Tai My, a 

cardiologist from Cho Ray Hospital, arrived in Danbury 

Hospital and was welcomed by Dr. Sadigh and Dylan 

Ochoa. 

423

September 17: Dr. Sadigh met with Ms. Mary Shah to discuss the creation of learning objectives designated for 

the Linde Health Educators Without Borders Scholars. 

September 18: Dr. Sadigh met with Dr. Rastegar, Director of Global Health at the Yale University School of 

Medicine, to update him on the Global Health Program in Nuvance Health. 

September 19: Dr. Sadigh met with Dr. Padmini 

Murthy to update her on the Global Health Program. 

September 19: Dr. Bulat Ziganshin, Director of Global 

Health for RUSM/AUC spoke about the genetics of 

aortic aneurysm and opportunities for cross-continental 

research at the Global Health Medical Grand Rounds at 


Dr. Sadigh with Dr. Rastegar 

September 20: Dr. Sadigh and Laura Smith met with 

Christopher Bellone, Clinical Regional Director at RUSM 

to discuss the global health elective for senior medical 

students. 

September 20: Dr. Sadigh visited the Norwalk 

apartments to inspect if the apartment has been 

furnished. 

September 21: Dr. Sadigh left the U.S. to Ho Chi 

Minh, Vietnam for a site visit. 

Dr. Sadigh with LHCEWB candidates 

September 22: Dr. Sadigh landed in Ho Chi Minh, 

Vietnam and had a dinner meeting with Dr. Duy Khoa 

Duong, one of the global health scholars to review the 

agenda for his visit and daily itinerary. 

September 22: Drs. Darlene and Jonathan Melk 

arrived to Burlington. 

September 23: Dr. Sadigh met with the Cho Ray 

Hospital leadership to prepare for donor Ron Nair’s 

future visit. 

September 23: Dr. Robyn Scatena delivered a global 

health lecture about sexual harassment in the context 

of cultural backgrounds at Norwalk Hospital. 

September 23: Dr. Sadigh met with Dr. To Mai Xuan 

Hong, Director of the Office of International Relations 

at the University of Medicine and Pharmacology in Ho 

Chi Minh City, to discuss the new partnership. 

424

September 23: Dr. Sadigh had a meeting with the 

leadership of Cho Ray Hospital to discuss the new 

initiatives and future direction. 

September 23: Dr. Sadigh interviewed 5 of 11 

candidates for LHCEWB. 

September 23: Dr. Sadigh met with Dr. To Mai Xuan 

Hong, Director of the Office of International Relations 

at the University of Medicine and Pharmacology in Ho 

Chi Minh City, to discuss the new partnership. 

September 23: Dr. Sadigh had an overview session 

with William Leach, Shaheen Lashani, and Danash 

Raja, Global Health Program participants from AUC. 

Left to right: William Leach, Majid Sadigh, Shaheen 

Lashani, Danash Raja 

September 24: Dr. Sadigh held a debriefing session 

with Global Health Scholars from the pulmonary 

division. 

September 24: Dr. Sadigh had a meeting with Professor Nguyen Van Khoi, Vice Director of Cho Ray Hospital, to 

discuss the results of his interviews with the LHCEWB candidates. 

Dr. Sadigh with Professor Nguyen Van Khoi 

Dr. Sadigh with pulmonary scholars 

A pulmonary resident presenting a case at noon 

conference 

Dr. Sadigh withmedical students and leadership at 

Children’s hospital No. 2 

425

September 24: Dr. Sadigh attended pulmonary noon conference where pulmonary residents and faculty 

discussed a patient with septic shock. The focus of discussion was selection of appropriate fluid for resuscitation. 

September 24: Dr. Sadigh attended the pulmonary journal club. 

September 25: Dr. Sadigh left Ho Chi Minh, Vietnam for Walailak University and landed in Nakhon Si Thammarat, 

Thailand. 

September 25: Dr. Sadigh had a debriefing session with educational leadership of Walailak University School of 

Medicine where future direction of partnership was discussed. 

September 26: Dr. Sadigh site-visited Thasala Community Hospital, an affiliate hospital of Walailak University. 

During this visit, he met with the CEO of the hospital as well as several faculty members. 

September 26: Dr. Sadigh spoke to fifteen teaching 

faculty of Walailak University about how to critically 

read a scientific article. 

September 26: Dr. Sadigh moderated a session in 

biostatistics and clinical epidemiology at Walailak 

University. 

September 28: Dr. Sadigh with Dean prachyapan 

Petchuay made a trip to Nakhon Si Thammarat to 

observe the Festival of the Tenth Lunar Month. 

Dr. Sadigh with members of the Traditional Medicine 

Department at Thasala Community Hospital 

September 28: Dr. Sadigh returned home from 

Nakhon Si Thammarat, Thailand. 

OCTOBER CALENDAR 

October 1: Dr. Sadigh meets with the Legal Department to discuss the Memorandum of Understanding with 

University of Botswana. 

October 2: Dr. Sadigh meets with Dr. John Murphy, Dr. Joann Petrnini and Dr. Jon Rosen to discuss establishing 

the Global Health Teaching Academy. 

October 8: Dr. Sadigh meets with the Provost of Sacred Heart University. 

October 10: Dr. Sadigh delivers a Grand Rounds lecture on the structure and function of the Global Health 

Program at Vassar Brothers Medical Center. 

October 10: Dr. Sadigh meets with Dr. Asha Marhatta to discuss global health rotations. 

October 18: A Global Health Conference Lecture is held at Norwalk Hospital. 

October 28: Dr. Sadigh delivers a lecture on Malaria and Tropical Diseases at Sacred Heart University. 

426

GLOBAL HEALTH 


Participant 

Affiliation Status Host Site 

Travel Date 

to Site 

Travel Date 

to Home 


AUC 

MS4 


3-Aug 

14-Sep 

Ahja Dominique Steele 

RUSM 

MS4 


3-Aug 

14-Sep 

Colee Michelle 

Mitchell 

RUSM 

MS4 


16-Sep 

25-Oct 

Oludolapo Oyetola 

Ilori 

RUSM 

MS4 


16-Sep 

25-Oct 

Andrea Louise Green 

RUSM 

MS4 


16-Sep 

25-Oct 

Shaheen Lashani 

AUC 

MS4 

Cho Ray Hospital, 

Vietnam 

16-Sep 

25-Oct 

Danash Raja 

AUC 

MS4 


Vietnam 

16-Sep 

25-Oct 

William James 

Leach 

AUC 

MS4 


Vietnam 

16-Sep 

25-Oct 


Nuvance 

Health 

Faculty 


Vietnam & Walailak 

University, Thailand 

21-Sept 

28-Sept 

427

Editor: Albert Trondin 

PHOTO CONTEST 

What you seek is seeking you (Majid Sadigh) 

Photo of a painting depicting a Maasai woman 

cleaning her baby 

Dendrosenecio Kilimanjari (Senecio trees, giant groundsel), Mount 

Kilimanjaro 

428

RESOURCES 







Ebola book 















Publications 










Cases and Reflections from Mulago 

429

430 

Photo by Dr. Eison Naggalama 2019

431

GH Blogs and eMagazines

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?