eMagazine March 2023

March 2023 Volume 51 

NUVANCE HEALTH 

Global Health Program 

LARNER COLLEGE OF MEDICINE 

NUVANCE HEALTH AND THE UNIVERSITY OF VERMONT LARNER COLLEGE OF MEDICINE 

Global Health eMagazine 

“I know you’re tired but come, this is the way.” -Rumi 

Editor; Majid Sadigh, MD 

Contributing Editor; Mitra Sadigh 

Creative Director; Amanda Wallace 

Cover Photo; Kaveh Sadigh (Long Island)

OUR PEOPLE, 

OUR MISSION 

Global Health 

eMagazine 

Highlights 

Global Health Bridge at Danbury Hospital, February first 

March 2023 

Highlights 

Reviews 

GH Narrative 

Reflections 

Hispanic and Latinx Voices 

Global Local 

Voices of Ugandan 

Students 

Nursing Division 

Women’s Health Education 

Innovation and Technology 

Our Beautiful Planet 

Art to Remind Us of Who We 

Can Be 

Article of the Month 

You’re Invited 

Photo News 

Calendar 

Global Health Family 

Resources 

Previous Issues of 

the eMagazine 

Written by Krystal Gopaul ‘24 

LCOM’s Class of 2024 

The Final Day of the Global Health 

Bridge Course at Danbury Hospital 

On February 1st, we concluded our first annual 

UVM/Nuvance Health Global Health Bridge course, 

an innovative curriculum designed to introduce 

medical students to global health. The day began 

with a talk on health professions education and a case study from Vietnam 

led by Dr. Duy Khoa Duong, a Fulbright Scholar from University of Medicine 

and Pharmacy in Ho Chi Minh City, Vietnam.This was a very interactive session 

where we had the opportunity to design our own medical curriculum and 

learn about medicine in Vietnam. Next, we heard a real life case study from 

Mulago, Uganda from Dr. Alex Kayongo, a research fellow in the department of 

Immunology and Molecular Biology at Makerere University College of Health 

Sciences, Kampala, Uganda, and Dr. Majid Sadigh. It was a very unfortunate 

case of a patient’s life that could have easily been saved but due to resource 

limited conditions in Uganda, passed away. Hearing the story and seeing the 

pictures from the physicians there in person was an indescribable experience. 

We must be extremely grateful for the medical resources we have in the United 

States. 

We then had a great active learning experience on intercultural development 

led by a local expert, Beth West. This workshop not only highlighted the 

importance of intercultural learning and development in global health but also 

how important it is at home. With the American population becoming more 

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diverse each day, it is essential that physicians are always providing culturally 

and linguistically appropriate care. 

Lastly, the day ended with a very unique talk led by Dr. Kaveh Khoshnood, 

Associate Professor at Yale School of Public Health, on the role of public health in 

response to armed conflict. Armed conflict has not traditionally been considered 

a public health priority but considering the number of armed conflicts occurring 

in the world and most recently the situation in Ukraine; the world can no 

longer be oblivious to the fact that armed conflict is indeed a public health 

concern. This was the first time I had heard of armed conflict spoken about in 

this fashion. It was a very refreshing and important perspective. The fact that 

the UVM/Nuvance Health Global Health program had a faculty member from 

such a cutting edge area of public health speaks immensely to the caliber of 

the program. I am excited to see what the UVM/Nuvance Health Global Health 

program has in store for all medical students in the future. 

Next stop, a Global Health elective at one of Nuvance Health’s international 

partners! 


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Beth West, Director of the 

Patricia A. Tietjen, MD Teaching Academy 

Dr. Alex Kayongo, 

MakCHS, Uganda 

Dr. Kaveh Khoshnood, Yale 

School of Public Health 

Dr. Khoa Duong, from UMP, Vietnam 

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Written by Jett Choquette 

MD Candidate, Class of 2023 

The Larner College of Medicine at the University of Vermont 

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Review of the Content of the Nuvance 

Health Global Health Bridge 

I reviewed the sessions and I like the balance of formats, 

topics, and partners who are sharing their thoughts. 

Here are my thoughts on the individual sessions. 

• Session 11: As I think about the topic, I wonder if students will take away 

from the session goals for their own training from the perspective of meeting 

systemic needs and also goals for their role in training students they work 

with in their future. 

• Session 12: I remember being very moved by this session when you and Dr. 

Alex Kayongo presented it during my global health bridge week. I hope it is 

thought provoking for this group of students! 

• Session 14: I’m excited about the session on culture. In undergrad, I had 

a lecture on high vs low context culture (I majored in communications so 

we talked a lot about such things). The lecture changed how I worked and 

approached the world thereafter. Perhaps students will find this cultural 

session particularly helpful too! 

• Session 15: Seems to cover a good range of topics. I just completed the Core 

Global Health Topics 2-week 4th year elective this week. It had a similar 

format of reviewing articles and reflecting on them. I found it to be very eyeopening 

so hopefully the students in this course also find the format thought 

provoking. 

• Session 16: So glad the course is tackling this. Not knowing the backgrounds 

of all the students, it might be worth mentioning at the beginning that if they 

are upset by any of the content, they are welcome to step out if needed. 

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Click here to visit 

the Nuvance Health 


COVID-19 

Resource Center 

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Highlights 

Pediatric Grand Rounds at UVMLCOM, 

February 15, 2023 

Written by 

Dilyara Nurkhametova, MD., PhD 

Director of Nuvance Health Global Health Electives 

Program for AUC/RUSM 

On February 15, 2023, Dr. Majid Sadigh, Director of 

the Nuvance Health Global Health Program, was 

the speaker at Department of Pediatrics Grand 

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Rounds, UVMLCOM. Dr. Sadigh’s presentation was “Creating an Empowerment 

(Decolonized) Model in Global Health: An Evolving Practice to Build Capacity, 

Research Methodologies, Educational Modalities, and Health Equity ‘’. The 

Grand Round was held in hybrid format with 30 attending in person and over 80 

online. Dr. Sadigh discussed global health and social disparities, decolonizing 

global health education, and the importance of capacity building and medical 

education. Dr. Sadigh also coverered the content, structure, and scope of the 

Nuvance Health/UVMLCOM Global Health Program; highlighting the importance 

of the bidirectional nature of the partnerships and critical contribution of our 

colleagues around the world. The presentation was received well and initiated a 

vivid discussion and feedback. 

Link to the talk: 

Creating an Empowerment Model in Global Health 

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Highlights 

Remarks about the grand rounds 

Thanks for your outstanding Grand Rounds that you gave to our department last 

week. 

Best, 

Lewis 

Lewis R. First, MD, MS 

Professor and Chair, Department of Pediatrics, University of Vermont Larner College of 

Medicine 

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Thank you, Dr Sadigh, for your inspiring words and call to action! 

I really appreciate your elevating the GH Educators without Borders and the 

Nuvance/LCOM program so more of my department is aware of your efforts to 

decolonize global health. You do amazing work and have a legacy of genuine, 

authentic, bidirectional relationships with Global partners! I am grateful for your 

example and your incredible efforts to give opportunities to both overseas and 

domestic clinician educators so that incremental and hopefully logarithmic 

change can be realized. 

Thank you Dr Sadigh for your inspiring call to action!! 

With appreciation, 

Andrea Green, MD 


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Dear Dr. Sadigh, 

Thank you so much for your excellent presentation this morning! This was an 

amazingly powerful call to action and an excellent opportunity to highlight the 

work already being done in this institution and abroad. Thank you for sharing 

your expertise and insight with the pediatrics department! 


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Jessica VanNostrand, MD 

Chief Resident 

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Dear Dr. Sadigh, 

I wanted to thank you for your very moving and inspiring pediatric grand rounds 

presentation this past Wednesday. It was a good push (or should have been) 

toward remembering why we all went into medicine. And a reminder to think of 

world health needs. 

I enjoyed your talk so much, I watched it again on a recording, which only 

increased my appreciation for your work, and that of others. Some of the faces 

I saw, and stories I heard, will stay with me forever. And it reinforced my belief in 

the bidirectional educational value, in so many ways, of global health activities. 

Again, thanks. 

Buzz 

Marshall L. Land, Jr., MD 

R.J. McKay, Jr., MD Green & Gold Professor of Pediatrics 

University of Vermont College of Medicine 


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Majid Sadigh (Sunset on Savino Vineyard, Woodbridge, CT.) 

The sky is on fire and the earth is soaked in wine! 

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Global Health Academy 

International Nurse Executive 

Committee (INEC) Meeting on 


At INEC meeting on 2/10/23, the following agenda 

were discussed: 

The academy addresses domestic problems as well as global issues. There is an 

opportunity for symposium submission. Request made to bring your creative 

ideas. 

How do we support marginalized people to fulfill their dreams? A golden heart is 

notenough. They need a powerful group to help them, not showing sympathy, but 

ratherhelping return justice to these communities. The major challenge is finding 

the peoplewho have both the clinical skills and the “golden heart” combined. Dr. 

Sadighhighlighted the importance of nursing in impacting education. Request 

to nursing toconsider participation in global health day. 

Latinx Community Partnership 

Partnership launched with the local community. Developing a program for 

involvement and potential scholarship for high school students. The focus for the 

high school students is on leadership and communication skills in health literacy. 

Requires participation in course work and a project. 

GH Day – June 3-6 2023 

Main event is on Monday (workshops on global health. Invitations include eight 

international sites, University of Vermont and Nuvance Health. Tuesday is a 

major grand round. The inauguration of the Global Health Academy is a result 

of a generous donor. Dr. Mariah McNamara, the director of the global health 

program at UVMLCOM, is generously accepted to be the lead person of the 

educational committee of the global health day. 

SHU 

Written by 

Catherine G Winkler, PhD, MPH, APRN-BC 

Director of the Nuvance Health Global Health 

Program Nursing Division 

Nursing students from SHU are doing 2 days of clinical as well as other interesting 

course work in Dingle, Ireland. An Insulin Pump/Diabetes program in collaboration 

with the Ireland faculty has been developed. Villanova University will be sending 

ten students. Other opportunities for students at SHU include an Appalachian 

trip for undergrads and nurse practitioner students, Guatemala and possibly 

Uganda in the fall. 

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Meeting with Leadership of NIH in Armenia on February 23, 2023 

Written by 

Wendi Cuscina BS, CPM, PACT 

Policy Governance Manager, Global Health Program Manager – Quality Certified Project 

Management 


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In the spirit of continued collaboration and growth, the leadership of both the 

Nuvance Health Global Health Program and the NIH Armenia met via zoom on 

February 23, 2023. The NIH was represented by Dr. Alexander Bazarchyan, Naira 

Davtyan, and Shushanik Isahakyan. 

During this meeting, the tentative program for the 2nd Annual Global Health 

Conference was discussed. The Global Health program at Nuvance Health 

offered observership to the faculty from NIH with interest in psychiatry, cardiology 

and general medicine (hospitalist). Shushanik Isahakyan was invited to come to 

Danbury Hospital for two weeks in advance of the conference to become familiar 

with the structure and function of the program at Nuvance Health as well as 

to educate the leadership of the global health program with the educational 

structure of the NIH in Armenia. 

Dr. Bazarchyan confirmed that NIH in Armenia is ready to accept our faculty, 

residents, and students. As the creation of a “homestay” model is in progress, 

guests will be housed in a safe apartment close to the clinical training sites. 


Resources 



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Reviews 

Written by Beth West 

Director, Nuvance Health Patricia A. Tietjen, MD 

Teaching Academy 

Nuvance Health Global Health 

Intercultural Initiative; Part 1 

In addition to my role as Director of the Patricia 

A. Tietjen, MD Teaching Academy, last year I was 

invited to become a member of the faculty of 

the Global Health Academy at Nuvance Health. 

I am grateful to have received support from the 

Nuvance Health Global Health Program who cosponsored 

my training to become a Qualified Administrator of the Intercultural 

Development Inventory (IDI). The IDI is an online, 50 question cross-culturally 

validated, psychometric, theory-based assessment of intercultural development. 

Results may be derived at the individual and group levels and indicate a position 

along an Intercultural Development Continuum (IDC). The IDI was developed 

based on the work of Milton Bennet’s Developmental Model of Intercultural 

Sensitivity (DMIS) (Hammer et al., 2003). Those who take the IDI also receive an 

individualized intercultural learning plan (IDP) to help facilitate progress towards 

personal goals and objectives related to intercultural growth and development. 

The IDI is a gold standard tool used to assess intercultural skill and quantifiably 

measure growth. A brief video explaining the IDI and how/why it is used follows: 

https://www.youtube.com/watch?v=gtdkq6zR3Xg 

The IDI has excellent applicability to the Global Health Academy, by measuring 

and providing individual reports as well as individual intercultural development 

plans to students, residents, fellows, and faculty who go abroad. Specific 

facilitation and trainings could be delivered to sample groups (convenience or 

self-selected) based on IDI results and a posttest IDI could be administered to 

all those individuals who have traveled overseas or engaged in a significant 

intercultural experience to determine if the international experience prompted 

movement on the intercultural development continuum (IDC). Using this tool and 

the data it provides will be extremely useful to support and grow programming 

in Global Health. 

Despite tremendous diversity of trainees and physicians at Nuvance sites in 

the U.S. as well as deep, bilateral partnerships with international institutions, 

there has been limited formal intercultural training or coursework offered by 

Nuvance Health. I was invited by the Nuvance Health Global Health Program 

to begin designing the first of such modules focused on intercultural learning 

and development for Global Health. I have benefited greatly from participation 

in significant intercultural learning, training, and teaching over the years, both 

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internationally, and in the U.S., and I am thrilled to use this experience to support 

the Global Health Program and our global partners. Nevertheless, I recognize a 

series of challenges ahead- not the least of which is the continued COVID-19 

pandemic which has largely brought travel and mobility within Global Health to 

a standstill. 

Follow Part 2 in the April Issue of eMagazine 


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Bald Eagles (Rose Schwartz) 

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Highlights 

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Written by Mary Shah, MLS, AHIP 

Medical Librarian & Archivist at Norwalk Hospital 

February Issue of eMagazine 

The Nuvance Health and UVM Larner College 

of Medicine Global Health Program has been 

in existence since 2012 and proudly works in 

a bi-directional exchange with healthcare 

professionals in over seven countries. The 

NH-LCOM Global Health Program recently 

published the New Year issue of its Global Health 

e-Magazine. 

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This issue opens with a quote from Rumi, followed by a piece on equity, diversity, 

and inclusion from a literary perspective. There is also a creative piece by a 

medical student about identity. An update is given on mental health work in 

Uganda and another piece on palliative care work is proceeding and the need 

for CT scans in another part of Uganda. Dr. Scholand wrote an overview and a 

link to the last Global Health Grand Rounds, providing a link to the recording of 

the Chagas and Other Neglected Tropical Diseases impacting Global Health. 

The next piece in the e-magazine highlighted the communication with the 

NVH Boards as well as other high-level meetings with other administrators 

and key stakeholders. Two very different perspective pieces followed and 

yet were equally impactful. A medical student from Uganda wrote about the 

costs of uterine fibroids and Dr. Parve discussed the benefits of innovation and 

technology for Global Health. The Nursing Director wrote of the challenges of 

caring for elderly people in various countries while being mindful of cultural 

norms. The newly formed women’s health education called for contributions 

from scholars and educators. In the Global local section of the e-magazine, 

a college student examined the impact of stress on cardiovascular disease in 

South Asians which was followed by a discussion of the use of art in political 

discourse. Then there was a link to an article with a most intriguing title, “If you 

had to read one book on global health….” The article and video of the month 

followed: a Time article about the women of Iran, a video about them as well 

and a video of Glen Campbell singing about kindness. Dr. Nurkhametova edited 

the new section on the environment, listing events that discuss climate change 

as well as a collection of photographs that capture the beauty of Africa from 

photographers who live there. The e-magazine then has a section of welcome 

and congratulations, as well as letters to the program, calendar of events and 

photographs from the Global Health family. 

The Rev. Dr. Martin Luther King, Jr. is frequently quoted, “Of all the forms of 

inequality, injustice in healthcare is the most shocking and inhumane.” While 

some might interpret the diversity of voices in the Global Health Program 

e-magazine incongruent or distracting, one should see it as a strength of the 

program. The diversity of our voices is a force to work toward equal healthcare 

for all. No one contributor has greater relevance. Each voice reminds everyone 

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to focus on the under-served and under-represented. Each participant balances 

another’s perspective. This program’s central tenet is that every organization and 

participant has equal input. The program is also trying to reach out and connect 

with people not yet involved—as evident from posting a Glen Campbell song. 

For those who think that discussion of the environment in the sphere of global 

health should consider what Dr. Margaret Chen said, “A ruined planet cannot 

sustain human lives in good health. A healthy planet and healthy people are two 

sides of the same coin.” Health does not happen in a vacuum, so it is important 

that the place where people live, work, and serve be considered when addressing 

health. 

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New Moon (Rose Schwartz) 

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Global Health 

Narrative Medicine 

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Written by Andrea Green, MD 

Professor of Pediatrics and Director of Global Health in 

Department of Pediatrics at UVMLCOM 

In December 2021, I offered a four-week 

reading elective on the topic of Global Health 

Narrative Medicine. Themes of the course were 

explored through a mixture of fiction and memoir 

complemented with journal articles. At the end of 

each reading, students wrote a short reflection 

on the assigned reading and its accompanying articles. A range of topics was 

made available to students who had the option of choosing six core readings 

and their accompanying journal articles. 

On the next page is a reflection from Micaila Baroffio’ 2023, one of the students 

who participated in this course in 2022. 




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Cima Sedigh (Ice coat) 

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Enduring 

Global Health 



Written by Micaila Baroffio 


The Robert Larner College of Medicine at the 

University of Vermont 

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they say, within ourselves 

we carry 

a small cemetery 

we visit, from time to time 

to pray 

here, the mother 

a silver nimbus stilled, restrained battered, not battering 

scarlet bonds severed 

floating 

freed, finally 

here, the father 

a statue snow crested, fallen 

bloom blooming through alabaster cracks the son, witnessed, 

facade 

crumbling 

here, the brother 

an old oak strangled 

from the inside, thorned needles creeping tumor pressing, pressing 

invading, insistent 

inevitable 

here, the child 

a willow blossom drawn 

from its branch, into riffle, tide, torrent of voices, howling 

willow mourning 

blossom 

drowning 

gravestones all 

here, enduring. 

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Butterflies 

Written by Keara Lynn 


The Robert Larner College of Medicine at the 

University of Vermont 

No matter how much reading and mental 

preparation you do before starting a global 

health elective, there are, unsurprisingly perhaps, 

some things you can’t prepare for. After only two 

days on the wards at Parirenyatwa Hospital in Harare, there have been many 

times where I have thought to myself “If we just had XYZ, this would be easier.” For 

a woman who had recently given birth with tachycardia and shortness of breath; 

“If we just had CTA, we could quickly rule out PE.” For a woman presenting with 

left hemiparesis and hypertensive emergency; “If we had emergent CT we could 

differentiate hemorrhagic vs ischemic.” For a man who was seen for mysterious 

symptoms in KS clinic who had been feeling ill for so long that he told us “I just 

want to stay at home and die” but who could not afford the histopathology for 

a skin punch biopsy; “how much does histopathology cost anyway and is there 

no way to get this test covered?” 

Our first night on call, we were a bit surprised to see a consultant with a Butterfly 

portable ultrasound. We gravitated to the patient’s bedside to watch the scan. 

“You have these at home?” the consultant asked. We confirmed that we use 

Butterfly quite a bit at home. “Well maybe you can bring us some more the next 

time you come?” Whether this was said in jest or in seriousness, it was difficult 

to tell. Either way, at that point I had butterflies in my stomach. Could we bring 

Butterfly units with us the next time students rotate here? Should we have brought 

something with us this time? 

I know for a fact that there are approximately 10 Butterfly kits in the UVM Dana 

Library available to students at any given time. I know this because I have 

checked one out twice now myself. For a month at a time, I was able to bring the 

kit home and practice scanning my friends. But other than the two hours I spent 

scanning over the course of the month, the Butterfly sat neatly packed away 

in its bag in my apartment. A perfectly useful tool, essential to diagnosis and 

management decisions, totally portable, totally functional, just sitting around. 

Some of the University of Zimbabwe medical students on our team wandered 

over to the patient’s bedside to see what was going on. One of the students 

mentioned she had not used a portable ultrasound machine before. The 

butterflies in my stomach were guilt and also sadness. Does UVM really need 10 

butterfly kits sitting in the library? There is never a waiting list to take one out. 

Could we get away with five or three kits instead? Can we justify this excess in 

the name of medical education? 

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UVMLCOM M4 students Micaila Baroffio, Keara Lynn, Charlotte Gemes at Nyanga National Park in 

Eastern Zimbabwe 

One of our professors mentioned to us this week that resuscitations in Zim look a 

lot different than they do in high resourced countries. She mentioned “before you 

rush to resuscitate the patient, you should look in the resuscitation cart to see 

what tools you have available to you so you can make a decision about how to 

proceed.” This is not something I have had to consider up until now. I understand 



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UVMLCOM M4 students Charlotte Gemes, Keara 

Lynn, Micaila Baroffio. Outside the Medical 

School 

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Beautiful trees outside of Parirenyatwa Hospital 

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deeply that the purpose of global health is the exchange of information and 

to learn from each other so we can best take care of patients in any practice 

environment. I understand that a one-time gift of resources is not sustainable 

global health. But I have learned so much during my first two days in the clinical 

environment and people have gone so far out of their way to help me that the 

exchange of information feels unequal. So now I am wondering- what do I have 

to give in exchange? 


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Florida (Olwen Gurry) 

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“Superwoman and Superman” 

Written by Monica Dhiman 

RUSM Class of ‘23 

The end of my third week is here and there is so 

much to reflect on! My week started off in the OPD 

Pediatrics clinic where we saw many new children 

as well as follow-ups from the inpatient ward. There 

were quite a few memorable cases that engaged 

my interest. One such case was a 7-year-old female 

who has h/o congenital coloboma (meaning partial 

tissue that makes up the eye is missing/was never formed) who came to us today 

for treatment of just the common cold. What was intriguing to me is the fact that 

most of the children like her come in for small community communicable diseases, 

but when you look into their history, they have such rare congenital issues. This 

really puts into perspective the patient population we face here. Most of today’s 

patients were just here for common colds and viral gastro illnesses, but it helped 

me become familiar with the medications and symptomatic care measures that 

are given here (as it is somewhat different than what would be given back in 

the states). Also, it was one of the senior doctor’s birthdays so we all got to 

feast on some amazing local cuisines during lunchtime; I was very grateful to 

be included! It again shows everyone’s kindness and humility. The next few days 

were spent in the general pediatrics ward. The 2-year-old patient who had 

been admitted for the last two weeks to undergo chemotherapy had finally been 

discharged; a sigh of relief for the attentive mother I had gotten to know in my 

short time there. I took some time out to speak with her separately in between 

rounds and admissions and was in awe of her bravery towards her child; she’s 

nothing short of a true ‘Superwoman.’ 

But that’s the thing; everyone here is 

a Superwomen (or Superman) in their 

own way. Regardless of having limited 

funds or resources, the way each and 

every parent goes to unimaginable 

extents for their child’s well-being is no 

less than a supernatural power. Seeing 

patients and their families like this, my 

respect for the residents of Wardha 

grows every day. The end of this week 

also marked the celebration of the 

day the Indian Constitution came into 

place, also known as ‘Republic Day’ 

here in India. We got a long weekend 

off in remembrance of this day and I 

was able to visit my grandparents in 

Northern India; I truly am grateful that 

I was able to do so as it had been 5 

years since I last saw them. I can’t wait 

to see what the next week will bring. 

My day out in the market 

(fresh display of Rangoli colors) 

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Hispanic/Latinx Voices; 

Stories from 

our Community 

Section Editor: Elvis Novas 

Written by Elvis Novas 

Advisor for the Dominican Community Center and 

member of the Board of Directors of Housatonic Habitat 

for Humanity, Danbury, CT 

“I am very grateful for the privilege of being selected 

as editor for the column “Hispanic/Latinx Voices: 

Stories from our Community ‘’ of the Global Health 

eMagazine.” 

My desire for a better community has been the guide to introduce me to 

community work, specifically in the Hispanic/Latinx community. This experience 

has allowed me to see and treat people in our community with great human and 

professional values; men and women who just need a platform to share their 

stories and amplify the voices of others. 

Our vision for the column “Hispanic/Latinx Voices: Stories From Our Community” 

is based on the interest of making our people, culture, values, and points of view 

known and at the same time motivate our audience to be more interested in our 

community. 

With this, we seek greater visibility for our community, the opportunity for our 

people to expose their talents and abilities to communicate and for others to 

know our true stories. I encourage you to follow us each month as we feature 

inspiring stories from our Hispanic/Latinx community in the city of Danbury, 

Connecticut. Please feel free to send me your ideas or thoughts at enovas@ 

gmail.com. 

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How to Begin Cultivating Healthy 

Relationships 

Written by Brailyn Rodriguez 

“Brailyn Rodriguez was born in the Dominican 

Republic. He moved to Danbury, Connecticut, at the 

age of 12 where he attended Rogers Park Middle 

School and Danbury High School. His interests 

include theater, arts, and nature. He attended the 

Academy of Art University. Brailyn hopes to be able 

to bring more opportunities in the performing arts 

and arts in general to the Dominican Republic.” 

What is a relationship? The word relationship has many definitions and meanings, 

depending on your background, what you define as a relationship can be 

different from what others may define by. Factors such as where you live, grew 

up, ethnicity, gender, social/economic status, and personal history can affect 

your perception of relationships. The most popular definition of a relationship 

is “a romantic or passionate attachment between two persons”. One thing 

that we must make clear is that relationships are not just romantic. The Oxford 

English dictionary defines relationship as “the way in which two or more people 

or groups regard and behave toward each other”. When we are aware and 

understand that all of our personal relationships are interconnected to create 

our life experience, we can cultivate and create a healthy lifestyle. The longest 

study on happiness has found that one of the most important things to achieve 

in order to enjoy a happy and fulfilling life is to cultivate healthy relationships 

across all aspects of life. 

How should you begin cultivating healthy relationships? 

The first relationship you should have understanding, is the relationship with 

yourself. You must be capable of understanding and representing yourself 

efficiently in any relationship. When we neglect ourselves from personal awareness 

in any personal or professional relationship, we restrain the full potential of that 

relationship. 

One of the first steps you can take to bettering your relationships is to slow 

down, yes! Slow down. You must put a brake on quick decision making or 

problem solving, when faced with any difficult moment, especially if it causes 

a big emotional reaction. The best way to show true respect toward yourself is 

to give yourself the time to come to terms with any situation. When those big 

decisions, emotions, and moments in life present themselves, we very often jump 

to giving answers, problem solving, or strategizing about the future. It is a way 

for us to try and not come off as unintelligent, incapable, or even immature. 

Our brain naturally wants to avoid uncomfortable or unstable situations, that’s 

how we survive as a species. It is a defense mechanism utilized by our brains 

to ensure our survival. So, thank your brain for it. But it’s during those difficult 

moments, that we must take into consideration slowing down. When we face 

those uncomfortable and awkward moments the first thing we think of is how do 

I get myself out of this. 

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Nobody wants to feel attacked, judged, questioned or unstable. By slowing 

down, you give yourself the chance to come to an understanding of what is 

being asked of you. You have the chance to make better choices that benefit 

all parties involved. You don’t want to neglect yourself by under-representing, 

wrongly expressing, or not expressing your needs. Asking yourself it’s this the 

right time for me to be engaged. When you find yourself in a complex situation, 

allow you to gather all the information needed to deliberate whether the choice 

or choices you are making align with your values and needs, if it serves in a 

positive way the relationship and other parties. 

Don’t allow the pressure of making choices, giving answers, or doing something 

about a situation to cause you to neglect you from meeting your basic emotional 

and physical needs. Understanding that you are not required to resolve any 

difficulty, or conversation in the moment and that you are allowed to feel 

prepared is one of the most empowering tools you can use for bettering your 

relationships. 

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Global Local 

Health Disparities within our Borders 

Section Editor: Ritesh Vidhun 

Closure of Rural Hospitals in the United 

States; Part 2 

Written by Ritesh Vidhun 

Even if a hospital has a lower number of patients, one 

may think that medical services have high costs and 

therefore they should be able to survive. However, in 

rural communities many of the patients that utilize a 

hospital’s services rely on federal programs. Around 20% 

of residents are 65 or older, making them eligible for Medicare, while close to 

22% of those under 65 are covered by Medicaid (MACPAC, 2021). Patients under 

these programs are still treated with the same level of care as anyone else, but 

the payments that hospitals receive are typically lower compared to those with 

private insurance. Yet a majority of rural hospital revenue can be attributed to 

the government, with approximately half coming from Medicare. This is highly 

problematic since reimbursement rates are quite low for these programs–as a 

matter of fact in 2020, rural hospitals faced $5.8 billion in Medicare and $1.2 

billion in Medicaid underpayments (AHA, 2022). Additionally, rural hospitals are 

not able to offset this with private payers like many urban hospitals putting them 

at an even greater disadvantage. The lack of consistent revenue makes it nearly 

impossible for rural hospitals to flourish leading to such a high number of closures 

in past decades. 

Given that this issue impacts such a vast number of Americans, lawmakers at the 

federal and state levels have proposed unique solutions. These range from bills 

to increase funding to entirely revamping the way rural hospitals are designated 

by the government. Given that this problem still persists, there has not been a 

particular initiative that truly improved the situation. 

As the pandemic significantly worsened this issue, federal legislators from states 

more affected were quick to propose various bills. The “Save America’s Rural 

Hospitals Act of 2021” proposed by Representatives Graves (R-MO-6) and Huffman 

(D-CA-2) aimed to reform payment requirements in Medicaid and Medicare 

for rural providers. It would suspend Medicare sequestration, adjust bad debt 

responsibility from 30% to 15%, extend increased MDH/LVH payments, reauthorize 

the Medicare Rural Hospital Flexibility Program, and much more (H.R.6400, 2022). 

All changes were focused on alleviating the pressures of Medicare and Medicaid 

on rural hospitals in order to increase efficiency. Additionally in September 2021, 

the federal government passed a spending bill with a clause that extended 

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two Medicare programs set to expire in October which provided $600 million in 

additional funding for rural hospitals (H.R.5305, 2021). Another notable past federal 

intervention took place in 1997 when the Centers for Medicare and Medicaid 

Services (CMS) established the “critical access” designation for hospitals across 

the nation. Those that qualified received 101% reimbursement for eligible patients 

(CMS, 2022). On top of bills and agencies, the National Health Service Corps 

(NHSC) is a federal program which seeks to provide incentives for newly certified 

providers to work in rural communities and address the staffing shortage. This 

wide variety of federal initiatives have sought to address the problem, but not 

many have made major inroads. 

At the state level, officials have proposed solutions for this problem and have 

a different structure than many federal policies. For instance, the Pennsylvania 

Rural Health Model was launched in January 2017 and uses a different approach 

for CMS payments. It requires payers to provide eligible hospitals with a fixed 

amount to cover all hospital care and services while the hospitals, in turn, work on 

improving quality and efficiency of care. This model also sets a series of metrics to 

track performance and ensure that participating hospitals meet the necessary 

standards and continue on a growth trajectory (CMS, 2017). There have been 

other proposed reforms, one being a Hub and Spoke Model in Georgia but was 

not as effective as that of Pennsylvania. Future ideas must include components 

at the federal and state level to generate true impactful reform. 

The issue of rural hospital closures is one of intricacy with multiple facets. There 

are several causes that have contributed to this situation, with the pandemic 

only exacerbating the challenges. Many of the struggles can be narrowed to the 

way payments are structured with the high number of Medicare and Medicaid 

patients served. While still important to push for increased staffing through the 

NHSC or improve health awareness campaigns in rural communities, meaningful 

reform will only come about through revamping federal payment design. This will 

lead to consistent revenue for rural hospitals and reduce the number of closures 

each year. No matter the path, significant reform must be pursued to improve 

access to healthcare for all Americans. 



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The Voice of 

Ugandan Students 

Section Editor: Joshua Matusuko 

“NODDING DISEASE” THE MYSTERY 

DISEASE OF NORTHERN UGANDA 

Written by Joshua Matusuko 

Medical student at MaKCHS 

Nodding syndrome is an unexplained neurologic 

condition characterized by episodes of repetitive 

dropping forward of the head, often accompanied 

by other seizure-like activity, such as convulsions or 

staring spells. In 1997 and 1998, strange and peculiar symptoms started happening 

in children that later led to the retrospective diagnosis of the nodding syndrome 

in the Kitgum and Pader districts of Northern Uganda. Children began suffering 

seizures, not occasionally, but numerous times a day. Their neck muscles would 

go temporarily limp, causing their heads to bob. This illness, which later came 

to be called nodding syndrome, posed many scientific and clinical questions 

that no doctor could answer. Its origin is unknown, and has devastated many: 

causing severe developmental delays and psychiatric disturbances. Many died 

from having seizures that resulted in burns, falls, or drowning. 



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Healthcare professionals report nodding syndrome cases in South Sudan, from 

the states of Western, Central Equatorial as well as southern Tanzania. The 

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clinical course of nodding syndrome begins with behavioral changes in previously 

healthy children–mainly between the ages of 5-15 years at onset–which is 

usually followed by recurrent episodes of head-nodding spells, cognitive decline, 

and generalized tonic-clonic seizures at later stages. Eating and other sensory 

stimuli such as cold weather, cold water, starvation, and febrile illnesses appear 

to trigger episodes . Most affected families commonly have multiple children 

with NS compared to other community members, suggesting a probable genetic 

connection. Nodding syndrome occurs in the same areas where river blindness 

is also prevalent, and this association has led some researchers to believe that 

the same parasitic nematode, Onchocerca volvulus, may be a culprit in both 

illnesses. But there is no scientific evidence that O. volvulus invades the central 

nervous system, so it is unlikely to cause neurodegenerative damage in patients 

with nodding syndrome. 

A virus carried by the black fly (the same vector as with river blindness) is one 

theory of NS’s origin. Other proposed etiologies include measles, malnutrition, 

toxins, and autoimmune response. Studies have linked the disease to numerous 

associations like Parkinson’s disease (David Lagoro Kitara et al.), nematode 

infestation and food stress (https://doi.org/10.1016/j.ensci.2022.100401). There 

has been no conclusive evidence on cause, diagnosis and management of the 

disease. 

The latest outbreak has left more than 2,100 children with lifelong disabilities, 

overwhelming their families. In Uganda, nodding syndrome is seen in 0.7% of the 

children aged 5-18, but in certain districts the prevalence is as high as 4.6%. A 

nonprofit that operated two clinics that fed and treated many of these children 

ran out of money and shut down in 2017, crippling the region’s capacity to care 

for them. Children with the syndrome require constant supervision, as a seizure 

could strike at any moment and the disease hinders decision-making abilities 

and impacts their behavior. Families with children disabled from the disease are 

strained and most have lost children due to lack of support. 


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Link to a Documentary Report on Nodding Disease 

Nodding Disease in North Uganda 

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Section Editor: 



Director of the Nuvance Health Global Health Program Nursing Division 

Update on International Nurses 

Executive Committee 

Written by 


Director of the Nuvance Health Global Health 

Program Nursing Division 


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The committee met this month to begin planning for the year ahead. We have 

a few new members who have joined us including representatives from Nuvance 

Health Nursing Education Department, Lisa Cerniglia, Mark O’Dell and Robin 

Sells, from ACCESS, John Bosco Ntambara, and from Makerere University, Scovio 

Mbalinda. We have 18 members with a pending addition of 2 additional nurses 

from Nuvance Health. 

The committee is focusing its efforts on increasing awareness of Global Health 

among the experienced nurses within our hospitals through the following ways: a 

module on Healthstream, an information table during National Nurses Week and 

a grand round in September. Further, nurses have received the Global Health 

eMagazine this past month and will continue to have access to it. 

The committee is made up of nurses from Nuvance Health as well as our 

academic partners at Sacred Heart University, University of Vermont and 

Western Connecticut State University. We have 4 members from Uganda and 1 

independent member, a recent graduate of the University of Vermont. 

Some of the committee members will serve as faculty members of the new Global 

Health Academy and others will plan a visit to Uganda later this year. 

We look forward to an exciting year as we work to strengthen nursing’s presence 

in global health as well as working with our academic and medical colleagues. 

Please contact Catherine Winkler or Deb Hewitt with any questions about Global 

Health Nursing! 

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Section Editor: Sarah Cordisco, RN 

Staff Nurse at the University of Vermont 

Impact of Poverty on Sexual Abuse of 

Pre-Teens 

Written by D. Parekh MD 

(Volunteer doctor at Adult Rape Clinic), Harare, 

Zimbabwe 

Dr. Darshani Parekh - Senior Resident Medical Officer at Parirenyatwa General 

Hospital in Zimbabwe. She is also a volunteer doctor at the Adult Rape Clinic 

for the past 4 years. She is the Treasurer of the Zimbabwe Women Doctors’ 

Association since 2021 and has been the social media manager for the 

association since 2020. 

The awareness of sexual abuse in the world, especially in the rural communities, 

has increased. Sexual abuse awareness has definitely helped people in seeking 

adequate help and being aware of what is counted as sexual abuse. However, 

there is still a high incidence of late reporting in Zimbabwe. 

Poverty has been one of the greatest contributors to sexual abuse in the rural 

and urban areas of Zimbabwe. Poverty has a direct impact on the education 

level of most of the sexual abuse survivors. 

Most of the pre-teens who have presented to the hospital for sexual abuse have 

had little to no education for their age due to lack of funds. The lack of education 

has impacted the understanding of what sexual abuse is, as they will not be able 

to read or be in a school setup to be taught about sexual abuse. The parents of 

these children have also had minimal education as they were also brought up 

in similar circumstances and became parents at a young age. Thus, the parents 

do not teach their children about sexual abuse or signs of it as they were never 

taught to recognize it. The cultural taboo of not speaking about sex has also not 

been addressed in these communities yet and thus “the talk” is never done. This 

is a cycle in which most of the kids have been exposed to and thus are not fully 

aware of what sexual abuse is and that it is not right. 

In the impoverished background the children are mostly malnourished and thus 

are weak and easy targets for perpetrators. The poor background has made the 

children easy targets of abuse by the slightly well off members of the community. 

The children are usually easily bribed by the perpetrators with sweets or $1 to 

not tell anyone about the incidents. If the kids are not bribed, then they may be 

threatened to be killed if they tell anyone thus reporting late if they report at all. 

As stated above, poverty has a direct impact on the sexual abuse of teens. 

Poverty affects education level, nutrition status, and contributes to low selfworth. 

This is a cycle that can definitely be broken by providing more awareness 

in these sensitive areas, self-worth workshops, and family-building exercise for 

easier and faster communication. 

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in Global Health 

Section Editor: Swapnil Parve, MD 

Written by Swapnil Parve, MD 

Director of International Affairs at the NH/ 

UVMLCOM Global Health Program 

A number of ground-breaking technologies have 

emerged in the twenty-first century that have changed 

the way we monitor our health. Wearables provide realtime 

information about some of the most important 

health parameters like heart rate, blood pressure, 

oxygen saturation, and blood glucose levels. The use of 

handheld devices (smartphones, tablets) to perform echocardiography or pointof-care-ultrasound 

have revolutionized the way physicians approach patients. 

This month Dr. Elina Mukhametshina writes about how artificial intelligence sees 

global health. 






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How Does Artificial Intelligence See Global 

Health? 

Written by Elina Mukhametshina, MD 

What kind of images come to mind when you think of 

Global Health? What sort of images appear when you 

google Global Health? 

In this article, I invite the readers to explore with me 

how Artificial Intelligence (AI) sees Global Health. 

Before we start gazing around the virtual museum exhibition curated by me and 

created by AI, I want to give a small introduction about the role of artificial 

intelligence in Art and explain in simple words how it works. Once I found out 

that AI has learned to create images, I became fascinated and curious about 

how the machine learning algorithm can create such impressive and realistic 

images/paintings almost immediately after a human types the description of 

the desired painting. 

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Artificial Intelligence art is a visual artwork generated by a machine learning 

process. Humans have collected the data and written instructions in the language 

that AI understands, so AI can independently learn how to connect words to 

existing images on the web. This information can then be used to generate a 

new unique image that has never existed before. Sometimes the created art is 

very difficult to differentiate from the creation of a real artist, and perhaps you 

might even think it is better! 

Anyway, this process is truly mind-blowing but is it also potentially scary at the 

same time? Should we worry that AI can take over not just mechanical processes 

but also be a threat to the future creation of Art? Without a doubt, AI can be 

much quicker and more efficient than humans in different kinds of jobs. According 

to the World Intelligence Congress, AI will replace over two-thirds of a manager’s 

workload by 2024. Will AI replace artists, or are we observing the dawn of a 

new era of human-machine collaboration, where all art will be restricted to just 

writing an effective input text for AI-art generating systems? 

It is known that in order for an art piece to exist and function, let it be a music 

piece, a novel, or a painting, there should be a person listening, reading, or 

watching it. Art is an interaction of two people’s minds. And what will happen if 

one of these has been replaced with AI? 

I welcome you to explore the virtual exhibition below entitled “Global Health 

through the eyes of AI”, where you can ponder the role of AI in art while looking 

at AI-created art pieces. 






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“Global Health through the eyes of AI” 

Author: AI art generator DALL·E 

DALL·E 2 is a new AI system that can create realistic images and art from a 

description in natural language. 

Description input: Global Health 

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DALL·E 2 is a new AI system that can create realistic images and art from a 

description in natural language. 

Description input: “Global Health advocate serving the community realistic 

art” 


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Description input: Global Health Advocate oil painting 


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Author: AI Art - Hotpot.ai 

Description input: Global Health 


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The Lancet Planetary Health 

Section Editor: 

Dilyara F. Nurkhametova, MD, PhD 

Director of Nuvance Health Global Health Electives Program 

for AUC/RUSM 

This new column exhibits the beauties of our planet earth 

and our everyday destructive actions against it. We are 

witnessing Earth undergoing a profound transformation. 

In this recently launched section, we appreciate the gems 

of our planet while raising awareness of climate change. 

We invite our global health community to share photos, 

videos, inspirational resources, and stories. We want to 

hear from you how climate change affects people and 

health in your part of the world. 

From the right to a healthy planet to the 

planetary right to health 

February 2023; DOI: https://doi.org/10.1016/S2542-5196(22)00337-0 

The author of this Commentary, Eric C Ip, reminds us of the obvious and 

indisputable interconnection between the health of our planet and basic human 

right to health. In 2022, the UN General Assembly released Resolution A/76/L.75 

stating, “the right to a clean, healthy and sustainable environment as a human 

right”. Even though the right to a healthy environment is not often cited in the texts 

of major environmental treaties, this right has been included in the constitutions 

of dozens of countries, clearly demonstrating that this right is becoming part 

of customary international law. Recognition of the healthy environment and 

healthy planet as a human right would also serve as a protection against 

excessive anthropocentrism and the assumption that our planet “an objectified 

human property that could legitimately be destroyed by people”. “Humans have 

an intrinsic right to flourish; however, that is impossible if they treat the natural 

foundations of life with disrespect” 

Read the full text of article here Planet continued on next page >> 

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Upcoming events and Webinars 

Healthcare Professionals Advocacy: Using our Powerful Voice to Help 

Advance Planetary Health (By Dr. Eugenie Waters) 

Wednesday, March 8, 2023, 5:30 PM - 6:30 PM EST (virtual) 

This is one of the webinar series, presented by the International and Global Health 

Office at uOttawa, and Planetary Health, is designed for Faculty members, 

learners and support staff of the Faculty of Medicine, features expert speakers 

from across Canada, and is accredited by the RCPSC/CFPC 

Register via this link 

Planetary Health and Collective Wisdom Webinar 

Recording of the “Planetary Health and Collective Wisdom” Webinar that took 

place 5 December 2022. This webinar builds on discussions during a panel session 

entitled “We Are All River People: Wisdom in the Tidal Wake of Planetary Health” 

held at the International Leadership Association Global Conference in October, 

2022. 

Watch the webinar here 

Education in Planetary Health 

The One UN Climate Change Learning Partnership (UN CC:Learn) is a joint 

initiative of more than 30 multilateral organizations helping countries to achieve 

climate change action both through general climate literacy and applied skills 

development. 



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The online courses under UN CC:e-Learn include such courses as Human Health 

and Climate Change and Climate Change Negatitaions and Health. 

Visit the UN CC:e-Learn website to explore all available courses. 

Global Health 



World Nature Photography Awards 

“Celebrating the world’s best nature photographers, as they highlight the 

wonders of our planet” 

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People and Nature 

© Virgil Reglioni, NORWAY 

© Alex Pansier, NETHERLANDS 

Nature art 

© Tom Shlesinger, ISRAEL 

Anirban Dutta, INDIA 

© Silke Hullmann, GERMANY 

© Evan Friedman, USA 

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Planet Earth’s Landscapes and Environments 

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© Jake Mosher, USA 

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© Beatrice Wong, Hong Kong © Miki Sptizer, Israel 

Check out more photographs and stories behind at this link 


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Walker’s Point Maine (Olwen Gurry) 

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Art To Remind Us 

of Who We Can Be 

Co-Editors: Mitra Sadigh and 

Elina Mukhametshina, MD 

During times of confusion, tribulation, grief, 

uncertainty, and despair, the arts enliven 

us by reintegrating the disjointed pieces of 

ourselves and replenishing them with clarity 

and hope. The arts remind us of our individual 

and collective potential to grow, evolve, and 

transform. They remind us of what and who we 

can be and what we can create. In this new 

section, we bring you works of art that have 

moved and inspired us. We encourage you to 

also share works that have inspired you. 


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Memories by Mac Davis 

Pressed between the pages of my mind 

Memories 

Sweetened thru the ages just like wine 

Quiet thoughts come floating down 

And settle softly to the ground 

Like golden autumn leaves around my feet 

I touched them and they burst apart with 

Sweet memories 

Sweet memories 

Of holding hands and red bouquets 

And twilight trimmed in purple haze 

And laughing eyes and simple ways 

And quiet nights and gentle days with you 

Memories 

Pressed between the pages of my mind 

Memories 

Sweetened thru the ages just like wine 

Memories 

Memories 

Memories; Mac Davis; Lyrics 

Link to the video 

Memories; Mac Davis 

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Memories: Elvis Presley 


Responding to the Turkey-Syria earthquake: What will it take? 

The Lancet 


“Such things have always happened. It’s part of destiny’s plan.” The reaction 

of Recep Tayyip Erdoğan, Türkiye’s President, to the devastating earthquakes 

that struck Türkiye and Syria on Feb 6, betrays a dangerous sense of fatalism, if 

not an active effort to deflect responsibility. As of Feb 14, the earthquakes have 

caused more than 35 000 deaths, and injured many more. As the chances of 

finding survivors under the rubble diminish, a second catastrophe is looming. 

The widespread destruction of buildings and infrastructure has left more than a 

million people homeless in Türkiye and displaced 5 million in Syria. These people 

need urgent shelter from freezing temperatures, food, clean water, and medical 

care. Earthquakes are natural disasters. They cannot be prevented and some 

harm is inevitable. But the human cost can be mitigated by effective preparation, 

response, relief, and rebuilding—if those in positions of responsibility are willing 

to do so. 

The earthquake brought back memories of earlier disasters. “It’s impossible to 

get used to earthquakes”, Ezer said. “Nothing will be the same after this”, he 

added. “If natural disasters aren’t properly managed, they turn into artificial 

disasters. We could have saved so many more people. I noticed this week that 

we were experiencing the same problems we faced during the 2011 Van-Erciş 

quake. We’ve not been prepared for this at all.” 

Link to the article: 

Responding to the Türkiye–Syria earthquake: what will it take? 

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Turkish health workers speak out on earthquake 

Kaya Genc 

The Lancet 


Doctors have told The Lancet of the health impacts of, and inadequate 

preparation for, the earthquake which has killed more than 33 000 people. Kaya 

Genc reports from Istanbul. 

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Ali Ihsan Nergiz, a Turkish doctor practising in the UK, was visiting his family in 

Gaziantep when the first earthquake struck. “At 4:17, I woke up with the sheer 

magnitude of the earthquake, and maybe for more than a minute, I experienced 

the biggest horror in my life”, he told The Lancet. Nergiz volunteered with other 

doctors to try to reach the most affected area in Nurdağı with an ambulance. 

“Because of the effect of the earthquakes, the main road was split into two and 

was unavailable to use, infrastructure was entirely collapsed, and the Nurdağı 

State Hospital building was out of use. In two medical tents, we tried to apply 

the most basic resuscitation to rescue people with minimal medical supplies. It 

was hard to watch the horror in people’s eyes as they spent hours under rubble.” 

Link to the article: 

Turkish health workers speak out on earthquake 


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WHO May Soon End Mpox Emergency — 

But Outbreaks Rage in Africa 

Nature News 

10 February 2023 

Global Health 



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Sources: Global.health Monkeypox (accessed on 2022-06-07)/WHO 

Resources 



Update: At a 15 February press conference, the WHO’s director-general said 

that mpox would remain a public-health emergency. The agency’s emergency 

committee will reconvene in three months to reassess the situation. 

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A doctor visits people with infections including mpox during his morning rounds at the Yakusu 

General Hospital in Tshopo, Democratic Republic of the Congo.Credit: Arlette Bashizi/Reuters 

A World Health Organization (WHO) committee met earlier this week to decide 

whether the mpox outbreak — which began in May 2022 — is still a global publichealth 

emergency, and the agency could soon declare it over. The outbreak 

has subsided in countries including the United Kingdom and the United States, 

thanks to the deployment of vaccines and therapeutics, as well as changes in 

awareness and social behaviour. But the same is not true in some nations in West 

and Central Africa, which have been battling the monkeypox virus for decades, 

and where the disease’s toll has historically been highest. 

Even while global mpox infections have plummeted from more than 1,000 

new infections a day at their peak to fewer than 70, numbers have not fallen 

substantially in African countries. The Democratic Republic of the Congo (DRC), 

for instance, has reported more than 1,000 suspected cases since October. But 

even those numbers are a “gross underestimation” of reality, says Dimie Ogoina, 

an infectious-disease physician at Niger Delta University in Amassoma, Nigeria. 

Many infections are never confirmed because of an underfunded testing and 

virus-surveillance system. 



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A woman and her child await treatment for 

monkeypox at a facility run by Doctors Without 

Borders in the Central African Republic in 2018.Credit: 

Charles Bouessel/AFP/Getty 

A man receives a vaccine at a monkeypox 

clinic in Montreal, Canada, on 6 June. 

Credit: Christinne Muschi/Reuters 

Link to the article:WHO may soon end mpox emergency — but outbreaks rage in 

Africa 

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An invitation from Professor Christina Gunther 

Colleagues, 

Please join Dr. Bronwyn Cross-Denny and me at our in-person, pre-conference 

satellite session on April 13th, 1pm – 5pm in the DuPont Room during the CUGH 

conference. Experience virtual reality as part of our cultural competence training 

for students in health professions. 

• Learn about the development of virtual reality modules with a curriculum 

framework. 

• Discuss challenges and opportunities. 

• Engage in open discussion for navigating challenges & modeling best 

practice. 

Attendance is part of the pre-conference, but registration is required. 

Information: Click here 






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Housatonic River (Rose Schwatz) 

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Global Health Bridge, Danbury Hospital, February first, 2023 


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Click here to visit the Nuvance 

Health Global Health Program 

COVID-19 Resource Center 

Resources 



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OUR PEOPLE, 

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Students in India 

Global Health 



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Photo News 

Dr. Taksande showing us the proper readings of 

an echo 

My cute little patient Arnav and his mother 

Calendar 


Resources 



Playground made for all the children who visit the hospital OPD 

Outpatient Pediatric Clinic 

(OPD) 

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OUR PEOPLE, 

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Calendar of Events 

Nuvance Health 

February 01: Global Health Bridge at Danbury Hospital 

February 02: Debriefing meeting with Dilyara Nurkhametova, assistant director 

of the GHP meeting with Wendi Cuscina, the manager of the GHP 

February 03: Meeting with Dilyara Nurkhametova, assistant director of the GHP, 

to address standardization of the global health bridge at Danbury Hospital and 

UVMLCOM based on LCME requirements 

February 05: Finalized Global Health Diaries with Mitra Sadigh and Amanda 

Wallace 

February 05: Finalized February issue of eMagazine with Mitra Sadigh and 

Amanda Wallace 

February 05: Contacting Dr. Kaveh Khoshnoud, Associate professor, Yale School 

of Public Health, to address the topic of the 2nd Annual Almira Grand Rounds in 

Global Health and Social Disparities 

February 06: Meeting with Dr. Rosen, associate dean of UVMLCOM, to address 

standardization of the Global Health Bridge at Danbury Hospital and UVMLCOM 

based on LCME requirements 

February 06: Debriefing meeting with Wendi Cuscina, the manager of the GHP 

February 06: Meeting with Dr. Herrick, the chairman and the director of residency 

program of department of psychiatry at NVH to host a faculty interested in the 

global mental health from NIH, Armenia 

February 06: Contacting Dr. Jarrett to host a new cardiology resident from the 

Heart Institute in Santo Domingo, Dominican Republic, and to discuss to invite a 

faculty from Cho Ray Hospital for cardiology rotation at Danbury Hospital 

February 06: Meeting with the members of the foundation office at Danbury 

Hospital and Dr. DeLeon, CAO, to discuss the global health endowed budget 

February 06: Meeting with Dr. Shalote R. Chipamaunga Bamu, to discuss the 

joint Master Degree in Medical Education with Zimbabwe University 

February 06: Meeting with one of the 3rd year medical students interested in 

projects addressing Latinx community in Danbury 

February 07: Presentation of research projects by inaugural Ruggles Scholars in 

Global Mental Health 

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February 07: Meeting with the NVH GHP leadership 

February 07: Meeting with Dr. DeLeon to discuss the values and benefits of “J1 

Research Visa” 

February 08: Meeting with the Dean of medical school at University of Medicine 

and Pharmacy, Ho Chi Minh, Vietnam, and other members of the leadership from 

this university 

February 08: Debriefing session with Dr. Andrea Green and Beth West on their 

site visit of Dominican Republic 

February 09: Meeting with Dr. Mariah McNamara, the associate director of the 

global health at UVMLCOM, to discuss the Global Health Day, the Global Health 

Academy, and selection of the first year students interested in global health 

elective 

February 09: Finalized the global health eMagazine with Amanda Wallace 

February 10: Meeting with Dr. Dilyara Nurkhametova, to discuss the partnership 

between Nuvance Health and UVMLCOM as well as the selection of the first year 

students interested in global health elective 

February 10: Zoom meeting with members of the executive committee, nursing 

division of the global health, to talk about the vision and mission of the Global 

Health Academy 

February 10: Finalized the topic and the speaker of the 2nd Almira Annual Grand 

Rounds on Global Health and Social Disparities 

February 10: International Nurse Executive Committee meeting to discuss global 

health nursing. 

February 10: Drs. Sousa, Luppinacci and Winkler met to discuss site visit to 

Uganda later this year and Ann Robey scholarship. 


Wallace 

February 13: Monthly meeting with Dr. DeLeon to discuss partnership with Armenia 

and the format and content of the Global Health Day in June 

February 13: Meeting with members of the NVH Foundation Office to discuss 

logistics of the Global Health Day 

February 13: Weekly meeting with Wendi Couscina, the manager of the global 

health program 

February 13: Meeting with the leadership of the global health at UVMLCOM 

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February 14: Meeting with Dilyara Nurkhametova to discuss the evaluation and 

objectives of the Global Health Bridge course and mapping the objectives with 

the objective of this course at UVMLCOM 

February 14: Meeting with Wendi Cuscina to discuss the objectives and logistics 

of the Global Health Day and accommodation challenges in Zimbabwe 

February 14: Interviewing a Candidate for Network Endowed Chair of Community 

Health Opportunity 


Wallace 

February 22: Debriefing session with Wendi Cuscina, the manager of the Nuvance 

Health Global Health Program 

February 22: Meeting with Krysta Buckley, the director of the global mental 

health and Dr. Elina Mukhametshina, to discuss the global mental health and 

to make plan for the global mental health conference in Kampala in September 

February 22: Pre Departure orientation meeting with primary care residents and 

Dilyara Nurkhametova 

February 22: Meeting with Dr. Elina Mukhametshina, the director of the 

collaboration with Armenia, to discuss how to map the objectives of the global 

health bridge based on CUGH competencies and domains 

February 23: Meeting with Drs. Deborah A Hewitt, Assistant Vice President Nursing 

Professional Development Nuvance Health and Catherine Winkler, the Director 

of the Global Health Nursing Division, to discuss how to introduce the concept of 

global health to the nursing staff during Nurses’ Week 

February 23: Discussion with Dr. Simon Otim, the director of the global health at 

St. Francis Hospital, on orientation of the new residents taking the global health 

elective in Naggalama 

February 23: Discussion with Dr. Dilyara Nurkhametova, the Assistant Director of 

the Nuvance Health Global Health Program on orientation of the new residents 

taking the global health elective in Naggalama 

February 23: Introductory meeting with Dr. Minh Quân Dư Quốc a critical 

care specialist and global health scholar from Vietnam who is currently doing 

observership in ICU at Danbury 

February 23: Meeting with Dr. DeLeon and leadership from NIH in Armenia 

February 23: Meeting with Dr. Robert Jarrett, the founder and president of the 

hearts around the world, to discuss the logistics in welcoming a cardiologist 

colleague from Armenia for observership 

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February 25: Finalized an accepted manuscript for publication with Mitra Sadigh 

and Maysoon Hussein, a senior student at RUSM 


Wallace 

February 26: Meeting with Dr. Robert Kalyesubula, the founder and president 

of ACCESS, Nakaseke, Uganda, to discuss the content and the format of a new 

manuscript 

February 27: Meeting with Trefz Family and their advisors to discuss the content 

and structure of the Global Health Academy 

February 28: Meeting with Wendi Cuscina, the manager of the global health 

program to discuss the logistics and the budget of the global health academy in 

preparation of a meeting with the leadership of the Nuvance Health Foundation 

February 28: Meeting with Dr. Elina Mukhametshina to discuss the content of 

the Global Health Bridge and overlap topics with the Global Health Bridge at 

UVMLCOM 

February 28: Meeting with the leadership of the Nuvance Health Foundation to 

discuss the logistics and the Global Health Academy budget 

February 28: Finalized the March issue of the global health eMagazine with Mitra 

Sadigh and Amanda Wallace 

UVMLCOM 

February 6: Meeting with Drs Mariah McNamara, Andrea Green, Amalia Kane, 

Krista Buckley to discuss UVM MS1 applicants for the summer GHE and preliminary 

placement 

February 10: Meeting with OIE Director Emma Swift to discuss UVM GHE Program 

February 13: Global Health Leadership Team meeting 

February 27: Global Health Leadership Team meeting 

AUC/RUSM 

February 6: Pre-departure orientation meeting with two AUC/RUSM students - 

Kayla Batista and Janessa Bell, in preparation to their GHE in Uganda in April 

2023 

February 8: Meeting with Dr. Elina Mukhametshina, discussion of GH final 

evaluation and research projects 

February 9: Meeting with Dr. Elina Mukhametshina to work on the manuscript 

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February 10: Meeting with Dr. Elina Mukhametshina to work on the research 

project proposal 

February 13: Interviews with AUC/RUSM students applicants for the GHE 

February 14: Meeting with Dr. Elina Mukhametshina to discuss students’ placement 

for summer GHE 

February 17: Meeting with Dr. Elina Mukhametshina to finalize research proposal 

February 17: Two RUSM students Scompleted their GH electives at DMIMS, 

India; two AUC and RUSM students completed their GH elective at UZFMHS in 

Zimbabwe 

February 20: Four RUSM students started their GH electives at ChoRay hospital, 

Vietnam 

February 28: Touch base meeting with Dr. Elina Mukhametshina 


Global Local 


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Rose Schwartz 

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Dr. Alex Kayongo in his lab, MakCHS 





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Blakely Cruz 

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Faith and Alex Kayongo with children, Lauren 

and Harvey 

Birthday of Lauren, 4 years 

Riley Wallace 16th Birthday 

49

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Yale Medicine 2008 

Photos and Reflections 2021 

Global Health & the Arts 

Nuvance Health and UVMLCOM Global 

Health Website 

COVID-19 Resource Center 

Nuvance Health and UVMLCOM Annual 

Report 2020 

AUC/RUSM Annual Report 2018 

Cases and Reflections from Mulago 

Climb for a Cause 2018 

Climb for a Cause 2019 

Ebola: Sequences on Light and Dark 

Ebola: Two Doctors Respond to the 2014 

Ebola Epidemic in Liberia: A Personal 

Account 

Global Health Annual Reports 

Global Health Conference 2019 Photos 

Global Health Conference 2019 Videos 

Global Health Conference 2019 Book 

Global Health Diaries and Newsletters 

2015-2016 


2016-2017 


2017-2018 

Global Health Diaries and eMagazines 

2018-2019 

Global Health eMagazines 2020-2021 

Global Health Diaries 2020-2021 

Global Health Program Website 

Global Health at WCHN Facebook 

Ho Chi Minh City and Cho Ray Hospital 

The Homestay Model of Global Health 

Program video 

Kasensero Uganda 

Resources 

Global Health Reflections and Photos 2017 

and 2018 

Global Health Reflections and Photos 2019 

Ethical Dilemmas book 

Nuvance/MakCHS Global Health 

Information Center Booklet 

Paraiso and the PAP Hospital 

Photographs from Uganda, by 

photojournalist Tyler Sizemore 

Presentations By Global Health Scholars 

Previous issues of the Global Health 


Program Partners 

Publications 

Site Specific Information 

Tropical Medicine Booklets (101, and 

202) 

Tropical Medicine Spanish 101 

Tropical Medicine Courses 

The World of Global Health book 

The World of Global Health Video 

Words of Encouragement 

UVM Larner College of Medicine Blog 

Participant Guide in Global Health, 

Thailand 

Cho Ray International Student Handbook 

DRC Facing a New Normal 

Photos and Reflections 2019 

Coronavirus 2019 Important clinical 

considerations for Patients & Health 

care Providers 

Interviews 

A Connecticut Doctor in Africa, by 

journalist Mackenzie Riggs 

Majid Sadigh, MD Interview Regarding 

Ebola in Liberia (Video) 

My Heart Burns: Three Words Form a 

Memoir (Video) 

Two UVM Docs Combat Ebola in Liberia 

(Article) 

50

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