eMagazine June 2023

June 2023 Volume 54 

NUVANCE HEALTH 

Global Health Program 

LARNER COLLEGE OF MEDICINE 

NUVANCE HEALTH AND THE UNIVERSITY OF VERMONT LARNER COLLEGE OF MEDICINE 

Global Health eMagazine 

Editor; Majid Sadigh, MD 

Contributing Editor; Mitra Sadigh 

Creative Director; Amanda Wallace 

Cover: Angel (Hakimov)

OUR PEOPLE, 

OUR MISSION 

Perspective 

Global Health 

eMagazine 

June 2023 

Perspective 

Global Health Academy 

Highlights 

Reflections 

Welcome 

Global Local 

Hispanic and Latinx Communities 

Voices of Ugandan Students 

Bringing Back Justice to Underserved Communities 

From the Editor; Majid Sadigh, MD 

Global Health Mental Health 

Art to Rwmind Us of Who We Can Be 

Our Beautiful Planet 

Innovation and Technology 

Nursing Division 

Women’s Health Education 

Among the Letters 

Announcements 

Article of the Month 

Video of the Month 

Congratulations 

Phoro News 

Calendar of Events 

“There could be no justice without fair opportunities for all. Justice 

demands the protection of those fair opportunities.” 

-John Rawls 

Something that has amazed me is that when I interview medical students, faculty, and residents, I 

ask them “why do you go to another country for a GH elective?”, they say they are going to help. 

My reply is, “you are going to go to help yourself.” The concept of ‘help’ in this respect is wrong. 

We need to substitute sympathy with justice. How can we teach our participants to see the roots 

of injustice in the GH setting? To identify those who have played a major role in bringing inequity 

and injustice to communities? How can we return justice to those communities? How can we teach 

people to be the voice of justice? How can we diffuse that philosophy among ourselves and our 

students? Many of our students are passionate and have come to medical school with empathy. 

They are brilliant and willing to be by the side of marginalized people in returning justice where it 

has been taken. Human rights activism should be the core of medical education. 

Our students today have the potential to be a strong voice of the under-voiced by appropriate 

inspiration and education. How can we teach our students and faculty to replace the concept of 

“helping” with “bringing back justice”? How to teach students from HIC when they come to LMIC 

that they are there not to help but to participate; to learn, not to teach? 

Resources 

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Perspective 


Highlights 

Reflections 

Welcome 

Global Local 


Written by Wendi Cuscina, BS, CPM, PACT 

Manager, Global Health Program 

Manager/Administrator, Policy Governance 

KYRUUS Administrator 

Perhaps 15-20 years ago, the idea of global health was a mere blip 

on the radar, a distraction in someone’s thought process. In 2012, 

at what was then Danbury Hospital, global health was a seed 

planted by Dr. Majid Sadigh. His vision, melded together with the 

encouragement and cultivating skills of Dr. Murphy, and Foundational 

support led by Grace Linhard, the Global Health Program today, is a living, fluid movement. It 

is not defined by one person, but rather the continuous engagement of brilliant minds and 

herculean efforts across the globe collaborating for one common goal – health equity for all. 

Nuvance Health Global Health Program is applauded and well respected for its mission, nonpartisan 

affiliations and organizational structure. It has become the standard industry model to 

emulate. 

High ranking universities, such as Harvard, Duke, Johns Hopkins, UPenn, Yale, Tufts, Georgetown 

et al, in over 42 countries now offer a global health elective to medical students. 43% have 

reported this course as compulsory. Global Health is no longer an afterthought. It is vital, it is 

dynamic and in the forefront of health education throughout the world. 

The Nuvance Health Global Health Program is celebrating and embracing this evolution during 

our upcoming Annual Global Health Conference in early June and the opening of the Majid 

Sadigh Global Health Academy. More details to follow in the June and July issues of eMagazine. 










Announcements 




Phoro News 

Parvin Sadigh (Iran) 


Resources 

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Highlights continued on next page >>

OUR PEOPLE, 

OUR MISSION 

Highlights 

Global Health 



Tributes to Dr. Michael Simms at St. Mary Hospital 

Dr. Sadigh attended a ceremony to pay tribute to Dr. Simms, a close friend and colleague at St. 

Mary Hospital. 

Perspective 


Highlights 

Reflections 

Welcome 

Global Local 










Announcements 




Dr. Raeissi, the chairperson of the 

department of medicine, opening 

remarks 

Dr. Simms closing remarks 

Phoro News 

From Left to Right; Dr. Buller, Dr. Raeissi, Dr. Simms, Dr. Sadigh, Dr. Aronin, Dr. Demayo, and Dr. Podell 


Resources 

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OUR PEOPLE, 

OUR MISSION 

The Ecuadorian Civic Center (ECC) Soccer 

Tournament 2023 

ECC Soccer 2023: The Godmothers of Sports Teams 

Global Health 



Written by Elvis Novas 

Advisor for the Dominican Community Center and 

member of the Board of Directors of Housatonic Habitat 

for Humanity, Danbury, CT 

Perspective 

“On Sunday, May 7, the opening ceremony of the XXVII Soccer Championship SUMMER 2023 of 

the Danbury Ecuadorian Civic Center (CCE) was held at Roger’s Park in Danbury, CT. It was a 

wonderful event, where dozens of players gathered with their respective godmothers, as well 

as local and state authorities such as Danbury Mayor Dean Esposito; CT State Senator, Julie 

Kushner; CT State Representative Farley Santos, and community leaders such as Roberto Alves, 

and Wilson Hernández. Also present as special guests were Javier Cintron from NUVANCE-Global 

Health, Elvis Novas and Jason Nova from the Dominican Community Center, among others. This 

event was masterfully organized by the excellent CCE team led by its President Mr. Leonardo 

Córdova and Vice President Mrs. Maria Lema. Congratulations!” 


Highlights 

Reflections 

Welcome 

Global Local 










Announcements 




Phoro News 


Resources 

Click here to visit the Nuvance 

Health Global Health Program 

COVID-19 Resource Center 

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Danbury Hospital Department of Medicine Grand Rounds- A Global Health 

Grand Rounds 

On Wednesday, May 17, 2023 at 8:00 AM - 9:00 AM, Dr. Stephen Scholand was the speaker of 

the Department of Medicine Grand Rounds - Global Health. 

The topic was “Meningitis without Borders - Confronting a Menacing Disease.” 


Perspective 


Highlights 

Reflections 

Welcome 

Global Local 










Announcements 




Phoro News 

Please see the link below to the presentation 

https://www.youtube.com/embed/tcccvAuBqww 


Resources 

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OUR MISSION 

Global Health 



Thank you Philista 

Written by Arezou Nazary 

Our Global Health experience would not be remotely as special 

or memorable without a very special young lady named Philista. 

Philista is the young woman who helped guide our stay at 

Naggalama hospital in Uganda. She runs the guest house for all 

visitors who pass by. Anything we wanted to learn, see, do, eat, 

Philista was there to help make it a reality. Everyday was a new 

excursion with her. 

Philista’s voracious appetite to explore and learn new things was infectious and made our 

exploration of Uganda one hilarious roller coaster ride we cherish. She didn’t know how to swim 

yet took the leap to go rafting on the Nile with us! Weekly grocery runs became mini concerts as 

we played music and sang on the back of boda bodas (motorcycles) under the african sky. She 

protected and guided us as we made our shopping trips for the Go Fund Me project, making 

sure her muzungus got value for their buck. 

Perspective 


Highlights 

Reflections 

Welcome 

Global Local 










When we felt weak from a long day in OR or wards, she would have our favorite snacks and 

foods ready. When we were sad over the patient we lost and tears streamed down our faces, 

she somehow knew exactly what to say to make us start laughing. 

After countless hours of getting to know just 

each other’s worlds, hopes and dreams, we 

knew without a doubt Philista is meant to travel 

and explore the world. She opened up about 

her dreams, one of which is to continue her 

education and finish college majoring in Tourism. 

Philista is now taking the steps to sign up and 

continue her education which ultimately would 

allow her to apply for her dream job, an airline 

stewardess, and make her dreams of seeing the 

world a reality. In our last week, we started the 

process of making sure Philista got her passport 

and it is indeed in the works! 

Announcements 




Phoro News 


Resources 

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Perspective 


Highlights 

Philista educated us about Uganda and helped us navigate our way, but what Philista doesn’t 

know is that she taught us beyond that. She showed that no matter where in the world you 

come from, whatever you’ve experienced, the differences dissipate and the similarities in spirit 

and love predominate. And without a doubt, we would go back to Naggalama, just to visit our 

sister, Philista. 

Reflections 

Welcome 

Global Local 










Announcements 




Phoro News 


Resources 

Kent Falls, Kent CT (Olwen Gurry) 

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OUR MISSION 

Global Health 



Perspective 


Highlights 

Reflections 

Welcome 

Global Local 










Announcements 




Phoro News 


Resources 

Reflections 

Reflecting on My Global Health Journey During 

Medical School 

Written by Jett Choquette, MD, Class 2023 

Near graduation (May 21, 2023) from the Larner College of 

Medicine at Vermont University, I find myself reflecting on the 

role global health played throughout my medical school career. 

Soon I will start a new adventure, internal medicine residency 

at Virginia Commonwealth University (VCU) in Richmond, VA. As 

I reflect on the large role global health has played in my life so 

far, I’m also curious how it will continue to be part of my training 

at VCU. 

I started medical school knowing I wanted to be part of global health, but I was still formulating 

what that meant to me. I’d been a community health volunteer in the Peace Corps in Paraguay 

prior to starting medical school. From my time in the Peace Corps, I knew several things: I 

wanted to be based in the US, I believed in equal partnership, and (when I worked abroad) I 

ultimately hoped to develop a long-term relationship with one community to which I’d return 

over the years. 

The Nuvance/LCOM Global Health Program welcomed me as I started my first year of medical 

school. I was set to go to the Dominican Republic (DR) the summer after my first year of medical 

school, something I couldn’t have been more excited about. I couldn’t wait to see what global 

health from the medicine perspective was like as the Peace Corps had already given me a 

glimpse of global health from the public health perspective. Then COVID came and everything 

changed. 

My trip to the DR was canceled. Further no one, new or seasoned, in global health could 

travel easily as the COVID pandemic raged. The leaders in global health around me, who had 

previously looked abroad, looked inward to their local communities as they could no longer 

travel. Was it possible to address global health on a local level? 

I helped with flu clinics for migrant workers in Vermont. I took part in early discussions and 

projects of the UVMMC Emergency Department Diversity, Equity, and Inclusion Committee as 

part of the New American Subcommittee. I helped develop longitudinal global health curriculum 

to be included as part of the LCOM regular curriculum. I found a community in the Global 

Health Program, but still hadn’t found a project that blended my love of health and Spanish in 

the way I hoped. 

I moved to Connecticut for my clinical years of training (years three and four of medical school), 

as a member of the LCOM Connecticut campus 2023 class cohort. Dr. Sadigh connected me 

with Elvis Novas, a leader of the Dominican Community Center (DCC) in Danbury, CT. The DCC 

is a non-profit that seeks to empower the Dominican community and other Hispanic/Latinx/ 

Latino communities in the Danbury, CT area. Working together over the past two years, the 

DCC and I built a partnership between the Latinx community and the Global Health Program. 

As part of this partnership, we designed projects to promote health literacy. 

I was grateful for the kind welcome and dedication of the DCC members as our partnership 

blossomed. Earlier this spring, a new third year medical student took over my role as the 

Community Liaison from the Global Health Program to the DCC, as my graduation was looming. 

The DCC is currently planning a summer youth leadership academy that will include a health 

literacy component. 

Despite the unexpected twist the COVID pandemic caused in my global health journey, I 

ultimately found my medical school global health home in Danbury, CT working with the DCC. 

The opportunity to collaborate with an important population within the community where I was 

training as a medical student resonated with me as especially important. I was glad that the 

Global Health Program was prioritizing local global health efforts. 

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Global Health 



The importance of empowering Latinx people within the Danbury, CT healthcare system became 

more evident the more time I spent in the clinic and hospital. Nuvance serves many Spanish 

and Brazil-Portuguese speaking patients. Danbury, CT has a diverse medical community with 

many doctors, nurses, and other healthcare professionals who are native Spanish or Portuguese 

speakers – yet the challenges of communication across cultures and languages remains for 

many healthcare professionals (including myself) where Spanish and/or Portuguese are second 

languages. The challenge of using phone interpreters can delay care. It can cause confusion. 

Partnering with the local community, such as the DCC, gives the Global Health Program an 

opportunity to address the challenge of providing healthcare locally to people from all around 

the world. 

Partnerships like the DCC-Global Health Program allow our local health system to better learn 

from and involve local communities in health care improvement. It allows us to open a channel of 

communication where the exchange of ideas can flow both ways and the end goal of improving 

health for all becomes a mission that both the health system and the community own. I’ve been 

honored to take part in the development of the DCC-Global Health Program partnership. And 

while I’m no longer the medical student on the ground helping the DCC, I remain connected 

to the DCC community. I can’t wait to see how our Danbury community continues to grow and 

evolve in the future. 

Perspective 


Highlights 

Reflections 

Welcome 

Global Local 










Announcements 




Phoro News 


Resources 

Majid Sadigh 

10

OUR PEOPLE, 

OUR MISSION 

Week 2 and 3 Reflections 

Written by Asima Mian, PGY3 resident 

CIFC Health Primary Care Internal Medicine Residency Program 

Global Health 



It has been quite busy the past few weeks with finishing up work 

at the hospital and coordinating all the donation items for the 

school. There is an ortho camp doing pro bono hip and knee 

arthroplasties for the past 10 days. I scrubbed into several ortho 

procedures to help out, covered the gen med ward and anywhere 

else I could be helpful. At the end of week 1 we went on an African 

Safari which was incredible! I spent time on the maternity ward 

Perspective 


Highlights 

Reflections 

Welcome 

Global Local 







Alla Jusufi, Asima Mian, and Arezou Nazary at St Francis 

hospital, Naggalama 

Arezou Nazary, Asima Mian, and Alla Jusufi in Naggalama 



Asima Mian at local market, Uganda 

From left to right: Arezou Nazary, Asima Mian, Simon Otin, and Alla Jusufi 

in St Francis hospital, Naggalama, Uganda 


Announcements 




Phoro News 


Resources 

and maternal ultrasound. I learned that rather than cost of care, cultural practices and medical 

myths are what deter people from seeking health care. Many pregnant women did not seek 

any prenatal care due to cultural beliefs and myths. They fear that the ultrasound would harm 

the fetus. They also had personal fears of knowing their HIV status and would rather not know 

their status and would therefore not get tested. Most of the cultural beliefs occur in the village 

tribes. It was a challenge to educate these women given their strong personal and cultural 

beliefs however some women were very interested in learning about prenatal care. 

Near the end of week 3 was the end of Ramadan and Eid. We attended Eid prayer at the local 

Mosque then traveled to Kampala for the weekend. Eid is a public holiday here and celebrated 

for 3 days. It was so fascinating to see the entire country celebrate Eid which is a Muslim 

holiday in a non-Muslim country. One thing I have noticed is that there is a wide acceptance of 

different religions and the freedom to practice religion in peace without oppression. Everyone 

is very accommodating and welcoming towards each other’s faith. It is very heartwarming to 

see such kindness towards each other in this regard. When visiting Kampala, we went to the 

royal palace and parliament and learned about the history of Uganda’s independence. It took 

years of civil unrest and conflict before achieving a state of freedom of religion and peace. 

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OUR PEOPLE, 

OUR MISSION 

Global Health 



Perspective 


Highlights 

Reflections 

Welcome 

Global Local 










Announcements 




Arezou Nazary and Asima Mian, Uganda 

Asima Mian, Sr Jane Frances, and Arezou Nazary at St 

Francis hospital, Naggalama 

Phoro News 


Resources 

Rose Schwartz 

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OUR PEOPLE, 

OUR MISSION 

Week 1 in Vietnam Reflection 

Written by Olivia Warren 

American University of the Caribbean School of Medicine, Class of 2023 

Global Health 



Perspective 


Highlights 

Reflections 

Welcome 

Global Local 





I am sitting in my hotel room, with the window open, hearing 

the birds chirp, smelling the air and seeing the hospital from 

my window. My first week in Saigon has been fascinating and 

overwhelming at the same time. The city moves at a very quick 

pace, with a constant fluid movement of people going from one 

place to another. The unceasing of cars, scooters and people 

on-the-go is something that is unusual for me. I grew up in a 

quiet town in Orlando, where the streets and shops are closed and quiet after a certain hour; 

this is most definitely a shift in pace. I am handling it well though being that I have always 

been appreciative to see how other cultures exist in their respective countries. I think the most 

interesting thing I have seen thus far is how authentic Vietnam is. The people, the food and how 

people live here is very different. For example, I commonly see how families eat together and 

all eat the same meal during lunches and dinners. Common dishes include noodles, rice and 

vegetables, which has been a large adjustment for me as well. Eating together as a family has 

made me appreciate the dinners I have at home with my own family members. 

My time in the hospital has been eye-opening as well. I was in the emergency department 

the first two weeks and from day one I experienced shock in how different healthcare here 

is compared to America. Providers here are very resourceful. For example, witnessing nurses 

drawing blood they utilize a rubber glove as a tourniquet versus the usual tourniquet used in 

the U.S. I found that to be an absorbing moment for me. Patients who come to the ER are sick 

or commonly, victims of a bad motor scooter accident. Often patients are in critical condition, 

but the resources are not always available to provide them with care. 

The providers here utilize what they have in a 

multidimensional way, and I think that is something 

that I will carry with me for the rest of my medical 

career. 

I am grateful for my first week here. I am learning 

a lot in the hospital and witnessing so much! It has 

been humbling thus far and excited for the weeks 






Announcements 




Phoro News 


Resources 

ChoRay hospital, Emergency Department 

Olivia Warren, AUC MS4 

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Global Health 



Currently the global health program is hosting 4 global health scholars at Danbury and 

Norwalk Hospitals. Dr Trinh Ngoc Thanh, a cardiologist from Cho Ray Hospital in Vietnam, Dr 

Gabriel Polanco, a cardiology fellow from the Heart Institute in Dominican Republic , Shushanik 

Isahakyan, the Head of the International Cooperation Department at the National Institute of 

Health in Armenia, and Dr Pham Le Anh Nguyen, a pulmonologist and critical care specialist 

from Cho Ray Hospital in Vietnam. 

We are welcoming them to Nuvance Health. 

Welcome 

Perspective 


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Reflections 

Welcome 

Global Local 










Announcements 




Phoro News 


Resources 

Global Health scholars (from left to right): Dr Trinh Ngoc Thanh (Vietnam), Dr Gabriel Polanco (DR), Shushanik 

Isahakyan (Armenia), and Dr Pham Le Anh Nguyen (Vietnam) 

Shushanik Isahakyan 

The Director of Nuvance Health Global Health Program at 

National Institute of Health in Armenia 

Shushanik Isahakyan is the Head of the International 

Cooperation Department at the National Institute of 

Health in Armenia. 

She will be spending 3 weeks (May 21 to June 9) with the 

global health team at Danbury Hospital. 

On May 22, 2023, Shushanik Isahakyan - the Head of the 

International Cooperation Department at the National 

Institute of Health in Armenia arrived in Danbury for an 

official visit to the Nuvance Health Global Health Program. 

Shushanik has been instrumental in driving positive change in the healthcare sector through her 

involvement in local and international projects. During her time here, Shushanik visited Danbury 

and Norwalk hospitals, Global Health Academy, Sacred Heart University, and met with the 

leadership team to get acquainted with the structure and key elements of our program. 

On June 5-6, Shushanik, along with Dr. Alexander Bazarchyan - Director of National Institute of 

Health of Armenia, will attend the Second Global Health Conference. These visits are part of 

our evolving collaboration with the National Institute of Health of Armenia in efforts to establish 

a new program site. 

We welcome Shushanik to the Nuvance Health Global Health Program and look forward to our 

fruitful collaboration with the National Institute of Health of Armenia! 

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Gabriel Polanco, MD 

Heart Institute in Santo Domingo, Dominican Republic 

Dr Gabriel Polanco arrived in Danbury Hospital on May 8th 

for one month training in the Cardiology department under 

the supervision of Dr Robert Jarrett. 

“I am thrilled to come to Danbury hospital to experience 

the way you people deal with cardiology patients and see 

what I can learn and apply back home in DR. And of course 

tell you about our experiences and ways of doing things 

in DR, especially when it comes to the Latin American 

patient.” 

Perspective 


Highlights 

Reflections 

Welcome 

Trinh Ngoc Thanh , MD 

Cardiologist, Cho Ray Hospital, Vietnam 

Dr Trinh Ngoc Thanh is a Cardiologist from Cho Ray hospital, 

he arrived in Danbury hospital on May 22 for two months 

of clinical rotation at Cardiology Department under the 

supervision of Dr Robert Jarrett. 

Global Local 









Pham Le Anh Nguyen , MD 

ICU Doctor, Cho Ray Hospital, Vietnam 

Dr Pham Le Anh Nguyen is an ICU doctor from Cho Ray 

hospital. Dr Pham was nominated as a Nair Scholar and 

arrived in Norwalk hospital on April 10th for two months of 

clinical rotation in Pulmonary and Critical Care Medicine 

under the supervision of Dr Robyn Scatena. 


Announcements 




Phoro News 


Resources 




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OUR PEOPLE, 

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Global Health 



Global Local 

Section Editor: Ritesh Vidhun 

Merge & Acquire: The Modern-Day Business of 

Running a Hospital 

Written by Ritesh Vidhun 

Perspective 


Highlights 

Reflections 

Welcome 

Global Local 

Hospitals in America have gone through significant changes 

over the past few decades. The 21st century brought a wave 

of advanced technology and treatments along with a wave 

of steadily increasing costs. Many providers across the United 

States have relied on smaller high-cost populations but as the 

industry moves toward value-based payments, many institutions are looking to merge with 

larger groups in order to avoid financial struggles. This leads to larger organizations being able 

to control a greater share of the market while having more influence over costs. The increased 

number of hospital mergers and acquisitions has an overall negative impact on healthcare in 

the U.S. due to lower competition and higher prices. 

The Increase in Hospital Mergers and Market Consolidation: Currently, the top 10 health 

systems in the United States, which include names such as HCA Healthcare, Ascension, and 

Trinity Health, control around 24% of the market.1 This staggering number has only been growing 

over the last decade, with increased hospital mergers & acquisitions (M&As) across the nation. 

There were a total of 92 M&A deals in 2019, slightly higher than the 90 in 2018 and lower than the 

117 in 2017.2 In 2020, challenges brought about by the pandemic attributed to a lower number 

deals at 79. 










Announcements 




Phoro News 


Resources 

What Factors Have Led to This Trend? When examining the increased levels of hospital mergers 

and acquisitions in the U.S., understanding the principle roots of the trend are important in 

navigating the complexity of the topic. One of the primary reasons for the growth of M&A 

deals can be attributed to the shift toward value-based payment reform. Many providers, 

particularly smaller ones, seek to join larger systems in order to reduce the burden of financial 

risk. Additionally, merging helps smaller hospitals gain access to more advanced technology, 

increased standardization, further coordination, and better financial support. Utilization has 

also been generally declining over recent years, especially during the pandemic. With lower 

levels of health care spending by the American population, many providers face significant 

challenges in maintaining their revenue and profits. After all, running a hospital in the U.S. 

requires some level of business strategy and executives are looking for more ways to stay afloat 

in this challenging economy. 

Although publicly, hospital groups state 

that the main motivations for mergers 

and acquisitions are to improve quality 

and access for patients, there are a 

series of financial gains that must be 

explored. Especially in smaller urban or 

suburban communities, when multiple 

hospitals combine, insurers are less 

likely to exclude one from the network 

despite greater prices or lower quality.3 

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Global Health 



Perspective 


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Reflections 

Welcome 

Global Local 










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This gives less prominent hospitals an opportunity to increase their utilization and revenue. The 

growth in these mergers and acquisitions has significant impacts on the health care market 

and patient experience as well. 

What are Some of the Drawbacks? There is one main concern that health economists and 

experts have alluded to: higher costs and less access. In most industries, when a handful of 

groups or companies control a significant portion of the market, it typically leads to them being 

able to better determine prices due to the reduced competition. Many hospital executives 

believe this is not true for healthcare, including Dr. Kenneth Davis M.D., President and Chief 

Executive Officer of Mount Sinai Health System in New York City stating, “the fear that mergers 

curtail competition, leading to higher prices for medical care, reflects an old way of thinking. 

Thanks to cataclysmic changes in the delivery of health care, hospital mergers now offer the 

potential for higher quality and more efficiency.4” These arguments are not always applicable, 

as multiple studies conducted across the nation have found that the increase in market 

consolidation over the last decade have, in fact, led to somewhat higher costs for patients due 

to less competitive markets.5 Organizations are able to bring more weight into negotiations with 

insurance companies, leading to more expensive contracts and consequently higher premiums 

for members. This is a very nuanced subject, but in general, research shows that M&A deals do 

not always lead to patient benefits. 

But Don’t Larger Groups Lead to Higher Quality? Arguments in favor of increased mergers 

and acquisitions often cite greater quality of services and access to advanced treatments. 

This can certainly apply to smaller hospitals in difficult financial situations, however it does 

not necessarily apply to the wide majority of deals. A study published in the New England 

Journal of Medicine examined data on M&As from 2007 to 2016 while comparing a variety of 

quality measures to determine composite scores.6 It concluded that “hospital acquisition by 

another hospital or hospital system was associated with modestly worse patient experiences 

and no significant changes in readmission or mortality rates.” In general, M&A transactions do 

not lead to significant improvements in the quality of health care that patients receive, and in 

many cases may actually lead to lower quality. In addition to increased costs, these findings 

emphasize the dangers of this steadily growing trend. 

The Impact of COVID-19 & Looking Ahead: Prior to 2020, the number of hospital mergers was 

on an increasing trajectory. However, the COVID-19 pandemic has had a variety of implications 

that led to fewer M&A deals last year, from decreased utilization of services to massive drops in 

health care revenue.7 These factors have decreased incentives while increasing risks for health 

groups to pursue merger and acquisition deals. 

Although there was stunted growth on market consolidation during the pandemic, the trend 

continued afterward. This is apparent right here in Connecticut with the expansion of Yale 

New Haven Health into greater Waterbury. The number of independently owned hospitals has 

gone from 23 in 2000 to 6 this year.8 Although the effects are still unclear, there is a cause 

for concern especially in rural communities (as discussed in previous editions). If we seek to 

minimize these challenges and increase access to high quality services in this country, a series of 

important questions must be answered: Can the government restrict M&As in order to promote 

competition in the healthcare market? Should there be a limit to the size that hospital groups 

are able to grow? If public health insurance grows in the U.S. what effects will this have, if any, 

on the current trend of M&As? 

This trend will continue to have serious implications over the coming years, and is something 

that needs to be addressed if we seek to make healthcare more equitable and accessible for 

all. 

References: 

1. https://www2.deloitte.com/us/en/insights/industry/health-care/hospital-mergersacquisition-trends.html 

2. https://www.kaufmanhall.com/insights/research-report/2020-mergers-acquisitionsreview-covid-19-catalyst-transformation 

3. https://californiahealthline.org/news/sutter-health-class-action-lawsuit-hospitalconsolidation-medical-prices-health-care-costs/ 

4. https://www.wsj.com/articles/kenneth-l-davis-hospital-mergers-can-lower-costs-andimprove-medical-care-1410823048 

5. https://academic.oup.com/qje/article/134/1/51/5090426?login=true 

6. https://www.nejm.org/doi/full/10.1056/NEJMsa1901383#article_citing_articles 

7. https://www.healthsystemtracker.org/chart-collection/how-have-healthcare-utilizationand-spending-changed-so-far-during-the-coronavirus-pandemic/#item-covidcostsuse_ 

marchupdate_1 

8. https://ctmirror.org/2022/05/08/as-hospital-systems-grow-consolidate-rural-patientsct-lose-services-labor-delivery-intensive-care/ 

Contact: ritesh.vidhun@tufts.edu 

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Hispanic/Latinx Voices; Stories 

from our Community 

Global Health 



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.” 

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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. 

On this occasion we are pleased to have a great article from Denisse Rodas, a 21-year-old 

nursing student who graduated in May 2023 from Western Connecticut State University with her 

Bachelor of Science. She will start her nursing career in the Med-Surg floor unit and Danbury 

Hospital. She was also part of the Latinx Panel last year. 





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Rose Schwartz 

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OUR PEOPLE, 

OUR MISSION 

Global Health 



Perspective 


Highlights 

Reflections 

Welcome 

Global Local 







Denisse Rodas is a 21-year-old nursing student who graduated 

in May 2023 from Western Connecticut State University with her 

Bachelor of Science. She was born and raised in Ecuador, and at 

the age of 13 years old, she migrated to the land of opportunities. 

She started her path to achieving the American Dream as an 

undocumented student and encountered various challenges, 

as many scholarships, financial aid, and jobs were not available 

due to her immigration status. After eight years of commitment 

to learning a new language and adapting to a new country, 

those barriers have not stopped her from pursuing her dream of 

becoming a successful nurse. During her journey in nursing school, 

she participated in various extracurricular activities, including 

her role as a secretary in the Student Nurses Association, a peer 

nursing tutor, and a Blood Drive Ambassador with the Red Cross. She is a Kathwari Honors 

Program Scholar, a Henry Barnard Award recipient, and was inducted into the Sigma Theta Tau 

International Honors Society of Nursing, Kappa Alpha Chapter. 

Due to the barriers, she has valued the importance of participating in leadership opportunities 

to advocate for the undocumented community. Being an undocumented student brought her 

closer to Connecticut Students for a Dream, a youth-led organization that fights for the rights 

of undocumented families and students. As an active member for more than five years, her 

community service work has focused on doing school presentations and leading membership 

meetings and events that have benefited the Latino and Hispanic communities by raising 

awareness about issues affecting the immigrant community. She became the College Access 

Program Fellow and supported undocumented students’ transition from high school to college. 

She tutored senior high school students and helped them understand the basics of college 

and apply for college, scholarships, and financial aid. She was part of the “Afford to Dream 

Campaign,” which allowed undocumented students across CT to be eligible for the AACTUS, 

which is the application designed specifically for undocumented students to apply for financial 

aid. 

As a nursing major, serving the community has given her purpose, and even though she is no 

longer an undocumented student, she continues to advocate for undocumented families and 

students desiring to achieve higher education. Currently, she is preparing to take the NCLEX and 

is enthusiastic to begin her nursing career in the Med-Surg floor unit and Danbury Hospital. She 

desires to advance her career by applying to graduate school to become a nurse practitioner 

and move forward to work towards an EdD in nursing education. As a future nurse, she hopes 

to be compassionate and empathetic and is dedicated to treating everyone with respect and 

providing high-quality care. She desires to make a difference regarding gender, social class, 

immigration status, and ethnic background. Lastly, being a first-generation Latina student has 

allowed her to honor her roots and celebrate her Ecuadorian culture and inspired her to support 

undocumented students and families across CT. 




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Majid Sadigh 

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OUR PEOPLE, 

OUR MISSION 

The Voice of 

Ugandan Students 

Global Health 



Section Editor: Joshua Matusuko 

COLONISATION AND DECOLONISATION OF GLOBAL 

HEALTH CURRICULUM AMONG MEDICAL SCHOOLS IN 

UGANDA 

Written by Joshua Matusuko 

Medical student at MaKCHS 

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Colonization continues to have a long-term significant impact on 

health systems, global health education, and healthcare practices in 

many countries that were colonies not long ago, including Uganda. 

Of the many influences that colonialism continues to have in healthcare, a colonial mindset 

among medical students and health workers in low and middle-income countries (LMICs) 

stands out to be the most significant to date. This issue makes it challenging to find long- and 

short-term solutions to the continued home health problems and inequalities that still plague 

many communities, despite possessing richness in numerous other resources. New physicians 

are often ill-equipped to address the true causes of health disparities, which are deeply rooted 

in historical, social, and political contexts. The current global health education curriculum 

in Ugandan medical schools fails to adequately discuss issues related to colonization and 

decolonization, which are crucial for understanding these health disparities. As a result, medical 

students in Uganda lack the knowledge and skills necessary to critically analyze the impact of 

colonialism on healthcare, to recognize its ongoing effects, and to work towards decolonizing 

medical practices. Additionally, they lack the skills to effectively navigate the complexities of 

global health, perpetuating the inequities in the healthcare system stemming from the gap in 

their medical curriculum. 

While numerous efforts have been made to decolonize global health education and improve 

health outcomes, there remains a colonial mentality among most of medical students in Uganda 

and in other LMICs—so even if advocates push for structural changes and power balances, by 

not tackling the core issue, which is mentality and mindset, we risk wasting most of our efforts. 

There is still a significant knowledge gap in global health curricula regarding colonization and 

decolonization in Ugandan medical schools, making it necessary to introduce this education at 

MakCHS and other institutions. Closing the knowledge gap will help fight the colonial mindset 

and ensure that more healthcare professionals are empowered to address the long-standing 

legacies of colonialism, improving the health of all. 


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Click here to visit the 

Nuvance Health Global 

Health Program 

COVID-19 Resource 

Center 

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OUR PEOPLE, 

OUR MISSION 

Global Mental Health 

Global Health 



Co-Editors: 

Krista Buckley, MD 

and 

Elina Mukhametshina, MD 

Perspective 


Highlights 

Reflections 

Welcome 

Global mental health is a growing field of Global Health that seeks to address the burden of 

mental illness. Mental illness affects people of all ages, genders, and cultures and is a significant 

contributor to the global burden of disease. When it comes to mental health, all countries can 

be thought of as developing countries. Vast inequities exist in the distribution of and access to 

mental health resources, not only between but also within countries. 

Global mental health aims to promote the prevention, treatment, and management of mental 

illness worldwide while also addressing the social and cultural factors that contribute to mental 

health disparities. 

The Global Mental Health column endeavors to shed light on the inequalities surrounding mental 

health and shares inspiring narratives of mental health advocates from around the globe. 

Global Local 










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Sherwood Island, Westport, CT (Julie Robinson) 

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OUR PEOPLE, 

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Global Health 



Written by Svanjita Berry, RUSM, MS4 

Global Health Elective alumni (February 2023) 

Following are two short stories inspired by my global health 

experience in India. I was fascinated by the role that religion 

played in both instances. It made me reflect on how each one 

of us formulate our own realities based on where we are born, 

what we see, what we learn, and what we feel throughout the 

course of our lives. Our personalities and behaviors are simply a 

manifestation of those individual realities interplaying with our 

neurobiology. 

“Lakshmi”- The Hindu goddess of abundance 

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Golden threads weaved into her bright red 

saree. The saree is draping over her torso and 

wrapping over her head covering most of her 

face, though one could still see the bright red 

‘bindi’ (dot on the forehead) underneath. Her 

hands adorned with glass bangles embellished 

with tiny rhinestones. Her palms and feet were 

painted with ‘alta’ (red dye). As she walked into 

the room, her anklets made the most beautiful 

clinking sounds. Heads turned in awe as she 

made her way through, till she saw an empty 

bed and very gracefully sat down with one leg 

crossed and the other leg hanging down. Her 

hands quickly transitioned into ‘mudras’ (hand 

gestures) while she moved her gaze across the 

room. “I am Lakshmi” she said. “Tell me more,” 

replied the psychiatry intern, while the other 

patients continued to stare. 

The mortal who married a god 

“Lakshmi and Saraswathi (Hindu Goddess of Wisdom) 

are trying to ruin my life” said the patient pointing 

at her sister and her nurse. “They are jealous of my 

marriage with Shiva (Hindu god of destruction and 

transformation). “In 1996, I heard Shiva singing Tu Hi 

Re.. (a popular love song in the 90s). Since then, we 

have been lovers. He would come to me in different 

ways, sometimes through my brother’s friend Yogesh 

(another name for Shiva). I have never seen him, but 

I can hear his voice and feel him. I have attained 

supreme pleasure during intercourse with him. I can 

feel his ling (penis) penetrating and rubbing against 

my yoni (vagina). We have 2 kids together - Ganesh 

and Mayur (actual names of Shiva and Gauri’s sons 

in Hindu mythology). He guides me on how to live 

my life. He protects me from my neighbors and my 

sister who are trying to poison me. All the other gods 

have tried to kill me before. Vishnu (Hindu god of 

preservation) shot poisoned arrows at me and sent 

his snakes to fill me with their venom. I could feel the snakes crawl on my skin and the arrows 

hurt so bad that I couldn’t move for days. They also tried to slit my throat and I lost my voice for 

months. But my Shiva saved me and gave me back my voice. I am Gauri, his wife, and through 

him I have the power to destroy the world if I want to.” 

How many delusions are too many delusions? I asked myself after this 2-hour-long detailed 

patient interview in central rural India. My back had started to hurt from sitting on a tiny metal 

stool placed next to the patient bed, but the behavioral health enthusiast in me had refused to 

leave. My single sheet of paper was overflowing with my notes and observations. Her medical 

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1 2 

charts revealed that in the last 

27 years, her positive symptoms 

had never responded to any 

psychiatric medications, despite 

adequate trials with Clozapine 

and ECT. How could a case be this 

complex? How could the patient’s 

developmental and social history 

shape her psychiatric illness to 

this extent? Were the delusions 

the basis of her hallucinations 

or did the hallucinations fuel 

the delusions? Had her longstanding 

delusions become fixed 

memories? I had an endless list 

of questions that needed to be 

addressed. I knew this case was 

going to be the highlight of my 

clinical experience in India. 

Perspective 


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Photos from the psychiatry wards 

1.Entrance. First door on the left is for the outpatient clinic (see photo 3). Further down the hallway on the left are the 

inpatient wards (see photo 2). 

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23

OUR PEOPLE, 

OUR MISSION 

Art To Remind Us 

of Who We Can Be 

Global Health 



Co-Editors: 

Mitra Sadigh 

and 

Elina Mukhametshina, MD 

Perspective 


Highlights 

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. 

This month we are highlighting one of the Latinx artists from Danbury. 

Reflections 

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Global Local 










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Jacqueline Cabrera 

Jacqueline is a Dominican-American, abstract artist who has always 

been fascinated by the beauty of nature and people. She studied 

sociology at Baruch College in New York City, but as she pursued her 

degree, she realized that there was more to life than just theory. She 

had always been artistically inclined, but she felt like she couldn’t 

create the same kind of work as others. 

In 2018 she moved to Danbury where she was able to reconnect to 

nature just as she did when she was a child growing up in a Campo 

in the Dominican Republic. Reconnecting to nature allowed her to 

connect more to herself and understand herself in a more profound 

way. It was while walking through the East branch reservoir in Brewster 

that she realized, after years spent away from art, how important it is 

to express herself in her preferred styles. Jackie incorporates natural 

elements such as rocks, feathers, sand and soil into her paintings. 

Nowadays, she creates canvas pieces that are both beautiful and thought-provoking. Jackie 

believes in the power of art to make the world a better place. Jackie’s goal is to inspire others 

to find beauty in their own unique way of seeing the world—and we can’t wait to see what she 

comes up with next! 



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Jacqueline Cabrera 

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OUR PEOPLE, 

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Perspective 

Ms. Saldana is in the center. Pictured here with her four children) 

Jacqueline Saldana 

Ms. Saldana is a Dominican born artist 

whose work has been featured in 

galleries in both New York City and New 

Hampshire. She started painting at the 

age of 5 when she was in bed recovering 

from Polio and has never stopped since. 

Jacqueline moved to the United States 

in 1996. Her mother and sister had 

migrated years earlier allowing her to 

acquire a US visa as soon as her mother 

became an American citizen. 

She is the mother of four children who 

now have grown up and are living their 

own lives here in the United States. 

She says that one of her greatest joys 

has been to help her children come 

to this country, where they can find 

opportunity and happiness. She is 

now grandmother to 5 adorable little 

children who adore her. 


Highlights 

Reflections 

When asked what inspires her, she says it’s her family, nature and its beauty. Her paintings are 

always inspired by these things and reflect a love for life itself through her lens. She incorporates 

many landscapes, shades and colors to always give her paintings a sense of the Dominican 

Republic, preferably some kind of body of water. 

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Jacqueline Saldana 


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Litchfield Hills, Ct,(Olwen Gurry) 

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OUR PEOPLE, 

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Global Health 




Section Editor: 

Dilyara F. Nurkhametova, MD, PhD 

Director of Nuvance Health Global Health Electives Program for AUC/RUSM 

Perspective 


Highlights 

Reflections 

Welcome 

Global Local 


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. 

Preserving forests means culture change 

EDITORIAL| VOLUME 7, ISSUE 5, E346, MAY 2023; The Lancet Planetary Health; DOI:https://doi. 

org/10.1016/S2542-5196(23)00085-2 

In this Editorial authors discuss the existing challenges for forest preservation, highlight the role 









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This Photo by Unknown Author is licensed under CC BY 

of planetary health researches “in understanding, quantifying, and communicating the value 

of intact, biodiverse forest for human health and wellbeing”. The authors highlight the need 

for “a wider cultural shift toward recognizing the full value of intact forests and other natural 

ecosystems; this will be hard won, but is vital if we are to stop undermining our own wellbeing.” 

Read the full text here 

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OUR PEOPLE, 

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Upcoming events and Webinars 

June 6, 2023, 8:30 AM – 5:00 PM (virtual or in-person) 

Global Health 



5th Annual Clinical Climate Change CME Conference: Clinical Care for Workers in the Climate 

Crisis 

Register via this link 

June 13-15, 2023 (virtual) 

Global Community Health Annual Workshop 

Perspective 


Highlights 

The third edition of the Global Community Health Annual Workshop will take place from 13 till 

15 June 2023. The overall workshop theme is “Sustainable community health: practice-based 

solutions for today’s challenges”. The theme will be explored via three sub-themes, one for 

each workshop day: Food security, Mental health, and Environmental health. Organizers are 

the UNESCO Chair Global Health & Education, University of Clermont Auvergne, University of 

Huddersfield, International Union for Health Promotion and Education (IUHPE)and EHESP School 

of Public Health. 

Read more about the event here, register here 

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Welcome 

Global Local 










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An Onlooker Witnesses the Annular Solar Eclipse as the Sun Sets on May 20, 2012. Photo by Colleen Pinski (Peyton, 

CO). Photographed in Albuquerque, NM, May 2012. 

Resources 

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“Guardians of the Giraffes” by Ami Vitale. Photo Story 

Winner (one of six images). BigPicture Natural World 

Photography 

“Snack Attack” by Gunther De Bruyne. Human/Nature 

Finalist. BigPicture Natural World Photography 

Perspective 


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Reflections 

Welcome 

Global Local 










Announcements 

“A River Gone Awry” by Juan Jesús González Ahumada. 

Art of Nature Winner. BigPicture Natural World 

Photography 

“Berg Buffet” by Greg Lecouer. Aquatic Life Winner. 

BigPicture Natural World Photography 


“Speed and Strategy” by Yi Liu. Terrestrial Wildlife Winner. BigPicture Natural World Photography 



Phoro News 

BigPicture Natural World Photography Competition: Website | Facebook | Instagram 


Resources 

28

OUR PEOPLE, 

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in Global Health 

Global Health 



Section Editor: Swapnil Parve, MD 

Written by Swapnil Parve, MD 

Director of International Affairs at the NH/ 

UVMLCOM Global Health Program 

Sal Khan believes that artificial intelligence (AI) has the potential to 

transform education for the better. “We’re at the cusp of using AI for 

probably the biggest positive transformation that education has ever 

seen,” he said in his 2023 TED talk. 

Perspective 


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Reflections 

Welcome 

Global Local 





Sal Khan’s 2023 TED Talk: AI in the classroom can transform education 






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Litchfield Hills, Ct,(Olwen Gurry) 

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A Note from the Editor: 

Catherine G Winkler, PhD, MPH, APRN-BC 

Director of the Nuvance Health Global Health Program 


Strengthening Healthcare Systems 

Strong healthcare systems are needed for all people to 

achieve timely access to quality healthcare to promote, 

restore and maintain health. Improving healthcare systems 

In the USA as well as on a global level requires administrators 

and healthcare leaders to take a hard look at the delivery of 

care, the cost of care, the timeliness of care and “the caring” 

in healthcare. 

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After the pandemic, change has been necessary on behalf of all healthcare providers in the 

delivery of care, the content of care and the timeliness of that care. Front line providers needed 

to don extra gear, change protocols, use resources differently and reprioritize their work with 

staff levels low and with care complicated by isolation and uncertainty. 

Patients and their families also needed to make ongoing changes since the pandemic by 

making careful decisions about whether they should seek care, when to seek care, how to seek 

care, and from what source in what venue would accessing this care be possible. 

Healthcare systems and administrators have changed too – but it requires more effort because 

they need to recognize problems and develop strategies, quick responses, and activities to 

allow providers to do their work effectively, and to sustain positive changes now through the 

next pandemic or crisis. Healthcare organizations and their leaders need to meet the needs of 

their staff and the patients that they provide healthcare to every day. 

Delivery of care needs to be available and timely. Often with large healthcare systems that 

span across a state or states that have set themselves up with service lines designed to 

manage expensive disease states such as orthopedics or cardiovascular care - lose sight of 

what services their communities need that may be lost leaders financially but are vital to the 

local people such as pediatric services or primary care. A shift should happen to review the 

community needs and then formulate a plan about how to access it. Does it make sense to 

have telemedicine visits, clinic, or home visits? Then once decided, look beyond the hired call 

service that may pick up the call in 30 seconds but still struggles to get a patient seen within 

a month. Community connectivity is needed to ensure that in addition to service lines, rapid 

response, urgent care, emergency care, and primary care are offered and accessible locally. 

Where is the care in healthcare? 

Care needs to be cost-effective but should also be safe and convenient for the patient that 

needs an outpatient procedure. Perhaps a cholecystectomy can be done same day, but in 

thinking about the secondary consequences of that surgery and the issues with urinary retention 

or symptom management – does it seem like a good idea to have the 75 year old patient need 

to follow up on Friday evening after the procedure in the ED as their only course of action 

available to have a urinary catheter placed or ongoing nausea treated? This happens often, 

and patients bear the burden of an ED visit with the associated health risk and cost. Where is 

the care in healthcare? 

Patients who are 10 minutes before going into surgery should not have to find their credit card 

in their clothes that have already been placed in the pre-op locker to pay an out-of-pocket 

expense to the hospital before they are wheeled into the OR. Perhaps this could have been 

considered the week before so that the frightened patient is not further troubled. After that 

the same restructuring of finances would make sense without asking the parents of a sick child 

going in at 5 in the morning for an invasive procedure to also pay for the estimated cost of care. 

Where is the care in healthcare? 

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Communication and transparency need to be either reinstated or developed post pandemic. 

With the primary care physician replaced in the hospital setting by hospitalist and intensivist 

along with snfist - then without timely communication and perfect electronic medical records 

that are secure and available-important information is lost, gaps in care occur and patients 

and the families suffer the consequences. A phone call or an in-person visit is best and should 

be done in addition to information provided in a patient portal. Some patients have 5-10 portals 

they need to manage and still data is missing or lost. Access to care and coordination of that 

care needs to be done across platforms and locations. Where is the care in healthcare? 

Environment of care needs to be upgraded with more privacy, that’s accessible space to meet 

the needs of a child, a person who uses a wheelchair, or a person with blindness or a hearing 

deficit and with resources and clean areas available to promote a patient’s independence, 

confidence, safety, and health while enabling front line healthcare providers to do their work. 

Healthcare administrators need to support the advancement of science with time for providers 

to conduct research, review literature and consult with colleagues. The interconnectedness 

of the world requires administrators and leaders to strengthen partnerships with colleagues 

across the world, as well as down the street and around the corner to improve public policy, 

encourage advocacy, and work on screening, health promotion and disease prevention. There 

are major changes in patterns and trajectories of health, disease, and aging and to improve 

and sustain change, healthcare leaders must adapt now to the changing world to ensure that 

the care is reinstated in healthcare and that it is sustainable. 

Perspective 


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Comments 

Written by Mary Kincart, MS, RN 

Dr. Winkler has provided a candid and comprehensive look at the 

challenges in healthcare we face as a nation and worldwide. The 

work to restore healthcare systems has been greatly impacted 

socially, emotionally, physically, and financially by the Covid 

pandemic. In many ways healthcare has experienced great 

setbacks and in other ways we have learned to be nimbler, more 

resilient, and more innovative. 

Treatment of chronic illnesses and preventative health measures 

were suspended during the acute phase of the pandemic, leading to a backlog of unaddressed 

healthcare needs by many. In addition, the nation is experiencing a significant influx of migrants 

from other countries, placing an even greater strain on an already vulnerable system, and 

greatly impacting access to care. 

The loss of healthcare providers and staff, from illness and/or burnout, as well as the massive 

financial impacts on hospitals, practices and healthcare facilities, compel healthcare leaders 

to address these challenges in new and innovative ways. The past several years have forced 

us to think differently about how we deliver healthcare. Specialists such as Intensivists and 

Critical Care Nurses provided virtual guidance to ICUs to support care to a greater number 

of patients. Virtual visits became the “norm” for addressing the needs of patients with chronic 

illnesses as well as those that needed non acute medical attention. Pop-up mobile testing 

and vaccine stations were implemented. These are only a few examples of the capabilities 

of healthcare leaders that will prove to be invaluable as we work towards strengthening our 

Healthcare Systems in the future. 

In a recent publication by Forbes contributor Bernard Marr, Dec 6, 2022, Mr. Marr provides 

an overview of trends that are addressing some of the challenges described in Dr. Winkler’s 

article. Mr. Marr describes the many uses of artificial intelligence in healthcare delivery. He gives 

examples such as remote surgery, virtual hospital wards, virtual homecare and the building of 

online communities linked to specific health conditions that can provide information, education, 

and support. The public has already integrated the use of wearable medical devices to monitor 

health and track sleep patterns, activity, vitals signs, blood pressure, and EKGs to aid in the 

management of chronic medical conditions. 

Financial recovery also requires resiliency and innovation. Administrators and Leaders must 

support the optimization of private and Medicare/Medicaid value-based care models without 

further burdening the frontline providers and staff. Embracing the opportunities made available 

through technology and artificial intelligence affords our healthcare systems the ability to move 

forward and gain advances in healthcare. 

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Global Health 




Section Editor: Sarah Cordisco, RN 

Staff Nurse at the University of Vermont 

Cesarean Sections 

Written by Sarah Cordisco, RN 

Perspective 


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Reflections 

Welcome 

Global Local 







Across the globe, the maternal mortality rate is decreasing, yet remains extremely high. In 

2020, about 287,000 women died during and after pregnancy and childbirth (WHO), most of 

which could have been prevented. An analysis published in The Lancet, found that maternal 

deaths in LMIC are 100x higher than those in high income countries, and a 1/3rd of all babies 

in some regions do not survive cesarean section. The use of cesarean sections has continued 

to rise globally and now they account for more than 1 in 5 childbirths (or 21% of all births). By 

2030, this number is expected to reach nearly a third or 29% of all births (WHO, 2021). In LMIC 

countries, about 8% of women give birth via cesarean section, which indicates a lack of access 

to this type of surgery compared to MHIC countries where rates are as high as 43% of all births. 

Maternal death rates may be high in LMIC where the cesarean section rate is low due to lack of 

access to resources and care, and lack of surgical intervention in a timely manner. 

Cesarean sections are often lifesaving procedures when vaginal delivery would pose great 

risks, but it is important that health care systems are doing these operations appropriately and 

safely with the proper post-op care; as well as, having the proper indications for this procedure. 

Cesarean sections are typically indicated during labor dystocia, abnormal or intermediate fetal 

heart rate tracing, fetal malpresentation, multiple gestation or suspected fetal macrosomia 

(Safe Prevention of the Primary Cesarean Delivery, 2014.). Some women may also choose to 

have a cesarean section due to their own medical history (such as thrombocytopenia), having 

previous traumatic births, or in cases where a vaginal birth is unwanted. 

While this procedure may be elective or emergent, it is important for women to understand 

the risks and benefits, as well as, the outcomes, specifically in the realm of maternal and 

natal deaths. In LMIC the risk of death while undergoing a cesarean section was 7.6 per 1000 

procedures, the highest burden being in Sub-Saharan Africa. The overall rate of stillbirths in 

babies born via C-section was about 56 per 1000, with the highest rates in sub-Saharan African 

(82.5/1000). The risk of infant death (stillbirths 




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or deaths within the first week of life) is about 84 per 1000 C-sections, with the highest rates 

in the Middle East and North Africa (Study, 2019). Women undergoing emergency C-sections 

are also twice as likely to die compared to those who had elected to have a C-section, and 

this risk increased 12x when the surgery was performed during the second stage of labor. 

Similarly, the risk of neonatal deaths increased 5x with emergency C-sections compared to 

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elective and 10x when the procedure happened during the second stage of labor, compared 

to the first. About a third of all maternal deaths associated with a cesarean section occur due 

to postpartum hemorrhage (32%), pre-eclampsia (19%), sepsis (22%) and anesthesia-related 

causes (14%) (Study, 2019). 

Through the research on the outcomes of this procedure, the gaps in resources, skill and 

knowledge about C-sections are seen and highlight the need for more training and education. 

There is a high need for interventions and implementation strategies to be put in place to ensure 

that this life saving procedure is done correctly and has the appropriate health outcomes. 

References 

Caesarean section rates continue to rise, amid growing inequalities in access. (n.d.). Retrieved 

April 24, 2023, from https://www.who.int/news/item/16-06-2021-caesarean-section-ratescontinue-to-rise-amid-growing-inequalities-in-access 

Maternal mortality. (n.d.). Retrieved April 24, 2023, from https://www.who.int/news room/factsheets/detail/maternal-mortality 

Perspective 


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Study: Maternal deaths from cesarean sections far higher in low and middle-income countries. 

(2019, March 29). News-Medical.Net. https://www.newsmedical.net/news/20190329/Study- 

Maternal-deaths-from-cesarean-sections-farhigher-in-low-and-middle-income-countries.aspx 

Study: Maternal deaths from cesarean sections far higher in low and middle-income countries. 

(2019, March 29). News-Medical.Net. https://www.news-medical.net/news/20190329/Study- 

Maternal-deaths-from-cesarean-sections-far-higher-in-low-and-middle-income-countries. 

aspx 

Safe Prevention of the Primary Cesarean Delivery. (2014). Retrieved April 24, 2023, from https:// 

www.acog.org/en/clinical/clinical-guidance/obstetric-careconsensus/articles/2014/03/safeprevention-of-the-primary-cesarean-delivery 

Global Local 










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Nantucket (Michelle Connor) 

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33

OUR PEOPLE, 

OUR MISSION 

Hello everyone, 


Global Health 



We are writing to express our sincerest gratitude for your generous donation to our recent 

fundraiser for the small school in Uganda with a big name “Legacy”. Thanks to your kindness and 

generosity, we were able to raise a total of $4250, which allowed us to purchase the following: 

1. Playground including swing set, spinner and multifunctional unit along with soccer balls 

2. Desks 

3. Backpack for each kid which included a pencil storage unit, stack of 10 notebooks, 10 

pencils, a crayon set, a coloring pencil set, sharpness, erasers, and colored pens. 

4. Crocs for each kid 

5. Candy goodie bags 

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6. Textbooks for teachers per grade level 

7. White chalk and colored chalk for each classroom along with erasers 

8. Mini library encompassing atlas, dictionary and fun reading books. 

Your contribution has made a significant difference in the lives of these children and their 

community. They now have access to the basic necessities that they need to succeed in school, 

which will help them build a brighter future. We are incredibly grateful for your support in making 

this possible. We are excited to let you know that we have recently released a video that 

showcases the impact of your donation. The video shows the children at “Legacy” using the 

school supplies and playing on the new playground. It is truly heartwarming to see the joy and 

gratitude on their faces. You can view the video on our YouTube channel at https://youtu.be/ 

rcwqMy83_w0. We hope that you will take the time to watch it and see the impact that your 

donation has made. Once again, thank you so much for your support. We could not have done 

this without your generosity and kindness. 

Sincerely, Asima, Alla and Arezou, 

PGY-3 residents at Connecticut Institute For Communities 





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OUR PEOPLE, 

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Announcements 


The Second Global Health Conference 

Welcome 

Dear colleagues and friends of the Global Health Program, 

It is with great pleasure that we invite you to the Second Annual Nuvance Health/UVMLCOM 

Global Health Conference, which will be held from June 4th through June 6th, 2023. We hope 

to create a thoughtful educational platform for the exchange of information and ideas, with 

networking and reflection, on our decade long journey together. Our hope is to build stronger 

partnerships and friendships with the goal of improving patient care through enhancement of 

medical education. 

On behalf of the Global Health Team, 

The Directors of the Second Global Health Conference 

Majid Sadigh, MD, 

Director of Global Health Nuvance Health/ UVMLCOM, Christian J. Trefz Family, Endowed Chair in Global 

Health at Nuvance Health 

Mariah McNamara, MD 

Associate Director of Global Health Nuvance Health/ UVMLCOM 

Link to the program and registration 

Home | The Second Global He (globalhealthday2023.com) 



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OUR PEOPLE, 

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Addressing the issue of a depleting health workforce in subSaharan 

Africa 

Lancet, May 20, 2023 

Naomi Chinyere Chikezie, Deborah Oluwaseun Shomuyiwa, Ebere Angela Okoli, Ifebuche Maureen Onah, 

Oluwaseun Omolade Adekoya, *Greatman Adiela Owhor, Adeniyi Ayinde Abdulwahab 

Health-care workers have a crucial role in improving health outcomes, and their migration 

has harmed the quality of health services in sub-Saharan Africa. The region has 25% of global 

diseases,1 and only 3% of health workers globally, highlighting a severe shortage of skilled 

professionals to tackle high rates of mortality. The main reasons for migration are poor working 

conditions, low remuneration, and a scarcity of career development opportunities. Insecurity 

and high crime rates also contribute to migration in countries such as South Africa.1, 2 

A study done in South Africa showed that the main reasons health professionals migrated were 

corruption, personal and family safety, poor infrastructure, and their children’s future.3 To address 

this issue, the retention of health-care workers should be prioritised in the national planning 

process. Incentive packages, better work environments, team training, and opportunities for 

career advancement can improve job satisfaction and develop positive work attitudes. 

Harnessing technology can also benefit health-care systems by facilitating patient education, 

providing seamless access to medical records, and reducing the workload of health-care 

professionals.4 Improving community health workers’ programmes will help to enhance service 

delivery.5 Creating a balance of duties so that professionals’ activities match their qualifications 

can improve working conditions in health systems. 

A global survey from the Organisation for Economic Co-operation and Development found that 

79% of nurses and 76% of doctors were carrying out processes for which they were overqualified.6 

Restructuring service delivery processes to minimise tasks and optimise disease management 

and service delivery is integral to addressing this issue. The mobilisation of preventive healthcare 

approaches in health systems can also work in the long term to reduce the workload of 

health-care professionals, reduce emergency rates, and prevent complications. 

Overall, the depletion of the health workforce in sub-Saharan Africa is a crucial issue. Retention 

of health-care workers depends on the creation of supportive environments that enhance 

service delivery, work culture, and systems to improve population health outcomes. Improving 

the health delivery landscape in sub-Saharan Africa is essential to retain the health workforce 

and reduce migration. Policy development is required to promote retention, provide technology 

to optimise service delivery, improve work packages, and revamp health care; ultimately, 

enhancing preventive care can stall the depletion of the health workforce and improve the 

quality of care. 



Addressing the issue of depleting health workforce in Sub Saharan Africa 

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OUR PEOPLE, 

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Global Health 



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We went to visit a primary school with very limited resources in a small rural community. It was 

a humbling experience to be with children who were so happy and joyful despite not having 

the bare minimum needs in a school. After seeing that school and the hardships those children 

are going through to obtain an education, Alla, Arezou and I decided to raise funds to help the 

school out. 

Link to the video: 

To watch the video, please visit https://www.youtube.com/watch?v=ZE6j3agnkZE. 






Another example of the beauty and blessings the GH program brings to the world, fueled by 

caring and generous hearts. 

SK 





Announcements 



This is such a beautiful and powerful story. 

It is so moving to see the joy in those who are receiving the gift but also in the young narrator/ 

benefactor who said “this is the happiest day of my life”. 

God bless all of them for their love of fellow man. 

JM 


Phoro News 


Resources 

Such a beautiful video capturing the pure joy and happiness of children and even adults, upon 

their receiving such a gift. Glorious smiles that warm the heart. Thank you for sharing. 

PA 

37 

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OUR PEOPLE, 

OUR MISSION 

Global Health 


Written by Stephen Scholand, MD 


Congratulations to our dear Dr. Khoa, on his graduation with a Masters in Health Professions 

Education from Boston University. 


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Accompanying Dr. Khoa are Stanley Kowalski III 

and Truong Nguyen, medical technologist - who 

fully supported Dr. Khoa in Boston. 

We proudly celebrated the graduation of Dr. Khoa, our esteemed Nuvance Global Health 

scholar and now faculty, on May 18, 2023. It was a perfect day – and absolutely wonderful to 

share in his successes along with other graduates from Boston University. The occasion filled us 

with pride and anticipation for the future of healthcare in Vietnam. 

Dr. Khoa trained at Vietnam’s prestigious University of Medicine and Pharmacy at Ho Chi Minh 

City. He has consistently amazed us with his exceptional dedication and pursuit of excellence. 

He has a genuine passion for health education that is exemplified by his active involvement in 

our Nuvance Global Health program. He ultimately envisions promoting educational reforms 

and advancements in Vietnam, particularly for vulnerable populations. 

Dr. Khoa’s successful completion of his Masters in Health Professions Education showcases his 

remarkable intellect and unwavering commitment to advancing medical education. We eagerly 

anticipate the transformative changes and invaluable contributions he will continue to make in 

the field of Global Health. 

Congratulations Dr. Khoa! 




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To Julia Nyamururu, BSc 

The new coordinator of the global health program at 

University of Zimbabwe faculty of Medicine and Health 

Sciences 

Julia Nyamururu works at the University of Zimbabwe 

under the Faculty of Medicine and Health Sciences in 

the Electives Office as Office Manager since 2008 up to 

date. She is a holder of a BSc Psychology from Women’s 

University in Africa. She is a passionate young lady, selfmotivated 

and a goal getter. 

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OUR PEOPLE, 

OUR MISSION 

Photo News 

Global Health 


ECC Soccer 2023 


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ECC Soccer 2023: from left: Roberto Alves (Community 

Leader, Mayoral Candidate for Dems party in Danbury) 

and Javier Rincon, a UVM medical student. 

ECC Soccer 2023: Javier Rincon, Elvis Novas, Wilson 

Hernandez and Leonardo Cordova (President of 

Ecuadorian Civic Center) with his grandson 

ECC Soccer 2023: from left: Elvis Novas, CT State Senator 

Julie Kushner, Wilson Hernandez (Community Leader and 

former President of the Ecuadorian Civic Center), Roberto 

Alves, Javier Rincon and CT State Rep. Farley Santos 

ECC Soccer 2023: from left: Danbury Mayor Dean 

Esposito, Miss Sports 2023 and Najely Clavijo (Miss 

Sympathy) 


Resources 

ECC Soccer 2023: Master of Ceremony Eva Aveiga (CEO 

of Miss Danbury CT), Leonardo Cordova and CT State 

Senator Julie Kushner 

ECC Soccer 2023: The participating teams 

39

OUR PEOPLE, 

OUR MISSION 

Graduation of Dr. Khoa 

Global Health 



Global Health Scholars 

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From left to right: Dr Trinh Ngoc Thanh (Vietnam), 

Shushanik Isahakyan (Armenia), Dr Pham Le Anh Nguyen 

(Vietnam), Dr Gabriel Polanco (DR) 

GH Scholars in front of the GH Academy building: Dr Trinh 

Ngoc Thanh (Vietnam), Shushanik Isahakyan (Armenia), Dr 

Gabriel Polanco (DR), Dr Pham Le Anh Nguyen (Vietnam) 

GH Scholars in Danbury 

40

OUR PEOPLE, 

OUR MISSION 

Global Health 



Scholars with Beth West, the director of PT Teaching Academy 

Shushanik Isahakyan and Dr. Karen Daley in 

simulation lab at Sacred Heart University 

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Ireland (Lana Wallace) 

41

OUR PEOPLE, 

OUR MISSION 

Global Health 



Nuvance Health 


May 1: Finalized the global health diaries with Mitra Sadigh and Amanda Wallace 

May 1: Finalized the global health eMagazine with Mitra Sadigh and Amanda Wallace 

May 1: Meeting with educational leadership to learn about the future direction of global health 

partnership with the UVMLCOM 

May 1: Meeting with Grace Linhard, the Chief Development Officer at NVH, to discuss the 

structure and function of the global health academy executive committee 

May 1: Meeting with Dilyara Nurkhametova and Elina Mukhametshina to discuss the content of 

the 2nd Global Health Conference 

May 1: Meeting with Wendi Cuscina to discuss the logistics of the Global Health Conference 

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May 2: Meeting with Professor Christina Gunther, the director of the global health program 

at SHU to discuss further collaboration between global health programs between these two 

institutions 

May 2: Meeting with one of Yale college students interested in global health 

May 3: Meeting with the global health conference logistic team 

May 3: Meeting with Wendi Cuscina to discuss the statuses of international guests travel to the 

USA to attend the global health conference 

May 3: Debriefing session with Dr. Joanna Moore, the pulmonary fellow at Norwalk Hospital to 

discuss her observation from Vietnam and her involvement in global health program 

May 4: Meeting with Dr. Mark Kulaga, DIO at Nuvance Health, to discuss future direction of 

partnership with UVMLCOM 

May 5: Meeting with Elina Mukhametshina to learn about her potential visit to the USA and 

follow up on the content of the global health conference 

May 7-8: Finalized the global health diaries with Mitra Sadigh and Amanda Wallace 

May 8: Global Health Monthly Meeting with CAO, Dr. Dereck DeLeon 

May 8: Introducing the Global Health Program to the nursing staff at VBMC 

May 9: Meeting with the educational leadership to discuss the future of the global health 

partnership with UVMLCOM 

May 9: UVMLCOM Global Health Leadership Team meeting 

May 9: Meeting with Dr. Dereck DeLeon, DIO, and the legal office to discuss Dr. Bulat Ziganshin’s 

contract as the new director for the global health program 

May 10: Global Health Conference preparation meeting with the logistic team 

May 10: Global Health Conference preparation meeting with Wendi Cuscina, the manager of 

the program 

May 11: Meeting with Dr. John Murphy, the president and the CEO of the Nuvance Health to 

discuss the future directions for the global health academy 

May 11: Meeting with Beth West, the director of PT Teaching Academy to discuss the future 

collaboration between global health academy and PT teaching Academy 

May 15: Meeting with the NVH global health leadership to discuss the content and logistics of 

the itinerary for the coordinator of the global health program in Armenia. 

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OUR PEOPLE, 

OUR MISSION 

Global Health 



May 15: Meeting with Dr. Rudy Ruggles to discuss the panel on global mental health during the 

global health conference. 

May 15: Meeting with Dr. Andrea Green and Beth West to discuss potential projects between the 

NVH global health program and UNIBE in Dominican Republic 

May 16: Review of the quarterly goals with CAO 

May 17: The Global Health Medical Grand Rounds at Danbury Hospital 

May 17: Debriefing zoom meeting with recently returned residents from Naggalama, Uganda 

May 17: Debriefing zoom meeting with Dilyara Nurkhametova to finalize the travel of 3 psychiatry 

residents from Nuvance Health to Uganda 

May 17: Zoom meeting with Dr. Bulat Ziganshin in preparation for the second global health 

conference, June 4-6 

May 17: GH pre-departure session for UVMLCOM MS1 students in preparation for summer GH 

electives 

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May 18: Zoom meeting with Susan Byekwaso, the coordinator of the international office at MakCHS 

to discuss the A/V studio and the second global health conference 

May 18: Zoom meeting with Wendi Cuscina and Dr. Dereck DeLeon, CAO, to finalize the recruitment 

of a faculty for the global health program 

May 18: Meeting with Elina Mukhametshina to finalize the itinerary for the coordinator of the global 

health program in Armenia 

May 18: In person meeting with John Leopold, the director of Simulation lab to discuss collaborative 

work with UNIBE to design of modules addressing the challenges of participants of global health 

elective 

May 19: A tribute to Dr. Simms at St. Mary Hospital 

May 19: Finalizing the research project in Dingle with Dean and Catherine Winkler 

May 18-20: Finalized the website of the Second Global Health Conference with Amanda Wallace 

May 20- 21: Finalized the global health diaries with Mitra Sadigh and Amanda Wallace 

May 21: Discussion around the second global health conference with Dr. Stephen Scholand 

May 22: Orientation session; coordinator of the global health program in Armenia, with Wendi 

Cuscina 

May 22: Orientation session; coordinator of the global health program in Armenia, with Dr. Bemen 

Habashi, Yale Faculty in Waterbury Hospital 

May 22: Global Health Leadership Team meeting 

May 23: The first day of the Global Health Course for the global health scholars at Nuvance Health 

May 24: Visiting Norwalk Hospital to explore potentials for collaboration with NIH and identify 

overlap interests between the PT Teaching Academy and the Global Health Academy 

May 25: Visiting SHU to explore potentials for collaboration with NIH in Armenia 

May 26: Discussion of the content of the global health conference with Dr. Stephen Scholand 

May 27: Zoom meeting with one of the global health faculty in London 

May 28-29: Finalized the global health diaries with Mitra Sadigh and Amanda Wallace 

May 29: Finalized poster presentations, excerpts from reflections, and selected photos for 

exhibitions and slideshow with Dilyara Nurkhametova, the assistant director of the global health 

program 

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OUR PEOPLE, 

OUR MISSION 

May 30: The Second day of the Global Health Course for the global health scholars at Nuvance 

Health 

May 28-31: Finalized the June issue of eMagazine with the global health leadership and 

Amanda Wallace 

Global Health 



AUC/RUSM 

May 2: Touch base meeting with Dr Elina Mukhametshina 

May 3: Meeting with Dr Elina Mukhametshina to work on the GHE application package 

May 5: CIFC residents completed their GHE in Uganda 

May 8: Orientation meeting with two AUC/RUSM students in preparation for GHE in Vietnam in 

June 

May 10: Touch base meeting with Dr Elina Mukhametshina 

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May 11: Meeting with Susan Byekwaso international coordinator at MakCHS 

May 15: two AUC students started their GHE in ChoRay hospital, Vietnam 

May 16: Orientation meeting with two AUC students in preparation for GHE in DR 

May 22: Meeting with Dr Elina Mukhametshina to review Shushanik Isahakyan visit itinerary 

May 23: Meeting with Dr Elina Mukhametshina 

May 23: Meeting with Jeffrey Andreson to discuss application process for 2024 AUC/RUSM 

Global Health Electives 









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Butterfly (Rose Schwartz) 

44

OUR PEOPLE, 

OUR MISSION 

RESOURCES 

Global Health 



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Highlights 

Reflections 

Welcome 

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Announcements 




Phoro News 


Resources 

Photos and Reflections 2021 

Global Health & the Arts 

Nuvance Health and UVMLCOM Global Health 

Website 


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 



Global Health Diaries and eMagazines 2018-2019 

Global Health eMagazines 2020-2021 

Global Health Diaries 2020-2021 

Global Health Reflections and Photos 2017 and 2018 

Global Health Reflections and Photos 2019 

Ethical Dilemmas book 

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 

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) 

Kasensero Uganda 

Katanga video 

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 eMagazine 

Program Partners 

Publications 

Site Specific Information 

Tropical Medicine Booklets (101, and 202) 

Tropical Medicine Spanish 101 

Tropical Medicine Modules 

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 

45

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