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In This Issue:
From left, Jean Ainé Pretanvil, Tieho Nichola Lesia and Raymond Dusabe.
“After here, things will never be the same again.”
That’s how strongly Dr. Tieho Nichola Lesia, or “Dr. Nico,” of Lesotho, Africa, felt about a new program that brought him and two other physicians from Partners In Health (PIH) sites to BWH this summer.
“This thing opened our eyes,” said the physician, one of BWH’s first Smith Family Visiting Scholars in Global Health Equity. “We feel this equipped us with skills to not only focus on individual patients, but to look at problems more broadly.”
Dr. Nico, along with Dr. Raymond Dusabe or “Dr. Raymond” of PIH Rwanda at Kirehe District Hospital, and Dr. Jean Ainé Pretanvil of Zanmi Lasante in Haiti, attended rounds and teaching conferences and shadowed interns and residents for three weeks. Prior to that, they attended a three-week Global Health Effectiveness course co-sponsored by the Global Health Delivery Project, Harvard School of Public Health and Harvard Medical School with 26 students from 12 countries.
“We send our BWH Global Health Equity residents to Haiti and Africa where they are trained by local physicians working alongside BWH faculty,” said Joseph Rhatigan, MD, director of the Doris and Howard Hiatt Residency in Global Health Equity. “By bringing some of these local physicians to BWH, we are striving to give them the same learning opportunities they give our residents.”
This exchange was the brainchild of longtime BWH supporters Sandford and Ellan Smith, who brought it to fruition with their physician, Marshall Wolf, MD, director of medical residency programs emeritus, and the Division of Global Health Equity’s chief Paul Farmer, MD, PhD, former chief Jim Kim, MD, PhD, Joia Mukherjee, MD, MPH, and Rhatigan. Professional development for in-country clinical staff has long been a top priority for PIH.
“The Brigham and Partners In Health do wonderful work in sending physicians to poorer countries, but I thought something was missing,” said Sandford Smith, who focuses on the international side of health care. “If we could bring doctors from developing countries here, they would return home with greater knowledge and share that with their communities. Ultimately, that would create a higher level of care in these countries.”
The Smiths’ gift supported all the costs of this unique program for three years. They also made a bequest in their estate to ensure the program will continue into the future.
“We’ve been privileged to get to know these amazing physicians, who took time away from their families and communities to take part in this inaugural program,” Smith said. “Improving patient care is their life’s mission.”
Plans to enhance the program next year include extending the academic portion another week to allocate one day each of these weeks to be spent at the hospital. “This way, the doctors will see more of the hospital and think about what they want to focus on during the subsequent three weeks of clinical training,” Wolf said.
Dr. Pretanvil, Dr. Raymond and Dr. Nico are grateful for the experience.
“It gave us ideas about health programs and not only how to control diseases like HIV, TB and malaria, but also to plan to prevent them,” said Dr. Pretanvil.
Dr. Raymond added, “It’s helping us to figure out what our objectives are and how to work with nongovernmental organizations to achieve them.”
The program also created a bond among the three doctors, who said they will continue to share their experiences with each other. “From the first day we met here, it was like we were a bunch of brothers,” Dr. Nico said. “Partners In Health is the same everywhere.”
They connected over the PIH philosophy of a community-based care model and know that they will keep in touch, sharing the ideas and changes they bring back to their respective countries. “PIH helps the poorest of the poor,” said Dr. Raymond. “It’s not just about treating a disease, it’s about helping people to change and helping them change the social problems that could lead to disease.”
What strikes them in particular about BWH is the abundance of technology and the way it supports physicians in diagnosing diseases and conditions. “We have one CT scanner in the whole country of Lesotho, and it’s in the central hospital,” said Dr. Nico.
In addition to the training at BWH, the scholars enjoyed the teaching style at HSPH and HMS, where they were surprised to find class discussions were the norm, and that every student was encouraged to share their experiences. “We can learn a lot from this type of teaching,” said Dr. Raymond.
Smith noted that the course offered an opportunity for these physicians to network with students from many other countries, something he hopes they continue to do.
“If the outcome of this program could be a new community of physicians around the world that share the same vision through the Global Health Equity program, we’d accomplish our mission,” he said. “It’s exciting to be involved in the architecture of a truly pioneering program that will become even more robust. We’re just beginning.”