Tag Archives: global health

More Surgery for Better Global Health: Dr. Mark Shrime

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Is surgery too expensive for global health?

expensive photo
Is surgery ‘too expensive’ for global health?

Mark Shrime is an otolaryngologist (and American Ninja Warrior competitor) who may just be on the leading edge of change in the way global health sees surgery.  In this conversation with Tony Mai, Amanda Manorot, Brian Wall, and Hadeal Ayoub, Dr. Shrime argues that the way surgery is used in international development to date–surgeons fly in for two weeks, do their thing, and fly back out–doesn’t do much to allow their host countries to develop their own surgery skills.  For his part, he’s managed to arrange his work at Harvard to allow him two months abroad helping to strengthen health systems in countries like Congo, Haiti, Cameroon, and Madagascar.

The problem is, policy-makers see surgery as ‘too expensive,’ disregarding it as a tool for global health intervention.  Ebola and Zika therefore get all the attention.  But analysis of the cost-effectiveness of surgery as a tool in global health efforts belies this view, and shows the burden of surgical diseases may be as high as a third of the global total.  Fortunately, Dr. Shrime has good advice for future surgeons who face a system that embraces Relative Value Units as a measure of physician performance, and yet want to pursue work outside their hospitals to effect global healthcare change.

We Want to Hear From You

What are your thoughts on the effort to elevate surgery as a global health intervention? Any thoughts on who we should interview next? Call us at 347-SHORTCT anytime, visit our Facebook group, or email theshortcoats@gmail.com to share your ideas.

Continue reading More Surgery for Better Global Health: Dr. Mark Shrime

Doctors Without Borders, and the Future of Humanitarian Intervention

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John Lawrence, MD
John Lawrence, MD

Dr. John Lawrence returns to the show to talk about MSF, or Doctors with Borders, as it’s known in the United States. Dr. Lawrence has been with the organization since 2009, and is the vice president of its USA board of directors. MSF has played a major role in delivering emergency aid during crises around the world. In 2014, the most recent year for which MSF has published statistics, the aid organization was active in more than 60 countries, most memorably in war-torn Syria and in West Africa with its Ebola outbreak.
Continue reading Doctors Without Borders, and the Future of Humanitarian Intervention

Dr. Paul Farmer and Liberation Medicine

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"Any serious examination of epidemic disease has always shown that microbes also make a preferential option for the poor. But medicine and its practitioners, even in public health, do so all too rarely." -Paul Farmer, MD, PhD
“Any serious examination of epidemic disease has always shown that microbes also make a preferential option for the poor. But medicine and its practitioners, even in public health, do so all too rarely.” -Paul Farmer, MD, PhD. From left to right: Petra Hahn, Greg Yungtum, Paul Farmer, Katie Ryken, Josh Bleicher, and Jordan Harbaugh-Williams
Dr. Paul Farmer is sort of the rock god of global health.  He’s an incredibly busy and influential guy, so when he flew in from Liberia to spend the entire day here with us at the Carver College of Medicine, it wasn’t easy to keep the stars from our eyes.  Of course, he’s a physician, but he’s also a medical anthropologist, chief of Brigham and Women’s Division of Global Health Equity, professor of medicine at Harvard, and the UN Special Adviser to the Secretary-General on Community Based Medicine and Lessons from Haiti.  One of the things you notice about Dr. Farmer is that although he’s clearly a celebrity in his field, it doesn’t dampen his enthusiasm, idealism, and the pleasure he takes in meeting students who share his passion for understanding and changing how healthcare is delivered to the world’s neediest people.
Continue reading Dr. Paul Farmer and Liberation Medicine

Episode 024: John Lawrence, Doctors Without Borders, and Syria

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A simple field hospital in Syria.  Flickr: FreedomHouse

Syria is in the midst of a civil war.  As a measure of the seriousness of the situation, a Reuters report out recently says that the war has claimed the lives of 115,000 people.  And with 5000 of those deaths in September alone, it seems as though international pressure to eliminate Syria’s chemical weapons hasn’t slowed the war down at all.  The UN reports that only twelve international aid organizations are approved by Syrian officials to work in country. One of those is Doctors Without Borders, or Medecins Sans Frontieres.  This time on The Short Coat Podcast, we welcome back Dr. John Lawrence, pediatric surgeon and associate professor of Surgery at the University of Vermont College of Medicine. and formerly of the University of Iowa Carver College of Medicine.  Dr. Lawrence has performed six surgical missions working with MSF, and he’s come to Iowa to talk about Syria, from which he’s recently returned.  Not long ago, medical students Jessica Gaulter, Katherine Ryken, and Ethan Forsgren sat down to talk with him about his experiences with MSF and in Syria.

Listen now–Episode 024: John Lawrence, Doctors Without  Borders, and Syria

The opinions expressed in this feed and podcast are not those of the University of Iowa or the Roy J. and Lucille A. Carver College of Medicine.

Episode 014: Doctors Without Borders, Part 2

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Welcome back for Part 2 of Dr. John Lawrence’s discussion on Doctors Without Borders (here’s Part 1).

In 1971, a group of doctors and journalists in France got together to create Medecins Sans Frontieres.  Today, MSF, or Doctors Without Borders, boasts more than 27,000 committed individuals representing dozens of nationalities who provide assistance to people caught in crises around the world. They are doctors, nurses, logistics experts, administrators, epidemiologists, laboratory technicians, mental health professionals and others who work in more than 60 countries helping people whose survival is threatened by violence, neglect, or catastrophe.  They also bring attention to neglected crises, challenge inadequacies or abuses of the aid system, and to advocate for improved medical treatments and protocols.

In the second part of this two-part episode of The Short Coat, Dr. John Lawrence, formerly associate professor of surgery at the University of Iowa and now at the University of Vermont, continues to discuss his work in Doctors Without Borders.

Special thanks to the Carver College of Medicine’s Global Programs department, and to Mo Yacoub for production assistance! 

Listen: Episode 014: Doctors Without Borders, Part 2
Or, start with Part 1.

The opinions expressed in this feed and podcast are not those of the University of Iowa or the Roy J. and Lucille A. Carver College of Medicine.

Episode 014: Doctors Without Borders, Part 1

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In 1971, a group of doctors and journalists in France got together to create Medecins Sans Frontieres.  Today, MSF, or Doctors Without Borders, boasts more than 27,000 committed individuals representing dozens of nationalities who provide assistance to people caught in crises around the world. They are doctors, nurses, logistics experts, administrators, epidemiologists, laboratory technicians, mental health professionals and others who work in more than 60 countries helping people whose survival is threatened by violence, neglect, or catastrophe.  They also bring attention to neglected crises, challenge inadequacies or abuses of the aid system, and to advocate for improved medical treatments and protocols.

In this two-part episode of The Short Coat, Dr. John Lawrence, formerly associate professor of surgery at the University of Iowa and now at the University of Vermont, returns to the Carver College of Medicine to discuss his work in Doctors Without Borders.

Special thanks to the Carver College of Medicine’s Global Programs department, and to Mo Yacoub for production assistance! 

Listen: Episode 014: Doctors Without Borders

The opinions expressed in this feed and podcast are not those of the University of Iowa or the Roy J. and Lucille A. Carver College of Medicine.

Episode 012: Dr. Mansoor Ali Khan, Clubfoot, and The Ponseti Method

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Clubfoot is a congenital deformity of the foot, and affects between 150,000 and 200,000 babies each year worldwide. Extensive surgery was once the standard of care for clubfoot, improving the appearance of the foot but resulting in poor mobility and pain in midlife. Dr. Ignacio Ponseti, a Univeristy of Iowa Physician, pioneered what has become known as the Ponseti method. It involves manipulation of the newborn’s feet via casting and splinting, and has replaced surgery as the standard of care.
While the Ponseti Method doesn’t involve expensive surgeries or equipment, it does require detailed knowledge of both the anatomy of the foot and the method itself. In the case of clubfoot, the key to a cure is the education of physicians. Easy enough in the US and other developed countries. But 80% of cases occur in the developing nations, and most babies are left untreated or receive substandard care. it is difficult for physicians there to get the information they need to perform the method correctly.

To date, spreading the Ponseti Method involved visits by physicians from the developed world to the developing world to teach and perform the method. But Carver College of Medicine student Asitha Jayawardena’shealthcare experiences in South America lead him to the notion that educating one leader on the topic would allow them to spread the method among his colleagues in a culturally appropriate manner. At his urging, The American Medical Student Association created the Ponseti Scholairship to help spread the technique.

Recently, Asitha sat down with Dr. Mansoor Ali Khan, an orthopaedic surgeon from The Indus Hospital in Karachi, Pakistan, and the Ponseti Scholarship’s first beneficiary, to talk about Khan’s experiences at the University of Iowa as he learns more about the Ponseti Method.
 
Listen:  Dr. Mansoor Ali Khan, Clubfoot, and The Ponseti Method

The opinions expressed in this feed and podcast are not those of the University of Iowa or the Roy J. and Lucille A. Carver College of Medicine.