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Post by Admin on Dec 13, 2021 18:42:57 GMT
Name one global health project/initiative you read about, or you have participated in that was successful and describe why you think it succeeded. What aspects made it different from projects that you’ve read about or seen fail?
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Post by Camille Robinson on Dec 14, 2021 15:58:33 GMT
A successful project I have participated in was started at my medical school by a Family Medicine physician in the town of Andahuaylillas, Peru. He had traveled there for multiple years in a row with a physician who was from there to provide medical care. With that local connection, he was able to build a longstanding partnership with the local government and municipality where they continued to invite him back. He was able to grow the project into something larger than himself where the local government would dictate the communities we would visit and where we might offer basic care. It increased to 2 trips a year with medical student, physicians, nurses, NPs and dentists all would participate. We were visiting towns deep into the mountains with little access to care. We were mostly treating acute illnesses like infections, diarrhea, tooth cavities, vaginitis, etc. When we found something that needed a higher level of attention we would help get that person to the local hospital. In this sense, we were not disturbing the existing medical infrastructure but instead working with them and supplementing them. The places we visited did not have a local physician so we were also not undermining a local practitioner. This worked better than other mission trips I had been where we were directed to go by the government but we did not seem welcome by the local physicians, there was a definite strain on that relationship, and it was a one and done approach where a longstanding partnership was not occurring. While I did not know it at this time, these types of trips are often more damaging.
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Post by Audrey on Jan 7, 2022 0:00:45 GMT
During my last year of college, I was able to volunteer with an NGO called the Arizona Sonora Border Organization (ARSOBO). ARSOBO is a collaborative organization between the border city of Nogales, Mexico and the University of Arizona which is a two hour drive away. ARSOBO provides assistive devices to disabled people living in Nogales in an effort to address the health disparities and social inequality in this local border community. ARSOBO manufactures and provides wheelchairs, leg prosthetics, and hearing aids. They are primarily run by locals who build the devices in a warehouse provided by the government at no cost. The University of Arizona sends technicians to help build and repair the devices and helps obtain supplies from private manufacturers in Arizona. Volunteer physicians and speech language pathologists work in the clinic caring for patients with diabetes, vascular disease, and hearing loss. One of the core principles of this project is training and employing individuals with disabilities to build medical devices for use by others. The wheelchairs are built by two skilled technicians who live in Nogales and also use the wheelchairs themselves. This way, ARSOBO empowers the people they serve and builds capacity and sustainability of the organization. It also helps for people purchasing these devices to know that the providers actually use the devices themselves. Another core principle is charging families for these devices but only what they can afford. The local leadership felt that this policy was necessary to respect the dignity of the recipients and to encourage people to take ownership of their devices. Their thought was that if the devices were provided as charitable donations, the recipients might feel ashamed and disempowered. They hypothesized that the recipients would be less inclined to take the devices in for routine repairs if they did not have some sense of ownership of the device. The sliding scale method of payment additionally promotes sustainability of the organization. Finally, I think what makes this project successful is that the intervention is individualized to the community it serves. In the past, the organization had received a donation of several motorized wheelchairs to give away to the disabled in Nogales. This failed however because the roads and sidewalks in Nogales are too rocky and uneven for this type of wheelchair and the repairs on these wheelchairs are expensive and time consuming. Instead, ARSOBO manufactures RoughRider wheelchairs which are assembled partially from bicycle parts and work well on hills and rough terrain. This technology is low cost and durable, so that people have better access and the community is empowered by this intervention. sonoranucedd.fcm.arizona.edu/arsobo
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Post by mollybrazil on Jan 10, 2022 3:09:06 GMT
I think both of these examples point to the importance of local stakeholder buy in. Without such, it is hard to gain the trust (and cultural knowledge) necessary for the longevity of these interventions. When a project can seek out ways to assist or improve existing infrastructure, there seems to be a much higher success rate.
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Post by mollybrazil on Jan 10, 2022 3:17:31 GMT
One of the projects I participated in was a large, multi center implementation trial of a low cost intra-uterine device to stop post partum hemorrhage. It ultimately was implemented across multiple countries in sub-Saharan Africa and Asia with great success. I think that most of the success can be attributed to partnering with the Ministries of Health of the individual countries to get governmental buy in, but it also relied heavily on local stakeholders. One of the first step was finding someone in country who could not only identify local practioners that are respected in the community, but was someone who those practioners would respect themselves. Once those midwives and physicians were identified, they received formal training on the device, were encouraged to use it in their own practice, and also were provided with materials to train other community providers. Ultimately the in country providers were who drove the success of the project. Maternal mortality is something that I think just about everyone can support.
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Post by ChristyH on Jan 19, 2022 21:31:54 GMT
I led a group of college students to Guatemala for a week providing basic primary care to rural communities. I felt like this particular trip was successful, because we partnered with local Guatemalan physicians who worked in towns close to the ones we visited, thus providing continuity of care long after our team left. We brought supplies and a few family physicians with us, however, I felt like the focus of the college students was to provide public education and connect the community to their local resources, which would empower them moving forward.
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Post by christyhenderson on Jan 19, 2022 21:32:43 GMT
I led a group of college students to Guatemala for a week providing basic primary care to rural communities. I felt like this particular trip was successful, because we partnered with local Guatemalan physicians who worked in towns close to the ones we visited, thus providing continuity of care long after our team left. We brought supplies and a few family physicians with us, however, I felt like the focus of the college students was to provide public education and connect the community to their local resources, which would empower them moving forward.
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Post by christyhenderson on Jan 19, 2022 21:35:39 GMT
During my last year of college, I was able to volunteer with an NGO called the Arizona Sonora Border Organization (ARSOBO)... What an awesome project! Highly important to identify barriers to use resources that we provide. So often, we think free supplies are always beneficial, but in your case, if they hadn't identified and modified the wheelchairs for local terrain, they would have merely contributed to their waste...
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Post by Camille Robinson on Jan 21, 2022 1:44:29 GMT
As an OBGYN I love hearing about the project using an IUD to help prevent PPH. It makes sense how crucial the local practitioners were in implementing this project as they hold the respect and trust. It can be challenging to implement something new, especially if it is a device you place inside your body. Love to hear how the local midwives and practitioners created that trust to make it a success
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Silky
New Member
Posts: 7
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Post by Silky on Feb 13, 2022 15:21:30 GMT
In medical school, I participated in the UNICEF organized Vitamin A deficiency prevention initiative. The initiative was well-organized and thought out at various levels. First the instructions received were clear and concise, the local medical school preventive medicine professors were in charge of conducting the dose delivery of Vitamin A to the children in underserved areas. Given that medical school faculty was involved, medical students had enthusiasm to volunteer for the mission. The role of medical student was not only to deliver Vitamin A but also to counsel the local families regarding the importance of healthy eating habits and providing options of nutritious food that is inexpensive and easily available. The engagement of local leaders and willingness of volunteers to understand their socioeconomic dynamics and providing assistance based on that was the key to the success of that program.
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Post by alyssaseibold on Apr 30, 2022 0:27:22 GMT
In college I had the opportunity to go to Pucallpa, Peru to volunteer at a medical clinic. The Amor Project was organized by a family medicine physician in the US interested in helping an impoverished community in Peru. With his help, they have created a missionary clinic that allows for access to medical care for those in poverty. They have a full time local physician at the clinic that provides care to patients when there are no volunteers. I think that having a local physician that can provide care to the community as it may not be possible to provide care all at times when solely relying on volunteers. This goes back to the idea of using local resources as when we volunteer and bring outside resources it can hurt the community, especially when the community is expecting volunteers but they cannot meet those expectations at all times. I think this idea leads to the success of the Amor Project as they have a full time local physician who can help out the community.
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