Announcing 2022 Faculty Global Health Grants

The Center for Global Health is pleased to announce the recipients for our latest global health faculty grant awards. These global health grants support faculty pilot research and non-research projects in low- and middle-income countries. Below find more information about the recipients and their respective projects.

Global Health Faculty Pilot Research Grants

Ideas are catalyzed into action through seed grants, helping faculty get their research projects off the ground and advance scientific discoveries.

Project: An Assessment of Maternal Recognition of Neonatal Sepsis following Implementation of Standardized Newborn Discharge Education in Western Uganda

Location: Masindi, Uganda

Sepsis is a leading cause of death in newborns, especially in low- and middle-income countries (LMICs) where the majority of global neonatal mortality occurs. Recognition of the early warning signs of neonatal sepsis by health care providers and mothers can make the difference between death and survival.

Training and education of health workers, and mothers, are vital to improving the outcomes of these newborns. Yet, identifying neonatal sepsis in LMICs remains an ongoing challenge due to a lack of resources and diagnostic tools. Sub-Saharan Africa is the region with the highest neonatal mortality rate at 27 deaths per 100 live births.

Dr. MenkinSmith is partnering with investigators at Masindi Kitara Medical Center, a regional hospital in Western Uganda, on an intervention to address this gap. The primary objective of this study is to identify whether implementing standardized maternal discharge education and a newborn discharge education checklist will lead to improvement in mothers’ ability to identify the danger signs of neonatal illness. The team will also conduct interviews to better identify maternal barriers to education, maternal opinions on educational needs, and how mothers will seek care in case of neonatal sepsis concerns. 

While many high-income countries have standardized protocols for neonatal sepsis, challenges remain in low- and middle-income countries. Thus, interventions to improve mothers’ ability to recognize these warning signs when seeking medical care is one strategy to decrease preventable neonatal deaths in Uganda.

        Dr. Lacey MenkinSmith       
 MUSC College of Medicine

 Dr. Christopher Daly          Dr. Ian Kane         Dr. Kathryn Koval         Dr. Andrea P. Summer       Anthony Alerre    
MUSC College of Medicine

Project: Impacting the Sustainability of Health and Economic Self-Sufficiency Through an Organic Farming Business Model in Rural Ghana

Location: Okurase, Ghana

Small rural farmers, rather than large-scale corporate farms, produce a fair portion of the world's food and stand to make a strong positive impact on food security and health. Despite good agricultural practices, global standards to guide safe farming, and the growth of scientific knowledge of organic farming, implementation is lagging behind among the small rural farmers who could have the greatest impact.

Sustainability is one of the most challenging aspects of interventions in low-income countries. Dr. Swenson's project will leverage the work of the past six years that began with an MUSC Center for Global Health grant to help farmers in Okurase, Ghana convert to organic farming methods.

Results from the initial pilot indicated a successful transition, with 92.9% of farmers reporting seven months later to using solely organic methods. The program was awarded the Ghana Green Label certification, a government standard for producing safe food in an environmentally sustainable way. Farmers were also awarded organic certification through the Participatory Guarantee System, the regulatory body for pure organic farming. The Okurase Organic Farmers Association formed soon afterward. 

Dr. Swenson's current research in Okurase will focus on the sustainability of a successful organic farming project. The objective is to implement and test the Nkabom Organic Farming Business Model, supporting the independent sustainability of healthy farming practices and increasing the economic status of farmers. This intervention, based on extensive input from farmers gathered through preliminary qualitative interviews, provides a structure for farmers to sell their produce plus a reward system for implementing components of the model. The overall focus is to support and empower farmers to work together to increase their earnings and spread organic methods to positively impact health.

 
Dr. Cynthia Cupit Swenson
MUSC College of Medicine

Project: Assessment of Variation between Low- and Middle-Income Countries (LMIC) and High-Income Countries (HIC) Surgical Resident Training Experience and the Development of a Universal Case Log System for LMIC Settings

Locations: Kenya, Tanzania, Gabon, Ethiopia, Niger, Egypt, Madagascar, Malawi, Cameroon

Global surgeons have long recognized the difference in experience trainees receive in low-and middle-income countries (LMIC) versus high-income country (HIC) settings. It is theorized that HIC trainees miss exposure to pathology and technique not encountered in high-resource environments, while LMIC trainees may lag behind in exposure to newer techniques enabled by technological advancement. However, this difference has not been extensively described in the current global health literature.

The intent of Dr. Mallah's project is to address this gap through the development of a free, universal but adaptable surgical resident case log system applicable to low- and middle-income countries. The cloud-based platform will enable the collection of representative and comparable data regarding surgical trainee experiences. Results of the study will be used to identify differences between LMIC and HIC surgical training. Such an understanding would help identify mutually beneficial, bidirectional, and evidence-based educational opportunities for resident exchange programs.

Preliminary data demonstrates a highly disparate experience between LMIC surgical residents and the experience of graduating U.S. general surgery residents. For example, in the United States, 94% of all appendectomies performed by surgical residents are done in a minimally invasive fashion, while in a sample data of Tenwek Hospital in Kenya only 20% are done minimally invasive. Detailing such variations between trainee exposures will identify opportunities for bidirectional learning, not just in general surgery, but across surgical subspecialties.

The pilot study also leverages existing data through a partnership with the Pan-African Academy of Christian Surgeons, which offers general surgery and some specialty-specific surgical training programs, approved and accredited through The College of Surgeons of East, Central, and Southern Africa, at fifteen training sites across nine African countries.

Dr. Mike M. Mallah
MUSC College of Medicine

 Dr. Edgar B. Rodas       Dr. C. Sierra Stingl       Benjamin Cassidy   
   Virginia Commonwealth University   Stanford University     Virginia Commonwealth University

 

Faculty Global Health Impact Grant

This innovative grant supports faculty for non-research projects, including, but not limited to education and training, capacity-building, service, or implementation projects.

Project: Addressing Health Inequalities in Trinidad through the Development of the First Student-Run Free Therapy Clinic

Location: Saint Joseph, Trinidad and Tobago

The concept of student-run free health clinics began in the United States in the 1960s and the number of clinics has increased exponentially over the last two decades in response to the rise in uninsured individuals. At MUSC, the student-run CARES Therapy Clinic provides free therapy services to over 700 uninsured and underinsured patients each year.

The primary goal of Dr. Coker-Bolt's project is to develop the first student-run free therapy clinic in Trinidad through a collaboration between the MUSC faculty and students involved in the CARES Therapy Clinic and faculty and students at the University of the Southern Caribbean (USC). This collaboration would expand training for future rehabilitation providers in Trinidad and also provide access to essential therapy services to hundreds of Trinidadians who currently have limited rehabilitation options.

A formal mentorship program between MUSC and USC faculty and students will initially focus on how to best operationalize a student-run clinic that will fit within the local healthcare system and address priority education and rehabilitation needs in Trinidad. The team plans to open its clinic in the fall of 2022 to offer weekly pediatric and adult therapy sessions.

A peer mentorship program will also be initiated between MUSC students who serve in leadership roles in the CARES Therapy Clinic and USC students. Students from both institutions will learn, first-hand, the issues clients in the U.S. and Trinidad face related to access to quality rehabilitation services. A bi-weekly virtual “Grand Rounds” will be initiated to present clinical cases of patients seen at the Trinidad and MUSC student-run free clinics to help students to situate themselves as therapists and use clinical decision-making skills when evaluating and treating patients under the mentorship of faculty.  

Dr. Patricia Coker-Bolt
MUSC College of Health Professions

Project: Society for Pediatric Anesthesia (SPA) Global Visiting Scholar Program

Location: MUSC and Nairobi, Kenya

The risk of mortality after surgery for children is much higher in East Africa than in the United States. Much of this disparity is due to inadequate workforce and training limitations for pediatric anesthesia. The Society for Pediatric Anesthesia (SPA) Global Scholars Program began as a way to support newly begun pediatric anesthesia fellowship programs in low- and middle-income countries through continued training and a two-week observership at prominent pediatric hospitals in the United States.

Linking the academic resources of centers in the U.S. to anesthesia clinicians and educators in East Africa is a key way to support the development of local leaders for anesthesia capacity building. Dr. Choi's project aims to connect MUSC's Department of Anesthesia and Perioperative Medicine and the SPA Global Scholars program to promote capacity building, as well as provide the potential to expand bi-directional educational and service opportunities.

MUSC will host a SPA-selected fellow from the University of Nairobi. This young leader is expected to become one of only a handful of physician anesthesiologists with pediatric training in Kenya. The fellow will spend two weeks observing all aspects of pediatric anesthesia care at MUSC Shawn Jenkins Children's Hospital while participating and providing lectures to residents and fellows. The fellow will also be sponsored to attend the American Society of Anesthesiologists meeting and mentored to present an abstract and network with other anesthesiologists.

The opportunity for this fellow to engage with the broader anesthesiology community will provide invaluable insight into how anesthesia care can be improved in the local East African context. The relationships built will provide opportunities for MUSC faculty and residents to participate in capacity building for pediatric anesthesia care in East Africa.

Dr. Sung-Wook Choi
College of Medicine

Project: Development and Implementation of Rehabilitation Services at OneWorld Health's Masindi Kitara Medical Center

Location: Masindi, Uganda

People in low- and middle-income countries have poor access to rehabilitation services. One critical barrier is the shortage of trained health professionals who can deliver those services. In Uganda, the World Physical Therapy Confederation estimates there are 0.09 physical therapists available - versus 9.56 in the U.S. - for every 10,000 citizens. Shortages in Ugandan physical therapy educational programs and infrastructure resources including health science libraries, databases, ongoing mentorship, and most importantly the technology that can help to deliver access to these resources needs to be improved.

The goal of Dr. Dodds' project is to build capacity in Ugandan physical therapy to implement evidence-based rehabilitation services at Masindi Kitara Medical Center (MKMC) operated by One World Health. MKMC is currently building a rehabilitation clinic. This program will provide in-person and virtual instruction, training, and mentorship by MUSC faculty to advance the knowledge and skills of Ugandan physical therapist(s) to provide safe, evidence-based, and patient and family-centered rehabilitation services. Dr. Dodds' team will also identify and implement technological infrastructure to provide ongoing virtual instruction and mentorship to Ugandan physical therapist(s) by the faculty mentor rehabilitation team. Working with the Ugandan Disabled Persons Union, the teams will strive to improve the awareness and productivity of the rehabilitation clinic. 

Dr. Cynthia Dodds
College of Health Professions

Project: Building EKG Capacity for Emergent Conditions in Rural Uganda

Location: Masindi, Uganda

Emergency medical diseases - where interventions within minutes to hours are required to improve health outcomes - account for over half of all deaths worldwide. The mortality rate is significantly higher in low-income countries, which suffer from emergencies caused by communicable diseases, as well as a rising burden of non-communicable diseases such as cardiovascular disease. In addition, low-income countries have limited access to acute, and emergency care, with fewer health care workers trained to manage these conditions.

Electrocardiogram (EKG) is a key, cost-effective tool for diagnosing cardiovascular disease in low-resource settings, but the technology and EKG training is extremely limited in Masindi, Uganda. Dr. Koval will be working with collaborators in Uganda to address this issue by developing an EKG program at Masindi Kitara Medical Center, a regional hospital operated by One World Health. A key component of the project is creating and delivering extensive training for local healthcare workers on how to correctly use and interpret EKGs.

In addition, the team will create an EKG screening program and database to evaluate and better understand the burden of cardiovascular disease present in the community, and identifiable by EKG. This will guide them in creating screening protocols based on the primary complaint and treatment algorithms for the management of abnormal EKGs.

Dr. Kathryn Koval
College of Medicine