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U.S. Universities Partner with African Nation of Rwanda to Improve Health Education


The University of Maryland, Baltimore (UMB) is among 25 American universities that are collaborating with the governments of the United States and Rwanda to reshape and strengthen the Rwandan health care education system and make it self-sustainable.

A special report on the groundbreaking, $150 million partnership was published Nov. 21 in the New England Journal of Medicine (NEJM). As of that date, UMB had placed about 20 faculty members as part of the seven-year effort of the Human Resources for Health Program (HRH) of the Rwandan Ministry of Health.

UMB is engaged in this effort to improve health in the central African country through the University's Global Health Initiatives, with the Office of Global Health in the School of Nursing taking a leadership role beginning in 2012, the initial year. The School of Dentistry and the School of Medicine joined in the HRH effort this year.

Agnes Binagwaho, MD, Rwanda's minister of health and lead author of the (NEJM) article, said the HRH partnership "is allowing Rwanda to move from a brain drain to a brain gain of unprecedented magnitude in the health sector." In a news release, she said, "Together, we are training a highly skilled health work force built to last, and equipping them with the tools they need to save lives. In essence, we are investing in Rwanda's greatest resource: its people."

The Clinton Health Access Initiative helped launch the HRH program by assembling academic partners. President Clinton and daughter Chelsea Clinton paid a visit in August to the University Teaching Hospital of Kigali, where School of Nursing faculty have been mentoring their Rwandan peers.

The School of Nursing provides a senior faculty member to serve as a national adviser on clinical simulation. Kathryn Schaivone, MPA, shown at work in Rwanda in the photo above, held that position at the time of the visit and during the previous academic year. She crisscrossed the country helping to construct simulation programs in all schools of nursing, medicine, and dentistry.

Schaivone handed the job off to Gail VanVoorhis, MSN, RN, who left her home in Morgantown, W.Va., to lead the team in Rwanda. She has begun documenting the team's accomplishments and adventures in a blog that includes an informative map. Rwanda, a developing nation with an area of 16,365 square miles, is slightly smaller than the state of Maryland.

Assistant Professor Marik Moen, MPH, MSN, RN, who leads the Nursing School's Rwandan program, was instrumental in recruiting the members of the nursing faculty beginning last year. The School deployed six faculty members in the first year, and with additional faculty has reached a total of 11 nurse educators working in seven locations in 2013.

Performing one-on-one as mentors to their Rwandan counterparts, they impart best practices in clinical specialties such as critical care, emergency/trauma, and adult medicine. The pairs are known as "twins" to the HRH participants.

School of Nursing faculty have assisted their Rwandan "twins" in developing ICUs from scratch, creating new procedures for operating rooms and other units, developing preceptor training programs, initiating specialty practice midwifery programs, and revising clinical and classroom instruction methods throughout all accredited nursing schools and teaching hospitals.

"The impact of participation on our faculty and their Rwandan 'twins' has reached levels described as life-changing in such a short time," said Moen. "We hope this impact will have a ripple effect across this campus and to other universities engaged in global health to encourage all of us to embrace this new approach to global development."

The School of Dentistry is engaged in an HRH effort to triple the number of oral health care providers by 2020. One aspect is the launch this year of a revitalized Rwandan school of dentistry. The University of Maryland (UM) dental school is collaborating with faculty at the Harvard School of Dental Medicine and the Rwandan Ministry of Health to develop an updated curriculum tailored to the needs of the country.

Dr. Meeks in Rwanda

Valli Meeks, DDS, MS, RDH, associate professor at the UM School of Dentistry, has led that effort and has identified several challenges such as sporadic computer access and too few textbooks. Despite these hurdles, she was impressed by the determination in Rwanda to make dental education self-sustaining.

"I can see that this is going to happen in Rwanda. It is very rewarding to be a part of the impetus to start something important in a different country," said Meeks, who is shown in the photo at a site overlooking Kigali with other members of the Clinton Health Access Initiative dental team.

Marie Johnson, DDS, has begun working with a Rwandan dental educator and a dentist from Harvard. The threesome make for a slight departure from the common HRH "twinning model" and are being referred to as the "triplet model."

Rwanda's inaugural class began a course in dental surgery this fall. The 15 students will spend two years at the University of Rwanda's College of Medicine and Health Sciences in Butare before beginning clinical training in Kigali. Currently, fewer than 300 oral health care providers are available to treat a population that is greater than 11 million.

The UM School of Medicine has deployed visiting instructor Doee Kitessa, MD, as a mentor in obstetrics and gynecology in Rwanda. "I have had a long interest in working there," she said. "My parents are from Ethiopia. It's a chance to shore up my teaching skills and hopefully have an impact."

The Institute of Human Virology (IHV) at the UM School of Medicine has been working in Rwanda for nearly a decade, under the leadership of Robert Redfield, MD, co-founder of the IHV and through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR).

Faculty members of the IHV and the School of Medicine, in partnership with the Rwandan Ministry of Health and the U.S. Centers for Disease Control and Prevention, are implementing a clinical mentorship program to train doctors and nurses in treating infectious diseases for all of the district hospitals in the country. Recently the IHV has also taken the lead to create a new infectious diseases diploma program in conjunction with the National University of Rwanda.

Posting Date: 11/26/2013
Contact Name: Patricia Fanning
Contact Phone: 410-706-7946
Contact Email: pf