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Brittn Grey, executive director of global and national immersion programs here in Providence, spoke at the Tropical Health and Education Trust’s latest online conference, COVID Partnerships: Transformative Pathways for a Healthy Recovery.
Providence has an active partnership with Medical Teams International in Guatemala, which has been strengthened through virtual mentoring during the COVID-19 pandemic.
Providence also has an active partnership with the World Telehealth Initiative in Nigeria, which strives to provide virtual continuing education to local healthcare professionals.
The COVID-19 pandemic has dramatically changed the face of global health partnerships. When travel bans were in place, medical professionals could no longer travel overseas to support local efforts in disadvantaged communities. Even on the ground, restrictions and lockdowns have had a profound impact on how health care works. We had to adapt to continue our partnerships during the pandemic. These once-essential adaptations have now proven to be positive changes we can pursue in the effort to improve healthcare globally.
This phenomenon inspired Tropical Health and Education Trust‘s (THET) latest online conference, called COVID Partnerships: Transformative Pathways to a Healthy Recovery. It took place on Friday 22 April 2022 and our very own Brittn Gray spoke at the session “Prescriptions for a Pandemic: Adaptation and Innovation”.
Brittn Gray is the Executive Director of Global and National Immersion Programs here in Providence. She provides oversight of global health partnerships, as well as system-led employee volunteer programs. This article highlights insights she shared at the THET conference.
Our call for global health care
As a non-profit Catholic health care system, we believe that health is a human right. This fuels our commitment to providing health care beyond the borders of the United States; we are currently working in partnership with healthcare organizations in Guatemala, Mexico, Malawi, Uganda and Nigeria. Partnership is key to our mission.
“As we seek to expand the decolonization of global health as a system, we are leveraging the talents of our medical community and voluntary organizations to better support this generation and the next of local health care workers,” Gray said. .
Providence Partnerships in Times of Pandemic
Of course, COVID-19 has dramatically changed the way we engage with our global partners, but technology has been key to keeping our partnerships strong.
“The mutually exacerbated disasters of COVID-19 have truly been devastating,” Gray said. “But in the changing landscape, there have been opportunities to reframe partnership engagement.”
Since the start of the pandemic, we have adapted our strategy, moving away from global travel-based volunteering and finding new ways to engage virtually. This has led to new opportunities for mentorship between Providence caregivers here in the United States and on-the-ground partners within these communities, increasing access to training and continuing medical education. We value solidarity and working alongside our partners – never stepping in and taking over.
Gray said it best:
“Transformation happens through relationships, and the power belongs to those on the ground.”
The Work of Providence in Guatemala
In Guatemala, we are sponsoring a maternal and child health program with International Medical Teams. When the pandemic threatened our old in-person “train-the-trainer” model, the Guatemala Medical Teams team spent a year redesigning the program so that Providence volunteers could virtually mentor Ministry of Health staff.
“COVID has given us a completely different way of thinking about supporting connectivity relationships and advancing capacity building goals…in new virtual ways,” Gray said.
What do these virtual mentorships look like? Spanish-speaking American clinicians mentor Guatemalan clinical trainers via Zoom, Teams, or WhatsApp on topics such as emergency obstetrics, integrated management of childhood illnesses, monitoring and evaluation, and soft skills development.
These mentorships are part of a nine-month maternal and child health certificate program that Providence supports. The program is a collaboration with the Ministry of Health in our service area of Guatemala and its objective is to train a group of 15 ministry-employed clinicians in maternal and child health, emergency obstetrics, and monitoring and evaluation. These clinicians in turn train, mentor and supervise 200 clinicians in the Chicaman area, which is dotted with very small rural health outposts.
The nurses who usually lead these outposts usually have less than a year of clinical training, so this access to continuing medical education is rare and valuable. Our Providence Caregivers have mentored the trainers both in the curriculum they teach and also in the art of mentorship itself to continue to build local training and education capacity in the region.
The Work of Providence in Nigeria
Unlike adapting an existing program from an in-person volunteer model to virtual engagement like we did with medical teams in Guatemala, we forged a new partnership last year with Global Telehealth Initiative (WTI) in Nigeria. This organization connects medical expertise to vulnerable communities and supports local capacity building in healthcare – such as the use of Teladoc to make virtual capacity sharing sessions possible even in low network bandwidth areas . Then, WTI helps strengthen the delivery of basic health services based on needs identified by the in-country partner.
In this case, the need identified is glaring: 88% of Nigerian doctors in the region where we work leave to seek employment abroad for lack of support for continuing education. This results in a shortage of doctors.
“Ongoing training at the local level is key to reducing the attrition of healthcare professionals,” Gray said.
Providence volunteer doctors are working with Nigerian clinicians to strengthen services where extreme distance has separated community members from care. Through this “telementoring” model, we provide support for case analysis, specialty consultation, and didactic sessions to advance vendor knowledge and specialization in the field.
Nosa Akpede, MD is the faculty of the Ministry of Health in Opoji leading this work and sees the value of continuing medical education and on-the-job learning. “The program contributes to building the capacity of local health teams and reducing brain drain, such as in the migration of doctors, and this helps to retain health workers in the areas most needed,” said the Dr. Akpede.
Providence physicians also benefit from these mentorships. Connie Bartlett, MD, a pediatrician in Providence, shares, “It is an honor and a privilege to share my medical expertise to train the next generation of physicians. The delivery of health care made possible by technology has removed all physical barriers.
Truly, learning opportunities are two-way; As Providence providers help fill gaps in medical education, they are also able to strengthen their own understanding of providing care in alternate geographies and develop cultural humility, which enhances their own capabilities. to serve diverse populations in the United States.
The future of global partnerships
What does the future of Providence’s global partnerships look like? Leveraging virtual connection and innovative technologies with our global partners will be our core assumption – our default. While we can’t wait to get back to traveling, we have a new idea of where traveling will be most meaningful and what can be done remotely. And we hope to expand and adapt the telementoring model that was created during the pandemic.
“As part of the expansion, I hope to open new doors to other types of capacity building in healthcare administration, finance, human resources, supply chain and other wonderful aspects of health care delivery that are so vital to effective and sustainable care,” says Gray.
The COVID-19 pandemic has brought deep losses, that’s for sure. But it only reinforced our ethical call to hold our global partners accountable. We remain committed to respectfully and sustainably engaging internationally and ensuring that the needs of the communities we serve guide our work, as outlined in the Brocher Statement.
“This [The Brocher Declaration] served as a beautiful point of reflection as we connected with internal stakeholders about the balance of power within our work and our continued call to build a future together where our American support is irrelevant,” said Grey.
It’s true — we want to empower our partners to the point that they no longer need us.
“To make that future a reality, we are working to support sustainable strengthening efforts led by and benefiting local healthcare providers,” Gray said.
After all, real change in healthcare happens at the local level, one clinician at a time.
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This information is not intended to replace professional medical care. Always follow the instructions of your healthcare professional.