November 2019

Global Pediatrics Program Newsletter

Photo by TREAT and Company

Note From Dr. Howard

Hi Everyone!

We have lots of news this month!

Wild type polio 3 was declared eradicated by the World Health Organization on World Polio Day, October 24. See WHO news release below.
GPEDS!!!!! Global Pediatric Education Series, our online presentations are updated, on CANVAS - and awesome - take a look!
It's time to think about global electives for next year - July, 2020 to June, 2021. If you are planning to do a global elective at home or abroad, please make an appointment with your global advisor or email Emily, edanich@umn.edu to schedule.
Our monthly meeting, November 11th, Monday will focus on Markers of Neonatal and Child Health. Join us at 6:30 for a light dinner and discussion led by Dr. Jameel Winter. Take time if at all possible to look at this presentation in GPEDS, you will need to take the pretest, then click on Fundamentals of Global Child Health, then select Markers of Child and Neonatal Mortality, watch the video and be prepared to discuss. Click here to RSVP.
Finally, take a look at the AAP Section on International Child Health Newsletter below. Think about joining the section for quarterly newsletters and opportunities to connect with with the larger global peds community.

Hope to see you soon - Monday night?!

Cindy

Congratulations!

Cindy Howard received the Hillman-Olness Award for Lifetime Service and Lasting Contributions to Global Child Health. It recognizes individuals who have devoted their careers to advancing global child health. Selected by the AAP Section on International Child Health executive committee, she joins leaders like Errol Alden, Linda Arnold, William Keenan and Donna Staton who have previously received this recognition.

Upcoming Events

Monthly Pediatric Global Health Track Dinner Meeting

Date & Time: Monday, November 11 — 6:30 p.m.—8:30 p.m.

Location: Dr. Howard's House

Topic: Global Burden of Disease (SDGs, Global indicators, epidemiology, top causes of under 5 mortality, global indicators)

Click here to RSVP

Global Medicine Lecture Series

Date & Time: Wednesday, November 13 — 6:00 p.m.—7:30 p.m.

Location: Cancer and Cardiovascular Research Building (CCRB), Room 1-125; 2231 6th St. SE, Minneapolis, MN 55455

Topic: Food Disparities in the Twin Cities

Click here to RSVP

Click here to view our events for the year.

Elective Selection for 2020-2021

Elective Selection Starts January 2020 for the 2020-2021 Academic Year.

In our January 2020 newsletter we will ask residents to fill out the Pediatric Global Health Elective Application. If you intend to do a pediatric global health elective in 2020-2021, you must fill out this application in January 2020. Failure to fill out the application will make you ineligible to do an elective, including local and domestic pediatric global health electives.

Visit our Global Health Elective Planning page to see the overviews of each site. Once you have an idea about the sites you may want to visit, please reach out to Risha Moskalewicz or Cindy Howard to discuss your top choices.

Residents Abroad

Phillip Plager - Cameroon 10/2/19-10/13/19

I was fortunate to be able to join Dr. Moran and the pediatric endocrinology department for a training and education trip to Cameroon. Diabetes in Africa, in particular, the treatment and management of type 1 diabetes has been of interest of mine for a long time. I lived in Rwanda for a couple years following college, and living with type 1 diabetes myself, I found there were many new challenges in my care. However, around the world kids with diabetes have many similarities. Almost all seek to be viewed as “normal” kids, fighting constantly to not be held back by their disease. Diabetes is a chronic disease, day-to-day for a lifetime; there are no breaks. It takes a tremendous wellspring of energy on behalf of the patient, parents, community and medical home to encourage, support, and build resiliency in these patients. It was this experience of being a patient in Africa, as well as patient advocate, that led me to pursue a career in medicine. It also connected me to Dr. Toni Moran, who has been training and supporting pediatric endocrinologists and diabetes teams across the continent for over a decade.

Traveling to Cameroon was my first time back to Africa in 7 years and my first time ever in West Africa. It was exciting to be back, and completely new at the same time. Cameroon has four new pediatric endocrinologists. Previously children with diabetes had been taken care of by a few adult endocrinologists, which is now changing. Currently there are around 600 children in country that receive care for diabetes. Our team was asked by new pediatric staff to deliver a “train-the-trainer” conference.

The pediatric endocrinologists invited general pediatricians, clinic nurses, and dieticians from different regions in the country to our three-day workshop on team-based diabetes care. We covered many medical topics (e.g detection, pathophysiology, pharmacokinetics, complications, nutrition, management, approach to education). Most fun were the case-based discussions. Each participant was given a glucometer and was required to check their blood sugar throughout the conference. They were required to log all carbohydrates at lunch and break times. And, naturally, most of the doctors squirmed when we had them inject themselves with saline subcutaneously as a mock insulin injection. Overall, the hands on experience was received very positively.

The conference was also a time for personal reflection; a time to take a step back and examine why we do what we do. We shared success stories, identified challenges, and talked about hard cases. I continue to be amazed and inspired by the providers at the conference, who are acutely aware of the barriers and limitations in their practice and still enter each day with a passion for taking care of kids. One evening at dinner I spoke with one of the pediatric endocrinologists, Dr. Ritha Mbono Betoko. She told me how all of the children in the hospital may not know her name, but know she is an expert in cartoons. One of her favorite things is to talk about cartoons on rounds. I am finding that the heart of a pediatrician is the same around the world. It made me think of all the Frozen and Moana experts in our program.

The culmination of the conference was a planning session to lay the groundwork for a diabetes 5 year national plan. Currently, shifts in public and private funding, along with a growing recognition of pediatric diabetes has created a critical nexus in diabetes care in Cameroon. It was a privilege and an honor to be a part of the conversation and to feel connected to fellow pediatricians across the ocean.

Fellow's Corner

Note from Dr. Anisha Rimal

Pediatric Hospitalist Medicine Fellow

In July of 2017, I found myself embarking on a journey back to my birth country of Nepal. I would spend the summer working in the pediatric ward of Dhulikhel Hospital, in a city an hour outside of Kathmandu. Before arriving, I was incredibly nervous about working in an entirely new setting. As the weeks unfurled before me, I felt myself becoming more steady and confident. The Nepali language, which sat dusty and unused in my brain, began to spring back to life. The rhythm of the inpatient pediatric setting began to feel familiar. I was able to dive into a tremendous range of disease processes. I participated in didactic teaching sessions with other residents. There was a real surge of joy in pushing myself to find my voice, to becoming both a teacher and learner in an unfamiliar setting.

Later that summer, I became involved in a small project in partnership with the hospital’s Community Health Department. A group of nurses were seeking to better understand how to implement health services within a local government school. After working on the project, I learned a tremendous amount about the utility of school based health programs, and how they can serve as a powerful framework for promoting health and wellness in resource limited settings.

I returned to Dhulikhel the following year to continue my work with the Community Health Department. During that time, we embarked on a project to gather qualitative data from various government schools in the city, and sought to understand the barriers to implementing school based health interventions throughout the community.

Since returning to the US, I have continued to learn more about global school based health. I have partnered with a group of pediatricians from various institutions to create a global school based health toolkit, which is a collection of resources and best practices for pediatricians seeking to collaborate with local stakeholders on school based health interventions. We hope to publish and disseminate our work through the American Academy of Pediatrics.

I’m deeply grateful to have been afforded the opportunity to return to my birth country and contribute, in some small way, to a community that means a great deal to me. During my time in Nepal, I marveled at how young Nepali people are working to strengthen their communities and optimize health systems—with great creativity and passion, they are creating real change. I believe school based health is one avenue for creative and effective implementation of health interventions in resource limited settings, and I hope to continue working on similar efforts, at home and abroad.

Resident Spotlight

Holly Belgum, MD - Pediatric Resident PL3

Holly Belgum grew up in northern Minnesota in the middle of the woods, went to college at St. Olaf, spent a year before med school at Minneapolis Children’s Hospital working to make the PICU a safer place for kids, and went to the U of M for med school. And here she still is! (Minnesotan for life!). She spent a month in Peru with a medical team during college, and took a social medicine course in Haiti during medical school. Her favorite phrase and mantra from that trip: "To be a physician is to be an activist" – an idea she wants to live out daily. She plans to go to Alaska for her global health elective, where she’ll work with the Native Alaskan population in a primary care pediatrics clinic. Can’t wait!

Favorite quote: “It’s not what the world holds for you. It’s what you bring to it.” Lucy Maud Montgomery in Anne of Green Gables

Favorite travel destination: the Quetico (the Canadian side of the Boundary Waters)... also mountains, any mountains.

What the world needs more of: What the world needs more of: my grandma’s hot fudge sauce over ice cream (just kidding... I’m going to say women in leadership positions!)

If you weren't a physician you would be: A writer (but plan to be both!)

News and Highlights in Global Child Health Literature

WHO Announces Eradication of WPV3 https://www.who.int/news-room/feature-stories/detail/two-out-of-three-wild-poliovirus-strains-eradicated

American Academy of Pediatrics Section on International Child Health Fall 2019 Newsletter

The LANCET Global Health

The November Edition is now available.

Global Health Matters Newsletter

Sept/Oct edition of the Fogarty International Center's newsletter is now available.

Click on Welcome on the left hand side to get to the Pediatric Global Health Home page.

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