November 2024

Global Pediatrics Program Newsletter

Emily Danich

Though I enjoy sunny warm days, I can also appreciate a good cold wet fall day too. It gives me a chance to get some house projects done without feeling guilty about not being outside. I also love baking and cooking soups when it's cold and wet out. I hope you are able to find joy on these cold and wet days as well.

Fall is a time of changeover for me, shifting the focus of our visitors from last summer, to summer 2025, helping residents meet their requirements to go on their elective this year, and work with residents to plan for the upcoming year. In this newsletter, we will introduce Dr. Namvongsa who will be visiting from Laos, and hear from Drs. Angella Nanteza Mirembe and Julian Afoyorwoth. They have been back in Uganda for three months and have reflected on their time here.

This time of year also gives me the opportunity to meet with residents to discuss elective plans, graduation requirements, and general Track information. If you haven't scheduled a meeting with me yet - please do so!

More of our residents are getting ready to travel on their global peds electives. We have a group leaving in January for their elective at Jos University Teaching Hospital in Jos, Nigeria with Dr. Tina Slusher.

Emily Danich

Manager, Global Pediatrics Program

Upcoming Events

GEMS: Global Experiences and Memorable Stories

Wednesday, November 6, 2024 | 6:00 - 8:00 p.m.

Topic: Perspectives from Cambodia with Dr. Nathan Ostlie

Location: Dr. Viviane Leuche's House

GEMS: Global Experiences and Memorable Stories

Monday, December 9, 2024 | 6:00 - 8:00 p.m.

Topic: Perspectives from Uganda with Dr. Haley Zweber

Location: Dr. Tina Slusher's House

Welcome to the University of Minnesota to

All Intern Pediatrics and Med-Peds Residents!

If you would like to be part of the Global Pediatrics Track, fill out the application. Visit our track website at z.umn.edu/pedsgh to learn more. If you have questions about the Global Pediatrics Track feel free to reach out to one of us or another faculty member.

Dr. Mike Taylor, Director, Global Pediatrics Education - tayl0369@umn.edu

Dr. Viviane Leuche, Director, Global Pediatrics Programs - tchon002@umn.edu

Emily Danich, Manager, Global Pediatrics Program - edanich@umn.edu

Dr. Nadia Sam-Agudu, Director, Global Pediatrics Program - agudu@umn.edu

All Global Pediatrics Track Residents: Schedule your appointment with Emily Danich if you haven't already. We will discuss:

Introduction to the track for Intern residents
Elective planning for 2025-2026 academic year
Check on elective requirements for residents traveling 2024-2025
Check graduation requirements for residents graduating June 2025

Emily Danich's appointment calendar. If you can't find a time that works for you, please email Emily at edanich@umn.edu.

Visiting doctors updates

Vannyda Namvongsa, MD - Laos, visiting 11/6/24 - 12/15/2024

Dr. Namvongsa, is a pediatrician based at Setthathirath Hospital in Vientiane, Laos. She is the Deputy Director of Medical Education at Setthathirath Hospital, where she is responsible for quality improvement in healthcare services and research. She has won several teaching awards at her hospital and is well loved by the residents there. Dr. Namvongsa will be observing at our hospital before and after her poster presentation at the ASTMH conference Nov 13-17th in New Orleans where she is presenting on hospital waste management. She is being hosted by both Global Medicine and the Global Pediatrics Program, in particular, Dr. Kristina Krohn is hosting her as the site lead for our partner site in Laos.

My name is Dr. Angella Nanteza Mirembe and I have just completed my residency training in Paediatrics and Child Health, qualifying as a paediatrician.

What an incredible yet heartbreaking experience! I had so many mixed feelings and numerous "wow" moments. As someone passionate about uncommon pediatric conditions, I was thrilled to meet a family with three children who have Hurler syndrome, all of whom had received bone marrow transplants. They encouraged me to learn more about the Hurler community. I also encountered cases like a baby with Edwards syndrome, who lived for three months despite a genetic diagnosis, and a child with prune belly syndrome who thrived until four years old thanks to a kidney transplant, among others.

I was amazed to see 22-week preterm infants not only surviving but thriving, benefiting from advanced forms of respiratory support. Some babies stayed in the NICU and then the PICU until their first birthdays and beyond—one even lived there until two and a half years old. I was in awe of how dedicated the medical staff is to keeping every patient alive, no matter the circumstances!

I learned that gene therapy for children with sickle cell disease can lead to a cure! I couldn't help but think of the millions of affected children in Uganda and what a breakthrough this would mean for them. Discovering organ and bone marrow transplants was equally remarkable! There' a database of donors and recipients that allows transplant specialists to evaluate organs within 48 hours of a donor's passing. How incredible is that?

I was also inspired by child life specialists who help families cope with the trauma of hospitalization through art therapy, music therapy, and even therapy dogs. It was enlightening to see how crucial psychosocial support is to the overall treatment process.

The 911 ambulance ride was incredible! I witnessed paramedics literally bring patients back to life, which was awe-inspiring. However, it was heartbreaking to remember the parents who rush to the emergency room at Mulago Hospital on a motorcycle, arriving with their child already deceased. This made me realize just how crucial timely patient transfers are.

I am grateful to Dr. Viviane Leuche and Emily Danich for making our stay truly memorable! This was an unforgettable experience.

Dr. Afoyorwoth on her first day at work since she got back with all the enthusiasm she hopes to keep it up.

Greetings from Uganda. I am Dr. Julian Afoyorwoth, a pediatrician. I completed a master of Paediatrics and child health this year from Makerere University in Kampala, Uganda. It was such a great opportunity to come to the University of Minnesota after the course, under the global Paediatrics program this summer in July.

I started my rotations with PICU where I witnessed highly complex trauma cases and learnt a lot about their management and the benefits of early rehabilitation. The critical care conference was interesting with lots of lessons learnt from both successful and less successful emergency responses and procedures. One of the most exciting experiences was the ambulance ride and I was so amazed by the paramedics, fire fighters, their expertise and the emergency preparedness of the hospital teams.

I also rotated in NICU, Cardiology and Nephrology. I was particularly thrilled by coordination of the emergency response when a child coded in NICU and the lifesaving procedures done by the multidisciplinary team in the shortest time possible. I learnt much about management of Congenital Diaphragmatic hernias (CDH) and the use of extra corporal membrane oxygen (ECMO). I was also privileged to attend simulation labs with residents and fellows on the new technique of video assisted endotracheal intubation in both hospitals and central line placement. In cardiology, I attended cardiac catheterization, electrophysiological studies and treatment of a supraventricular tachycardia (SVT) by cryotherapy and were really fun to observe and learn. It was great seeing an adult with hypoplastic left heart who had undergone the 3 staged repair in childhood and was still well. My highlight in nephrology was the ward discussions and the teachings with the residents and attempting the boards’ questions quite successfully. I saw similar conditions we have back in Uganda like post streptococcal Glomerulonephritis and steroid resistant nephrotic syndrome, prune belly syndrome and rare ones like dyskeratosis congenita. I also noted that dialysis and renal transplants were more readily available than in Uganda. There were moments during the rotations I felt the cultural shock and frustration at the huge difference in the health systems and availability of resources as compared to Uganda and I am inspired to be part of the change for better healthcare starting with me.

Child life was particularly a new concept to me and I highly appreciated its usefulness in pediatric care which I hope to add in my practice as a pediatrician, with the available resources. Away from the wards, it was fun shopping in the malls especially the mall of America and target during our free time. I enjoyed the visit to Como zoo, Minnehaha falls and the picnic.

I hope to apply the many lessons learnt appropriately in my practice as a pediatrician. Special thanks to the global paeds team; VIV, Emily, Mike, Tina, Cindy, Nadia and my colleague Angella for making it a memorable stay.

Dr. Viviane Leuche with Sophia Laquinta

Dr. Viviane Leuche with the IOM team

Dr. Viviane Leuche with the residents and the Butterfly Machine

Dr. Viviane Leuche with the residents

Dr. Viviane Leuche with the residents and Dr. Nicolette Barungi

Dr. Viviane Leuche with the Mulago Leadership. L to R: Dr Ezekiel Mupere, Dr. Nicolette Barungi, Dr. Viviane Leuche, Dr. Victor Musiime, and Dr. Phillipa Musoke.

Faculty Update

Viviane Leuche, MD, Director, Global Pediatrics Partnerships

Uganda Trip June 20-30, 2024

Ki Kati! I had the opportunity to spend time in Kampala with our Ugandan colleagues this past summer 2024. My time was divided between teaching at the International Office of Migration (IOM) office in Naguru and teaching Mulago Pediatric residents how to do point of care Ultrasound with a Butterfly POCUS machine.

The IOM experience was facilitated by Dr. Nasreen Quadri (HealthPartners), Dr. Elizabeth Dawnson-Hahn (University of Washington) and Erin Mann (Center for Global Health and Social Responsibilities). On the ground, I had a great time working with Sophia Laquinta RN, PHN, Dr. Risat and Deepanjali RN - charge nurse. The goal was to teach the pediatric physical exam as most centers have primarily adult trained physicians - though IOM Naguru recently hired a pediatrician Dr. Irene Nakatudde.

Activities during each day included: observing physicians during their pediatric physical exams and providing constructive feedback, co-teaching sessions with Sophia, Dr. Irene and Dr. Joseph (both IOM Master educators) in the afternoons about various pediatric topics including milestones, considerations before travels, particular considerations for neuroatypical children.

Not enough words to acknowledge the excellent work of all their physicians, who day in and out, medically screen numerous beneficiaries from the region including influx from the Democratic Republic of Congo and Ethiopia with complex and arduous migration history. These beneficiaries eventually qualify to immigrate to the US, Canada or Australia - though the process can be very long for some families. The highlight of my time at IOM was seeing the intricate work of the physicians, nurses, interpreters at IOM and hearing their stories about screening children in more remote areas (camps).

The rest of my time was spent teaching Mulago Pediatric Residents how to do point of care Ultrasound. With the input of Dr. Nicolette Barungi, the Uganda site lead, two Uganda second year residents were identified as leads. We had an introduction to Ultrasound on Zoom prior to my arrival. Clinical schedule was challenging and busy, however 5 residents were able to participate and get an orientation on how to use the probe. We were able to use the probe on a few patients in the cardiac, nephrology and acute care ward. Two Butterfly probes (Android and Apple) were left to the site for ease of access to continue to scan. We have continued to have monthly Zoom sessions with the interested residents on Zoom to learn more about each POCUS system such as FAST, RUSH, Cardiac. The goal would be, using train-the-trainer model, to have residents acquire POCUS proficiency over time with the lectures and more scanning and to teach their other classmates.

Lastly, my main highlight of the trip was to meet with the Mulago leadership Dr. Victor Musiime, Dr. Ezekiel Mupere, Dr. Phillipa Musoke and Dr. Nicolette Barungi and also reunite with almost all of the previous residents we have had as part of the Bidirectional Exchange program. Some have gone on to open clinics, others continue to be strong advocates for their patients. My many thanks to all the folks I worked with and looking forward to future collaborations! Webale Nyo!

Midwest Consortium of Global Child Health Fall Meeting Recap

Last month pediatric physicians and staff in the pediatric global health department attended the 15th annual midwest consortium hosted by the University of Wisconsin Madison. This group of global health educators has been around since its first meeting in 2010, and the founders of the initial group include our very own University of Minnesota faculty, Drs. Cindy Howard and Michael Pitt! This amazing group has continued to grow over the years and the consortium includes members from 7 organizations in the Midwest including Mayo, Rochester and University of Minnesota; Milwaukee and Madison, Wisconsin; Cincinnati Childrens and UH Rainbow Babies and Children’s Hospitals in Ohio; and Northwestern University in Illinois. The Midwest Consortium has been integral in allowing for the mingling of minds of people from different backgrounds, universities, and with different passions and knowledge in the global health sector. Some notable achievements that have come from this group include the Sugar curriculum, GHEARD, and over 30 publications in the forms of articles and book chapters. This group has been helping pave the way for global health programs and continues to do so every year.

The weekend started with grand rounds at Medical College of Wisconsin, given by consortium members who shared their journeys and careers in global health. It was amazing to hear about where they started, where they are now, and how integral the consortium and its members have been in their lives. Not only has the group been the birthplace to many academic achievements, but its members are colleagues turned friends, and really, family. The remainder of the meeting was spent determining what projects the group would continue to work on and delegating how best to achieve this year’s goals. Other highlights from this year’s meeting include Drs. Haley Zweber and Megan Lucas, this year’s Global Pediatrics Instructors, experiencing their first consortium weekend and our very own Emily Danich being voted one of this year’s consortium Co-Chairs! The days of the consortium were long but filled with lots of good conversation, laughter, and great local food - it truly ended too soon!

Some of the original Midwest Consortium members: Dr. Cindy Howard, Dr. Nikki St. Claire, Dr. Phil Fischer, Dr. Sabrina Butteris.

Map demonstrates where members were born, received their education, and where they have worked.

Retired Midwest Consortium members: Dr. Cindy Howard, Dr. Chuck Schubert, and Dr. Phil Fischer

2024-2025 Midwest Consortium Co-Chairs: Dr. DeMarco Bowen, Dr. Rachel Bensman, and Emily Danich

2024 MWC meeting attendees!

UMN Representation: Dr. Viviane Leuche, Dr. Megan Lucas, Dr. Michael Taylor, Dr. Haley Zweber, Dr. Steve Selinsky, Emily Danich, and Dr. Cindy Howard

Resident Spotlight

Sydney Vahling - PL2

Hi everyone! I grew up in a small town in Western Kansas and did my undergraduate education at Kansas State University. I stayed close to home for medical school at the University of Kansas. I moved to Minnesota for residency, and I absolutely love it here! I plan to specialize in hematology/oncology and would also like to spend time serving others in rural communities in Uganda. I was able to spend time in Bududa, Uganda in undergrad and fell in love with the people and community. I spend my free time reading, baking, drinking unnecessary amounts of coffee and playing with my sweet pup, Charlie!

Favorite Travel Destination: Aruba
What the World Needs More Of: Kindness
If I weren't a physician, I would be: A baker! Or commercial airline pilot

Announcing Small Research Awards

We are happy to announce the call for Global Pediatrics Small Research Award Proposals.

Global Child Health Literature and Awards

Amadi HO, Slusher T, Mokuolu O, Ganle J. Editorial: Technologies for neonatal care in LMICs. Front Pediatr. 2024 Sep 6;12:1462735. doi: 10.3389/fped.2024.1462735. PMID: 39309640; PMCID: PMC11413660.
Tomlin B, Lamichhane B, Dhungana R, Richards G, Grubb P, Mahato A, Fassl B, Judkins A. Determining Consensus Alignment and Barriers of Neonatal Thermal Management in Nepal Using a Modified Delphi Process. Glob Pediatr Health. 2024 Oct 17;11:2333794X241273300. doi: 10.1177/2333794X241273300. PMID: 39483615; PMCID: PMC11526250.

Global Pediatrics Track Passport - Log-It!

You need to complete 75% of the passport to graduate on the Track. Make sure to log into Canvas.umn.edu to document your progress.

Faculty: Traveling for Global Peds Work? Let us know!

Please fill out the Global Pediatrics Program Faculty International Travel form. Note: This doesn't replace the need to register your travel with the University of Minnesota. You must still register at https://global.umn.edu/travel/register.

Give to the Global Pediatrics Program Fund

Please consider a tax-deductible donation, if possible. We use these funds to bring trainees and faculty here from our international partner sites. The trainees do four to six week electives during the summer in our hospitals and clinics. We are grateful that we have been able to bring faculty here as well to present their research and collaborate with colleagues here in Minneapolis.

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