Teaching, Learning, Growing: A Global Health Journey

A true bidirectional exchange — one in which people from different backgrounds come together to both offer and receive knowledge — is a challenging but worthwhile endeavor, especially when it helps save children’s lives. Every six months, a small group of employees from Children’s Hospital of Philadelphia (CHOP), under the direction of the Global Health Allies Program, receive the chance to do just that in Consuelo, Dominican Republic (DR).

The Global Health Allies Program is a unique opportunity for CHOP employees from any area of the Hospital or CHOP Care Network to apply their expertise to critical global health projects. The week-long visit to the Niños Primeros en Salud (NPS) pediatric clinic, CHOP’s partnership program in the DR, happens twice a year in June and November.

The most recent trip took place June 25 to July 2, 2017, and included five CHOP employees with a diversity of experience with health topics ranging from nutrition and allergies to dental health and breastfeeding. Participants included: Mutaz Al Mudaris and Massiel Ortega from Language Services; Audrey Foster from Clinical Nutrition; Lorena Gonzalez from Atlantic County Specialty Care; and Cindy Viscuse from the Nursing Central Staffing Office.

Customized medical education

The Global Health Allies week provides a customized continuing medical education experience for 10 NPS health promoters. The health promoters are women who have children in the Niños Primeros en Salud program and, based on their skills as exemplary mothers, were chosen to be advocates for child and family health in their communities.

The health promoters drive the educational agenda of each Allies trip by requesting specific health topics. This ensures that every topic is relevant to families in the communities served. The expertise of CHOP employees is used to bridge the gaps in skills of the health promoters. The biannual training weeks are a way of guaranteeing that local health promoters are constantly updated on healthcare topics pertinent to their communities.

Each morning, the two groups — CHOP staff and NPS health promoters — gathered in a local classroom and delved into topics using a creative, fun mix of presentations, games and interactive activities. Some topics presented common themes for the health promoters, while others revealed entirely new information.

For example, Audrey Foster, the first CHOP clinical dietitian to participate in an Allies trip in several years, brought a fresh spin to a crucial and constant concern at Niños Primeros en Salud: child nutrition. Foster discussed child nutrition through the various stages of child development from prenatal to preschool age. She also discussed food allergies, which are thought to be uncommon in Consuelo. The topic sparked interesting conversation and questions about a few specific case studies leading the group to believe food allergies may be more common in the region than originally believed.

Massiel Ortega, who works for CHOP as a Spanish-English interpreter, trained as a dentist in her home country of Panama. Throughout the week, she taught extensively about child and adult dentition, dental hygiene and cavities, oral cancer and other oral health risks. These topics were new to the Allies trip curriculum, and the health promoters found them extremely useful and interesting.

Side by side in the community

Each afternoon, the Allies travelled with health promoters to conduct “community health fairs” — a mobile clinic the group set up in a different neighborhood each day to conduct preventive health screenings. More than 1,000 people attended the health fairs.

Each participant received a handout of a baseball diamond (baseball is the Dominican Republic’s national sport). Each base represented a preventive health station for them to visit: being weighed, measuring blood pressure, applying fluoride to their teeth, and last, a toothbrush and toothpaste as a takeaway to promote dental hygiene. Health promoters and CHOP Allies worked side by side screening children, parents and grandparents for any health challenges, as well as educate them about the importance of prevention efforts.

“This group of CHOP Global Health Allies was exceptional; they were energetic and interesting,” says Ramona Cordero, NPS pediatric nurse and supervisor of the health promoters. “These trainings are so beneficial.”

The health promoters had many positive things to say as well: most reported that all topics were of great interest and use to them; one even said “Every month, when I do my home visits, I am able to say something different in each house thanks to these trainings.”

Lessons learned

In the process of contributing their knowledge and expertise, the CHOP Global Health Allies also learned a great deal about global health partnerships like the one in the Dominican Republic.

“Some of the barriers to breastfeeding, for example, were very similar to experiences of women who live in Philadelphia,” says Audrey Foster, who works in clinical nutrition at CHOP. “Breastfeeding promotion is universally challenging. The hurdles that moms in low-income settings face, like lack of maternity leave or the inability to pump breast milk and store it at work, are exactly the same in Philadelphia and Consuelo.”

The Allies also gained a broader perspective of global healthcare. While many healthcare challenges in the DR were similar to those faced at CHOP, the local health promoters confronted those challenges with commitment, creativity and passion. The role of the Global Health Allies Program is to continue to equip them with knowledge and skills to provide high-quality care for children in their neighborhoods.

The CHOP Global Health Center emphasizes sustainability in this program and all of its work around the world. The Center aims to build local capacity and increase knowledge so the programs become stronger, more self-sufficient, and empowered with one main goal — to help children worldwide.

Learn more about the Global Health Center, its programs in Botswana and the Dominican Republic, and the opportunities to get involved.