Forging New Paths in Global Health
Published on in Global Health Update
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Published on in Global Health Update
The field of global child health is growing — and Children’s Hospital of Philadelphia (CHOP) is leading the way, with several innovative training opportunities. In collaboration with the Global Health Center, the Pediatrics Residency Program offers a Global Health Track that includes four-week long clinical rotations at the center’s key partner sites in Botswana and the Dominican Republic. Rotations are also offered at other locations through other CHOP and University of Pennsylvania partnerships.
The Global Health Track is very popular with residents. Irène Mathieu, MD, the outgoing Global Health Track resident, chose CHOP because she was impressed by the enthusiasm of the people she met during her interview. “They truly seemed to love CHOP,” she says. She was also impressed with the hospital’s program in the Dominican Republic (DR). “I had a theoretical understanding of best practices in creating sustainable, equity-oriented global health partnerships, but CHOP's program in the DR is one of the first examples I have come across that fully embodies these practices,” she says.
In addition to their clinical work, Global Health Track residents have protected time for research and projects. While performing well-child visits during her first rotation in Consuelo, DR, Dr. Mathieu observed that in-depth conversations about development were rarely part of well-child checks. She also saw that children in Consuelo faced poverty, malnutrition, iron-deficiency anemia, and recurrent diarrheal episodes, all of which are risk factors for developmental delays. Her curiosity piqued, and she decided to focus on the issue of early childhood development — and explore early interventions — in her Global Health Track research project.
The goal of Dr. Mathieu’s research is to understand parental attitudes about early child development (ECD) and positive practices that promote ECD, such as reading, talking and playing with young children. Dr. Mathieu, who was mentored by the Global Health Center’s Medical Director, Andrew Steenhoff, MBBCh, DCH, and the center’s Research Director, Elizabeth Lowenthal, MD, MSCE, says that her experiences greatly enhanced her residency training.
“For people who speak Spanish, the rotation in Consuelo is an excellent opportunity to learn not only from amazing Dominican nurses and pediatricians who work there year-round but also from Dominican residents who rotate through the clinic,” she says. “It’s illuminating to learn from them and to compare our experiences as residents in different countries.”
Preliminary results from her study indicate that caregivers in Consuelo are very interested in learning more about supporting their children’s early development, but they face barriers such as a lack of age-appropriate books for children in most homes. Dr. Mathieu hopes to use what she’s learned to develop cost-effective solutions to promote ECD.
Opportunities for global health training for residents also exist outside of the Global Health Track. “I am extremely lucky that CHOP has a great partnership with providers in the DR, where there is such a great need for health services,” says Edith Bracho-Sánchez, MD. “During my second year of residency, I completed a monthlong rotation there, and I returned in my third year to complete a study on attitudes toward HIV pre-exposure prophylaxis in adults in La Romana.”
With mentorship from Dr. Lowenthal and Sarah Wood, MD, MSHP, Dr. Bracho-Sánchez successfully navigated the challenges that come with conducting research in global health. Her project has helped her understand the factors that contribute to HIV transmission, and she now has a greater appreciation of the need to develop and refine strategies to reduce HIV transmission.
For Dr. Bracho-Sánchez, the decision to pursue her pediatric residency training at CHOP was an easy one. “CHOP’s commitment to training residents not only in general pediatrics but also in advocacy, global health and primary care was clear to me from the beginning,” she says. “During interviews, I met warm and kind individuals who I knew would be invested in my growth both as a pediatrician and as a person.”
CHOP faculty members are thrilled to support residents as they pursue their passions. From local advocacy efforts to formal global health research endeavors, these dedicated faculty members are eager to guide and mentor residents as they identify areas to pursue during their residency.
“There is a tremendous amount of satisfaction in witnessing how the seeds planted during a resident's training can flourish into a strong foundation for future work in the local and global communities,” says Adelaide Barnes, MD, Assistant Program Director of the Pediatrics Residency Program. For example, Dr. Bracho-Sánchez has been featured by the American Academy of Pediatrics in Spanish public service announcements (PSAs) for Spanish-speaking families, completed a rotation with the ABC Medical Unit, and developed a weekly Spanish podcast, Las Doctoras Recomiendan, in collaboration with fellow Latina residents at CHOP.
Both Dr. Mathieu and Dr. Bracho-Sánchez will soon be completing their residency training, and they are eager to use their new knowledge and skills to make even more contributions to the field of global health. After observing that marginalized communities in the United States have many of the same health needs as low-resourced communities in the DR, Dr. Mathieu plans to pursue a career in academic primary care, global health and medical education, and will be at the University of Virginia next year. Dr. Bracho-Sánchez will pursue a fellowship in journalism and global health offered through Stanford University, CNN and the World Health Organization. She hopes to work as a primary care pediatrician, incorporating her knowledge of medicine, journalism and global health to advocate for all children.