Global Health at CHOP: It Takes a Village

Savarra Mantzor, MD Ten years ago, Children’s Hospital of Philadelphia (CHOP) and the Pincus Family Foundation (PFF) established the David N. Pincus Global Health Fellowship to train future leaders in global pediatric health. Savarra Mantzor, MD, the 2015-17 Botswana Pincus Fellow, is one of the exceptional pediatricians who recently completed her fellowship with CHOP in Botswana.

An early interest in global health

Growing up, Dr. Mantzor always had an interest in global health. She and her family spent five years living in Sydney, Australia, when she was an adolescent, and moving to another country and adapting to a different culture changed her understanding of what “home” meant: “Without distinct, physical boundaries, I became rooted in values more than places,” says Dr. Mantzor. By the time she went to college, she had decided she wanted to help others in an international framework, which led her to pursue a degree in political science at Seattle University. When an opportunity for an internship abroad with CARE International came her way, she immediately applied. She was accepted and assigned to work in Zambia for three months. During her internship, Dr. Mantzor observed the complex barriers of bureaucracy and felt that her work was “disconnected from those it was intended to aid.” After significant consideration, she chose to pursue medicine, a field that would allow her to engage in a more “practical and personal interaction” with each patient.

Medical training

Dr. Mantzor attended the Medical School for International Health (MSIH) at Ben-Gurion University of the Negev in Israel, which is affiliated with Columbia University's Vagelos College of Physicians and Surgeons. She then completed her pediatric residency and a chief year at Our Lady of the Lake Regional Medical Center in Baton Rouge, LA. According to the Commonwealth Fund’s Scorecard on State Health System Performance, Louisiana ranks 49 out of 50 U.S. states in overall health system performance. Dr. Mantzor’s experience in Louisiana further reinforced her desire to work with communities in low-resource settings. “I learned that the needs of society don’t always exist within borders, and my passion was to help regardless of borders.” In many respects, the challenges that patients in Louisiana faced were similar to those faced by people living in other resource-limited settings around the world.

For Dr. Mantzor, the CHOP David N. Pincus Global Health Fellowship was the ideal next step because it gave her the chance to contribute to the fellowship’s mission of increasing access to healthcare for children in the United States and other parts of the world through longstanding, bidirectional collaborations in Botswana and the Dominican Republic. The fellowship provides clinical, educational, research, advocacy and leadership experiences that equip fellows to become global health leaders.

The David N. Pincus Global Health Fellowship

Clinical

In her role as a Botswana-based fellow, Dr. Mantzor delivered general pediatric inpatient care at Princess Marina Hospital (PMH), the University of Botswana’s (UB’s) primary teaching hospital in Gaborone, Botswana. She led both a pediatric team and a neonatal team in addition to supervising medical students and residents.

Education

CHOP’s longstanding partnership with UB and PMH ensures that fellows have an established role with a defined set of expectations during their fellowship. This allows them to integrate more easily and quickly into the host system. Additionally, this means that they can begin their research or advocacy work earlier, thereby making the most of the time they have in-country.

In looking back at her fellowship experience, Dr. Mantzor is struck by the support she received from the Fellowship Director, Andrew Steenhoff, MBBCH, DCH. “Andrew was supportive of my personal and professional development. He facilitated networking opportunities, which have led me to pursue a PhD program in health professional education at the University of Cape Town in South Africa.”

Research

Individualized research mentoring allows fellows to explore their specific research interests. Fellows have access to CHOP’s Global Health faculty, as well as faculty at the University of Pennsylvania and the University of Botswana. Fellows work with these faculty mentors to develop research projects according to each fellow’s specific research interests.

At Our Lady of the Lake, Dr. Mantzor had served as chief resident, a role that exposed her to academic medicine and piqued her interest in medical education, which she wanted to explore further during her fellowship. Following several discussions with key stakeholders, including Loeto Mazhani, MD, Assistant Programme Director of Paediatric and Adolescent Health, Faculty of Medicine at UB, Dr. Mantzor decided to focus her project on developing strategies to optimize bedside teaching for medical students and residents during rounds. Using a phased approach, Dr. Mantzor began her project by conducting focus groups and interviews with medical students, residents and attending physicians to understand the teaching methods that were being used at the time. The focus groups and interviews informed the introduction of various bedside teaching strategies aimed at providing high-quality, learner-centered teaching.

Advocacy and leadership

During her clinical work, Dr. Mantzor realized there were many healthcare system challenges that limited medical practice at PMH. Based on her previous experiences working with quality improvement (QI) as chief resident, she took the initiative working with a CHOP QI expert, Maura Powell, MPH, to develop a seven-week QI course for members of the Pediatrics Department at PMH. The course’s goal was for attendees to gain knowledge and applicable skills in QI methodology as a means to facilitate positive changes within the Botswana healthcare system.   

Life after fellowship

After completing her fellowship with CHOP, Dr. Mantzor was recruited by Texas Children’s Hospital and the Texas Children’s Cancer and Hematology Centers as a Botswana-based pediatrician in their Global Hematology Oncology Pediatric Excellence (HOPE) program. Dr. Mantzor credits the David N. Pincus Global Health Fellowship for her current role with the HOPE program. “In addition to providing excellent clinical services, part of the mandate of the Global HOPE project is to educate and empower the next generation of physicians working in Botswana to ensure sustainable and locally driven care for children with cancer and blood disorders. My fellowship gave me on-the-ground clinical and teaching experiences that made me a competitive candidate.”

An extraordinary experience

“The program fulfilled and exceeded my expectations, says Dr. Mantzor. “The fellowship was a formative experience for me.” When she moved to Botswana for her fellowship, her husband and her then 4-month-old daughter accompanied her. Both Dr. Mantzor and her husband felt supported by the program. “I also had my second child during my fellowship. I was pleasantly surprised by the program’s support as I was raising a family while also pursuing my career.”

Dr. Mantzor is also extremely grateful for all of the in-country support she received from Tonya Arscott-Mills, MD, MPH, CHOP’s lead pediatrician in Botswana. “These relationships endure beyond the fellowship. Andrew and Tonya are still the first people I reach out to for professional advice. Andrew knows my children’s names and my husband’s name. He genuinely cares, and even though I may be far away, I still feel connected to CHOP and the United States.”

How to Apply

CHOP’s Global Health Center team works in more than 15 countries around the world. In addition to saving lives through direct clinical care, we are dedicated to conducting locally relevant research and training the next generation of global health providers like Dr. Mantzor, who in turn learn from and teach their colleagues abroad.

If you are an early-career pediatrician or pediatric subspecialist seeking the skills to become a leader in pediatric global health, this is the fellowship for you. It is an immersive, expertly mentored, and fully funded three-year experience in global health practice. Find more information about the fellowship and download an application.