FOUR GLOBAL HEALTH SPOTLIGHTS

Brendan Raleigh, MD ’14, left, treating patients in Fontaine, Haiti, assisted by Peterson Audate, a medical student in Port-au-Prince and a translator. Observing, right, is Michael Campbell, Class of 2021.

NOT IMMUNE TO DISPARITIES

BY MARK SOMMER

GLOBAL HEALTH SCHOLARS TRACK OPENS EYES AND DOORS

Global health programs in the Jacobs School of Medicine and Biomedical Sciences opened doors that Brendan Raleigh, MD ’14, eagerly walked through, both as a student and a resident. In his fourth year of medical school, he completed a one-month rotation in Impfondo, Republic of Congo. As a resident, he trained in the Department of Family Medicine’s Global Health Scholars Track, which refi nes residents’ core primary care skills and enhances their cultural competency in meeting the needs of underserved populations, internationally and locally. In his fi rst year of residency as a global health scholar, Raleigh practiced in Chiapas, Mexico. He was in Moyobamba, Peru, his second year and in Davao, Philippines, his third year. All these experiences proved eye-opening, Raleigh says, especially in regard to glaring disparities in health care. In the Philippines, he worked in an underfunded hospital, where he helped patients with hypertension, high cholesterol and diabetes. In contrast, wealthier people in the country had access to fi rst-rate private hospitals and clinics. This was also the case when he worked in the emergency room of a small tertiary hospital. “We did a lot of suturing of people who rode small motorcycles and came in with cuts and fractures,” Raleigh says. “The ambulance they arrived in lacked basic life-support systems. It was a big van, so more like a bus ride than an ambulance. Care was fee-for-service and because the patients had to pay for the lidocaine and the suture, we tried not to use too much.” Raleigh’s one-month rotation in the Republic of Congo was in Impfondo, a remote area where malaria and fevers were endemic. When he arrived, the hospital was down to one physician. “People came from hundreds of miles away to get care—even from other countries. The saddest thing is that because people are so malnourished, they have little reserve to make it through infections or other things that people in the United States normally recover from.” The United States is not immune to disparities in health care, Raleigh notes, even if they’re not as severe as in the countries overseas where he has worked. It’s a big reason why he chose to practice family medicine at Jericho Road Community Health Center on Buff alo’s West Side (see related article on page 18). Jericho Road serves a large immigrant population as well as local residents, regardless of their ability to pay. Most are low-income. “We aim to raise the level of care for the most desperate and vulnerable people in our society,” explains Raleigh, who serves as medical director of Vive, a branch of Jericho Road that assists asylum seekers. In August 2017, Raleigh returned to the Republic of Congo, where he practiced in one of Jericho Road’s overseas clinics, located in Goma. In December 2018, he teamed up with the Jacobs School’s student-run Global Health Interest Group to work with mobile clinics in Fontaine, Haiti.

A MEDICAL STUDENT’S LIFE-CHANGING EXPERIENCE

BY MARK SOMMER

Evelyn Quist, Class of 2019, was feeling pressure to decide about what fi eld of medicine to pursue as the fourth-year residency application cycle loomed on the horizon. The answer came in January 2018 on a medical outreach trip she organized to Ghana’s capital, Accra, the city where she grew up. Quist partnered with Doctors in the Gap, an organization that provides limited medical care in remote regions. She and her team provided medical care at a Christian government hospital and at a makeshift clinic on remote Hope Island. Speaking to patients in Ewe, her native language, Quist checked vitals, took medical histories and decided on a course of action between medical treatment, counseling and education. “The experience was life-changing,” she says. “It cemented my decision to go into family medicine. I was seeing everyone, from small children to middle-aged and older people. I could see that family medicine would give me the training to cater to the full spectrum of patients and address each age group’s concerns.” Quist is also pursuing a master of business administration degree since she hopes to return to Ghana one day to build a network of community clinics that provide health care as well as health education and community events. “Our medical system in Ghana is subpar in certain regions of the country, and I believe the people of Ghana are capable of making it better,” she says. Quist has gone on other medical outreach trips “to give something back.” Aft er her second year of medical school, she spent a week with a UB medical team in Fontaine, Haiti. As an undergraduate, she spent two weeks in a rural region of Honduras doing intake, checking vitals, assisting with physical exams and developing patients’ medical histories. Traveling as a medical student has fueled her interest in global health. “You hear about all these places with strife, but it’s not until you’re on the ground and see it with your own eyes that it has a signifi cant impact on you,” Quist says. “It’s easy to just watch something on TV and think, ‘I feel bad about this situation.’ But experiencing it fi rsthand gives a diff erent meaning and a diff erent awareness. It stays with you and motivates you always.” In December 2018, working with Ghanaian native Dorothy Siaw-Asamoah, PhD, MBA, clinical assistant professor in the UB School of Management, Quist returned to Ghana with a team of faculty and students in medicine, nursing, pharmacy and public health, some of whom are also pursuing an MBA degree. In addition to providing medical care to inner-city elementary and middle school students, the team returned to Hope Island, where they slept in tents for four days and saw more than 1,000 patients. “The selfl essness, bravery and kindness shown by members of the medical team I served alongside—and by the people we provided medical care for—continues to fuel me to do more and to do better,” says Quist. “I’m already looking forward to the next medical trip in 2019.”

Obstetrician-gynecologist Nina Seigelstein, MD ’92, founder of One World Women’s Helath (OWWH) with friend in Sierra Leone.

Nina Seigelstein, MD, performing surgery, assisted by Deborah Shuster, MD ’92, in the foreground. Shuster is a board member of OWWH.

THE GLOBAL REACH OF ALUMNI

BY MARK SOMMER

ONE WORLD WOMEN’S HEALTH

Alphabetically-assigned seating brought Nina Seigelstein, MD ’92, and Deborah Shuster, MD ’92, together on their fi rst day of class in medical school at UB. That chance encounter in September 1988 led to the opening of a maternity ward in Sierra Leone 30 years later. The late Richard V. Lee, MD, a UB professor dedicated to international health, provided each of the women their fi rst foray into global health. In 1990, Shuster participated on a medical trek to India led by Lee. She learned the importance of cultural awareness when practicing health care in other parts of the world and to combine hands-on health care delivery with fi eld research. “Dr. Lee was such an excellent mentor and role model,” Shuster recalls. “That trip demonstrated how one small medical team over a relatively short duration could make a huge impact on the health of a village.” In 1999, Seigelstein, working in private practice in New Jersey as an obstetrician-gynecologist, also accompanied Lee to India. In January 2006, the two women, accompanied by a third doctor, ventured forth on their own medical mission, this time to Sierra Leone, a country recovering from a brutal civil war. “It was shocking. It was eye opening. It was rewarding. It was heartbreaking. It was devastating,” Seigelstein says of the experience. At St. John of God Hospital, armed guards, barbed wire and bullet-riddled hospital walls were a constant reminder that they were working in a war zone. There was no electricity, running water or roads; prenatal care and maternity wards were nonexistent. Everywhere they went they were greeted with welcome songs. “They made a radio announcement, and hundreds of people showed up to see us,” Seigelstein recalls. “The need was overwhelming.” Supplies were scarce. Only two pairs of gloves were available to examine patients, so Seigelstein washed her gloves and dipped them in baby powder between patients. “I asked for betadine to prep the patients before operating. At home, you slop it on. There, they gave us three drops.” The most harrowing experience came when they were summoned in the middle of the night to attend to a teenage girl who was hemorrhaging aft er delivering a premature baby. “She was lying naked and unconscious on a cement fl oor in the dark; our feet were sloshing through pools of blood,” Seigelstein recalls. Flashlights were their only light source. They manually extracted three more babies, none of whom lived, resuscitated the girl and saved her life. “It was a profound experience for all of us,” Seigelstein says. These experiences prompted Seigelstein to found One World Women’s Health with a focus on improving women’s health in Sierra Leone. Shuster, a retired neuropathologist in Oregon, became a board member. In 2016—aft er several more trips and much fundraising—their nonprofi t organization proudly opened a 35-bed maternity ward at Holy Spirit Hospital in the northern region. Their next step is to hire a full-time obstetrician-gynecologist. They also hope to inspire future UB medical students to pursue global health. To learn more, visit www.oneworldwomenshealth.org.

UB PEDIATRICIAN WILL NEVER FORGET THE CHILDREN

BY MARK SOMMER

Pediatrician Vijay Aswani, MD, PhD, has participated in medical relief trips to Africa, Latin America, Eastern Europe and the British West Indies. But the hardest trip for him was a six-week stint to Sierra Leone in 2015 with Partners in Health, a nongovernmental organization. Sierra Leone experienced the largest outbreak of Ebola during the West African epidemic of 2014-2015. Aswani volunteered, in part because he was born in West Africa and lived there until the age of 10, and because there was a critical need for healthcare workers to work in the epidemic. Aswani oft en could do little more than give his patients IV fl uids to counter the dehydration the disease caused, though malnourished children had little strength with which to do this. “I took care of about 40 children with Ebola, and 29 died,” Aswani says. “That was the worst experience of my life. In 15 years as a pediatrician, I have never lost as many patients as I did there, but there was no cure to give.” Many of the children who came to the Ebola Treatment Unit were vomiting, bleeding and had diarrhea. Because of the contagious body fl uids, working with them was high-risk even when wearing a protective body suit. The 115-degree temperature inside the suit also meant it could only be worn for an hour before putting the wearer at risk of heat exhaustion. Human touch wasn’t possible, and trying to put intravenous lines into dehydrated patients while wearing several pairs of gloves was a challenge. A fl ailing child once knocked off the face mask to Aswani’s Ebola suit. “I quickly put it on again and prayed that the exposure to his fl uids wouldn’t give me Ebola,” he recalls. On his last day in Sierra Leone, Aswani visited the graveyard for Ebola victims, including some of the children he treated. The photo he took serves as a reminder to him of the toll the deadly disease took and the need for more research. “The sight of simple dirt mounds with signs— including those marking the graves of children I had cared for—will haunt me for a long time,” Aswani says. “I’m a doctor, and graves are not an outcome I ever want to have for my pediatric patients. That’s why I do research, and that’s why I do global health.” Aswani joined UB’s faculty in 2017 as an associate professor of internal medicine and pediatrics in the Department of Medicine and is pleased to have found such a high level of interest and enthusiasm for global health among UB faculty and students. “We live in the richest Aswani Vijay Aswami, MD, PhD, associate professor of internal medicine and pediatrics, worked at the frontlines of the Ebola epidemic in Sierra Leone.

country in the world, and I feel that those of us who are privileged to have the resources and opportunities we have here need to give back to the rest of the world,” he says. In 2017, Aswani accompanied a team of medical students and faculty on a biannual medical relief trip to Fontaine, Haiti. He is currently involved in a research project there on malnutrition among Haitian children.