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Brittn Grey, the Executive Director of Global and Domestic Immersion programs here at Providence, spoke at Tropical Health and Education Trust’s latest online conference, COVID Partnerships: Transformative Pathways for a Healthy Recovery.
Providence has an active partnership with Medical Teams International in Guatemala, which has been strengthened through virtual mentorship during the COVID-19 pandemic.
Providence also has an active partnership with World Telehealth Initiative in Nigeria, working to provide continuing education virtually to local health professionals.
How Providence sustained thriving global partnerships in a pandemic
The COVID-19 pandemic has drastically changed the face of global health partnerships. When travel bans were in place, medical professionals could no longer travel internationally to support local efforts in under resourced communities. Even on the ground, restrictions and lockdowns had a profound impact on how health care operated. We had to adapt to continue our partnerships during the pandemic. Those once-essential adaptations have now proven to be positive changes we can carry forward in the effort to improve health care globally.
This phenomenon inspired Tropical Health and Education Trust’s (THET) latest online conference, called COVID Partnerships: Transformative Pathways for a Healthy Recovery. It took place on Friday, April 22, 2022, and our very own Brittn Grey spoke during the session “Prescriptions for a Pandemic: Adaptation and Innovation.”
Brittn Grey is the Executive Director of Global & Domestic Immersion Programs here at Providence. She provides oversight to global health partnerships, as well as to system-led employee volunteerism programming. This article highlights the insights she shared during the THET conference.
Our call to global health care
As a Catholic, not-for-profit health care system, we believe that health is a human right. This fuels our commitment to providing health care beyond the borders of the United States; we currently partner with health care organizations in Guatemala, Mexico, Malawi, Uganda and Nigeria. A partnership is key to our mission.
“As we seek to expand the decolonization of global health as a system, we leverage the talents of our medical community and volunteer organizations to better support this generation and the next of local health care workers,” Grey said.
Providence partnerships in a pandemic
Of course, COVID-19 drastically changed the way we engage with our global partners, but technology has been key to keeping our partnerships strong.
“The mutually exacerbating catastrophes of COVID-19 have truly been devastating,” Grey said. “But within the changing landscape there have been opportunities to reframe partnership engagement.”
Since the beginning of the pandemic, we have tailored our strategy, moving away from travel-based global volunteerism and toward finding new ways to engage virtually. This led to new mentorship opportunities between Providence caregivers here in the U.S. and partners on the ground within these communities, increasing access to training and continuing medical education. We value solidarity and working alongside our partners — never stepping in and taking over.
Grey said it best:
“Transformation occurs through relationships, and power belongs to those on the ground.”
Providence’s work in Guatemala
In Guatemala, we sponsor a maternal and childhood health program with Medical Teams International. When the pandemic threatened our formerly in-person “train-the-trainer model,” the Medical Teams Guatemala team spent a year redesigning the program so that Providence volunteers could mentor ministry of health staff virtually.
“COVID has given us a completely different way of thinking about supporting relationships of connectivity and advancing capacity-building goals…in new, virtual ways,” Grey said.
What do these virtual mentorships look like? Spanish-speaking U.S. clinicians mentor Guatemalan clinical trainers via Zoom, Teams, or WhatsApp on topics like emergency obstetrics, integrated management of childhood illnesses, monitoring and evaluation, and soft-skill development.
These mentorships are part of a nine-month maternal and child health certificate program that Providence is supporting. The program is a collaboration with the Ministry of Health in our service region of Guatemala and its goal is to train a cadre of 15 ministry-employed clinicians in maternal and child health, emergency obstetrics, and monitoring and evaluation. These clinicians in turn train, mentor and supervise 200 clinicians across the Chicaman region, which is peppered with very small, rural health outposts.
The nurses who usually run those outposts tend to have less than a year of clinical education, so this access to continuing medical education is rare and precious. Our Providence caregivers have been mentoring the trainers both in the curriculum they are teaching and also in the art of mentorship itself to continue building local training and education capacity in the region.
Providence's work in Nigeria
Unlike adapting an existing program from an in-person volunteer model to virtual engagement like we did with Medical Teams in Guatemala, we forged a new partnership in the last year with World Telehealth Initiative (WTI) in Nigeria. This organization connects medical expertise to vulnerable communities and supports local health care capacity-building — like using Teladoc to make virtual capacity sharing sessions possible even in low-network bandwidth areas. Then, WTI helps strengthen the delivery of core health services based on needs identified by the in-country partner.
In this case, the need identified is dire: 88% of doctors in Nigeria in the region where we work to seek employment abroad due to a lack of support for ongoing education. This results in a shortage of doctors.
“Continuing education locally is key to reducing the exit of medical professionals,” Grey said.
Providence physician volunteers work with Nigerian clinicians to strengthen services where extreme distance has separated community members from care. Through this “telementorship” model, we offer support for case analysis, specialty consultation and didactic sessions to advance the knowledge and specialization of providers on the ground.
Nosa Akpede, M.D. is the Ministry of Health faculty in Opoji who leads this work and sees the value of continuing medical education and learning on the ground. “The program contributes to building capacity of local health teams and reduction of brain drain, as in migration of doctors, and this helps retain health workers in much needed areas,” Dr. Akpede said.
Providence doctors benefit from these mentorships, too. Connie Bartlett, M.D., a Providence pediatrician, shares, “It’s an honor and privilege to share my medical expertise to train the next generation of doctors. Health care delivery enabled by technology has removed all physical barriers.”
Truly, the opportunities for learning are bi-directional; as Providence providers help fill in medical education gaps, they are also able to strengthen their own understanding of providing care in alternate geographies and grow in cultural humility, which enhances their own abilities to serve diverse populations in the United States.
The future of global partnerships
What does the future look like for Providence’s global partnerships? Leveraging virtual connection and innovative technologies with our global partners will be our baseline assumption — our default. While we look forward to returning to travel, we have a new sense of where travel will be most meaningful and what is possible to do from a distance. And we hope to scale and adapt the telementorship model that was created during the pandemic.
“As a part of expanding I hope to open new doors for other types of capacity building at the level of health care administration, finances, HR, supply chain and other formidable aspects of health care delivery that are so vital to effectively sustainable care,” Grey said.
The COVID-19 pandemic has resulted in profound loss, to be sure. But it has only strengthened our ethical call to empower our global partners. We remain committed to respectfully and sustainably engaging internationally and ensuring that the needs of the communities we serve are driving our work, as expressed in the Brocher Declaration.
“This [The Brocher Declaration] served as a beautiful point of reflection as we have connected with internal stakeholders about the balance of power within our work and our ongoing call to build a future together where our U.S. support is irrelevant,” Grey said.
That’s right — we want to strengthen our partners to the point that they don’t need us anymore.
“To make that future a reality, we strive to support sustainable strengthening efforts led by and benefitting local health care providers,” Grey said.
After all — true health care change happens at the local level, one clinician at a time.
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This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.
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