A group of 4th year medical students in Mangochi, Malawi after a class with Dr. Anna McDonald (Swedish) on medication management for cardiovascular disease.
By Brittn Grey, Executive Director of Global & Domestic Immersion Programs
While Providence is best known for our western US presence, our vision of health for a better world and our advocacy for health as a human right motivate us to partner globally. Partnerships are vital for fostering global health interconnection, cross-cultural learning, and reducing global health disparity. By growing our efforts on sustainable solutions through support for necessary healthcare infrastructure—including clinical mentorship, training, and educational resources to strengthen the global workforce—Providence’s global programs seek to make a positive and sustainable social impact.
Just as US healthcare workers have been battered by the pandemic, the global healthcare workforce has faced unprecedented challenges. As a part of a growing capacity sharing strategy to strengthen systems of care, Providence is leveraging medical specialists to provide targeted support for global partners. By supporting professional development of global health and care workers, we respond to country-specific priorities, clinic leaders’ identified specialty needs, as well as broader regional health priorities. The African Union and Africa CDC have identified professional development and “structures that can support, motivate, and retain healthcare workers” as key to advancing the healthcare workforce. Targeted efforts with our partners demonstrate the potential for global capacity sharing and educational infrastructure to contribute. Through clinical tele-mentorship, support for Family Medicine medical learners, exchange programs that foster bidirectional learning, and support for academic partners, Providence responds to urgent workforce needs of today and tomorrow for a more sustainable future.
Skilled volunteerism through virtual provider mentorship
Teladoc-enabled clinical mentorship with World Telehealth Initiative (WTI) opens opportunities for Providence volunteers to partner virtually with medical providers in both Opoji, Nigeria and Longisa, Kenya. Through didactics and specialty clinical consultation, Providence caregivers respond to medical education needs identified by local clinical leaders with the goal of building the skills of medical students and providers to address more complex cases and effectively increasing access to care in underserved, remote geographies. Dr. Nosa Akpede, Executive Director of Precious Gems, leads the implementation of tele-mentorship relationships at the Opoji clinic supported by WTI and Providence and has witnessed the impact firsthand. Akpede has asked for the program to grow, noting that US volunteers contribute to “building capacity of local health team and reduction of brain drain—as in migration of doctors—and this helps retain health workers in much needed areas.” This partnership enables high impact volunteerism and relationship building without the costs and time associated with travel. “Before I used a computer I used an airplane,” notes Providence physician Dr. James Beckerman in a recent Hear Me Now episode with WTI co-founder and Executive Director Sharon Allen. “[This partnership] creates opportunities for people like me who enjoy…accompanying other healthcare providers [and] learning more about the cultural intersections of health, illness, poverty in different locations,” Beckerman notes.
On the ground education & bidirectional exchange programming
Dr. Anna McDonald and visiting Malawian Family Medicine registrars Dr. Amos Mailosi and Dr. Charles Hassan at Swedish in Seattle, Wash. during the fall 2022 Collaboratory.
In Mangochi, Malawi, Providence partners with Seed Global Health (Seed) and Kamuzu University of Health Sciences (KUHeS) to support the Ministry of Health’s goal of growing the specialty of Family Medicine, thereby increasing services across a largely rural health landscape. Providence funds an annual US family physician faculty position filled by Swedish physician Dr. Anna McDonald and Dr. Jacob Nettleton of Healthpoint to provide mentorship support for this burgeoning specialty and to strengthen services for patients at Mangochi’s 500 bed hospital. Within the pandemic era, support has grown to include vital PPE supplies and co-funding a point of care ultrasound (POCUS) training program using Butterfly technology to greatly strengthen ultrasound capacity for now and the future as well as ensure vital tools for confirming COVID positivity are in the hands of local clinicians. In advancing Family Physicians, Providence increases care for Malawian patients through those who know them best—the healing hands of their own local providers—and contributes to sustainable patient care by advancing local ministry of health priorities.
In addition to supporting Family Medicine through Dr. McDonald and Dr. Nettleton’s support, Providence offers two-way exchanges between US residents and Malawian registrars to break down systemic disparities and foster bilateral learning. This fall, Providence is hosting two Malawian Family Medicine registrars in Seattle for a Collaboratory experience and deploying three US residents to Mangochi. In the Collaboratory, Malawian registrars participate in a First Hill Family Medicine Residency observational rotation, a University of Washington Global Health Certificate program, and present at the American Academy of Family Medicine FMX conference. Meanwhile, Providence Family Medicine residents will also travel to Mangochi this fall for four-week rotations to mentor a new generation of Family Medicine students, registrars, and other learners while learning about tropical medicine and gaining new insight from the resiliency of their Malawian counterparts. Evaluations of past Providence resident participants demonstrate that global rotations improve US residents’ communication skills, enhance culturally sensitive care, and increase the likelihood of residents supporting underserved populations in their future US practice.
Infrastructure to further local education programming
Support for infrastructure to advance ongoing learning within academic structures adds to our focus on sustainability. In addition to mentorship and bilateral exchanges, Providence supports training environments to ensure that locally led education efforts have additional resources to thrive. Providence’s sponsorship of the construction of a simulation lab with KUHeS at their Mangochi district facility is an example of just such an effort. Simulation labs create vital opportunities for medical learners to practice core skills by acting out crisis situations and emergency procedure protocol using real equipment in a test environment. At KUHeS, lack of a dedicated space has limited students’ ability to engage in simulation activities. Having a targeted simulation lab space and structure within its own campus offers over 200 annual KUHeS medical learners consistent access to a key learning environment for professional development. Here they will practice complicated deliveries, newborn resuscitations, and venipuncture among many potential emergencies within a simulated, practice environment. The simulation lab at KUHes sponsored by Providence is under construction now and projected to be completed this fall. Through additional funding from regional partners, the structure is anticipated to be equipped with comprehensive lab resources.
Sustainability cannot wait—it needs our investment now
To ensure positive social impact, at Providence we think long term. Sustainable change comes from working in partnership with systems and structures of care and aligning with the goals of local providers, educators, and healthcare leadership. As a health system, we see investments in the global health workforce and health system strengthening as essential for reducing health disparities for the most underserved and increasing global health equity. Partnering with global health organizations focused on capacity sharing, we honor our organizational vision of health for a better world in a rapidly shifting global landscape. By investing in strategies that support local leadership as well as national and regional priorities, we seek to promote sustainable efforts integrated with local systems of care to maximize impact for this generation and the generation to come.
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Visit our Global and Domestic Engagement page
Learn more about what Providence is doing to partner with communities globally and domestically, check out the Global and Domestic Engagement page.
About the Author
Brittn L Grey is the Executive Director of Global & Domestic Immersion Programs within Providence, one of the largest nonprofit health systems in the United States. She provides oversight to Providence’s global partnerships and employee engagement in Guatemala, Mexico, Malawi, Nigeria, Uganda, and Kenya, as well as to system led US volunteerism initiatives and immersion programming within Providence’s 7-state footprint. Brittn is committed to programming that supports transformative health outcomes, fosters global citizenship, and advances the common good.