From a global perspective

Whether responding to disaster or simply to an ongoing acute need, faculty, students, and employees in Emory's Woodruff Health Sciences Center work around the world to help relieve suffering today and build infrastructure for tomorrow.

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Après le jour: This is how Haitians refer to time after the day of the historic earthquake last January. Across the Woodruff Health Sciences Center, many faculty and students rushed to help because they felt the tragedy personally. They knew Haiti, having spent time there already as volunteers. Others understood the impact of the quake based on their experiences elsewhere, having helped stunned victims of natural disasters in other locales.

 

In this section

 

Après le jour

Keeping the promise of protection

Supporting safe childbirth

Helping create giant databases

Spring break in Jamaica

Drugs for the neglected killers

Taking care where it is needed

For example, several times a year, some 10 Emory medical faculty and 40 medical students travel to Haiti, carrying supplies and equipment and providing primary, surgical, and ob-gyn care to some of the most medically underserved people in the world. They go as members of Emory Medishare, a branch of the national nonprofit Project Medishare for Haiti.

It’s a long-term commitment. “We don’t just parachute in and then leave,” says one of the medical students. They help set up clinics in villages, train local health care workers, and assist in improvement of the health care infrastructure. Project Medishare is so well respected that the Haitian president asked it to lead the medical relief field sites in and around Port-au-Prince following the earthquake.

Before the earthquake, the Emory team had launched a campaign to build a year-round primary care center. After the quake, they redoubled their fundraising efforts and headed back, with more supplies and help.

Other faculty have their own paths to Haiti. Emory gyn-ob Eva Lathrop has volunteered there for years so it was only natural that after the earthquake, she would head there to see what she could do. Emory neurosurgeon Nick Boulis packed his personal OR tools and electric drill in a footlocker, along with mosquito nets and flashlights. He performed not only neurosurgery but orthopedic and general surgery—basically, whatever needed doing. By day 5, as volunteer physicians came and went, Boulis found himself serving as chief medical officer. Now back at Emory, he continues working to procure a portable CT scanner and a stable rotation of neurosurgeons for the Haitian site.

After the earthquake, many displaced Haitians ended up in the Dominican Republic. That’s where emergency medicine resident Mark Fenig went, setting up a clinic in a compound in Jimani. Emory nursing students armed with food, medicine, and clothing spent their spring break partnering with Dominican nursing and medical students to provide health screenings and other services.

Students in the Rollins School of Public Health (RSPH) gathered funds and supplies, which they sent to Haiti with fellow students Jean Cadet and Madsen Beau de Rochars, both of whom are physicians from Haiti. Cadet used megaphones to provide classes on prevention of infectious disease, construction of latrines, and proper garbage disposal. Beau de Rochars had directed the lymphatic filariasis program in a hospital about 18 miles west of Port-au-Prince before coming to the RSPH. Soon after arriving in Haiti, he was tapped to serve on a presidential commission to provide technical assistance on needs assessments, preparation for infectious disease outbreaks, and distribution of medicine.

To read student blogs from Haiti, visit emorymedishare.org.

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Protection

Keeping the promise of protection: Some of the patients referred to Emory physician Jeremy Hess (left) were discovered stowed away in a ship. Others arrived over a long and arduous path through Central America. Still others managed to buy an airplane ticket, knowing they would be taken into custody when they arrived in the states without papers. For all, it was a journey away from fear and politically motivated persecution and toward the dream of asylum in the United States.

Hess is medical director of the Atlanta Asylum Network. His job and that of the 20 or so other Emory physicians and psychologists who volunteer their time and expertise to the network is to evaluate asylum seekers and then write affidavits for the Asylum Court to document any physical and psychologic findings of torture and abuse: scars, crushed bones, nerve damage from being hung by one’s arms, cigarette burns on the hands or feet.

Such work is emotionally difficult, even for an emergency medicine doctor like Hess. It’s also challenging, since some kinds of torture, such as electrocution or repeated rape, don’t always leave lasting physical evidence. But it is important, says Hess, that America keep her promise to at least hear the concerns of those who come here seeking protection. It’s important, he adds, that medical professionals bear witness.

Hess helped found the Atlanta Asylum Network while he was a medical student at Emory more than a decade ago, as part of the Emory Institute for Human Rights. The program is affiliated with a similar, national network administered by Physicians for Human Rights.

It’s also important, Hess says, that the medical students and residents who volunteer with the program see what immigrants have been through. Even if they are not asylum seekers, many who immigrate to this country have experienced torture and mistreatment that have long-term impacts on their physical and mental health.

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Safe Childbirth

Supporting safe childbirth: In rural Ethiopia, where more than 90% of births take place at home, women have a one in 27 lifetime risk of dying during childbirth. Their babies fare even worse—the infant mortality rate there is about one of every 13 live births.

Lynn Sibley, a nurse midwife, anthropologist, and faculty member in Emory’s Nell Hodgson Woodruff School of Nursing, is working with the Ethiopian Ministry of Health to change those dismal figures. Their community strategy will serve as a model throughout the country. Mothers and babies are most vulnerable during birth and the following 48 hours. Sibley calls this period of vulnerability a window of opportunity to intervene for newborn survival and well-being.

With funds from the Bill & Melinda Gates Foundation, Sibley and her collaborators are working to improve the capability and performance of frontline health care workers. This includes teaching traditional birth attendants simple, yet critical procedures such as care for mother and child at delivery, postpartum health assessments, and counseling on nutrition, personal hygiene, and illness recognition and care seeking. The Ethiopia project is part of the nursing school’s Lillian Carter Center for International Nursing, which focuses on improving health for vulnerable populations.

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Helping create giant databases

Helping create giant databases: Emory genetics specialist Christa Lese Martin (above) is helping lead the effort on an international genomics database that collects data from 50,000 to 100,000 patients with autism or other developmental disorders every year. The online database will create a powerful new resource for gene discovery and for interpreting results of genetic testing. Emory also is providing registry coordination and other services to the first and only international registry for congenital muscular dystrophy (CMD). CMD represents several rare forms of muscular dystrophy that often are misdiagnosed because of physicians’ lack of familiarity with CMD. The registry will raise awareness, facilitate diagnosis, and connect affected individuals with research trials and future therapies.

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Spring Break in Jamaica

Spring break in Jamaica: As part of a robust service-learning curriculum in Emory’s nursing school, students travel to Caribbean islands on spring or winter break each year to provide care to those in need. In Jamaica, they work in coordination with Missionaries of the Poor, a faith-based organization. They work with medically fragile children—“holding, diapering, bathing, feeding, and loving them,” in the words of one student. They also provide wound care and other services for adults with mental or physical disorders, including HIV/AIDS. Another student wrote about the experience: “My expectation was to see a center of sadness where loneliness dwelled and hope was extinguished. However, I saw happiness and love in the faces of the brothers and in the smiles of the residents.” To see a related slide presentation, visit bit.ly/alternative_break.

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Drugs for the neglected killers: Dreadful tropical diseases that kill and maim millions every year often go neglected when pharmaceutical companies select targets for research and drug development. This year, the Emory Institute for Drug Discovery (EIDD) joined with GlaxoSmithKline and Alnylam Pharmaceuticals on research aimed at developing new drugs for 16 neglected tropical diseases that disproportionately strike the least developed countries. Among these are malaria, blinding trachoma, dengue hemorrhagic fever, leishmaniasis, and leprosy. Emory and other participating scientists will sort through research data and select the most promising compounds that could lead to effective new medicines. The EIDD builds on Emory’s strong history of drug discovery research, including development of drugs taken by more than 90% of patients with HIV/AIDS in the United States and many more patients around the globe.

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Taking care

Taking care where it is needed: Linda Cendales is one of many Emory physicians who volunteer their services to help patients who otherwise would never have a chance at a normal life. Cendales heads the Emory Transplant Center’s research program evaluating hand transplantation as a potential therapy for loss of one or both hands.

Earlier this year, she returned to Vietnam to treat dozens of limb injuries and to follow up on patients from a previous trip, including an 11-year-old boy with the country’s first toe-to-hand transfer. The boy had lost four fingers on his right hand. After transplanting one of the boy’s toes to his maimed hand, Cendales surgically fashioned it into a finger. The procedure has allowed him to perform tasks like dressing himself and holding a pencil.

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