IMS 4-12 Issue on Global Health
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Transcript of IMS 4-12 Issue on Global Health
8/2/2019 IMS 4-12 Issue on Global Health
http://slidepdf.com/reader/full/ims-4-12-issue-on-global-health 1/4
insideMount Sinai
Providing Medical Care to the Masses
CONTINUED ON PAGE 2
The world is more densely populated, urbanized, and
interconnected than ever before. In understaffed city
hospitals and rural clinics throughout Africa, Asia, and
Latin America, health care workers are encountering
increasing rates of obesity, diabetes, lung cancer,
and heart disease in their patient populations. Theseconditions once affected mostly people in industrialized
countries. Now they are more prevalent in developing
nations that are also battling infectious diseases such as
AIDS, malaria, pneumonia, and tuberculosis.
Mount Sinai Global Health, which unies The Mount
Sinai Medical Center’s many international missions
and programs—as well as efforts in underserved U.S.
communities—is addressing these challenges through
research, training, and clinical practice. With Mount
Sinai’s innovative thinking and intellectual rigor, we are
maximizing human and technological resources, and
giving equal weight to the demands of the present and
the predicted needs of the future.
— Philip J. Landrigan, MD, MSc
Promoting cardiovascular health throughout the world is a priority for
physicians at Mount Sinai Heart, led by Valentin Fuster, MD, PhD, Physician-
in-Chief of The Mount Sinai Medical Center. They see the expanding
spectrum of cardiovascular diseases increasingly affect low-and-middle-
income countries.
“How do we reach the millions of people in remote areas of the world who
are as likely to be affected by cardiovascular disease as those in high-income
countries?” Jagat Narula, MD, PhD, Associate Dean for Global Health, and
Editor-in-Chief of Global Heart , the journal of the World Heart Federation,
asks rhetorically. “How do we reach the masses?”
For one day in January, Dr. Narula, the Philip J. and Harriet L. Goodhart
Professor of Medicine (Cardiology), and Director of the Cardiovascular
Imaging Program at Mount Sinai Heart, was able to do so. Through a
program he co-founded, known as HAPPY (Heart Attack Prevention
Program for You), Dr. Narula reached out to thousands of individuals who
had converged in Sirsa, a remote area of India, for a one-week meditation
A Commitment to Global Hea
Bringing Safe,
Sustainable Health Care
to Women in Guatemala
In Colombia, Children
Learn about Heart Health
Improving Quality of
Life on the Spirit Lake
Tribe Reservation
Building a Strong Health
Care System in Haiti
Mount Sinai’s
Global Reach
Lookinside
THE
GLOBALISSUE
|Ap
ril2
15,2012
These women were among millions of people who gathered
recently in Sirsa, India, for a one-week celebration and
meditation camp. Mount Sinai physicians performed thousands
of cardiovascular screenings at the event (see story below).
Dr. Landrigan is Dean for Global Health, Ethel H. Wise Professor an
Chairman, Department of Preventive Medicine, Professor of Pediat
Director, Children’s Environmental Health Center, Mount Sinai Scho
of Medicine.
Mount Sinai’s Partho P. Sengu
MBBS, MD, DM, screens a pat
in Sirsa, India.
8/2/2019 IMS 4-12 Issue on Global Health
http://slidepdf.com/reader/full/ims-4-12-issue-on-global-health 2/4
camp. The Reverend Gurmeet Ram Rahim
Singh Ji Insan, a spiritual leader whom they
had come to hear, relayed a message from
Dr. Narula on the importance of eating well,
exercising, and not smoking.
Over a 24-hour period, Dr. Narula led a
health care team that screened 4,684
patients for blood pressure, glucose,
and cholesterol, and performed carotid
ultrasounds for more than 650 at-risk
patients. The record-breaking feat wasrecognized by editors at Guinness
World Records.
The event also included an initiative
led by Partho P. Sengupta, MBBS, MD,
DM, Associate Professor of Medicine
(Cardiology), and Director of Ultrasound
Research at Mount Sinai Heart. Dr. Sengupta
mobilized 75 cardiologists and sonographers
from medical institutions around the world,
including the United States, Australia,
and Bulgaria, who volunteered to read
echocardiograms that were sent via cloud
computing to their homelands on behalf of
the American Society of Echocardiography.
Using new handheld ultrasound devices,
Mount Sinai investigators and their team
performed scans on 1,030 patients over two
days, also earning a Guinness World Records
certicate. Joining Dr. Sengupta onsite was
a second cardiologist and nine sonographers
from the United States, including Mount
Sinai’s Ingrid Altamar, and local cardiologists
and health care workers.“We saw really sick patients who had
severe valve disease and undiagnosed
congenital defects,” says Dr. Sengupta. Five
people were sent directly to the hospital.
“Ultimately, we connected 1,030 hearts with
75 experts from around the world,” he adds.
Dr. Narula says global initiatives like the
one in Sirsa, help Mount Sinai by providing
investigators with an opportunity to analyze
and understand the disease process using
modern technology.
Tourism is robust in the Lake Atitlán region in
the Guatemala Highlands, an area known for
its winding mountains, and beautiful volcanic
lake. But in the outlying villages, far from the
busy hotels, residents live without running
water and electricity. Here, the maternal
death rate is the highest in Central America.
Mount Sinai’s Global Health Program
is making strides toward sustainable
women’s health care here and in other
indigenous societies throughout Central
America. Taraneh Shirazian, MD, Director of
Global Health, Department of Obstetrics,
Gynecology and Reproductive Science
at Mount Sinai School of Medicine, has
spearheaded initiatives that provide onsite
clinical care, and teach best practices in
pre- and post-delivery protocol to local
health care workers.
Prior to being deployed to communities
throughout Guatemala, El Salvador, and
Honduras, Mount Sinai residents are trainedto understand the local cultures. They are
taught how to address global health issues
such as women’s rights, and access to
family planning, along with cultural beliefs
surrounding delivery and pregnancy.
“We focus on understanding, educating, and
empowering women in the context of their
local perspective,” says Dr. Shirazian.
Approximately one Mount Sinai resident goes
on each of the six or so annual missions to
the Lake Atitlán region, which are conducted
in cooperation with a nongovernmental
organization (NGO) called Saving Mothers.
Local birth attendants have no formal
training; they’re unequipped for life-
threatening complications such as post-partum hemorrhage and eclampsia, a
convulsive condition that often follows
pregnancy-induced hypertension. The Mount
Sinai teams train birth attendants in critical
practices such as clean and safe delivery,
shoulder dystocia, and appropriate and
timely referral in cases of emergency. The
local hospital staff also receives training in
appropriate administration of medications
through a best-practices protocol manual.
When Mount Sinai’s teams noticed the
absence of even the most basic resources
for a clean, safe delivery, they began
distributing birth kits with soap, gloves, clea
sheets, blankets, and baby hats, along with
simple, pictorial instructions for delivery.
In May, they will begin distributinghemorrhage kits to the Guatemalan birth
attendants to stem post-partum hemorrhag
the leading cause of maternal death.
“Mount Sinai prepares its physicians for
responsible global citizenship,” says Dr.
Shirazian. “They become better physicians
when they can educate women from diverse
backgrounds. Only through culturally
sensitive collaboration can we hope to
make any sustainable impact on global
women’s health.”
Providing Medical Care to the Masses (continued from page 1)
Bringing Safe, Sustainable Health Care to Women in Guatemala
Mount Sinai residents provided Guatemalan birth attendants with birth kits that contain necessities
such as soap, gloves, clean sheets, and pictorial instructions for delivery.
At the celebration in Sirsa, India, men lined up
to receive echocardiograms.
8/2/2019 IMS 4-12 Issue on Global Health
http://slidepdf.com/reader/full/ims-4-12-issue-on-global-health 3/4
Mount Sinai Heart researchers, in collaboration with Sesame
Workshop, have shown that children ages four through six are eager
to learn the importance of exercising and maintaining a healthy diet.
With proper intervention, and support from parents and teachers,
they can develop healthy habits that last a lifetime. These key ndings
were reported recently in a three-year study of thousands of pre-
school children in Bogotá, Colombia that was led by Valentin Fuster,
MD, PhD, Physician-in-Chief of The Mount Sinai Medical Center and
Director of Mount Sinai Heart.
Dr. Fuster and his team have been examining ways to prevent the
spread of cardiovascular disease (CVD) in both developed and
developing countries as lifestyles become more sedentary, and
high-fat, high-carbohydrate diets become the norm. In Bogotá, CVD
has become the leading cause of death, according to an assessment
of seven Latin American cities that appeared in The American Journal
of Medicine.
The Mount Sinai team says their encouraging results in Bogotá,
using popular characters from Sesame Workshop, can be replicated
across cultures. They say prevention programs like this will save lives
and enormous amounts of money that governments now spend to
treat CVD.
“We have to promote health and stop talking about disease,” says
Dr. Fuster, who is also Director of the Zena and Michael A. Wiener
Cardiovascular Institute and the Marie-Josée and Henry R. Kravis
Center for Cardiovascular Health at The Mount Sinai Medical Center.
“Young children learn what you teach them. And children impact the
behavior of their parents.”
The Spirit Lake Tribe Indian Reservation
covers about 405 square miles in the East-
Central part of North Dakota, an area in theremote Northern Plains bounded by lakes
and at terrain that gives way to rolling
hills. This branch of the Dakotah tribe, with
approximately 6,600 members, has lived on
the reservation since the tumultuous days
of 1867, when Native Americans fought to
preserve their way of life.
Today, Mount Sinai School of Medicine—
under the leadership of Jonathan Ripp, MD,
MPH, Assistant Professor, Division of General
Internal Medicine, Department of Medicine,
and Associate Director, Global Health Training
Center—is working with the Spirit Lake Tribe
to improve their quality of life. Almost 60
percent of the community is unemployed,
and about 50 percent live at or below thepoverty level. Rates of obesity, diabetes,
and alcoholism among Native Americans, in
general, far exceeds that of the rest of the U.S.
population, and members of the Spirit Lake
Tribe are no exception.
For three years, Mount Sinai has partnered
with the tribe’s Cankdeska Cikana Community
College (CCCC) to help educate and promote
healthy behaviors among tribe members, and
to encourage tribal youth to pursue careers in
health care.
Mount Sinai’s students helped the community
conduct an elder health needs assessmen
in 2010. The data collected was used to
help fulll grant requirements for fundingto support services for the tribe’s elderly
population. For the past three years, CCC
has offered a health care course that is ta
by Mount Sinai’s medical and public heal
students, residents, and faculty.
In June 2012, approximately six of Mount
Sinai’s medical and public health student
residents, and faculty will visit the reserv
for a fourth summer to teach the course
CCCC, and help run a day camp for midd
school children that exposes them to diff
health professions, and encourages healt
habits. The camp’s activities include visit
from Emergency Medical Service worker
nurses, and assistance in producing video
public health announcements.
“The people of Spirit Lake honored and
welcomed us into their lives with unexpe
openness,” says Dr. Ripp. “Each experienc
we shared—the elder interviews, tradition
ceremonies, and family ceremonies—gav
us a new appreciation of their complex
community.”
Improving Quality of Life on the Spirit Lake Tribe Reservation
In Colombia, Children Learn About Heart Health
We have to promote health and stop talking
about disease. Young children learn what you
teach them. And children impact the behavior
of their parents. — VALENTIN FUSTER, MD, PHD
Pre-schoolers in Colombia perform for their peers, singing and dancing abou
the importance of exercising and maintaining a healthy diet.
PHOTOS, FROM LEFT TO RIGHT: Cankdeska
Cikana Community College students march
at the Spirit Lake Tribe’s annual celebration,
which culminates with a traditional pow wow
CONTINUED ON PAGE 4
8/2/2019 IMS 4-12 Issue on Global Health
http://slidepdf.com/reader/full/ims-4-12-issue-on-global-health 4/4
Haiti’s catastrophic
earthquake in 2010 quickly
drew physicians, nurses and
other health care workers
from The Mount Sinai
Medical Center and around
the world. As expected,
National Hospital, Haiti’s
large hospital in the capitalof Port-au-Prince, was in a
shambles. What the outside
world did not realize, however, was how inadequate and fractured
Haiti’s health care system had been long before the earthquake hit.
“The earthquake was a catalyst that opened people’s eyes to how
bad things were, and what we could do to make it better,” says Ernest
Benjamin, MD, Professor of Surgery and Anesthesiology, Chief, Division
of Surgical Critical Care Medicine, and Director of the Surgical Intensive
Care Unit at The Mount Sinai Medical Center. Dr. Benjamin, arrived
at National Hospital three days after the earthquake, and led Mount
Sinai’s medical relief efforts there.
Now, Dr. Benjamin is galvanizing Mount Sinai’s physicians, residents,
and medical students, and members of other U.S. medical centers to
help establish a strong health care infrastructure in Haiti. Their multip
efforts include the following initiatives:
Building a Strong Health Care System in Haiti
Mount Sinai’s Global Reach
Inside Mount Sinai2012 Marketing & Communications
Carrie Gottlieb, Editor
Marilyn Balamaci, Editor
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Ernest Benjamin, MD, demonstrates
critical care procedures for Haitian
medical students.
• Twice a year, Dr. Benjamin and Adel M. Bassily-Marcus, MD,
Assistant Professor of Surgery, at The Mount Sinai Medical Cente
travel to Haiti to teach fth-year Haitian medical students an
intensive, four-day course in critical care medicine.
• Dr. Benjamin and François Lacour-Gayet, MD, Chief of the Divisio
of Pediatric Cardiothoracic Surgery at Monteore Medical
Center in New York, are planning four missions to Haiti in 2012, in
which they will perform heart surgery on a total of 60 children.
Ultimately, Dr. Benjamin would like to help create a Heart Institute
of Haiti to treat adults and children, and develop an advanced
cardiac care program that includes cardiac surgery.
• A group of third-year medical students at Mount Sinai are
conducting research on the prevalence of neurological problems
Haiti, under the supervision of Isabelle M. Germano, MD, Professo
of Neurosurgery, Neurology, and Oncological Sciences.
In Colombia, Children Learn About Heart Health (continued from page 3)
The study in Bogotá, started with 1,000 children
in 2009, and has grown to more than 25,000.
Research supervisors spend 40 hours over
a ve-month period with the children, using
specially designed Sesame Workshop characters
that promote healthy habits in books, posters,
videos, games, and songs. Their teachers attend
training sessions, and their parents participate in
workshops, and receive weekly notes containing
positive health messages about nutrition and
active lifestyles to share with their children. The
changes in knowledge, attitudes, and habits weremeasured using a standardized tool. Children
in the intervened group exercised regularly and
maintained their weight over six months.
The children provide the impetus for families to
change their lifestyles, says Michael E. Farkouh,
MD, MSc, Associate Clinical Professor of Medicine
(Cardiology), and a co-author of the study. “We
are promoting good health and we can do this
across countries,” says Dr. Farkouh. “Our program
opens up a whole new area for cardiovascular
public health.”
A larger effort in Spain that is modeled after the
program in Bogotá currently involves 100,000
children. In Spain, Dr. Fuster plans to add a second
level of educational intervention for when the
children turn seven. The project also examines
whether the control of emotions can help prevent
drug addiction after the age of 10.
Argentina
Bangladesh
Belize
Brazil
Cameroon
Chile
China
Colombia
Costa Rica
Dominican
Republic
Ethiopia
Grenada
Guatemala
Haiti
Honduras
India
Iran
Ireland
Italy
Kenya
Liberia
Malawi
Mexico
Mongolia
Mozambique
Paraguay
Peru
Rwanda
St. Vincent and
the Grenadines
South Africa
Spain
Tanzania
Thailand
Uganda
United States
Uruguay
Vietnam
A SNAPSHOT OF INITIATIVES AROUND THE WORLD: