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Global Health: Making a Difference Robert Malkin Director, Global Public Service Academies.

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Presentation on theme: "Global Health: Making a Difference Robert Malkin Director, Global Public Service Academies."— Presentation transcript:

1 Global Health: Making a Difference Robert Malkin Director, Global Public Service Academies

2 Instructions During our call To mute #5 To unmute press #5 again Press #0 for technical assistance

3 First: What is Global Health?

4 $29 billion Global Health

5 $29 billion $31 billion Global Health

6 $29 billion $31 billion Global Health

7 What are they all talking about? What is Global Health?

8 What is global? Dry, ice and green on earth

9 What is Global? Earth at Night

10 What is Global? Population Density (Millions per square mile)

11 % Without safe water What is Global Health?

12 % Stunting

13 What is Global Health? % HIV Positive

14 What is Global Health? Life Expectancy

15 What is Global Health? UN Human Development Index Low Human Development (least, third) High Human Development (most, first) Medium Human Development

16 So, what can we do? Conclusion: Send $$ Least Most Developed Nations

17 Not so fast!


19 Conclusion: Send Equipment Just Sending Money Wont Work Savannah Carson, EWH volunteer with new friends in Tanzania Corruption Brain Drain Infrastructure

20 80% of hospital equipment in least developed nations is donated WHO Guidelines for Medical Equipment Donations WHO Essential Health Care Technology:

21 At the end of the day, this girl was waiting My Experience at Kissy Eye Clinic Freetown,Sierra Leone Arrival with cataract surgeon

22 Where Sierra Leone? UN Human Development Index Low Human Development (least, third) High Human Development (most, first) Medium Human Development Sierra Leone

23 Life Expectancy - 38 years Safe Drinking Water - 54% Infant Mortality - 170/1000 Under Five Mortality - 286/1000 Ingrid BB Adolfo Cindy

24 Something Was Wrong It was late at night Cataract patients waiting Phaco and XYZ = 20 minutes

25 Got to Work In 30 minutes Fixed the XYZ All Patients Treated Training Paul to work on XYZ Scope Needed Spare parts Tools Knowledge

26 70% of all donated medical equipment does not work*+ Hypotheses Spare Parts Consumables Too Complicated *WHO Guidelines for Medical Equipment Donations + Malkin, Annual Review of Biomedical Engineering, 2007

27 O2 sensor Needs replacement Tracy Lipps with donated Siemens Ventilators Worked for 4 months, then stopped

28 Jinotepe, Nicaragua Sidelined due to consumables

29 Electrodes Sensors Test strips Reaction Cartridges Blood Pressure Cuffs Printing Paper Sterilization Check strips IV Pump Cartridges Reagent Packs Bovie Pens Tubing Canulae Consumables

30 Malignant neoplasm, % of population Inappropriate Donations

31 Leading Causes of Mortality WHO data 2003 (COPD= chronic obstructive pulmonary disease) Most Developed Nations Least Developed Nations

32 Leading Causes of Morbidity (loss of quality of life - DALY)

33 All Causes of Morbidity

34 What is Everyone Talking About? Global Health us –archetype = Africa Sending money is NOT the answer –Only medium human development Sending equipment is NOT the answer –Consumables –Lack of trained staff –Spare parts Our equipment is NOT appropriate –Solves the wrong problems –There is no silver bullet

35 What are we doing? Duke-EWH Summer Institute Global Public Service Academies (GPSA) Duke Research: Capacity Building Duke CUREs What can you do?

36 Duke-EWH Summer Institute 56 Participants in Month Training in Costa Rica/Tanzania 1 Month in a poor Hospital Nicaragua, Honduras, Tanzania

37 Analysis Failures Repairing Equipment 29% Spare Parts for the Power Supply

38 Inventory What do they have? Training 24% training including user error and installation

39 Identifying Technical Needs The Long Interview

40 Health Impact : >2000 pieces into service >$4 million worth

41 Trip Profile: Stephanie Patnode University of Southern California, UC Berkeley Id go back tomorrow. I … for once, felt like an engineer. Training 100s Global Engineers

42 Students Making a Difference Academic Summer Programs for High School Students Global Public Service Academies

43 Students Making a Difference High School Students Sophomores/Juniors Interested in health careers 4 weeks in a developing world clinic/hospital Mornings in training educational collaborator MIT, FLGCU language Pediatric Ward Jacmel, Haiti

44 Students Making a Difference Afternoons working in the clinic Health Screening (vision, BP, temperature, weight, etc) Shadowing physicians, pharmacists, nurses Traditional volunteer roles Research with MIT faculty, undergrads, grads Needs Finding – Disabilities FGCU faculty, undergrads

45 Students Making a Difference Expecting it to be very competitive Will cost, scholarships available Applications available Oct First summer in Mens Ward, Sierra Leone

46 A few pictures from Calhuitz, Guatemala




50 What can you do? Design for the Developing World Web Site: Lists about 20 Identified Needs Anyone can design solutions –EWH will pay for prototyping –May enter distribution system

51 High School, Middle School, Clubs, EWH Chapters and individuals purchase kits and build equipment High School in Nashville Science Club In Memphis Summer Camp in Durham LA Tech Kits available

52 Sudan Nicaragua >1000 pieces delivered >$1 Million (replacement value) El Salvador Philippines Indonesia

53 EWH Chapters Cambridge and Oxford, England, … and others

54 EWH Chapters Meet Weekly or Bi-Weekly Students per meeting Chapter guidelines available from UNC/NC State/Duke EWH Chapters building phototherapy devices Congressman Price, the Mayor of Durham, Chuck Messer

55 Duke/EWH: Succeeds Through Generous Support of our Partners Duke University Hamilton Roddis FOUNDATION Gift of Life Leonard M. Foundation

56 You Have Unique Role You must make that Role a Reality

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