HANDS-ON HELP Cybéle Renault, M.D., examines a patient at Mulago Hospital, where some of the poorest and sickest residents of Uganda seek treatment. Dr. Renault is part of the Yale/Stanford-Johnson & Johnson Global Health Scholars Program, which sends health care professionals to work at some of the world’s most overburdened health care sites, including locations in Africa, Asia and Central America.
Visiting Scholars Bring Expertise, Relief to Overburdened Hospitals
At Mulago Hospital in Uganda, Infectious Diseases Specialist Cybéle Renault, M.D., is gently holding the hand of a frail, young woman suffering from fever, headache and diarrhea. “These symptoms could be caused by a long list of diseases in this part of the world—malaria, meningitis, typhoid fever,” says Dr. Renault. “We have very limited resources here. Most wards don’t have a thermometer or blood pressure cuff to check vital signs. Physicians must diagnose and treat patients based largely on the patient’s symptoms and a physical exam.”
Dr. Renault is one of more than 60 medical residents, teaching faculty and career physicians who are taking part in the Yale/Stanford-Johnson & Johnson Global Health Scholars Program during 2009 and 2010. The program selects the most promising candidates from major American institutions, mainly Yale University and Stanford University, and sends them to one of six overburdened health care sites in places such as Eritrea, Indonesia, Liberia, South Africa, Uganda and Central America. Participants stay six weeks or longer.
“It’s a different world in these hospitals,” says Dr. Renault, a Johnson & Johnson scholar from Stanford. “At Mulago, we have limited medications. CT scans are not available unless patients are able to pay a high price; basic tests take days to process. It’s a challenging environment, but it’s also a highly enriching one for visiting scholars and Ugandan residents and students.”
MAKING A DIFFERENCE AT MULAGO
Mulago is a teaching hospital for Makerere University and a national referral center, which means “we do not turn anyone away,” says Nelson Sewamkambo, M.D., Principal of the College of Health Sciences. The hospital was built as a 900-bed facility but often holds more than 1,500 patients. Six to 10 beds are wedged into each room, and foam and straw mats line hallways. “We have a huge patient load and very few physicians and nurses.”
A nearby private hospital is available, but the patients at Mulago cannot afford private care. “These are the poorest and sickest patients in the area,” says Dr. Renault. “I’ve seen advanced disease states that are dramatically different from those that we typically see in the United States.”
One benefit of the Yale/Stanford-Johnson & Johnson Global Health Scholars Program is that it gives visiting physicians and students an opportunity to learn how to diagnose and treat complex diseases, but “the program goes much deeper than that,” says Dr. Sewamkambo. “Our medical students gain exposure to the visiting health care professionals and how they practice medicine. The visiting physicians give patients access to more doctors who can contribute to better diagnoses and outcomes.”
The Johnson & Johnson involvement at Mulago continues to grow. In 2009, the Company funded a laboratory for one of the medical wards. “In that ward, the recovery rates for tuberculosis are high,” says Dr. Sewamkambo. “Patients are diagnosed the same day—instead of in a week—and are given appropriate treatment immediately, which reduces their stay in a hospital that has too few beds and health care providers.”
EDUCATING 500 PHYSICIANS
Johnson & Johnson began partnering with the scholars program in 2001 to support the Company’s mission to build the skills of people who serve community health needs. As part of the Company’s strategy to build health care capacity, more than 500 physicians at various stages in their training have participated in the program since 2001.
In 2006, Mulago Hospital was added to the list of rotation sites after Majid Sadigh, M.D., Associate Professor of Medicine at Yale, traveled to Uganda to teach African doctors about the treatment of AIDS. “Mulago touched my heart,” says Dr. Sadigh. “This was a place treating 120,000 patients a year, and a third of those patients were dying during their hospital stay. I was an eye witness to a tragedy, and I had to do something about it.”
To develop a program for Mulago Hospital, Dr. Sadigh worked with Dr. Sewamkambo and Asghar Rastegar, M.D., and Michele Barry, M.D., Co-directors of the Yale/Stanford-Johnson & Johnson Global Health Scholars Program. “Our hope is that faculty and students will draw upon the Uganda experience not only to expand their medical knowledge, but to highlight the need for cultural competence and humanism in medicine,” says Dr. Sadigh. “We want to help deepen core values such as love, respect and empathy toward patients. This is the essence of medicine.”