Without Borders

Editor's Blog

  • Global Stuff You Should Know

    Neurology Outreach Clinic for HD in Peru: A Model of Care Provision on Exiting the Capital City
     
    Gretchen Birbeck, MD, MPH, Without Borders Editor, Rochester, NY interviewing Anastasia Vishnevetsky, MD and Mario Cornejo-Olivas, MD, of the Instituto Nacional de Ciencias Neurológicas and Instituto Nacional de Ciencias Neurológicas, Lima, Peru
     
    In this week’s edition of Neurology there is a must read for anyone pondering how one might provide multidisciplinary neurologic care to a population with a substantial burden of disease in an area with very few but some neurologic expertise1. The impetus for developing the program described by Vishnevetsky and colleagues was the very high burden of Huntington’s Disease (HD) in the area around the Cañete valley about 3 hours outside of Lima. HD occurs at rates ~4 times expected. Through 2 days of clinic and community-based outreach provided every 3 months, they are able to bring specialty care and critical home-based assessments to not only the HD population but the broader group of people in area with chronic neurologic disorders. As I was reading their description of what they are doing and how they are doing it, several questions same to mind. Dr. Anastasia Vishnevetsky and Dr. Mario Cornejo-Olivas have kindly agreed to answer them for us here.
     
     
    Bringing Neuroscience to Cambodia 
     
    Soma Sahai-Srivastava, MD, FANA, FAHS, Clinical Prof. of Neurology, Dir., Neurology clinics Program Director, Headache Dept. of Neurology Keck Medical Center of USC, Los Angeles, CA
     
    Cambodia is a Southeast Asian country, of 15 million, with a per capita annual income $1,080. For 100 years until 1953, it was a French colony, followed by the formation of a kingdom. In 1970, civil war led to rise of the Khmer rouge and Pol Pot who had a communist agenda “a classless society with no economy”. During this time, 2-3 million Cambodians were executed and the educated class was targeted. Only a handful of doctors remained (many died or left the country). In my many trips to Cambodia in the last decade, volunteering solo, I realized that there are no short term volunteering opportunities for neurology clinical care, unlike other specialties like Emergency Medicine, Pediatrics, Surgery etc. No neurology outpatient clinics or inpatient specialized programs existed until recently. There were only 3 neurologists in the country in 2012 (Loo, 2012). The first Internal Medicine residency program launched in 2011 and there are still no adult or pediatric neurology residency programs. There is one pediatric neurosurgeon and no pediatric neurologists in the entire country. There is a lack of commonly prescribed neurological medications, (e.g. phenytoin and phenobarbital are the only antiepileptics available at the public hospitals). Under these circumstances, I realized that rather than volunteering in clinics treating individual patients, the first priority was neuroscience education and curriculum development at all levels —undergraduate, medical school and postgraduate.
     
     
     

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  • On The Road

    Congress Report: The 23rd World Congress of Neurology, September 16 - 21, 2017, Kyoto, Japan

    Steven L. Lewis, MD, Rush University Medical Center, Chicago, Illinois, USA and Wolfgang Grisold, MD, KFJ hospital, Vienna, Austria

    We are pleased to report on the XXIII Congress of the World Federation of Neurology, which took place from September 16 - 21, 2017 in Kyoto, Japan. This report is based in large part on our report on the World Congress that we recently published in World Neurology (1), the WFN’s official newsletter. Interested readers are also encouraged also to sign up for a free subscription to World Neurology.

    The World Congress of Neurology is the premiere international conference of the World Federation of Neurology (WFN) and occurs every two years, rotating among each of six major regions of the world, and hosted by a national neurological society (2). This rotation among many regions of the world, to quote WFN president Raad Shakir, “ensures its diversity and uniqueness.” (3). The location of each world congress is decided four years in advance by the WFN’s Council of Delegates (who represent the national member neurological societies from around the world [4]), who vote on nominations from the upcoming region. The previous World Congress of Neurology was held in Santiago, Chile in 2015.

    Continued...

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  • Extra! Extra! Read All About It!

    National Institute of Health Opportunity -  The National Institute of Neurological Disorders and Stroke (NINDS) is currently seeking a Health Disparities and Global Health Program Director – Division of Clinical Research. The Program Director position is within the Division of Clinical Research (DCR) at NINDS, located in Bethesda, MD. The Division of Clinical Research (DCR) within NINDS oversees a large program of observational studies, clinical trials, and other clinical research supported by extramural funding mechanisms. Check here for a full description and information on how to apply.

    The second annual Women Leaders in Global Health conference - It will be held on 8-9 November 2018 at the London School of Hygiene & Tropical Medicine, UK. The purpose of the conference is to put a gender lens on global health leadership and with a focus on mentoring and skills building. This meeting will bring together established and emerging leaders from across sectors and cultures to work towards gender equity in health leadership and to improve health for all. If interested,  link to the conference here.

    Zambia seeks Neuro-educators for its new post graduate program in Neurology - Currently, there are no Zambian adult or pediatric neurologists, but that will soon be changing. Deanna Saylor, MD, MHS, relocated full-time to the University Teaching Hospital in Lusaka, Zambia to launch two-year fellowship programs in both adult and pediatric neurology. These programs will begin in October 2018 through the University of Zambia School of Medicine and will train the first cohort of Zambian neurologists. She is currently looking for volunteers to come to Zambia for one month periods to attend on the neurology services and teach our neurology trainees. The program is looking for adult and pediatric neurologists in all areas of neurology to come anytime in the 2019 calendar year. (While one-month blocks are preferred, two week periods would be considered.) If you are interested or would like to hear more details, please reach out to me at deanna@jhmi.edu. 

    Resident and Fellow Section: International Issues A Guide to U.S. Academic Global Health Programs in Neurology U.S. trainees interested in undertaking a global health elective should check out this month’s Resident’s and Fellow’s Section. In International Issues: A Guide to U.S. Academic Global Health Programs in Neurology, Samudralwar and colleagues provide pragmatic, insightful advice about how to go about doing this along with a helpful listing of existing opportunities. If you are a health professional in neurology or allied fields working outside of the US who accepts US trainees, please also check out this paper and consider adding your opportunity for neurology trainees to the online directory. 

    Practice Current Newest Survey: When do you order ancillary tests to determine brain death? Neurology: Clinical Practice has just launched a new Practice Current survey.  Given the broad range of approaches to determining brain death in diverse settings with varying resources, this survey promises to provide interesting insights. Please consider completing the survey to add your own perspective at NPub.org/NCP/pc07.

    The American Academy of Neurology Global Health Section has posted its most recent newsletter - In this issue you'll find information on the Foundation for African Medicine & Education (FAME), Iceland's health care system, observership experiences at the Neuroscience Center of All India Institute of Medical Sciences, and The International AIDS Society Conference on HIV Science in Paris. 

  • Meet the Editor

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    Dr. Gretchen Birbeck, MD, MPH, DTMH, FAAN, Without Borders Editor, Rochester, NY