Outreach Mission Research Articles

747 Important Considerations for Healthcare Outreach Missions

747 Important Considerations for Healthcare Outreach Missions

Presentations of bladder exstrophy in a resource-limited setting and the role of Mainz II continent diversion for late referrals or failed primary closures: a multicentric report.

Primary closure techniques that have been updated and longterm follow-up for CBE (classic bladder exstrophy) may be out of reach for many patients living in resource-limited settings. Late referrals to medical care and primary closures that lack the necessary skills and facilities for comprehensive treatment are still common. Alternative and long-term surgical solutions may improve the lives of these unfortunate patients. During surgical outreach missions, patients with CBE, either non-operated or with a previous unsuccessful bladder closure, who were referred from vast under-resourced rural areas to three Eastern African hospitals, were studied. The following information is provided: mode of presentation, clinical history, diagnostic workout, management, and outcome. There were 25 cases (M/F ratio 17/8) ranging in age from two days to twenty years. Five of the seventeen patients who were not treated (35%) were under 120 days old and eligible for primary closure in a qualified tertiary center when one was available in the country. There were twelve late referred cases (ranging from 120 days to 20 years). Between the ages of ten months and twelve years, eight children arrived following a failed primary closure. In all of them, the bladder plate was too altered to allow closure. Following a preoperative diagnostic workout, a Mainz II continent internal diversion was proposed to fourteen patients with acceptable bowel control and postponed in the other three. Three cases were lost before treatment because parents refused the procedure. Twelve cases ranging in age from three to twenty years (mean seven years) were operated on. Eight people were followed for a total of 53.87 months (range: 36-120). Except for three people who complained of occasional night soiling, day and night continence were good. The average voiding frequency during the day was four and 1.3 at night. There was no evidence of a metabolic imbalance, urinary infection, or significant upper urinary tract dilatation. Two fatalities could not be linked to urinary diversion. Four patients were not followed up on. Due to the limited number of specialist surgical facilities, CBE late referral or failed closure is to be expected in a resource-limited context. In lieu of the primary closure, a continent internal diversion will be proposed and encouraged even at the level of a non-specialist hospital to improve the quality of life of these unfortunate patients. It is recommended that patients be warned about the procedure's potential long-term risks, which will necessitate a limited but regular follow-up.

The Path Toward a Sustainable Global Health Partnership

Residents' Review| April 2023 The Path Toward a Sustainable Global Health Partnership Aria Shafai, MD; Aria Shafai, MD Search for other works by this author on: This Site PubMed Google Scholar Vahe S. Tateosian, MD Vahe S. Tateosian, MD Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor April 2023, Vol. 87, 35. https://doi.org/10.1097/01.ASM.0000925024.33869.88 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Cite Icon Cite Get Permissions Search Site Citation Aria Shafai, Vahe S. Tateosian; The Path Toward a Sustainable Global Health Partnership. ASA Monitor 2023; 87:35 doi: https://doi.org/10.1097/01.ASM.0000925024.33869.88 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: partnerships, world health Five billion people around the word lack access to safe surgical care (International Journal of Surgery Open 2021;28:202:63-9). Approximately $4 billion is spent annually on medical mission trips to provide medical services to countries in need (Global Health 2016;12:45). Despite this, a dire need continues to exist. The SARS-CoV-2 pandemic temporarily halted many humanitarian outreach missions, further exacerbating existing global inequities. The questions we must now ask are not only how we can help bridge this gap, but how we can strengthen our efforts in promoting sustainable change within the communities we seek to serve. Engaging providers who are relatively early in training, such as students, medical residents, and fellows, can foster a greater awareness and understanding of the needs that exist in the developing world. Residents who have participated in such initiatives have reported an improved adaptability to new health care settings, communication with patients... You do not currently have access to this content.

Contextual Mission Construction according to the Jubata Concept in the Kanayatn Dayak Tribe in Introducing the Triune God

The purpose of this research is to describe the contextual mission construction using the concept of Jubata to introducing the concept of the Trinity in a biblical view to Dayak Tanayatn people This study uses a qualitative descriptive approach to identify how the Kanayatn Dayak understand the Jubata figure. The results show that through the adaptative method and using the seven Jubata names in the Kanayatn Dayak language to understanding the concept of the Triune God in biblical view and change the understanding of the survivors' sacrifices to be understood as worldly salvation, not eternal in nature through the image of Jubata (which is equated with the spirit of the ancestors) but is directed to one of God's persons in the Trinity of God the Son (Jesus Christ) as the Savior of mankind. Thus, the contextual mission construction of the Jubata concept in the introduction of the Gospel of the Triune God can be a reference material for carrying out outreach missions to remote tribes and building contextual mission studies that are culturally appropriate to spread the Gospel among the Kanayatn Dayak tribe in Landak, West Kalimantan.

Humanitarian aid involvement factors among IMARET volunteers

In many domains, core activities of people’s lives would be disrupted if volunteers were not present to provide much-needed help especially medical-based mobile clinics that rely heavily on the labour of volunteers. This study was designed to identify the factors related to humanitarian aid involvement of volunteers, to discover the background of volunteers attending Islamic Medical Association of Malaysia (IMAM) Response and Relief Team (IMARET) mobile clinic and outreach mission and to determine the association between the humanitarian aid involvement factors and the background of volunteers. This cross-sectional study used Volunteer Function Inventory (VFI) scale to measure the motivation factors of volunteers and total of 178 volunteers were recruited. Among the six motivation factors such as values, protective, understanding, enhancement, security and social factors being studied, understanding factor was found out to be the highest factor that motivated the volunteers. Based on the Fisher’s Exact Test, the motivation factors were found to have no association with the demographic data of volunteers. This study suggests that non-profit organisations should be aware that people joining volunteering or humanitarian aid work were not influenced by their sociodemographic characteristics.

Mentoring in Medicine (MIM): Motivating and enabling disadvantaged youth to become the next generation of minority health professionals.

Mentoring in Medicine, Inc. (MIM) is a nonprofit health and science youth development organization based in the Bronx, NY. Founded in 2006 by three physicians and an engineer- trained entrepreneur, MIM’s organizational goal is to expose socioeconomically disadvantaged students to the wide variety of health and science careers and to increase the health literacy of their communities. It is aligned with the outreach mission of the U.S. National Library of Medicine (NLM) whose former Director, Donald A.B. Lindberg M.D., fostered an enduring relationship. Technical assistance, evaluation, and financial support provided under his leadership helped MIM to become a nationally recognized organization leading the field to diversify health careers and to increase health literacy in often hard to reach populations. Through live and virtual programming, MIM has impacted nearly 58,000 students, parents, and educators in urban epicenters in the U.S. The MIM Team has helped 503 students who were discouraged to build a competitive application and matriculate in health professional school. MIM has 88 press features highlighting its work in the community.

Resumption of Short-term Burn Reconstruction Missions to Ukraine in Light of COVID-19: A Paradigm Shift.

The COVID-19 pandemic has disrupted the lives of billions of people globally. Some medical systems continue to be overburdened due to the viral illness leading to incredible public health challenges domestically as well as abroad. However, with vaccination distribution increasing globally, many are pushing for a return to some form of normalcy. In the medical community, some are weighing the risks of returning to global health missions and considering protective strategies to minimize risk of viral spread. Here we describe our experience in returning to an annual burn reconstruction mission in a low- and middle-income country. We have successfully carried out a return surgical mission trip. Our team of ten individuals was able to perform over 75 procedures on 25 pediatric patients in four operative days. We applied a variety of protective strategies and altered mission protocol to limit exposure and transmission risk while focusing heavily on education and training Additionally, we increased the use of telemedicine and eliminated typical in person clinic visits. We increased operative complexity to increase impact while limiting patient exposure. Rigorous perioperative safety and follow-up protocols were implemented. The increased use of telemedicine, reduction of in person visits, emphasis on education, and implementation of safety and follow-up protocols have led to an improvement in efficiency, safety, and accountability. Our adaptations have provided guidance on responsibly resuming surgical outreach missions, with changes that are likely to endure beyond the COVID-19 pandemic.

Implementation of a novel malaria management strategy based on self-testing and self-treatment in remote areas in the Amazon (Malakit): confronting a-priori assumptions with reality

BackgroundA novel strategy to combat malaria was tested using a methodology adapted to a complex setting in the Amazon region and a hard-to-reach, mobile community. The intervention strategy tested was the distribution, after training, of malaria self-management kits to gold miners who cross the Surinamese and Brazilian borders with French Guiana to work illegally in the remote mining sites in the forest of this French overseas entity.Main textThis article aims at presenting all process and implementation outcomes following the Conceptual Framework of Implementation Fidelity i.e. adherence, including content and exposure, and moderators, comprising participant responsiveness, quality of delivery, facilitation strategies, and context. The information sources are the post-intervention survey, data collected longitudinally during the intervention, a qualitative study, data collected during an outreach mission to a remote gold mining site, supervisory visit reports, in-depth feedback from the project implementers, and videos self-recorded by facilitators based on opened ended questions.As expected, being part of or close to the study community was an essential condition to enable deliverers, referred to as “facilitators”, to overcome the usual wariness of this gold mining population. Overall, the content of the intervention was in line with what was planned. With an estimated one third of the population reached, exposure was satisfactory considering the challenging context, but improvable by increasing ad hoc off-site distribution according to needs. Participant responsiveness was the main strength of the intervention, but could be enhanced by reducing the duration of the process to get a kit, which could be disincentive in some places. Regarding the quality of delivery, the main issue was the excess of information provided to participants rather than a lack of information, but this was corrected over time. The expected decrease in malaria incidence became a source of reduced interest in the kit. Expanding the scope of facilitators’ responsibilities could be a suitable response. Better articulation with existing malaria management services is recommended to ensure sustainability.ConclusionsThese findings supplement the evaluation outcomes for assessing the relevance of the strategy and provide useful information to perpetuate and transfer it in comparable contexts.Trial registrationClinicalTrials.gov. NCT03695770. 10/02/2018 “Retrospectively registered”.

Mentoring in Medicine (MIM): Motivating and Enabling Disadvantaged Youth to Become the Next Generation of Minority Health Professionals.

Mentoring in Medicine, Inc (MIM) is a nonprofit health and science youth development organization based in the Bronx, NY. Founded in 2006 by three physicians and an engineer-trained entrepreneur, MIM's organizational goal is to expose socioeconomically disadvantaged students to the wide variety of health and science careers and to increase the health literacy of their communities. It is aligned with the outreach mission of the U.S. National Library of Medicine (NLM) whose former Director, Donald A.B. Lindberg M.D., fostered an enduring relationship. Technical assistance, evaluation, and financial support provided under his leadership helped MIM to become a nationally recognized organization leading the field to diversify health careers and to increase health literacy in often hard to reach populations. Through live and virtual programming, MIM has impacted nearly 58,000 students, parents, and educators in urban epicenters in the U.S. The MIM Team has helped 503 students who were discouraged to build a competitive application and matriculate in health professional school. MIM has 88 press features highlighting its work in the community.

Optimizing international neurosurgical outreach missions: 15-year appraisal of operative skill transfer in Lima, Peru.

Background: While several medical outreach models have been designed and executed to alleviate the unmet need for international neurosurgical care, disparate strategies have evolved. There is a need to determine the optimal pediatric neurosurgical outreach model through which resources are efficiently utilized while imparting the largest possible impact on global health. This study evaluates the efficacy of an international pediatric neurosurgery outreach model at transferring operative skill in a sustainable and scalable manner in Lima, Peru over a 15-year duration.Methods: Three 1-week neurosurgical missions were carried out (2004–2006) in Lima, Peru to teach neuroendoscopic techniques and to provide equipment to host neurosurgeons, equipping the hosts to provide care to indigent citizens beyond the duration of the missions. Follow-up data were obtained over a 15 year span, with collaboration maintained over email, two in-person visits, and video-conferencing services.Results: Since the outreach missions in 2004–2006, the host neurosurgeons demonstrated sustainability of the neuroendoscopic instruction by independently performing neuroendoscopic operations on a growing caseload: at baseline, 0 cases were performed in 2003, but since 2012 and onwards, 40–45 cases have been performed annually. Scalability is illustrated by the fact that the institution established a rigorous neuroendoscopy training program to independently pass on the techniques to resident physicians.Conclusion: The described international pediatric neurosurgical outreach model, centered around teaching operative technique as opposed to solely providing care to citizens, allowed operative skill to be sustainably transferred to surgeons in Lima, Peru. Having served the neuroendoscopic needs of hundreds of citizens, the strategic design is replicable and should be mirrored by future medical endeavors seeking to substantially impact the deficit in global surgical care.

Lessons from failure: neurosurgical outreach in Managua, Nicaragua

With respect to the tremendous deficit in surgical care plaguing developing nations, it is critical that medical outreach models be organized in such a fashion that sustainable advancements can be durably imparted beyond the duration of targeted missions. Using a didactic framework focused on empowering host neurosurgeons with an enhanced surgical skillset, a mission was launched in Managua, Nicaragua, after previous success in Kiev, Ukraine, and Lima, Peru. Unfortunately, the failure to critically assess the internal and external state of affairs of the region’s medical center compromised the outreach mission. Herein lies the visiting team’s lessons from failure and insights on facilitating effective communication with host institutions, circumventing geopolitical instability, and utilizing digital collaboration and video-conferencing tools in the post-COVID-19 era to advance the surgical care of developing regions in a fashion that can be generationally felt.

Simulation Use in Outreach Setting: A Novel Approach to Building Sustainability.

Simulation is a well-studied teaching tool for multidisciplinary teamwork, crisis resource management, and communication skills. These attributes are essential for successful international medical missions, which include healthcare providers with different familiarities with the outreach environment and each team member's role. However, immersive simulation remains underused in similar settings. Our team designed a simulation-based curriculum that focuses on multidisciplinary teamwork and crisis resource management skills. In this commentary, we describe its implementation during high-risk cleft care outreach missions conducted by the Global Smile Foundation. We discuss the importance of a simple, feasible, and flexible platform to successfully overcome the limitations of time and resources inherent to outreach mission work while addressing the clinical and geographic needs specific to each site. We highlight challenges, including unpredictability of the outreach environment, a language barrier, and the short duration of missions. Finally, we offer a roadmap for groups involved in similar global health efforts.

The humanitarian and outreach ethics charter in ENT. Ethics at the heart of missions

Humanitarian action, in the broad sense, including global outreach missions by ENT physicians, has been effective for many years. These volunteer missions have not had any specific regulatory framework, be it medical, social or above all ethical. The testimony of ENT physicians in certain “recipient” countries, in particular during the 2017 Paris Congress of the International Federation of Otorhinolaryngological Societies (IFOS), revealed the importance of adequate coordination between “provider” and “recipient” teams. Several ethical reports have been made, but few specifically focused on ENT outreach. The present review is based on feedback from several missions given to the French Society of OtoRhinoLaryngology and Head and Neck Surgery (SFORL) and IFOS, and on a review of the literature. A specific charter of global outreach and humanitarian missions in ENT has been drawn up. This review is essential for optimizing the sharing of knowledge and training in otorhinolaryngology across the world while respecting mandatory sociocultural and ethical rules.

IHPBA: the first 25 years

BackgroundThe International Hepato-Pancreato-Biliary Association (IHPBA) was established in 1994. In the prior 16 years, considerable international hepatic, pancreatic and biliary association activity had been undertaken. In the subsequent 25 years, the association has grown and evolved dramatically. The aim of this historical account is to document how the IHPBA has advanced from 1994 through 2019. MethodsOriginal materials written by the founders of the precursor societies and Regional Associations were collected. Input from the first five Secretary Generals was solicited. Numerous documents provided by the Management Associations were gathered. ResultsThe IHPBA's origins, vision and mission are documented. The leadership, committee evolution and World Congresses are chronicled. The Regional Associations, National Chapters, membership growth and logos are detailed. The IHPBA's official journal, HBP, and learning platform, myHPB, are discussed. The Warren Fellowship and the IHPBA's Foundation are described. The education and training, research and outreach missions are reported. The HPB Medallion recipients are acknowledged. The financial growth, corporate partners and harmonization efforts are documented. Thoughts about the future are expressed. ConclusionIn 25 years, the IHPBA has matured into an international organization devoted to relief of worldwide suffering caused by hepato-pancreato-biliary disorders by improving education, training and patient care.

Parotid gland neoplasms presenting as discrete infra-auricular swellings

Background: Parotid gland neoplasms usually present as pre-auricular swellings. Sometimes, they present as solitary infra-auricular swellings which make their localization difficult as they may be confused with submandibular gland or other lateral upper neck masses. Clinicopathological reports of discrete infra-auricular parotid lesions and their surgical managements are few. Objectives: To describe the clinical features and management of discrete infra-auricular parotid masses in a series of Nigerian patients seen during a surgical outreach mission. Methodology: This is a retrospective study of all infra-auricular swellings managed by a Nigerian surgical mission over 6 years. Patients' demographics, duration of swelling, symptoms, treatment, histopathological diagnosis, postoperative complications were retrieved from patients' records. Results: A total of 124 facial tumors were seen, of which 15 (12.1%) were parotid tumors. Eight cases (53.3%) of parotid tumors presented as discrete infra-auricular masses. Age range was 13–57 years (mean = 40.9 ± 15.4 years) with male predilection. Duration of swelling was between 1 and 15 years. All lesions were treated with extracapsular dissection. One patient had postoperative facial nerve paresis, but no facial palsy and sialocele. The histopathological results were 5 (62.5%) pleomorphic adenomas, 1 (12.5%) Warthin's tumor, and 2 (25%) low-grade mucoepidermoid carcinomas. Conclusion: Discrete infra-auricular swellings may present as benign and malignant parotid gland neoplasms.

Profitability vs Poverty alleviation: has banking logic influences Islamic microfinance institutions?

PurposeThe purpose of this paper is to shed some lights on the process of mission drifting or abandoning poverty objective by Islamic microfinance institutions (IMFs). The paper investigates whether the extensive use of banking logic changes IMFs, from focusing on both development and financial objectives to only considering sustainability as their primary mission.Design/methodology/approachThis paper adopts mixed methods by analyzing 7,200 microfinance data from Microfinance Exchange Market and reviewing annual reports and websites of 25 IMFs to examine their vision and mission statements and other related information.FindingsThe finding shows Islamic microfinance has not changed, despite increasing adoption of financial or banking performance measures. However, size and age of the institutions may affect the outcome in the future. The authors find that smaller microfinance institutions maintain genuine objective to serve the poor, as the grow larger they would be more inclined toward sustainability objectives.Research limitations/implicationsThe research is limited on the sample size as data on Islamic microfinance globally is limited. However, the paper looked at the global data rather than local data to compensate for this limitation. Future study would be further taking the study through qualitative methods to support the study.Originality/valueThis paper aims to shed some lights on the process of mission drifting or abandoning poverty objective by IMFIs. The paper investigates how has the extensive use of financing logic has changed IMFIs from focusing on both development and financial objectives to only considering sustainability as their primary mission. Arun and Hulme (2009) argued that the interaction of multiple logic within microfinance institutions, i.e. financial vs social, could pose some serious management dilemmas within microfinance institutions. Further, commercialization puts pressure on the field staffs to achieve financial targets and often neglect their poverty outreach mission to the poor. The well-known crisis in Andhra Pradesh, India where clients of microfinance institutions committed suicide after being shamed by field officers who tried to collect payments of loans (Mader, 2013; Taylor, 2011), provides a powerful case of the impact of financialization to microfinance clients.

MISI DALAM PERJANJIAN LAMA

AbstractGenerally, missiology can be understood as the study of the Gospel messagespreading or what is better known as Sending. Thus, this Gospel spreading isconsidered as one of the main task or function of churchestht is to share the good news about Jesus Christ worldwide. Therefore, this comprehension cannot be taken wrong, however in the Old Testament, missiology has to be seen from the standpoint on “how God the Father called and sent his servants to carry out all the tasks assigned to them in order to turn the people of Israel from their stubborness so that they could be saved and not be perished in the punishment that were bounded to them’’ In the old Testament there is an obvious assignment to do the outreach mission to all nations all around the world. The main focus in the Old Testament is the choosing of Israel and its relations to the other nations.Key words: Mission, Old Testament

Trauma Response Nurse: Bringing Critical Care Experience and Continuity to Early Trauma Care.

Multitrauma patients can benefit significantly from specialized care. Prior to mid-2016, this hospital's trauma team did not include a surgical intensive care unit (SICU) nurse. As the value of bringing this expertise to the patient upon arrival was realized, the role of the trauma response nurse (TRN) was developed. The TRN role was designed to provide a dedicated SICU nurse to care for trauma patients from emergency department (ED) arrival through disposition. The integration of the TRN role into the trauma team sought to improve quality and safety, as well as communication and collaboration, and enhance continuity of care. The primary responsibilities of the TRN were to assist with clinical interventions, transport patients fromthe ED to tests and procedures, and assume care through disposition. Additional TRN duties included education, community outreach, and performance improvement. TRNs now respond to all trauma activations that occur on weekday day shift. This role has improved collaboration between nursing disciplines, improved the overall function of the trauma team, and enhanced the safety of trauma patients during transport. TRNs make valuable contributions to the education and outreach missions of the trauma program and ensure that patients are receiving the highest level of trauma care.

Professional Development of Student Engineers Using Design Thinking

AbstractFuture Female Leaders in Engineering (FFLIE) Program participants at Los Alamos National Laboratory were tasked to provide a design solution that would help the Bradbury Science Museum meet its educational outreach mission, using the principles and practices of Design Thinking (DT). The DT project aimed to improve the students’ skills in the areas of project planning, problem definition, qualitative data collection and organization, problem solving, and product life cycle planning to prepare them for leadership roles on future technical projects. The instructional content used in the program is summarized at the outset of each section of the paper. How the students implemented the phases of Design Thinking and the resulting products are also described, using excerpts from the final project report they prepared. Throughout the project, the design team learned how to effectively brainstorm, communicate with others, gather needed information through interviews, analyze the information, and work as a team to finalize ideas. Prototyping and testing showed that the design solution they proposed is feasible and should help students in the targeted grade levels develop an interest in science.

Rural Medical and Surgical Outreach Mission: Experience of International College of Surgeons (The Nigerian National Section)

Nigeria lacks an equitable healthcare system. Low earnings characterize the income in rural areas where 55% of Nigerians who cannot afford basic medical care live. An organized rural medical and surgical outreach program can augment the formal healthcare system. Objective: To key into the International College of Surgeons Humanitarian Surgery Program by providing surgical specialists through collaboration to a sustainable free medical and surgical program. Methodology: International College of Surgeons (The Nigerian National Section), Imo State zone collaborated with Mbano National Assembly Inc. USA to do a Free Medical and Rural Surgical Outreach Mission at Mbano Joint Hospital March 14–18, 2016. Personnel to cover the clinical and nonclinical areas were recruited by the zonal branch of International College of Surgeons. Mbano National Assembly funded the project with $22,963.83. Results: Some 5028 patients attended. Of these, 2900 received attention, 800 medical, 512 surgical and urology, 262 obstetrics and gynecology, 270 pediatrics, 800 ophthalmic, and 500 received counseling, while 1500 received health education and 25, physiotherapy. Screening for prostate cancer was done for 146, 200 for human immunodeficiency virus and 110 for Hepatitis B virus. Surgical procedures on 88 patients, 1193 outpatient pharmacy dispensing, and 31 in-patients were recorded. Conclusion: Collaboration between sections of International College of Surgeons and non-governmental organizations already involved in rural free medical missions is feasible.