Introduction to the Global Health Scholars Program - Colombia

Transcript

• 00:00Oh, thank you very much,
• 00:02Tracy and Sheila for the
• 00:03invitation. I mean, I I
• 00:04I really feel very proud
• 00:06of,
• 00:06the things that are, the
• 00:08all the experiences, and congratulations
• 00:10to all the scholars because,
• 00:12really, I learned a lot
• 00:13today, and and this is
• 00:14real the real yield footprint
• 00:16around the world and and
• 00:18here in the in our
• 00:19country. So, really congratulations.
• 00:23I'm gonna you guys can
• 00:24see my slides, and can
• 00:26hear me correctly?
• 00:27Everything looks great.
• 00:29Excellent.
• 00:30So,
• 00:31I'm gonna I'm gonna talk
• 00:33about,
• 00:34this partnership between Yale Heaven
• 00:36Health and Yale, University and
• 00:38Fundacion Santa Fe Agota.
• 00:40It's a partnership to improve,
• 00:42care and education.
• 00:45Fundacion Santa Fe Agota is
• 00:47a private,
• 00:48nonprofit institution
• 00:49established in nineteen seventy two,
• 00:51actually, by two Colombians
• 00:55who traveled to, here to
• 00:56New Haven.
• 00:58They train as physicians.
• 00:59They graduated and then return,
• 01:01to, to, Columbia
• 01:04and with the dream of
• 01:05creating a hospital just like
• 01:06Yale New Haven Hospital, but
• 01:07in the middle of the
• 01:08Andes Mountains just because in
• 01:10a especially in a time
• 01:11in which where a lot
• 01:12of people in South America,
• 01:13a lot of people in
• 01:14Colombia, it was impossible to
• 01:15get the latest treatments or
• 01:17or access to the best
• 01:18technologies.
• 01:19So it's really a dream.
• 01:20It's really,
• 01:21something that as the superior
• 01:24purpose actually is to lead
• 01:25and to influence positively the
• 01:27health sector in Colombia and
• 01:28the region. Latin America
• 01:30nowadays is one of the
• 01:31best hospitals in Latin America
• 01:33in order to contribute the
• 01:34well-being of individuals and communities.
• 01:38Basically, they they want to
• 01:39provide the most efficacious and
• 01:41safe health care. And a
• 01:42lot a lot and and
• 01:43now that we're talking in
• 01:44global health about reciprocal innovation,
• 01:46there are a lot of
• 01:47things in patient safety, in
• 01:49patient centered care that actually
• 01:50we can learn from them,
• 01:52that actually we can try
• 01:53to,
• 01:54apply here. It's a beautiful
• 01:56hospital in the middle of
• 01:58Los Angeles mountains. They have,
• 02:00very modern, like, beautiful interior
• 02:02gardens. I mean,
• 02:04they, really,
• 02:06the with ex patient experience
• 02:07is unique. Their medical model
• 02:09is based on autonomy, professionalism,
• 02:11and and trust.
• 02:12They have this medical model
• 02:14white book is like a
• 02:16really like a like a
• 02:17a book where they explain
• 02:19and and really represents the
• 02:20therapeutic expression of their culture.
• 02:23Each chapter of this group
• 02:24represents the ingredients of this
• 02:26unique model with scientific, humanitarian,
• 02:29philanthropic approach. And you'll remember
• 02:31that once you step in
• 02:32this hospital, you're gonna feel
• 02:34that, like,
• 02:36wellness environment and everybody trying
• 02:38to work for the patients
• 02:39and,
• 02:40but, like, with the best
• 02:41technology and the best access
• 02:43to science.
• 02:44So it's a it's a
• 02:45it's a big institution.
• 02:48It's,
• 02:49two,
• 02:50really, they they have two
• 02:51hospitals, one in the main
• 02:52in the capital city of
• 02:54Colombia in Bogota and another
• 02:55one in Cartagena.
• 02:57Almost five thousand employees, thirty
• 02:59million,
• 03:00in revenue,
• 03:01almost four hundred beds.
• 03:04They have,
• 03:05a university and academic,
• 03:07affiliations with,
• 03:08University of Los Angeles and
• 03:10University of Rosario.
• 03:11This is a picture of
• 03:12the hospital in in Bogota,
• 03:15and this is a picture
• 03:15of the hospital in Cartagena
• 03:17where actually also where students
• 03:19can have, access to. Cartagena
• 03:21is is a beautiful city,
• 03:23in the north part of
• 03:24Colombia.
• 03:25If you have read Gabriel
• 03:26Garcia Marquez,
• 03:28is this Colombian Caribbean is
• 03:29where all this is his
• 03:30stories happen. So beautiful city
• 03:33to to visit.
• 03:35So this is a map
• 03:36of Colombia. So, again, the
• 03:37the the main hospital is
• 03:39located in the middle of
• 03:40the Andes Mountains in the
• 03:41center of the of the
• 03:43of the country. Here in
• 03:44the north, you have Cartagena
• 03:46and the Caribbean here.
• 03:48Colombia is a very biodiverse,
• 03:51country.
• 03:52The weather really depends on
• 03:54how high the city is
• 03:56located,
• 03:57in the mountains. So for
• 03:57example, Bogota is
• 03:59is is cold. It's, like
• 04:01our
• 04:02that's the reason why my
• 04:03favorite I'm I'm originally from
• 04:04Colombia. I'm from Bogota. That's
• 04:05why my favorite season is
• 04:07the fall because it's pretty
• 04:08similar to to our current
• 04:10temperatures.
• 04:11Then in the north part,
• 04:12you have the Caribbean in
• 04:13the that you have the,
• 04:14like, the the beautiful sandy
• 04:16beaches and all that. Then
• 04:17you have the Pacific Ocean
• 04:18that is more like jungle
• 04:20directly going to the ocean
• 04:21with the black sand beach
• 04:23beaches. And and then you
• 04:24have the the the great,
• 04:26the flatland,
• 04:27and then you have the
• 04:28Amazon region
• 04:29in the in the south
• 04:31part of Colombia. Now because
• 04:32it's the leading institution in
• 04:33the country, they they have
• 04:35all these are different,
• 04:37programs that they have around.
• 04:39And and and and, basically,
• 04:41you can tailor your visit
• 04:43depending on your interest.
• 04:47And
• 04:48we have had,
• 04:49they have, for example, programs
• 04:51in disease.
• 04:53They have programs in malaria.
• 04:54They have programs in dengue.
• 04:57So when we created this
• 04:59relationship, the mission was to
• 05:01to to find
• 05:03a sympathetic,
• 05:06to,
• 05:07like, a sympathetic
• 05:10relationship,
• 05:11to accelerate
• 05:12the development of their medical
• 05:13and surgical experts to field
• 05:15their own countries,
• 05:17to engage
• 05:18and share research training with
• 05:20emphasis on patient care and
• 05:22initiatives.
• 05:23Like, the vision of all
• 05:24these relationship is to,
• 05:26to create this long term
• 05:27relationship,
• 05:29providing and trying to to
• 05:31to fight against the brain
• 05:32drain. Basically, the idea is
• 05:34to invest in people and
• 05:35activities rather than in buildings.
• 05:37And, basically, we want to
• 05:38be the trainers who train
• 05:40the trainers and and be
• 05:41in education the the the
• 05:42the the key aspect of
• 05:44the of this relationship.
• 05:46So a little bit of
• 05:47the history. So Alfonso Sguerra
• 05:49and Josepilic Patino were the
• 05:51two Colombians who actually came
• 05:52here to New Haven. They
• 05:53trained at Yale,
• 05:55and then they returned to
• 05:56Colombia and had this at
• 05:57that time, when they when
• 05:59they used to talk about
• 06:00it, it was impossible. It's
• 06:01like you're not gonna ever
• 06:03be able to do that.
• 06:04And and, actually,
• 06:06they,
• 06:07they were able to reproduce
• 06:08a Yale hospital medical model
• 06:10in Bogota.
• 06:12They founded La Fundacion in
• 06:13nineteen seventy two. And for
• 06:15years from nineteen seventy two
• 06:16to two thousand fifteen, there
• 06:17was this relationship, but there
• 06:19was no, like, an official
• 06:20nothing in paper. Now it
• 06:21was an unofficial collaboration. So
• 06:22actually in two thousand fifteen,
• 06:25thanks to our Yale cardiovascular
• 06:26global health initiative,
• 06:28we were able to start
• 06:29this, relationship
• 06:31with highly specialized cardiology consultation
• 06:33and no cost in,
• 06:35low income and underserved communities
• 06:37in Colombia. And we were
• 06:38able to create a a
• 06:40symposium that,
• 06:42a cardiologist imposing every year
• 06:44with, attendees from La Fondacion
• 06:46and and and Yale. And,
• 06:47also, we created a cardiac
• 06:49imaging website that help us
• 06:50to teach students all around
• 06:51the world. And
• 06:53in,
• 06:55also,
• 06:56we
• 06:58signed this official agreement between
• 06:59Yale and La Fondacion. And
• 07:01since then, actually, Yale students
• 07:02have been able to go
• 07:04to to La Fondacion.
• 07:06Great experiences from them, very
• 07:07similar to what, what the
• 07:09scholars, told us today.
• 07:12One thing that I learned
• 07:13is that and and, actually,
• 07:14I'm very happy to see
• 07:15is is that everything is
• 07:16about the experience and the
• 07:17people that that you meet
• 07:19and how you can actually
• 07:20then with those experiences actually
• 07:22influence your career and
• 07:24and change the way how
• 07:25you see medicine. Just just
• 07:27the fact that you go
• 07:28and, you go and see
• 07:29how medicine is practiced in
• 07:30another place is unique.
• 07:34Now when we were trying
• 07:35to, like, figure out this
• 07:37relationship, we compare medical mission
• 07:39models. So, definitely, we didn't
• 07:41want to do this rescue.
• 07:42We didn't want to bring
• 07:43sick patients to a North
• 07:44American hospital. We didn't want
• 07:46to bring operating teams to
• 07:47a local site without any
• 07:49teaching or training.
• 07:51Then, other models, they they
• 07:53base their relationship in in
• 07:55in some teaching experience, but,
• 07:57I mean, not like a
• 07:58long term relationship. And, definitely,
• 07:59we don't want to build
• 08:00a Yale Hospital
• 08:02in Columbia. Right? This is
• 08:03colonization, so we don't we
• 08:03don't want to, what, do
• 08:03that. We want to to
• 08:04have a this reciprocal relationship
• 08:04when we have a long
• 08:05term commitment. We base
• 08:06our relationship in a, education
• 08:07exchange of personnel,
• 08:14like from attendings, students, and
• 08:17now internal medicine residents and
• 08:18fellows. I'm very I'm very,
• 08:20very excited for this next
• 08:21step and and and mentoring.
• 08:23Why we're why we're different?
• 08:26Because,
• 08:27we base the success of
• 08:28this program in trust, empathy,
• 08:30commitment, sustainability,
• 08:32and financial transparency. So there
• 08:34is no transactional I mean,
• 08:36La Fundacion is not paying
• 08:37Yale. Yale is not paying
• 08:38for La Fundacion. This really
• 08:40is something that we want
• 08:41to,
• 08:42in twenty years, see done
• 08:43and be very proud we'll
• 08:44be very proud of what
• 08:45we did. So we base
• 08:46our modalities of interaction in
• 08:48mentoring in this reciprocal,
• 08:51clinical exchange when that we
• 08:52started already with physicians and
• 08:54with the students, and now
• 08:55this next step is very
• 08:56exciting with residents and fellows.
• 08:59And telemedicine,
• 09:00we can we have we
• 09:03we have been doing these
• 09:05conferences
• 09:05and
• 09:07and symposiums.
• 09:08Also,
• 09:11we started to do research
• 09:13together, but we're we're our
• 09:15Colombian and South American physicians
• 09:16are actually the the first
• 09:18authors,
• 09:19and we actually opened, like,
• 09:20a new platform for them
• 09:22to to to share their
• 09:23research.
• 09:24And
• 09:25I raise a collaboration
• 09:26that that are mutually beneficial
• 09:28in learning, access to new
• 09:30ideas, clinical trials, novel,
• 09:33patients, basically, as you a
• 09:35lot of the of the
• 09:36presentations today. I mean,
• 09:38the
• 09:40when you are abroad or
• 09:41with limited resources, I mean,
• 09:42sometimes you have to be
• 09:43very creative in the way
• 09:44how you, take care of
• 09:46patients.
• 09:47So what are we trying
• 09:48to accomplish? We want to,
• 09:51establish this education without immigration,
• 09:54stop the brain drain from
• 09:55a lot of these countries,
• 09:56have this, improve their reciprocal
• 09:58innovations, and hopefully get, we
• 10:01when we establish these relationships,
• 10:02we're trying to stop the
• 10:04the,
• 10:05and and be able to
• 10:08recreate,
• 10:09like, a relationship with we
• 10:10are both partners, and we
• 10:12can learn from each other
• 10:13similar to what I have
• 10:15learned today.
• 10:16Inspire new generations, abandon the
• 10:18concept of mission. Now we
• 10:20we we want to to
• 10:21do this,
• 10:22long term collaboration
• 10:24and also this, abandon these
• 10:25transactional models.
• 10:27So now what we're trying
• 10:28to do is, promote more
• 10:30interactions with and help professionals
• 10:32from both institutions at liberal
• 10:34levels in education, research, and
• 10:36patient care.
• 10:37And we started with cardiology
• 10:38and cardiovascular surgery. I'm an
• 10:40I'm a cardiologist. I'm an
• 10:42attending the our,
• 10:43cardiology service, but now I
• 10:45think it's time to to
• 10:46expand it to other areas
• 10:47of, in internal medicine and
• 10:49other areas in medicine
• 10:50and really create this real
• 10:52international network of partners. So
• 10:54here we see as all
• 10:55the pictures of,
• 10:57here is Bob McNamara, very
• 10:59well known in the cardiology
• 11:00and the global health field.
• 11:02He is,
• 11:03we are carrying our portable
• 11:05echo cardiograms and doing,
• 11:08echoes in underserved communities in
• 11:10the middle of the Andes
• 11:11mountains without any cost.
• 11:15Always,
• 11:16teaching students from both Yale
• 11:18and
• 11:20and
• 11:20Santa Fe Agota.
• 11:22This area of Los Angeles
• 11:24mountains is very famous not
• 11:26only for the so Colombia
• 11:28is very famous, as you
• 11:29know, for the for the
• 11:30coffee, but actually, this,
• 11:33hospital is is close to
• 11:35the
• 11:36flower region. A lot of
• 11:37the flowers that actually we
• 11:38can we buy here in
• 11:39Stop and Shop and all
• 11:40the supermarkets. You pay attention,
• 11:42actually, they they come from
• 11:43Colombia.
• 11:44So, actually, we serve a
• 11:45lot of these, communities of
• 11:47the that that work in
• 11:48this, in these fields.
• 11:52Teaching the community, taking care
• 11:53of patients,
• 11:54and these are,
• 11:56some of the posters of
• 11:58the,
• 11:59of the meeting that we
• 12:00do every year in November.
• 12:01Actually, the next one is
• 12:03November twentieth. So we're gonna,
• 12:06travel. We always try to
• 12:07travel with a group of,
• 12:08physicians from here, from the
• 12:10our university and students and
• 12:12also,
• 12:14fellows and internal medicine residents.
• 12:17And,
• 12:19so here you have some
• 12:20familiar faces. For example,
• 12:22Sanju, who is now she
• 12:23was a a resident in
• 12:24internal medicine last year, and
• 12:26today is the chief. She
• 12:27was,
• 12:28here doing a presentation about
• 12:30pulmonary hypertension in high altitude.
• 12:32Colombo Bogota is,
• 12:34almost ten thousand feet about
• 12:36sea level, two thousand and
• 12:37six hundred meters about sea
• 12:38level. So a lot of
• 12:40I mean,
• 12:41it's not uncommon to see
• 12:42a high altitude sickness and
• 12:43pulmonary edema. Here is also
• 12:45familiar faces. I mean, everything
• 12:47from fellows, cardiology fellows, attendings,
• 12:51and residents participating in this,
• 12:54lectures and symposiums.
• 12:56And also now,
• 12:57we started to do research
• 12:59together. So we have a
• 13:00line of research about, screening
• 13:02for pulmonary hypertension and high
• 13:04altitudes in Los Angeles mountains
• 13:05in Colombia.
• 13:07Beautiful places, very close that
• 13:09you can visit. I mean,
• 13:11this is the Montserrat Monterrata
• 13:13here in the top.
• 13:14Montserrat
• 13:15mountain where you can actually
• 13:17hike or go there. Beautiful,
• 13:19views of the city. This
• 13:20is the the the team.
• 13:22We went to,
• 13:24place that was almost fifteen
• 13:25thousand
• 13:26feet above sea level, and
• 13:28we do we did a
• 13:29screening for pulmonary hypertension and
• 13:30and high altitude. And, again,
• 13:32here pictures of our
• 13:34students, sonographers,
• 13:36doing this, echocardiograms.
• 13:38So,
• 13:39we're very excited for for
• 13:41this, opportunity. I mean, I
• 13:42want to finish with this
• 13:44sentence from,
• 13:45Bob McNamara. This is the
• 13:47the science of medicine may
• 13:48be global, but the art
• 13:49of, on practice of medicine
• 13:51needs to be local. And
• 13:53that's kind of, we want
• 13:54to continue this, philosophy.
• 13:57And, again, I mean, I'm
• 13:58really, really excited
• 14:00that we're gonna have this
• 14:01next level of interaction
• 14:03now that our internal medicine
• 14:05residents and fellows,
• 14:07can have Colombia
• 14:08as one of their,
• 14:09sites to to rotate.
• 14:11Thank you very much.