Seven Years Teaching Family Medicine in Africa and

Seven Years Teaching Family Medicine in Africa: (and Why I Want You to Help Me Build a Medical School in Western Ethiopia Barry J. Bacon MD

Disclaimer • I have no relationships with pharmaceutical companies or healthcare manufacturing companies to disclose, nor have I interfered with the American presidential election in any way. 2

Seven Years Teaching Family Medicine: Goals and Objectives Provide high quality, objective information about health disparities unique to Africa Convince others that promoting peace is good medicine Lead discussion and sharing of ideas about the benefits and challenges of developing a medical school in a refugee dense area as a means of healthcare transformation and peace promotion 3

It all started in the Amazon Rainforest; Iquitos, Peru, 2009 SEVEN YEARS TEACHING FAMILY MEDICINE 4

Seven Years Teaching in Africa: Western Kenya • 2012 Western Kenya: • Family medicine and emergency medicine. Educating the entire team. Partnership with Contra Costa Global Health Fellows. Connect with South Sudanese students. • Very small volume of patients, private hospital, insurance challenges, leadership by emergency medicine. How will it fit into the existing healthcare model? 5

Seven Years Teaching in Africa: Malawi • 2016 Malawi: • Connection to global seed; partnership with UW and others; large volume of patients for clinical experience. Clear vision for integration of family physicians into existing structure. • Overwhelming clinical need. Difficult environment, limited tools, limited pool of physicians for recruitment. Leadership in Blantyre. Two sites with plans to expand to more. 6

Seven Years Teaching in Africa: the Horn • 2013 -17 horn of Africa: • Creation of an academic setting for teaching. Solid team of family medicine trainers at one site, including general surgeon. • Lack of financial strength of hospital led to uncertainty with residency placement- may need to be moved. 7

Seven Years Teaching in Africa: Summary • There is great value in developing family medicine internationally • Family medicine is highly desirable, needed, sustainable • Education is an important long term strategy for improving outcomes in developing countries • Appropriate relationships and integration of family medicine jobs into existing medical structure is needed • Adequate patient volumes, recruitment of local leadership, creation of academic learning environment • Disciplined, consistent teaching faculty on site is needed 8

Seven Years Teaching in Africa: Peace • Medical education as a peace initiative. Understanding health from a community perspective requires stepping outside of the clinic model. • What are the basic needs that every one of us shares no matter where we are on the planet, without which we suffer poorer health outcomes? • Air, water, food, shelter, clothing, fuel, basic health access, education/means to improve understanding, peace. 9

Seven Years Teaching in Africa: Gambela • South Sudanese friend introduced me to his dream of creating a medical school in Gambela, Ethiopia where there is a large refugee population. • Using medical education as an opportunity to work toward peace • An area of large refugee population who cannot go home and have no future in the camp 10

Seven Years Teaching in Africa: Refugees • • Global averages in school vs refugees: 91% vs 50% primary school 84% vs 22% secondary school 34% vs 1% university 16 million refugees under UNHCR. 6 million aged 5 -17 This represents a huge health disparity and resource lost In Kakuma Camp, northern Kenya, 1 in 50 children graduate from high school • UNHCR Website 11

Strategies for Education of Refugees • • Six Strategies: Adequately fund schools and universities Expand vocational training Develop a Syrian curriculum for displaced Syrian refugees Allow refugee teachers to teach Develop competency tests as an alternative to transcripts Facilitate travel for studies • World Economic Forum Website “Why refugee education is a problem- and six solutions” by Lorna Solis 12

Including Refugee Applicants to Gambela Medical School • Lots of articles on including refugee health as part of medical school curriculum. Assisting refugees. Medical clinics for refugees. • No articles about medical school training of students who are refugees. • Uncharted, important territory. 13

Seven Years Teaching in Africa: Partnerships • Ethiopia gains another medical school and improved health care. • South Sudanese gain a future and opportunity for education. • American partnership gains access to a long term, sustainable global health intervention, mutually respectful learning opportunity for African/American students. 14

Seven Years Teaching in Africa: Partners • The Ethiopian leadership is on board. The South Sudanese partners are on board. The University of Gambela is ready to move forward. We need American partners. 15

Seven Years Teaching: Gambela Conclusions • Bigger than any of us. Which is why I need your help. I need to develop American partnerships to make this happen. I am changing jobs and unloading my schedule so that I can work on this more consistently. Please talk to me baconbarry@juno. com 570 Hotchkiss Rd, Colville, WA 99114 16

Seven Years Teaching in Africa: Final Thoughts • Discussion 17

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