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The Global Health Program in the Department of Anesthesia, Critical Care and Pain Medicine at Massachusetts General Hospital aims to decrease global health disparities and improve clinical outcomes by providing education and clinical research expertise to clinicians in low-income countries around the world.
Anesthesia safety is a significant problem in many developing countries, and there is a severe shortage of adequately trained and supported anesthesia personnel. We partner with academic and health facilities in countries including Uganda, the Philippines, Ukraine and Vietnam, and our clinicians work directly with local health care workers in these communities to improve perioperative care through education, research, volunteer service and collaboration.
The Global Health Program delivers disaster relief and emergency humanitarian help in crisis situations. An integrated team of clinicians travels nationally and internationally, collaborating across disciplines to identify solutions to challenging cases and provide a high level of skill, knowledge and clinical support to areas of need.
Through our multidisciplinary teams and expert care, we have contributed to disaster relief efforts in:
Dr. Firth is a pediatric anesthesiologist and head of the Global Health Program in the Department of Anesthesia, Critical Care and Pain Medicine. He joined the faculty in 2006 and is a member of the executive committee of the Massachusetts General Hospital Center for Global Health. His work focuses on developing ways to optimize the functioning of anesthesia and surgical delivery in low-income countries, and the study of anesthetic practice in mass casualty situations. Dr. Firth is currently developing an electronic surgical and anesthesia database to track outcomes at Mbarara Regional Referral Hospital in southwestern Uganda. He is also involved in distance education for anesthetic trainees at Mbarara and helped to initiate and develop an ultrasound-guided regional anesthesia educational project.
Dr. Denman is a pediatric anesthesiologist at MassGeneral Hospital for Children. Dr. Denman has been co-leading medical missions in various parts of the world for more than 15 years, including Vietnam where his work focuses on building perioperative processes with the country's medical leadership. He was also instrumental in the initiation of taking residents on mission trips through the Global Health Program.
Dr. Dohlman is a staff anesthesiologist in the Department of Anesthesia, Critical Care and Pain Medicine since 1999. She is an affiliate of the Department of Global Health and Social Medicine at Harvard Medical School. She has had a long and enthusiastic commitment to global health since her 1981 experience in Celebes, Indonesia teaching regional anesthesia techniques and learning how to give ether anesthesia with an EMO inhaler. As a volunteer with Health Volunteers Overseas (HVO), she has taught anesthesia in Asia, Africa and Central America and has held several leadership positions within HVO. She has worked on global health issues through committees for the American Society of Anesthesiologists, the Society for Education in Anesthesia, and the World Health Organization. She is founder of the SEA HVO Traveling Fellowship, a program to sponsor senior anesthesia residents to spend a month teaching anesthesia at HVO sites in developing countries. She is a co-founder of the Harvard Global Anesthesia Initiative to encourage Harvard-wide networking and promotion of responsible leadership in global health among anesthesia residents. Dr Dohlman is currently involved in setting up a new educational program in Hue, Vietnam through HVO.
Dr. Fuzaylov is a pediatric anesthesiologist at MassGeneral Hospital for Children and serves as founder and president of the Doctors Collaborating to Help Children charitable organization. He works with the Global Health Program to bring residents and fellows on mission teams to Ukraine, with a focus on building sustainable systems to improve the care of children with burn injuries. Dr. Fuzaylov actively collaborates with the Department of Surgery at Harvard Medical School, the American Burn Association, the European Burn Association and the WHO to establish a multilayer outreach program and Annual Outreach Clinic in Ukraine.
Dr. Modest is a thoracic and regional anesthetist at Mass General. A graduate of MIT and Wake Forest School of Medicine, she is also an Eleanor and Miles Shore Fellow in global health and an affiliate of the Department of Global Health and Social Medicine, both at Harvard Medical School (HMS). An expert in ultrasound-guided regional anesthesia (USGRA), she collaborated with a colleague to introduce this technique in Uganda in 2011 and helped establish the first program in USGRA in sub-Saharan Africa. Her project in Mbarara, Uganda is supported by grants from her HMS Shore Fellowship and the Department of Anesthesia, Critical Care and Pain Medicine. Recently invited to participate in the Lancet Commission on Global Surgery, she is working in partnership with others to reduce the global surgical and anesthetically related burden of injury and death.
Dr. Tuason is a pediatric anesthesiologist at MassGeneral Hospital for Children and serves on the board of directors at Medical Missions for Children. He works with the Global Health Program to bring residents on short-term clinical missions to countries such as China, Ecuador, Guatemala, India, Peru, the Philippines, Rwanda, Tanzania and Ukraine.
Physicians and staff from the Department of Anesthesia, Critical Care and Pain Medicine at Massachusetts General Hospital are involved in the following global outreach efforts:
Our work in Uganda is a collaborative effort between Mass General and the Mbarara Regional Referral Hospital, the teaching hospital of the Mbarara University of Science and Technology. We focus on the education of Mbarara and Mass General residents, as well as outcome-based research.
Vicki Modest, MD, is improving postoperative pain control through recent technology and techniques. Her research collaboration with Ugandan clinicians exams the effectiveness of truncal blocks (transverse abdominal plane and paravertebral) for post-surgical analgesia. Through this partnership, she provides academic support and training for Ugandan anesthetists.
Paul Firth, MBChB, is developing a surgical outcomes database at Mbarara Regional Referral Hospital. The database tracks anesthetic, obstetrical, surgical and intensive care outcomes. Dr. Firth is also involved in a distance education project for anesthetic trainees. Learn more about Mass General’s work in Uganda
Gennadiy Fuzaylov, MD, takes trips to manage pediatric burns in Ukraine as part of a collaboration between Mass General and Shriners Hospitals for Children. His efforts involve working with public officials in Ukraine to formalize a program where physicians from Shriners visit Ukraine to teach, and Ukrainian physicians have the opportunity to come to Shriners to learn. Dr. Fuzaylov has also brought some of the most critically ill Ukrainian patients to Shriners for care.
Lena Dohlman, MD, supervises the department’s involvement in the Health Volunteers Overseas (HVO) Program. HVO is a private, nonprofit organization dedicated to improving the availability and quality of health care in low-income countries through the training and education of local health care providers.
Traveling fellowships are available through the Society for Education in Anesthesia (SEA) and HVO. Mass General residents have applied successfully to the SEA-HVO Traveling Fellowship every year for more than 15 years. The fellowship allows third-year anesthesia residents to spend a month teaching anesthesia at an HVO site, which have included countries in Africa, Southeast Asia and South America.
The SEA-HVO Traveling Fellowship exposes residents to a wide range of surgical pathologies and anesthetic techniques not commonly seen in the United States, as well as the realities and constraints of delivering health care in a resource-scarce environment. Fellows learn to communicate more effectively with people from different cultures and are challenged to be creative and flexible in problem solving. Fellows also serve as teachers of anesthesia and as role models for the anesthesia students at their program sites, contributing to the future safety of patients receiving anesthesia in developing nations. The program is active and growing, and Mass General is expected to continue to contribute talented and well-trained residents to this mutually beneficial effort. Learn more about the SEA-HVO Traveling Fellowship
Our physicians lead short-term clinical missions to various parts of the world to provide clinical expertise on treating a range of conditions, including cleft lip and palate deformities, burn injuries, microtia (absence of the outer ear) and head/neck tumors. Recent trips have addressed cleft palate in Vietnam and the Philippines.
We collaborate with several organizations that offer opportunities in global health, including:
As a senior resident, Olof Viktorsdottir, MD, spent a month in Mthatha, South Africa, in 2011 after being selected for a SEA-HVO Traveling Fellowship. She spent the month teaching medical students how to use ultrasound in regional and ICU medicine. She also worked with colleagues in the operating room at Nelson Mandela Hospital, a large regional academic hospital. Lena Dohlman, MD, joined her for two weeks as a staff anesthesiologist and HVO Country Director of the South Africa program.
In 2010, a team of Mass General clinicians traveled to Haiti to assist with earthquake relief efforts. The team included Paul Firth, MBChB; Neelakantan Sunder, MBBS; Akshay Dalal, MD, and technician Tom Monaghan. The team cared for many patients with multiple traumatic injuries such as compound fractures, open wounds, compartment syndrome, quadriplegia and paraplegia. They established a triage system to save lives and limbs and to manage closed fractures, and performed more than 140 anesthetic procedures in the operating room. The project was co-sponsored by Partners in Health and Project HOPE. Learn more about Mass General's relief efforts in Haiti
In 2005, Dr. Sunder, Dr. Dalal and Michael Fitzsimons, MD, worked with Project HOPE to assist tsunami survivors in Indonesia aboard the USNS Mercy.
Dominica; Texas; The Florida Keys; Puerto Rico. These four regions were consecutively ravaged by Hurricanes Harvey, Irma and Maria in 2017. But each time, the MGH responded. On Feb. 15 in the O’Keeffe Auditorium, a panel of those dedicated responders – led by the Global Disaster Response (GDR) at the MGH Center for Global Health and the Center for Disaster Medicine – shared their deployment experiences.
The Doctors Collaborating to Help Children organization recently launched a new telemedicine program allowing MGH and Shriners physicians to provide quick and efficient consultations for acutely ill burn patients in Ukraine.
IN THE UNITED STATES and other developed nations, caregivers can access to the latest technologies and techniques, allowing them to improve patient outcomes and comfort. Unfortunately, clinicians in developing countries often lack these critical resources.
Clinicians from Massachuetts General Hospital and the Department of Anesthesia, Critical Care and Pain Medicine join forces to provide much-needed assistance to victims of the Haiti earthquake.
Dr. Paul Firth, a physician in the Department of Anesthesia, Critical Care and Pain Medicine, participated in the Haiti relief effort on the hospital ship USNS Comfort as part of Project HOPE.
Paul Firth, MBChB
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