Early Successes: Global Medicine Update from Mozambique

Since it began last summer, the Global Medicine Program at UC San Diego has sent 11 internal medicine residents to Mozambique, sparked several new research projects, and stimulated learning on both sides of this unique international partnership.

The Republic of Mozambique. Map from CIA: The World Factbook.

The Republic of Mozambique.
Map from CIA: The World Factbook.

The Global Medicine Program is a two-way exchange of faculty and residents between UCSD and the Universidade Eduardo Mondlane in Maputo, Mozambique. It is part of the Department of Medicine’s efforts to expand its involvement in global health.

“I think the program has made absolutely incredible progress,” said Dr. Constance Benson, Professor of Medicine and Director of UCSD’s Fellowship Training Program in Infectious Diseases.

Dr. Benson is a faculty director of the program.

During their 3-week stay, the UCSD internal medicine residents rotate through four different wards at Maputo General Hospital. Dr. Michael Preziosi, Clinical Director of the program, serves as faculty attending physician on site in Maputo.

Mozambican internal medicine residents

Mozambican internal medicine residents (left to right) Drs. Clotilde Tilwene, Neusa Jessen, Marilia Vida. Photo by Mike Preziosi, MD

Working together with the Mozambican doctors, the UCSD residents are encountering diseases they have never seen before and far more advanced stages of diseases frequently seen in San Diego; schistosomiasis, for example, and full-blown tuberculosis.

In one 24-hour period, Dr. Preziosi said, his patients included one who had tetanus with lockjaw, one with a liver cancer caused by a fungus that grows on peanuts, and one who had an advanced case of pellagra.

Broadening UCSD’s Internal Medicine Residency Training Program is one of the goals of the Global Medicine Program. Promoting collaborative global health research is another.

Mozambican residents at a presentation

U.S. and Mozambican residents at a presentation. Photo by Mike Preziosi, MD.

In the past six months, UCSD residents, fellows, and faculty members have begun to partner with Maputo researchers in new studies of tuberculosis and other endemic diseases.

UCSD is also introducing tools and practices that will strengthen the medical education program at Universidade Eduardo Mondlane.

A weekly journal club, instituted by UCSD residents, has been very well received.

“On the wards with the Mozambican residents, what’s going on has been really inspiring,” said Dr. Preziosi. “We’re seeing them get excited about medicine again.”This, in turn, refreshes the American residents, he said.

“I think they are getting a renewed sense of the purpose and value of the educational activities they are helping to introduce,” Dr. Preziosi said, “and are participating in them with renewed energy.”

Mozambican and American residents

Mozambican resident Marilia Vida (left) with Dr. Sarah Fox, second-year UCSD resident. Photo by Mike Preziosi, MD.

Mozambican residents will begin rotations at UCSD later this year.

“What makes our program unique,” said Dr. Robert “Chip” Schooley, “is that the transfer of capacity is being done in a peer-to-peer fashion by people who are transferring knowledge about jobs they do all the time.“The Mozambican residents see our residents as counterparts who are sharing their own experiences.”

Dr. Schooley, a Faculty Director of the program, is Professor of Medicine and Chief of the Division of Infectious Diseases. “I think this program will break a lot of ground,” he said.

UCSD faculty appointments have been granted to Drs. Emilia Noormahomed and Sam Patel, the faculty leaders on the Universidade Eduardo Mondlane side of the Global Medicine Program.

UCSD is assisting with material needs in Maputo as well.

Last summer, a UCSD team brought a supply of modern tuberculosis protective masks for the Mozambican residents’ workroom at the hospital. There is a great shortage of other basic clinical supplies.

To help meet such needs and to sustain the Global Medicine Program, Dr. Schooley and colleagues are stepping up their fundraising efforts.

“We can make a real impact on the health of this country with a very modest investment,” said Dr. Kenneth Kaushansky. Dr. Kaushansky, Helen M. Ranney Distinguished Professor and Chair of the Department of Medicine, is Director of the Global Medicine Program.

As the U.S. and Mozambican residents care for patients and pursue their studies together, they lay groundwork for stronger healthcare systems in both nations. In the face of overwhelming need in Maputo, they press forward with the resources available.

Drs. Benson and Schooley are veterans of many successful efforts to improve healthcare delivery in Africa.

“You overcome,” said Dr. Benson. “One day at a time, one patient at a time.”

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The Global Medicine elective rotation is open to second- and third-year residents and to Department of Medicine faculty members from all specialties.

For more information on the Global Medicine Program,
visit http://imresidency.ucsd.edu/GlobalMed.shtml.

Read our news story about the launch of the Global Medicine Program here.

Give to our Global Medicine Program.