Malawi Surgical Initiative
As sub-Saharan Africa improves its economic position, it faces an increase in non-communicable diseases, many of which are surgical conditions. Effective, timely surgery can return people of all ages to a normal, productive life. Relatively simple, cost-effective and curative surgical procedures can avert disability and premature death from many life-threatening emergencies and other conditions.
In collaboration with surgeons at Kamuzu Central Hospital in Lilongwe, Malawi, the Malawi College of Medicine in Blantyre, Haukland University Department of Surgery, Bergen, Norway and the University of North Carolina Departments of Surgery and Otolaryngology/Head & Neck Surgery, a new surgical resident training program was established at Kamuzu Central Hospital in July 2009. The program is accredited by the College of Surgeons of Eastern, Central and Southern Africa (COSECSA). After 5 years of post medical school training, these young men and women will spend a lifetime providing surgical care to some of the poorest people in the world. In addition, they will become the faculty for the self-sustaining training program, training generations of surgeons and leaders.
Providing surgical care requires a diverse team of professionals: general and subspecialty surgeons, anesthesiologists, intensive care physicians, nurses, pathologists and radiologists. The Malawi Surgical Initiative brings together professionals from UNC and other institutions to provide training for the KCH General Surgery Residency Program and conduct research of surgical diseases.
Contact: Malawi Surgical Initiative website
Medical Geography Project
IGHID is partnering with UNC’s Spatial Health Research Group to use spatial analysis and geography information systems (GIS) to assist with clnical trials on HIV and malaria at UNC Project-Malawi.
The research team uses GPS devices to develop accurate mapping of Lilongwe, enabling researchers to analyze geographic patterns of disease transmission and reduce loss-to-follow-up in UNC Project’s many clinical trials. Community workers at the project are trained in the use of GPS devices.
The Spatial Health Research Group is assisting a major malaria vaccine trial that will measure the efficacy of a GlaxoSmithKline malaria vaccine (RTS,S/AS01E). The study is a multi-center Phase III randomized double-blind trial that will be implemented across diverse malaria settings throughout Africa. UNC is implementing the trial in Lilongwe.
The research group is assisting with measuring the vaccine’s efficacy under different transmission settings by providing data and data analysis of factors such as (a) population density, (b) proximity of households to standing water locations, (c) neighborhood-level household ecology (e.g. bed net usage) and d) mosquito trap data.
Contact: Michael Emch
Under the direction of Ian B. K. Martin, MD, assistant professor of emergency medicine and internal medicine, Global Emergency Medicine (EM) is an exciting new global health initiative at UNC.
UNC Global Emergency Medicine includes the following programs:
• International relief efforts
• Clinical rotations (East Africa and Latin America)
• Emergency medicine specialty development and research (East Africa)
• Cross-cultural “observational” experiences (UNC-Japan)
• Global Emergency Medicine academic track
• Global Emergency Medicine/Infectious Diseases educational module
Global EM is particularly committed to the development of emergency medicine as a specialty in East Africa. As an example, Dr. Martin partnered with three North Carolina-based emergency physicians and the Abbott Fund to establish the first American-style Emergency Department at Muhimbili National Hospital in Dar es Salaam, Tanzania.
The goal at Global EM is for emergency medicine to be recognized as a specialty in East Africa, which will improve the delivery of acute care in this region. Training program development and research will be an integral part of these efforts.
Mature EM residents can elect to do a clinical rotation in East Africa. The purpose of this rotation is to prepare EM trainees, volunteering in a low-income tropical nation, to care for patients presenting with fever and other disease states, including trauma.
Emergency medicine residents interested in a career in global emergency medicine can participate in the Global EM academic track. This new academic track involves EM residents with national groups focused on global/international emergency medicine, for example, Emergency Medicine Residents’ Association and Society for Academic Emergency Medicine interest groups as well as the American College of Emergency Physicians’ international section.
Residents on this track are integral in the planning of relief trips, helping to design a budget, plan logistics, and manage personnel. Participating residents are actively involved in the Global EM/ID educational module, and even lead some of the didactic sessions. Ideally, residents on this path will go on to complete an international emergency medicine fellowship program.
Global EM offers international volunteer opportunities for almost anyone affiliated with UNC: students, nurses, residents, fellows, or attendings.
Contact: Ian B.K. Martin, MD
PACT – Providing AIDS Care and Treatment in the Democratic Republic of Congo under the President’s Emergency Plan for AIDS Relief (PEPFAR)
In 2006, an estimated 1 million people were living with HIV/AIDS in the Democratic Republic of Congo (DRC), yet HIV prevention, care and treatment needs of its population remain largely unmet.
The overall goal of this project is to increase access to quality services and to improve health outcomes of PEPFAR beneficiaries by strengthening the capacity of health care facilities to provide family-centered HIV prevention, care and treatment in Kinshasa. Through a partnership between the Gillings School of Global Public Health and the Kinshasa School of Public Health, collaborations with public sector health care facilities and clinics managed by non-governmental organizations, and in alliance with the DRC Ministry of Health and its National Programs for HIV/AIDS and Tuberculosis, this program consolidates and expands existing activities while fostering sustainability of HIV services.
Contact: Frieda Behets
University of North Carolina-Democratic Republic of Congo Prevention of Mother-to-Child HIV Transmission (PMTCT) Program
This program provides technical assistance to antenatal care clinics in Kinshasa, DRC, to integrate quality PMTCT services into antenatal care, while also improving basic antenatal care services. The UNC program has successfully implemented these services in 31 Kinshasa clinics. UNC PMTCT Program provides assistance with the following:
- This program program monitoring and evaluation through the collection, interpretation and reporting of monitoring data
- acquisition of PMTCT-related supplies
- holding routine feedback meetings with clinic staff members who engage in PMTCT services, which provide an opportunity for clinic staff and UNC personnel to identify potential obstacles to providing quality services and solutions to overcome these obstacles
Contact: Frieda Behets, PhD
UNC-MAD Research Project
The University of North Carolina has been working in Madagascar since 1995. Led by Dr. Frieda Behets, UNC has built research infrastructure that includes more than 100 full-time employees. The in-country director at UNC-MAD is Dr. Kathleen Van Damme. The project has study sites in five cities in Madagascar. Central offices are located in the National Institute of Public and Community Health in Antananarivo.
Research at UNC-MAD is focused on sexually transmitted infections among a cohort of sex workers. UNC-MAD has trained local lab technicians in the testing of study specimens as part of its goal of establishing a sustainable workforce. Ongoing research directed by Dr. Behets includes a NIH-funded clinical trial for treatment of syphilis and prevention methods for chlamydial infections in high-risk women.
Contact: Frieda Behets
The HIV/AIDS epidemic is one of the world’s greatest public health challenges. The epidemic has aggravated the pre-existing tuberculosis (TB) epidemic, and escalating TB case-rates complicate the HIV epidemic. By 2007, there were approximately 1.37 million HIV-positive TB patients globally, about 80% of whom live in sub-Saharan Africa. South Africa is among the top 5 countries in terms of TB burden, HIV burden, and TB/HIV burden.
South African TB/HIV Training Program (SATBAT)This TB/HIV research training initiative aims to improve TB research in South Africa by providing short-, medium-, and long-term training to South African investigators in TB and HIV research in programs in both the United States and South Africa. The project is funded by an NIH International Clinical, Operational, and Health Services Research and Training Award for AIDS and Tuberculosis (ICOHRTA-AIDS/TB).
Contact: Charles van der Horst
Building Capacity in HIV/TB Research: the WITS/UNC Training Program
Capacity building in clinical, operational and health system TB/HIV/AIDS research in both the academic and governmental sectors in South Africa is urgently needed. This collaboration between UNC and University of the Witwatersrand is creating a comprehensive plan to build capacity for training and research in the fields of TB and HIV/AIDS. The program fosters the development of a multidisciplinary Research Training Unit (R&T Unit) for TB/HIV research and training in South Africa and the sub-Saharan African region. The R&T Unit will have expertise in clinical, operational and health service research methodologies, both quantitative and qualitative, onsite and distance learning teaching capacity and substantial core research support capabilities.
Contact: Annelies van Rie