Improving children's access to quality health care through international collaboration in education, research and clinical care.
Octavio Ramilo, MD, and Karen E. Heiser, PhD
As Albert Einstein noted, “The significant problems we face cannot be solved at the same level of thinking we were at when we created them.” Indeed, worldwide over 10 million children die annually from totally preventable causes (UNICEF statistic). Only by working together to share expertise and resources can we make significant inroads into this human tragedy.
In 1986 the International Program at Nationwide Children's Hospital officially began with the Ein Karem and Mt. Scopus Haddassah Hospitals (Jerusalem) and Giannina Gaslini Children’s Hospital affiliations. During the past 20 years, 200 physician, nursing, social work, pharmacy and other allied health scholars from 35 countries have received specialized pediatric training, shared clinical protocols and collaborated on scientific projects.
7 Costa Rica
8 Dominican Republic
10 El Salvador
18 St. Lucia
39 Saudi Arabia
53 South Africa
67 New Zealand
International exchange programs provide unique learning and teaching opportunities for faculty, staff and trainees. It is an investment in the future of each country. Most importantly, education is the universal language and methodology for continuous quality improvement. The Frederick Virginia Smith Stecker International Scholars Program was established in 1995. During the past 10 years, 85 mid-career physician and nurse scholars from 33 countries have received, on average, three months of advanced training at Nationwide Children's Hospital. Scholars are required to return to their home country to implement new programs and services.
Some of their notable accomplishments include:
- First Poison Center in Nepal which is still operational and maintains regular contact with the Children’s Poison Center (1995)
- Comprehensive hematology/oncology program in Shanghai, P.R. China, linked with the
- Children’s Cancer Study Group (1997)
- National Neonatal Resuscitation Course in South Africa (1997)
- Comprehensive Child Safety Promotion and Injury Prevention Research Center in Thailand (1998)
- First organized Child Abuse Program in Russia (1999)
- First recognized subspecialty in Adolescent Medicine in Turkey (2002 and 2005)
- First and only nurse perfusionist program in Chile (2004)
The Nationwide Children's Hospital China Program officially began in 2005, although medical staff members in oncology, rheumatology and psychology have been working in China for more than 10 years. In 2005, projects were centered in three hospitals: Cardiovascular Institute and Fuwai Hospital, Shanghai Children’s Hospital – Pudong District, and Wuhan Children’s Hospital. To date more than 20 physician leaders from these premier pediatric facilities have come to Nationwide Children's Hospital to collaborate in:
- The Heart Center
- Interventional cardiology
- Cardiothoracic surgery
- Cardiac intensive care
- Cardiopulmonary perfusion
- Childhood Cancer
- Center for Injury Research and Policy
- Child Neurology
Nationwide Children's Hospital faculty actively engages in teaching and learning internationally. In 2005 alone, faculty members gave over 100 presentations in 19 different countries. Specialties included interventional cardiology, cardiothoracic surgery, cardiac intensive care, child abuse, dentistry, gastroenterology and GI motility, genetics, immunology, infectious diseases, neurology, orthopedics, pathology, psychology, radiology and urology. In addition to these presentations, several faculty members served as Course Directors of international scientific programs in China. Finally, live case demonstrations from Nationwide Children's Hospital have been broadcast via satellite throughout the world.
Affiliated Health Care Institutions
Nationwide Children's Hospital currently has institutional affiliations with the following health care organizations:
- Basra Children’s Hospital, Basra, Iraq (through Project HOPE)
- Beijing Since Medical Scientific Co, Ltd., Beijing, P.R. China
- Cardiovascular Institute and Fuwai Hospital, Beijing, P.R. China
- Emma Children’s Hospital, Academic Medical Center, Amsterdam, The Netherlands
- Shanghai Children’s Medical Center, Pudong District, Shanghai, P.R. China
- Wuhan Children’s Hospital, Wuhan, P.R. China
Nationwide Children's Hospital allocates funds to support the medical/surgical care and treatment of international patients without the ability to pay. These humanitarian requests are based upon available resources and community support to meet the clinical, psychosocial and longterm care needs of the child and family. Hospital and physician services are donated. In 2005, seven children from Iraq, Jamaica, Nicaragua, Trinidad, Venezuela and Ukraine received care at Nationwide Children's Hospital. In addition to humanitarian care, highly specialized subspecialty services at Nationwide Children's Hospital have led to increasing international referrals for complex procedures in congenital heart disease, gastrointestinal motility, otolaryngology and radiology, to name a few. The Welcome Center supports the unique needs of families and patients traveling to central Ohio. Equally important is the international pediatric health care network that continues to develop through the educational and research affiliations. Children gain access to quality care through referrals to this network throughout Asia, Africa, the Middle East, as well as North and South America.
Although the world has seen gains in child survival statistics over the past decade, significant discrepancies within and across countries remain. Nationwide Children's Hospital works with other health care and service organizations to level the playing field to enhance every child’s right to survive and thrive. Examples of activities in which medical and hospital staff engage include international clinical mentoring and medical mission work, advocacy for child health issues such as HIV, and international adoption medical consultation. Through the volunteer efforts of staff, together with the support of hospital administration and community donors, Nationwide Children's Hospital coordinates the collection and distribution of medical supplies to countries. To date nearly $1 million in supplies have been used to improve the delivery of pediatric care in 15 countries.
Nationwide Children's Research Institute has collaborative international research initiatives in the following Centers of Emphasis: Biobehavioral Health, Cardiovascular Medicine, Childhood Cancer, Developmental Pharmacology and Toxicology, Gene Therapy, Injury Research and Policy, Molecular and Human Genetics, and Vaccines and Immunity as well as clinical research in GI Motility, Cardiovascular Disease and Radiology, to name a few. Expectations are high that these collaborations will lead to improved health outcomes for children throughout the world.