Around the Globe for Women's Health: A Practical Guide for the Health Care Provider

152 Pages·2013·2.916 MB·English

by  Carolina Bibbo MD, Taraneh Shirazian MD (auth.), Taraneh Shirazian, Erin Gertz (eds.)

Taraneh Shirazian Editor-in-Chief
Erin Gertz Co-Editor
Around the Globe
for Women’s Health
A Practical Guide
for the Health Care
Provider
123
Around the Globe for Women’s Health

Taraneh Shirazian, Editor-in-Chief

Erin Gertz, Co-Editor

Around the Globe
for Women’s Health
A Practical Guide
for the Health Care Provider
Editors
Taraneh Shirazian , MD Erin Gertz , MD
Division of Global Health Division of Global Health
Department of Obstetrics Department of Obstetrics
Gynecology & Reproductive Science Gynecology & Reproductive Science
Icahn School of Medicine at Mount Sinai Icahn School of Medicine at Mount Sinai
New York, NY , USA New York, NY , USA
ISBN 978-1-4419-8257-5 ISBN 978-1-4419-8258-2 (eBook)
DOI 10.1007/978-1-4419-8258-2
Springer New York Heidelberg Dordrecht London
Library of Congress Control Number: 2013939597
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Global Health in the Twenty-First Century
Globalization in the twenty-fi rst century is characterized by the increasing ease of
movement of products, culture, and people across traditional nation-state boundaries,
facilitated by technological advances. To successfully care for an increasingly diverse
patient population in the United States, health providers must be adept at cross-cul-
tural communication and develop culturally informed knowledge of health practices
and beliefs. Immigration and increased travel require us to be able to identify global
pathogens endemic to regions beyond our borders (Bateman et al. 2001). Understanding
global health approaches may aid us in improving national disparities in disease mor-
bidity and mortality among the underserved (Murray et al. 2006). Training physicians
who will be adept at these techniques and have a foundational knowledge of global
diseases, cultures, and determinates of health is key to a healthier future.
Fortunately, interest in global health and developing these skills is high among
medical trainees. The Association of American Medical Colleges 2012 Graduation
Questionnaire found that 30.4 % of medical students had participated in a global
health elective while in medical school, up from 6 % in 1984 (AAMC Graduation
Questionnaire 2012; Medical Student Graduation Questionnaire 1984). After global
health experiences, medical students report improved clinical and communication
skills, sensitivity to costs, greater appreciation for cultural differences, and an
increased likelihood to work in underserved communities and volunteer domestically
and internationally (Haq et al. 2000; Bissonette and Route 1994; Jeffrey et al. 2011).
The realities of globalization are not the only motivation for our interest in global
health. We believe that as health-care providers living and working in a wealthy
country, we have both the power and responsibility to work towards reducing dis-
proportionate suffering and death. Our view of “Global Health” is one that seeks to
increase health equity through interdisciplinary research and transnational coopera-
tion addressing both prevention and improved clinical care (Koplan et al. 2009).
The goal of this handbook is to educate the health-care provider on some of the
challenges and diffi culties inherent in global health work. While many providers seek
international volunteer or work opportunities, preparation for such endeavors is often
limited. This handbook highlights important medical issues and barriers to care faced
v
vi Global Health in the Twenty-First Century
by many women around the world. A case-based framework is used to discuss and
describe unique issues, barriers, and challenges in various communities. This is meant
to be purely instructional and to create a context for discussion and education. This
should not be viewed as a generalization of specifi c cultural groups or communities.
A Note on Language
There are many ways to classify disparate areas of the world and our authors have
used various terms in this text. World Bank classifi cations, often used in interna-
tional health literature, are based on gross national income per capita and include
the terms “low, middle, or high income.” For an extensive explanation of the World
Bank classifi cation system, please refer to h ttp://data.worldbank.org/about/country-
classifi cations . Because the provision of health-care services requires materials,
personnel, infrastructure, and funding, the term “low-resource” is used in this text
to highlight the relative lack of materials, personnel, funding, or other assets faced
by many areas around the world. As much as possible, we have encouraged our col-
laborators to avoid use of outdated terms such as “Third World” or “developing” to
refer to low- and/or middle-income countries.
We hope you will fi nd this handbook a useful preparation for working globally
in the fi eld of women’s health or that it will enhance your current understanding of
the barriers and challenges to working in low-resource settings. Our goal is to
empower the women’s health provider to feel better prepared to take on the chal-
lenges of global health delivery and to have a broad and successful impact in
improving the lives of women.
Taraneh Shirazian is the Director of Global Health in the Department of
Obstetrics, Gynecology and Reproductive Science at Icahn School of Medicine at
Mount Sinai in New York, NY. She created the Division of Global Health in the
Department of Ob/Gyn 5 years ago with the introduction of a Global Women’s
Health Course and Track for all residents desiring work abroad and started a Global
Women’s Health fellowship in 2012. She is a strong advocate for trainee and physi-
cian education prior to work abroad and advocated for this education as the National
American College of Obstetrician Gynecologists Junior Fellow chair from 2009–
2010. She is the cofounder and Medical Director of S aving Mothers ( w ww.saving-
mothers.org ) , a nonprofi t dedicated to reducing maternal morbidity and mortality
and improving the lives of women through prevention, education, training of local
providers, and clinical outreach.
Dr. Erin Gertz is the fi rst Global Health Fellow in the Department of Obstetrics,
Gynecology and Reproductive Science at Icahn School of Medicine at Mount Sinai.
She attended medical school at the University of Hawaii, John A. Burns School of
Medicine and completed her residency training in Ob/Gyn at the Beth Israel Medical
Center in New York.
New York , NY , USA Taraneh Shirazian
Erin Gertz
Global Health in the Twenty-First Century vii
References
Bateman C, Baker T, Hoornenborg E, Ericsson U. Bringing global issues to medical teaching.
Lancet. 2001;358:1539–42.
Murray CJ, Kulkarni SC, Michaud C, Tomijima N, Bulzacchelli MT, Iandiorio TJ, et al. Eight
Americas: investigating mortality disparities across races, counties, and race-counties in the
United States. PLoS Med. 2006;3(9):e260.
AAMC Graduation Questionnaire. 2012 All schools summary report. Washington, DC: Association
of American Medical Colleges. 2012. https://www.aamc.org/download/300448/data/2012gqal
lschoolssummaryreport.pdf .
Medical Student Graduation Questionnaire. Summary report for all schools. Washington, DC:
Association of American Medical Colleges; 1984.
Haq C, Rothenberg D, Gjerde C, et al. New world views: preparing physicians in training for
global health work. Fam Med. 2000;32:566–72.
Bissonette R, Route C. The education effect of clinical rotations in non- industrialized countries.
Fam Med. 1994;26:226–31.
Jeffrey J, Dumont RA, Kim GY, Kuo T. Effects of international health electives on medical student
learning and career choice: results of a systematic literature review. Fam Med.
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Koplan JP, Bond TC, Merson MH, et al. Consortium of Universities for Global Health Executive
Board. Towards a common defi nition of global health. Lancet. 2009;373:1993–5.

Contents
1 Maternal Mortality: The Greatest Health Divide
in the World ............................................................................................ 1
Carolina Bibbo and Taraneh Shirazian
2 Postpartum Hemorrhage in a Confl ict Setting .................................... 21
Nichole Young-Lin, Maya Garala, and Erin Gertz
3 Obstetric Fistula ..................................................................................... 33
Salma Rahimi, Tracy Capes, and Charles Ascher-Walsh
4 Diagnosis and Treatment of Malaria in Pregnancy ............................ 55
Veronica Ades
5 The Unmet Need for Family Planning ................................................. 69
Jessica M. Atrio, Kate A. Shaw, and Paul D. Blumenthal
6 Anesthesia in Action at a Global Health Site....................................... 93
Andrew M. Perez, Ram Roth, and Elizabeth A.M. Frost
7 At Your Cervix: Preventing Cervical Cancer
Using a Single-Visit Approach .............................................................. 105
Deborah Landis Lewis and Miriam Cremer
8 The Challenge of Global Cervical and Breast Cancer
Prevention, Detection, and Treatment.................................................. 117
Annekathryn Goodman
ix