Preparing Physicians to Take the Lead in Global Areas of Need

Main Category: Aid / Disasters
Article Date: 28 Jun 2005 - 14:00 PDT

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Just days after arriving in Banda Aceh, Indonesia to coordinate health clinics in the aftermath of the devastating tsunami, Dr. Mamta Malik, found herself in the midst of a new disaster; an 8.7 earthquake off the coast of Sumatra. The emergency medicine physician was quickly immersed in one of the most demanding, exciting and hands-on lessons of her life.

Malik traveled to Sumatra as part of the new International Emergency Medicine Fellowship, a joint two-year program at Rush University Medical Center, Stroger Hospital of Cook County, and International Medical Corps (IMC); a non-profit humanitarian organization. This fellowship, one of only thirteen such programs in the nation, teaches emergency physicians leadership skills in the international arena focusing on the development of emergency health services as well as on disaster relief. Dr. Malik found those skills essential as she tended to the injured on the island of Nias, the area hardest hit by the quake.

"We were the first clinical team to arrive on the island after the earthquake and we were inundated by injured patients who had gathered in a soccer field because the hospitals were overwhelmed. We stabilized patients in the field and organized the evacuation of over 300 patients off the island," said Malik.

While the fellowship helps prepare physicians for the immediate aftermath of a disaster, the scope of the program is much larger. Dr. Jamil Bayram, an emergency medicine physician at Rush and Stroger hospitals, is the director of the fellowship program. He developed the fellowship in collaboration with Dr. Robert Simon, the founder and chairman of boards of IMC and the executive chairman

of the Cook County Bureau of Emergency Medicine and Rush University Medical Center.

After finishing his emergency medicine training at Stroger Hospital of Cook County, Dr. Bayram went to Lebanon where he worked for three years as chairman of the largest emergency department in South Lebanon which remains an area of armed conflict until this day. During the 2003 Iraq conflict, he then joined IMC as an emergency medical advisor and worked with Iraqi civilian physicians in the city of Nasyria.

"Working in a disaster area, whether natural or man-made, you have a health crisis on your hands that could take months or years before the area's health system is self-reliant again," said Dr. Bayram. "The objective of the fellowship program is to teach how to evaluate international emergency health systems, design and implement training programs, and monitor the quality of health aid in order to develop a self-sustaining emergency medicine system."

For example, one of the difficulties Dr. Malik encountered in Banda Aceh was the overwhelming outpouring of help and donations. It can be a logistical nightmare to coordinate where to send volunteers and how to allocate supplies.

"In the emergency phase, we used everything. However, in the rehabilitation phase, our intention is to improve long-term healthcare in the region. If we receive a medication that is not typically used in Indonesia, that can be a problem for the local clinicians. We want to make sure we are following Indonesian guidelines and practices," said Malik.

While serving as the medical coordinator for the Aceh province, Malik's priority was re-staffing the hospitals. Many of the doctors, nurses and technicians were either killed by the tsunami, suffered tremendous losses, or fled the area. Malik oversaw the transition from Indonesian staff to local Achenese staff. When she left the area in May, the hospital in Banda Aceh were fully staffed and those outside the region were well on their way.

This past year, Dr. Malik has also traveled with IMC to Darfur, Sudan during the refugee crisis. Her goal as she enters the second year of the fellowship is to focus on emergency medicine development in countries that lack structured programs. She plans to develop models to help countries improve their emergency medicine health care.

"Due to antibiotics, infectious disease is no longer the main obstacle to healthcare in these countries. Emergency medicine is needed now in developing countries that are seeing a rise in trauma cases caused by more industry and more lifestyle diseases caused by higher fat diets," said Dr. Malik.

The fellowship is a two-year program during which the fellow will serve as an attending at both Rush and Stroger Hospitals. Every year, the fellow will spend 12 weeks overseas working on various international projects. The fellow will also earn a Master's degree in Public Health from the University of Illinois at Chicago. Applicants must be graduates of an emergency medicine residency program, board eligible or certified in emergency medicine.

"We are looking for hard-working people who are truly committed to the field of International Emergency Medicine" said Dr. Bayram. "I am confident that Mamta has had one of the best experiences in her first year of fellowship compared to her peers!"

For more information on the International Emergency Medicine Fellowship at Rush/Stroger/IMC, visit iemfellowship.org.

For any inquiries, please contact Dr. Jamil Bayram at Jamil_Bayram@rush.edu.

Rush University

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