GHD is seeking applicants for a new research assistant position that will begin on June 1. The RA will join GHD’s project investigating themes of strategy and management at scale, with a specific focus on HIV prevention programs. The research will form the basis of six teaching cases and the strategic framework, which will be reviewed at a live peer review session by thought leaders and implementers from around the world. A public community on GHDonline.org will be developed to disseminate resources and generate dialogue on HIV prevention.
If you are looking for an entry-level position in global health, this is a great opportunity to jump into some cutting-edge research and confront the questions of how to achieve universal access for health by enabling successful models to achieve scale. Please visit the Partners’ Healthcare employment website to learn more and apply.
While visiting several organizations in Pakistan, I joined current and former patients and their families, local and international celebrities such as Miss Zeba Bakhtiar, and staff in a ‘Open House’ event at the new TB care facility of Indus Hospital on March 23, a national public holiday.
“We really held this event for the patients. Today’s about them,” commented Tariq Qaiser, the building’s chief architect. Patients took a tour of the facility, learning what to expect when they soon returned for appointments. Some shared their struggles with the illness, the difficulties in accessing effective treatment and their gratitude for the program, while others won prizes by answering trivia questions on TB. The hospital leadership provided words of encouragement to current patients and congratulated those who had successfully completed their treatment course. Hundreds traveled several hours to attend the event. Excitement was palpable, one patient rejoicing “This is just like a picnic!”
Dr. Abdul Bari Khan, CEO of Indus Hospital, speaking at the event.
According to the most recent WHO report on MDR-TB, many countries including Pakistan do not have sufficient surveillance infrastructure to accurately assess their burden of MDR-TB; only 59% of all countries have been able to collect high quality, representative data on drug resistance. When not diagnosed properly – the WHO estimates that only 7% of patients with MDR-TB are diagnosed worldwide – patients end up taking the same regimen multiple times which leads to resistance.
Built primarily with local materials, the new TB facility combines a regal design with expert advice on infection control, and applies recent lessons learned on natural ventilation by providing a shady outdoor waiting area with stone benches and an open structure allowing for a constant natural breeze. Though still controversial and not always possible or reliable depending on climate and varying conditions (wind direction, seasons, etc.), “there has been an outpouring of enthusiasm for the natural ventilation approach,” notes TB Infection Control expert Dr. Ed Nardell. Dr. Aamir Khan, Executive Director of Interactive Research and Development, a partner of Indus Hospital in several of its service-research initiatives including MDR-TB, commented,
This building is a testament to Indus Hospital’s mission of providing quality care to all its patients with dignity, completely free of cost. My hope is that this building is known not just for its striking architecture, but for the integration of airborne infection control and the functionality of every day use. It inspires me to do more, faster and better for the control of drug resistance TB in Pakistan and the developing world.
Open structure allowing for a constant natural breeze
Indus’ TB treatment model includes lay-people in the community who provide treatment support, and the use of a sophisticated electronic medical record system developed using the open-source technology OpenMRS. In addition, Indus’ partners at Interactive Research & Development are currently working to integrate cell phones with the EMR system to allow community-based staff to access and enter patient information in their daily activities. As the program expands in Karachi and is potentially replicated elsewhere in Pakistan, having a robust delivery model that includes smart management of information will be critical to patient adherence necessary to effectively combat MDR TB.
Opened in 2007 with the aim of providing high quality care at no cost to patients, Indus Hospital also provides specialized services such as orthopedic surgery, dialysis treatment, and angioplasty – services whose prohibitive costs make them unaffordable to many poor patients, or come at the expense of selling all one’s property. Over the past two years, several new departments were added, and Indus’ leadership is now strategizing about how to increase the care it delivers at the community level.
From TB infection control issues to management of MDR-TB treatment, many of these topics are addressed by GHDonline members. We invite you to discover the following discussions and resources on GHDonline:
The GHD blog by the Global Health Delivery Project at Harvard University offers news and analysis on our work and on the field. We also feature guest blog posts and partners’ projects.
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