eMagazine August 2022

August 2022 Volume 44 

NUVANCE HEALTH 

Global Health Program 

LARNER COLLEGE OF MEDICINE 

NUVANCE HEALTH AND THE UNIVERSITY OF VERMONT LARNER COLLEGE OF MEDICINE 

Global Health eMagazine 

Yesterday I was clever, 

so I wanted to change the 

world. Today I am wise, 

so I am changing myself. 

Rumi 

Editor; Majid Sadigh, MD 

Contributing Editor; Mitra Sadigh 

Creative Director; Majid Sadigh, MD 

Cover Photo: Rose Schwartz

OUR PEOPLE, 

OUR MISSION 

Global Health 

eMagazine 

August 2022 

Highlights 

Clinical Case of the Month 

Highlights 

Dr. Mariah McNamara, Associate 

Director of the Global Health 

Program at UVMLCOM and Dr. 

Andrea Green, director of global 

health in the department of 

pediatrics at UVMLCOM had a 

successful and rewarding sitevisit 

in Uganda. The full report will 

be posted in the next eMagazine 

issue. 

Reflections 

Health Disparities Within Our 

Borders 

Nursing Division 

Art to Remind Us of Who We 

Can Be 

Our Beautiful Planet 

Among the Letters 

Congratulations 

Dr. Noeline Nakasujja (right) and 

Dr. Mariah McNamara (left) 

Dr. Andrea Green (right) and 

Dr. Sabrina Bakeera-Kitaka (left) 

Global Health Team 

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Dr. Mariah McNamara (second from left) and Dr. Andrea Green (second from right) with the leadership 

of ACCESS in Nakaseke, Uganda 

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Clinical Case 

of the Month 

Written by Joshua Matsiko 

Medical Student at MakCHS 

Matsikojoshua091@gmail.com 

Skin-Bleaching the Silent 

“Pandemic” in the Global South 

In the emergency ward of Mulago National 

Referral Hospital at around 10 PM while on night 

shift, an ambulance brings in a woman who had 

been involved in a road traffic accident. She 

had multiple lacerated wounds on her face and 

right upper limb. Given that all the doctors on 

call that night were attending to more severe 

emergencies, I was given permission to suture 

the lacerations, as they were not very deep, 

and I had performed quite a number of suturing 

procedures with supervision. 

I disinfected the site and applied local anesthesia. On beginning the suturing, I 

encountered an unexpected occurrence. Every time I tried to oppose the skin with 

average strength, the sutures consistently tore through the skin. My patient’s skin 

was softer and thinner than normal. Her skin tone was uneven, with her face very 

light-skinned while her lips, fingernails, elbows, knuckles, palms, and hands were 

darker. This is a common presentation of patients who use skin bleaching products. 

On asking the patient, she endorsed using skin-bleaching lotion. On further 

research, I discovered that there was a possibility that this occurrence could be 

due to the skin-lightening effects among other possible causes. 

With this in mind, I decided to carry 

out a short survey on the different 

effects of skin-bleaching on 

wounds. We observed 108 women 

with different kinds of wounds 

who were using skin-bleaching 

products including but not limited 

to bleaching creams, soaps, pills, 

injectables, chemical peels, and 

laser therapy. We discovered that 

these women experienced slower 

wound healing, and their wounds 

were more prone to infection and 

excess bleeding. There was also 

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increased wound dehiscence in these patients as well as an increased incidence 

of hypertension and diabetes in skin-bleaching populations. On further study, we 

found more local and systemic effects of skin bleaching including patchy hyperor 

hypopigmentation, skin atrophy, stretch marks, Cushing’s syndrome, adrenal 

insufficiency, nephrotic syndrome, neurological disorders, ocular disorders, and 

teratogenic effects. The WHO documented that 40% of African women regularly use 

bleaching products, and as high as 77% in some countries like Nigeria. In Uganda, 

approximately 32% of women regularly use skin-bleaching products. 

(https://www.un.org/africarenewal/magazine/april-2019-july-2019/paying-highprice-skin-bleaching#:~:text=Statistics%20compiled%20by%20the%20World,Mali%20 

use%20skin%2Dlightening%20products.) 

This high prevalence has persisted despite warnings from different entities about the 

proven dangers of skin-bleaching chemicals coupled with the lack of proven health 

benefits in conditions like hyper-pigmentation and vitiligo that these products claim 

to help treat. 

On studying the history, I found out that in part, colonization and slavery had a 

big role in developing skin-bleaching in Africa and Asia. A paper published by the 

American Sociological Society explains, “to justify racial slavery, slave-holding 

interests espoused a white supremacist ideology which held that persons of African 

descent were innately inferior to whites. Whiteness became identified with all that 

is civilized, virtuous and beautiful.” Lighter-skinned slaves received differential 

treatment from the darker-skinned ones like working indoors, and were closer 

to receiving privileges only given to white people. Unfortunately, this belief has 

persisted to date in the Global South where women with lighter skin are not only 

considered more attractive—one study showed that 83% of men in Uganda prefer to 

have a light-skinned spouse!—but are also more esteemed in society. 

Despite much of the Global South being absolutely against skin-bleaching,the tacit 

pressures continue to drive the practice. There is also a moderate prevalence of 

bleaching in medical students and medical workers of about 19%, based on a short 

survey I conducted on 1000 medical students and 100 medical workers. 

Skin-bleaching cannot be eliminated through sensitizing the public about its 

dangers or banning skin bleaching products, as skin-bleaching is still on the 

rise despite approximately 78% of users being aware of its side effects. I believe 

the problem is more deep-rooted. Perhaps we should focus on decolonizing the 

educational curricula of the Global South and combating the inferiority complex it 

perpetuates, and teaching Global South populations to be confident in their color, 

which is as beautiful as any other. 

At Better Health Uganda, we have been sensitizing children in primary schools to be 

confident in who they are while sensitizing the adult generation about bleaching. 

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Reflections 

Mwanamugimu Nutrition Clinic at 

Mulago 

Written by William Hsu 

University of Vermont Larner College of 

Medicine Class of 2025 

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My second week in Uganda has continued 

to be a wonderful, welcoming, and incredibly 

informative learning experience. We have 

continued to see primarily orthopedic cases, 

and were able to visit the lab and imaging 

buildings alongside listening in on the HIV 

clinic, all of which have been very informative 

experiences. 

We also visited the Mwanamugimu Nutrition Clinic at Mulago. This clinic, which 

has three separate units, treats children who are clinically malnourished. The first 

unit, P1, stabilizes the patients and ensures that any existing comorbidities are 

addressed. The second unit, P2, helps patients regain the weight and nutrients 

they were missing. The final unit, P3, educates parents about how to provide 

nutritious meals at an affordable price. This was a great learning experience not 

only clinically, but also in terms of medical education as fifth (final) year medical 

students rounded with us. 




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William Hsu, center, with classmates from UVMLCOM, at the Mwanamugimu Nutrition Clinic 

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However, this was a personally challenging experience. Many very young children 

were suffering not only from malnutrition but also malaria, cerebral palsy, or other 

comorbidities. This was my first time seeing kwashiorkor and marasmus in children. 

I was able to participate in screening incoming children using z-scores from the 

World Health Organization, mid-upper arm circumference (MUAC), and presence 

of edema. Every child that came in to be screened was severely malnourished 

with MUAC scores within the red zone (below 11.5). 

While I am of course grateful that these children were receiving much-needed 

treatment, it was incredibly challenging to witness the direct health impact 

of barriers to food security. Many infants younger than one year were being 

fed a primarily carbohydrate diet of mashed Irish potatoes or matoke after 

breastfeeding was stopped. This was sometimes due to a lack of resources to 

provide the necessary nutrients, and sometimes due to lack of knowledge about 

nutrition. The P3 unit’s role in teaching proper nutrition and helping increase food 

security is critical to the health of children and communities. 

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Bunny (Rose Schwartz) 

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Absorbing My Surroundings 

Written by John (Jackson) Burke 

University of Vermont Larner College of 

Medicine Class of 2025 

What a week it has been since we arrived in 

Uganda. I think I am finally through the jet lag. I 

have a little more energy every day, yet I’m sure 

I will burn through it this weekend as we travel 

to Jinja to see the source of the Nile and explore 

the Mabira forest. My morale is much higher 

than it was when I arrived. 

As we drove from Entebbe Airport to Kampala, culture shock hit me like a ton of 

bricks. Running on one hour of sleep and driving through the dark, I was wondering 

what I had gotten myself into. I thought to myself: “I could be home, sleeping in my 

own bed with the comforts of my known world around me enjoying my last proper 

summer vacation. Instead, I am on the other side of the planet in what feels like a 

different planet, exhausted, and homesick not even two days in.” Once we arrived 

in Kampala, we got a few hours of sleep before waking up early to check out St. 

Stephen’s Hospital. During the walk there, I felt detached. I was overwhelmed by 

everything around me and I wondered how I would make it through the month. 





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Things changed when we started traveling to Naggalama. Somehow, 

those overwhelming feelings started evaporating as I quietly absorbed my 

surroundings through the car window. When we made it to St. Francis Hospital, 

the whole hospital team rolled out the welcome wagon for us. On the first night, 

the head of the hospital Sister Jane Francis hosted a dinner with a group of the 

doctors. Our accommodations are immaculate. I feel spoiled here. The comfort 

and kindness of the people have made this adjustment process so much easier, 

allowing us to fully jump into our hospital days without issue. 

The clinics have been an incredible experience. In four days, I have seen a 

mother give birth, a woman with a herniated cervix, a c-section, an 89-year-old 

patient with chronic obstructive pulmonary disease (COPD) and pneumonia, 

children with sickle cell disease, many patients with malaria, and patients with 

HIV, just to name a few things. I am seeing and therefore learning an incredible 

amount that is helping me reinforce material I learned during my first year at 

school, which has been a godsend in light of my limited clinical experience. 

The medical team and my classmates provide strong support in overwhelming 

moments. I couldn’t have asked for a better group of people around me. 

Two years ago, I was sitting in my apartment in Boston wondering if I would 

ever get into medical school. There is no way I could have imagined that in 

two years’ time I would be in a global health rotation watching a c-section 

in Uganda. Life seems to move in mysterious ways, and I am grateful for this 

opportunity. 





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Katanga Community 

Written by 

Hossein Akbarialiabad MD, MSc 

Faculty, Nuvance Health Global Health 

Academy 

Katanga communites are located in the middle of 

Uganda’s capital, Kampala, between Makerere 

University and Mulago National Referral 

Hospital. The community has a population 

of around 5,000, of which two-thirds do not 

have a national identity card. A volunteer-run 

organization, Katanga 4 Kids educates and 

cares for around 50 children ranging from three to seventeen years old who live 

on the street in the community. One classroom serves the role of school, stage, 

playground, and church. They stay in two dormitories, with three to a bed and 

many on the floor. 

The Katanga communities are quite 

unsafe even during the daytime, even 

as a local. In fact, a few days prior to 

my arrival, a teenage girl was sexually 

assaulted there. As a traveler, safety 

is a fundamental issue. There are also 

health concerns in this area. Residents 

only have access to ten toilets in total, 

for which they must pay, meaning 

Unhygienic defecation and urination 

practices are common, due to a severe 

scarcity of toilets—ten in total for 5,000 

people—for which residents must pay to 

use. 

Furthermore, tap water throughout 

Uganda must be boiled before use, but 

almost 90% of residents in the Katanga 

communites cannot afford to purchase 

fuel for boiling and sanitizing water, 

making cholera a significant concern. 

With an average of seven family 

members, the average household 

income in Katanga is less than 10 USD 

per month, forcing everyone regardless 

of age to work to feed the family. 

“Children have the right to be children all over the world.” This clear notion in highincome 

countries is a fantasy here, as even survival is not guaranteed, let alone 

mental health, physical safety, and sexual and reproductive health and rights. 

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Despite all these challenges, I reveled in watching children play football with 

something resembling a ball, screaming joyfully, feeling excitement, and living 

their lives. We enjoyed singing multiple songs and dancing with the children of 

“Katanga 4 Kids” projects. 


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Photos from Katanga Community (Majid Sadigh) 

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Health Disparities 

Within Our Borders 

Editor: Ritesh Vidhun 

Undergraduate junior at Tufts University 

studying public health and economics on the 

pre-medical track 

Written by Ritesh Vidhun 

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Skip a Meal for Your Meds? The 

Increasingly Detrimental Situation 

of Pharmaceutical Drug Costs in the 

United States 

Part 1/2 

In any society, effective medical care and services are vital for growth and success. 

Optimal health is an important aspect of life, and a comprehensive healthcare 

system that truly values patient care will help create a more effective population. 

One area that plays a critical role in the healthcare system of the United States 

is prescription drugs. Medicine and drugs have advanced significantly over the 

past century, leading to life-saving cures and improvements in the quality of life. 

Consequently, pharmaceutical drug companies play an increasingly significant 

role in, not only the American healthcare system, but American society. 

Even though the United States 

has some of the brightest minds 

in biomedical research and drugs 

are becoming ever so effective, the 

costs for these vital medications 

have skyrocketed over recent 

years. This has made necessary 

prescription drugs unaffordable for 

many families across the country. 

A 2019 Kaiser Family Foundation 

(KFF) Health Tracking Poll recently 

found that nearly 8 out of 10 

Americans believe that the high 

costs of prescription drugs are 

unreasonable (Lopes 2019). In such 

a scientifically advanced nation like 

the United States, why must people 

sacrifice so much to obtain basic medications? This is an ever-growing problem 

that has recently gained the attention of news outlets and lawmakers across the 

nation, as many Americans are starting to realize its detrimental effects. As high 

prices of medications start to become the norm, many are turning to Washington 

to focus on making pharmaceutical drugs affordable for all Americans. This issue 

has generated various proposals from politicians on both sides of the aisle, with 

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varying degrees of support. It is critical to first understand the ways and reasons for 

which the pharmaceutical industry has changed, what has truly led to increased 

costs, and the effects this has had on the American population. 

Firstly, drugs and medications have been constantly evolving, particularly over the 

last two decades. New developments in research coupled with increased funding 

has led to a higher production of medications for serious illnesses. Advanced 

technology has led the pharmaceutical industry “to adapt innovative platforms 

to expedite formulation development for special disease classes, scaling up the 

synthesis for manufacturing molecules sensitive to temperature and pressure under 

cryogenic conditions” (Ali et al. 2018). This focus on furthering research methods and 

equipment has led to increased efficiency and success in this field. Additionally, 

there have been notable changes in the regulation of the pharmaceutical industry. 

In the U.S., the Food and Drug Administration (FDA) is currently working together 

with the United States Pharmacopeia as well as other organizations to develop 

new guidance as more complex molecules are discovered and new technologies 

are being implemented to expedite the development of new drugs. 

There are several new 

technologies, including gene 

therapy, stem cell research, 

and nanomedicine, which 

have all been beneficial in 

helping to drive improved 

economics, flexibility and 

quality while benefiting 

patients both directly and 

indirectly. Girish Malhotra 

of EPCOT International 

explains how there have 

been major improvements in new classes of drugs that treat HIV/AIDS to diabetes, 

however, “their affordability for the masses due to high prices is becoming 

increasingly limited” (qtd. in Ali et al. 2018). This explains a crucial aspect of 

these new developments: although there have been tremendous improvements 

in pharmaceutical drugs throughout past decades, they have not yet become 

accessible for everyone. 

The price of research and development, in addition to changing business mindsets 

have caused prescription drugs costs to skyrocket. Figures from the Organization 

for Economic Cooperation and Development found that Americans spend $1,200 

per year on prescription drug costs, the most in the world (Papanicolas 2018). 

Furthermore, excluding recent years the increases in drug costs have consistently 

exceeded general inflation over the past ten years, rising by nearly 10% each 

year from 2010 to 2015 (Hernandez et al. 2019). There are many reasons for this 

significant rise in drug prices, ranging from a changing business mindset to the 

cost of research and development. 

Follow Part 2 in the September issue 

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References 

1: Lopes, Lunna, et al. ``KFF Health Tracking Poll – October 2019: Health Care In 

The Democratic Debates, Congress, And The Courts.” The Henry J. Kaiser Family 

Foundation, 15 Oct.2019, https://www.kff.org/health-reform/poll-finding/kff 

healthtracking-poll-october-2019/. 

2: Ali, Shaukat, et al. A 20 Year Retrospective: The Pharmaceutical Industry Then and 

Now, October 15, Posted:, and 2018. http://www.americanpharmaceuticalreview. 

com/Featured-Articles/354573-A-20-Year-Rerospective-The-Pharmaceutical- 

Industry-Then-and-Now/. 

3: Papanicolas, Irene, et al. “Health Care Spending in the United States and Other 

High-Income Countries.” JAMA, vol. 319, no. 10, Mar. 2018, pp. 1024–39. Jamanetwork. 

com,doi:10.1001/jama.2018.1150. 

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Bath day (Rose Schwartz) 

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Editor: 


Catherine G Winkler, PhD, MPH, APRN-BC 

Director of the Nuvance Health Global Health Program Nursing Division 

Women’s Health Education 

Roe vs. Wade in America 

Written by Sarah Cordisco, BSN, RN 

Senior Nursing Student at the University of 

Vermont 

In January of 1973, the U.S Supreme Court 

decided on the famous case of Roe V Wade. 

This case was filed by Jane Roe, an unmarried 

woman living in Texas who wanted to terminate 

her pregnancy safely and legally. At the 

time, Texas had a law that made it a crime to 

perform an abortion unless the woman’s life 

was in immediate danger (Planned Parenthood 

Federation of America, 2014). When the Court 

initially ruled on this case, they recognized the constitutional right to privacy was 

“broad enough to encompass a woman’s decision whether or not to terminate her 

pregnancy” (Roe V. Wade 1973). This made abortion accessibly and safe for all 

people. 

To establish this decision, the Court drew on past cases that established the 

precedent that the government could not interfere with personal decisions regarding 

procreations, marriage, or other parts of family life. In 1965, the Court had ruled on 

Griswold v. Connecticut, which was an appeal case of the criminal conviction of the 

executive director of the Planned Parenthood League of Connecticut for providing 

birth control to married couples. The Court ruled that criminalizing the right to use 

birth control violated the privacy rights of married couples. Seven years later, the 

justices found that this right also applies to single people in the case Eisenstadt v. 

Baird, 1972 (Planned Parenthood Federation of America, 2014). 

The Court ruling came at the right time, as by 1965, 17% of all deaths due to 

pregnancy and childbirth were the result of illegal abortions (Planned Parenthood 

Federation of America, 2014). In the late 1960s, a nationwide effort was underway to 

change the law that criminalized the practice. Healthcare providers, women’s rights 

activists, clergy members, and the legal community all lobbied state legislatures 

and went to court to overturn this statue. Many of these laws date back to the mid- 

1800s when legislatures banned abortions despite abortion being allowed prior to 

quickening during the colonial times. Prior to the Court ruling on Roe v. Wade states 

already began changing their laws. Between 1967 and 1973, four states overturned 

their abortion bans, and 13 states enacted limited reforms (Planned Parenthood 

Federation of America, 2014). 

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Roe V Wade gave women the right to make decisions about her pregnancy and 

protected it under the constitution. However, the Court also recognized that the 

right to privacy is not absolute; therefore, states may ban abortion after the point 

of viability, except when it is necessary to protect a women’s life or health. At the 

time Roe was decided on, the point of viability was 28 weeks. Today, it is 24 weeks. 

Most abortions take place within the first trimester. The CDC estimates that in 

2019, 92.7% of all abortions were performed before 13 weeks gestation, 6.2% were 

formed at 14-20 weeks, and less than 1% were performed after 21 weeks. The rate 

of abortion in 2019, according to the CDC, was 11.4 abortions per 1000 women ages 

15-44 years old (CDCs Abortion Surveillance System FAQs | CDC, 2021). Abortion 

occuring in later gestation is typically due to either the mother or fetus being at risk 

of death during delivery. Only a few fatal fetal abnormalities are detected by 13- 

14 weeks, and many are not detected until around 20 weeks (20 Week Ultrasound 

(Anatomy Scan), n.d.). 

When creating legislation concerning pregnancy and pregnancy-related issues, 

women’s health must be at the forefront. Legal abortion is the only way to ensure 

safe abortion practices. As we have seen in history, women and girls will still try to 

obtain an abortion if they need one, and restricting access leaves many to resort to 

unsafe decisions and possibly die. While there have been many restrictions in place 

under Roe V Wade, like states banning funding for abortion clinics, or requiring 

people to gain consent from their parents, there has always been a choice. For the 

first time in 50 years, that choice is no longer a right, but a privilege that depends 

on where you live. 

On June 24, 2022 the Supreme Court once again voted on Roe V Wade, overturning 

the previous decision. This now means that abortion rights are left up to the states 

to decide. As of now, 44 states have some form of restrictions on abortions. Seven 

states have a complete ban on abortion, three have a ban at six weeks, and two 

have a ban at 15 weeks. Only 18 states allow abortion up to the point of viability, 

as it was under Roe V Wade (State Bans on Abortion Throughout Pregnancy, 2022). 

The states with total abortion bans do not allow for it in cases of rape or incest, 

and deem it only allowed when the women’s life is in immediate danger. This causes 

much confusion for healthcare workers, as the laws are not clear in defining what 

is considered immediate danger. While abortion is still legalized in several states, 

federal and constitutional protections no longer exist for women who seek this 

procedure. It is now up to the states. 

References 

20 Week Ultrasound (Anatomy Scan): What to Expect. (n.d.). Cleveland 

Clinic. Retrieved July 26, 2022, from https://my.clevelandclinic.org/health/ 

diagnostics/22644-20-week-ultrasound 

CDCs Abortion Surveillance System FAQs | CDC. (2021, November 23). https:// 

www.cdc.gov/reproductivehealth/data_stats/abortion.htm 

Planned Parenthood Federation of America. (2014). Roe V Wade: It’s History and 

Impact. https://www.plannedparenthood.org/files/3013/9611/5870/Abortion_Roe_ 

History.pdf 

State Bans on Abortion Throughout Pregnancy. (2022, July 16). Guttmacher 

Institute. https://www.guttmacher.org/state-policy/explore/state-policies-laterabortions 

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An American Nursing Student 

Working in a Hospital in 

Greece: An Experience of a 

Lifetime 

Part 1/2 

Written by Amanda Towey 

Nursing Student at Western Connecticut 

State University 

Amanda Towey participated in a student 

exchange program between Western 

Connecticut State University in Danbury, 

CT, and International Hellenic University 

(Alexander Campus) in Thessaloniki, 

Greece. Program funding was provided 

by Eramus, Dr. Monica Sousa, Professor 

of Nursing from Western Connecticut 

State University was the co-faculty lead 

on this project. 

For the last two-and-a-half months, I have been given the wonderful opportunity 

to explore healthcare abroad in Thessaloniki, Greece. As a junior student nurse at 

Western Connecticut State University, my education has been centered around 

healthcare in the United States. As expected, medical management is different 

between the two countries. Greece’s health system aims to provide free access 

to healthcare for its residents. I have been privileged to fulfill my externship at 

Papageorgiou Hospital, one of Thessaloniki’s newest public hospitals located a 

few miles outside of the city center. The hospital staff have welcomed me and 

made me feel like I was truly a part of the healthcare they provide. As a foreigner 

who speaks only a few short phrases and words in Greek, I have relied heavily upon 

observation, gathering as much information as possible through the wonderful 

nurses and nursing students that have taken the time to answer my questions. 

To begin, I am working on one of two surgical units at Papageorgiou Hospital 

called A’XEI. The unit has twelve rooms. The staff consists of doctors, medical 

students, nurses, nursing students, aids, and housekeeping. All healthcare settings 

have position hierarchies, and in my unit, each member of the staff treats each 

other with respect and works together to ensure the best patient care. There is 

always adequate staffing, which is not something I am used to in U.S. hospitals. The 

patients are admitted before surgery and return to the unit to be cared for after the 

procedures are completed. Upon observation, most of the patients receive open 

abdominal/gastrointestinal surgeries, with very few performed laparoscopically. 

They are taken into the private admitting room where an EKG, blood work, and 

a PCR COVID test is done. There are also patients who are admitted onto the 

unit for nonsurgical reasons, and that is due to the “on call” days. Every four 

days Papageorgiou Hospital is on call to receive all ambulance and emergency 

admissions. A’XEI receives overflow patients every eight days because there are two 

surgical units at the hospital. The day after the hospital is on call, oftentimes six or 

seven patients are assigned to each of the seven larger rooms. It has been noticed 

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that the patient population is younger, and many have been in car accidents. 

These patients are not admitted in the same way that the patients scheduled for 

surgery are. 

The patient population at Papageorgiou Hospital consists of those who are not 

able to afford private healthcare. Each patient at the hospital, no matter how long 

or extensive their stay, will not have to pay for care. The nurses have explained 

that many of the patients seen on the unit and in the hospital are low-income, 

elderly, and nomadic people who speak a different Greek dialect. They typically 

live outside in tent communities outside the town or city. Further, patients have 

more freedom to walk around the hospital, wear their own clothes, and venture 

into the waiting area of the unit than they do in the U.S. Walking into the main 

lobby, you see staff, families, and patients who have IV poles with medication. The 

patients have friendly demeanors even when they are suffering. They make an 

effort to learn how to say “good morning” to me in English and ask me where I am 

from. Every single day I look forward to my shift on this unit and caring for these 

wonderful patients. 

Religion is also a large part of the patient population at Papageorgiou Hospital, 

and religious practice is highly respected in the unit. A’XEI has religious pictures, 

holy books, and a section of the waiting area designated for religious practice. 

Patients have pictures under their pillows, and on the walls, surrounding them in 

a time of need. I have seen patients reading holy books and praying quite often. 

Follow Part 2 in the September issue. 





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Calendar 

Art To Remind Us 

of Who We Can Be 

Editor: Majid Sadigh 

Contributing Editor: Mitra Sadigh 

During times of confusion, tribulation, grief, 

uncertainty, and despair, the arts enliven us by 

reintegrating the disjointed pieces of ourselves 

and replenishing them with clarity and hope. The 

arts remind us of our individual and collective 

potential to grow, evolve, and transform. They 

remind us of what and who we can be and what 

we can create. In this new section, we bring you 

works of art that have moved and inspired us. 

We encourage you to also share works that have 

inspired you. 

Can an Artists’ Collective in Africa Repair a Colonial Legacy? 

Its founders believe that they can use the tools of the Western art 

world to help heal the effects of more than a century of plunder. 

By Alice Gregory 

New Yorker, July 18, 2022 

In January, 2020, two young men from Lusanga, a village in the Democratic Republic 

of the Congo, flew to New York. Cedart Tamasala had never been to the United 

States before; Mathieu Kasiama had, a few years earlier, and, during a visit to the 

Metropolitan Museum of Art, he had been scolded by employees for touching a 

Resources 

Mbuku Kimpala, center, and other collective members, on what used to be a Unilever plantation. 

With the proceeds from its art work, the group is slowly buying back land. 

Photograph by Léonard Pongo for The New Yorker 

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Congolese artifact. Together, they went to Times Square and ate Big Macs. Then, 

donning winter outerwear, they took the train to New Haven. They had been 

invited to address a tropical-forestry conference at Yale, a gathering that brought 

together, among others, a Puerto Rican ecologist, a Uruguayan photojournalist, a 

Kenyan agriculturist, an Indonesian lawyer, and a Malagasy lemur conservationist. 

Tamasala and Kasiama are founding members of the Congolese Plantation Workers 

Art League (C.A.T.P.C., as its initials are rendered in French), an artists’ collective 

established in 2014 with grand, sometimes surreal-sounding ambitions. Aided by 

images projected onto a screen behind him, Tamasala described the group’s work, 

which is informed by the legacy of a former palm-oil plantation, once owned by the 

giant consumer-goods company Unilever, where many of them lived. 

A convoluted schematic appeared on the screen; many arrows were involved. 

Tamasala explained that corporations such as Unilever have used the profits 

from plantation labor in Africa to fund the cultural enrichment of wealthy Western 

populations. A photograph of depleted farmland dissolved into a Pre-Raphaelite 

painting of the sort collected by the founder of what would become Unilever. 

“Nothing of all this investment goes back to the plantations,” Tamasala said. “It 

doesn’t benefit the place where the money comes from.” 

Explaining that the Lusangans “had thought about this situation and about how 

we might detach ourselves from its grip,” he described the C.A.T.P.C.’s sly, absurdist 

approach. The collective, which is made up of some thirty local artists of all ages, 

creates figurative sculptures using river clay, which are then scanned in 3-D. The 

files are sent to Amsterdam, where they are cast in chocolate, which until recently 

most members of the C.A.T.P.C. had never tasted, despite the fact that many of 

them harvested the ingredients from which it is made. The finished sculptures— 

technically edible, symbolically fraught—are sold in art galleries, mostly in Europe. 

With the proceeds from their art work, and with help from a European nonprofit, 

the coöperative buys back land—more than two hundred acres so far—and farms it 

using ecological methods, to replenish soil devastated by Unilever’s monocultural 

farming techniques. The C.A.T.P.C. calls the project a “post-plantation.” 

The process, with its dreamlike logic, has transformed life in Lusanga. Plantation 

workers there earn twenty or thirty dollars a month; as artists, they make much 

more. The collective has brought in more than a hundred thousand dollars since its 

creation, and it has had shows in cities including Berlin, Warsaw, Amsterdam, Tokyo, 

New York, Copenhagen, and Jeddah. 

Tamasala showed a photograph of a man working on a sculpture. “Here you’ll 

recognize my colleague Mathieu,” he said, and smiled at Kasiama, who had 

remained seated. Kasiama appeared in one of the following images as well—a 

portrait accompanying a rave review in the Times of a 2017 C.A.T.P.C. exhibition at 

SculptureCenter, in Queens. 

Read the Article: 

Can an Artists’ Collective in Africa Repair a Colonial Legacy 

https://www.newyorker.com/magazine/2022/07/25/can-an-artists-collective-inafrica-repair-a-colonial-legacy 

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Editor; Dilyara F. Nurkhametova, MD, PhD 

This new column exhibits the beauties of our planet earth and our everyday 

destructive actions against it. 

Award-winning photographer Mandy Barker shows us a new perspective on the 

devastating and far-reaching impact of marine plastic pollution through her art. 

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Watch this six-minute documentary below (WaterBear ): 

Trapped by Plastic Planet continued on next page >> 

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Listen to Bach, The Earth from “Solaris” 

Linking health justice, social justice, and climate justice 

Khadj Rouf, Tony Wainwright 

The Lancet, The Planetary Health, Volume 4, Issue 4, April 01, 2020 

Linking health, social, and climate justice can lead to the transformative activism 

that is needed for a better, healthier, and fairer world for everyone. The question 

now is, are you willing to help? 

Climate emergency is here. In 2019, many catastrophic climate events occurred, 

including huge cyclones in Mozambique and The Bahamas, protracted bushfires 

in Australia, and widespread flooding in Jakarta, Indonesia. Climate models 

predict further unprecedented and extreme weather events due to global heating. 

Unfortunately, there is still no unified political consensus regarding how to respond 

to the emergency. Individuals’ perceptions have a huge effect on how they respond 

to crises. If something is not perceived as an emergency, people do not react 

quickly. If people recognise that there is an emergency, then those people act to 

prevent further harms, prepare for and mitigate against harm, adapt, and have 

emergency drills. This action is part of good safety planning and it saves lives. Yet, 

some individuals are skeptical about whether the global climate crisis is happening, 

and whether human activity is responsible. Political orientation and ideology might 

influence framing of climate change and shared perceptions of the problem. There 

is a range of responses to the climate emergency, which are shaped by power, 

privilege, and psychology. Psychology shapes how individuals perceive risk and 

whether they connect health, social, and environmental justice together as related 

issues that affect everyone. 

Read the Article 

Health Justice, Social Justice, and Climate Justice 

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We are having a great time with our guests. They have a great sense of humor. 

Today, we have all of them since the pair at Naggalama came over for a city 

tour ahead of the switch over tomorrow. The road by our residence is finally being 

paved. We are therefore hopeful that after the current boost the dust levels 

will drop to more manageable levels. We have many monkeys and don’t know 

how to get rid of them. The water supply pipes have been cut by the road works. 

We are having to truck in supplies. We managed to install a good internet router 

but utilization is hampered by high-cost data. The cost of everything has skyrocketed. 

Inflation is at an all-time high, partly because of the war in Ukraine. It 

is very dry here but not too hot. None of us or the guests are in danger of suffering 

heat stroke. 

Be blessed 

Sam Luboga 

I have just wrapped up a very productive meeting with Noeline and some other 

colleagues in both public and mental health. 

I believe utilizing a rapid needs health assessment in Katwe and Karamoja will 

be not only useful but necessary. 

I look forward to speaking about this with you and Noeline via Zoom and getting 

your input. 

Gina de la Chesnaye 


Calendar 

Resources 

Click here to visit the Nuvance 

Health Global Health Program 

COVID-19 Resource Center 

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The Nuvance Health/UVMLCOM Global Health 

Program congratulates Dr. Abhay Gaidhane, Dean 

of Jawaharlal Nehru Medical College, Datta Meghe 

Institute of Medical Sciences (Deemed to be University). 

After obtaining primary medical qualification in 

1996, Dr. Gaidhane completed his post-graduation 

in Preventive and Social Medicine in 2002. Dr. Abhay 

Gaidhane was formerly the Dean of Global Health as 

well as the Director of School of Epidemiology and 

Public Health at the Datta Meghe Institute of Medical 

Sciences (DU). He is also the Chair of the Bioethics Unit 

at DMIMS, under the International Network of UNESCO 

Chair of Bioethics (Haifa). 

Dr. Abhay Gaidhane has over 100 publications in peer reviewed journals including, 

but not limited to, PLOS, BMC Public Health, Cochrane, Lancet etc. Dr. Abhay is also a 

recipient of seven grant awards for research projects from Grand Challenges Canada, 

Ministry of Health, and Family Welfare (India), NACO, USAID (USA). 

Dr. Abhay Gaidhane has been extremely supportive of the global health partnership 

between Nuvance Health/UVMLCOM and DMIMS (DU) from its inception. The Nuvance 

Health/UVMLCOM Global Health Program wishes him all the best for his new journey 

at DMIMS (DU). 




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Robert Kalyesubula, MD, PhD is the founder 

and president of the African Community 

Center for Social Sustainability (ACCESS), an 

exemplary community-based organization in 

Uganda. 

Here is the link to the publication 

Measuring kidney function in sub-Saharan Africa 

Congratulations to Dr. Robert Kalyesubula 

for being conferred a PhD from the London 

School of Hygiene and Tropical Medicine. We 

also congratulate him for his publication in the 

Lancet Global Health on measuring kidney 

function in sub-Saharan Africa. 

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July 07, 2022 


Weekly Meetings 

During a meeting with Dr. Vincent Setlhare, the point person of the program at 

Botswana University, the details of establishing a homestay model in Gaborone 

for the global health elective participants from Nuvance Health and UVMLCOM, 

along with the importance of supplementary curriculum addressing social and 

cultural aspects of global health, were discussed. 

The Nuvance Health GH program hopefully starts sending students to Botswana 

after March of 2023. The program will notify the hosting site about incoming 

students about two to three months prior to the start of the elective. 

The program will invite academically promising residents and young faculty from 

University of Botswana for observership in clinical medicine and/or participation 

in the Nuvance Health Global Health Academy. The program will cover travel 

expenses, accommodation and meals at the hospital canteen. 

Two to three faculty members from the University of Botswana will also be invited 

for a one-week site visit to Nuvance Health and UVMLCOM before students are 

sent to Botswana University. We hope that during this visit, our colleagues from 

Botswana University will become more familiar with potential projects in medical 

education between our institutions toward capacity building of human resources. 


An email has been sent to pulmonary medicine specialists to participate in 

capacity building of human resources at Global South sites. The Almira and 

Linde Scholarships will support the travel expenses for the faculty interested to 

participate in the capacity building of the human resources. Upon completion, 

the trainees at sites will receive a certification. 

Discussions are ongoing with the University of Botswana leadership to expand 

collaboration.The launch of exchange program and establishing the homestay 

model in Botswana is planned in early 2023. 

The start date of the partnership with the Heart Institute in Santo Domingo in 

Dominican Republic, due to the lack of the homestay model, requirement of 

advanced Spanish language fluency, and further challenges, has been deferred 

to 2023. During the talks, emphasis was laid on inviting young faculty members 

who could disseminate the knowledge and gained skills to a larger audience at 

home. 

Three research proposals have received IRB approval: the virtual global 

health elective for RUSM/AUC medical students, virtual 90-minute session on 

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colonization/decolonization of global health for AUC/RUSM students, and 

medical students’ challenges during brief clinical rotation in global health 

based on analysis of participants’ weekly reflections. 

Discussion with the leadership of DMIMS (India), UZFMHS (Zimbabwe) and 

NHGHP (USA) toward building a joint Master Degree in Medical Education has 

been started. 


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The leadership made safety of global health participants a priority. They 

will continue to ensure that safety is guaranteed in the learning and living 

environment at our hosting sites. To provide a better educational experience 

for medical students, they should be matched with residents taking the elective. 

The new safety guide is being reviewed by our colleagues in the new Global 

Health Elective site in India in Datta Meghe Institute of Medical Science in 

Sawangi. 

The global health site in Naggalama, Uganda will be available to host a student 

this September in a surgical department. 

Leadership members are working to ensure that students going to India next 

month for their global health elective undergo a rigorous orientation. 


“We are training an army of global health educators to deploy across the 

globe for capacity building.” 

During a meeting with Dr. John Murphy, CEO, and Ms. Grace Linhard, Chief 

Development Officer at Nuvance, the future of the Nuvance Health Global 

Health Program and establishment of the Global Health Academy were 

discussed. 

Three students have been selected to travel to India in August 2022 with Dr. 

Parve. Three additional students will be traveling: one to Uganda in September 

2022, one to India in November 2022, and one in 2023. Wendi Cuscina, manager 

of the Global Health Program, will be traveling to Uganda in September 2022 

for a one-week site visit. At this time, the program is anticipating fourteen AUC/ 

RUSC students traveling in 2023. 

The Global Health Program will host participants from the Zimbabwe Master’s 

Degree program after approval of this project by the leadership of Zimbabwe 

University. 

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Calendar of Events 

Nuvance Health 

July 5: Discussion of eMagazine with Amanda Wallace 

July 5: Weekly touch-base zoom meeting with Wendi Cuscina 

July 5: Touch-base Zoom meeting with Dr. Dilyara Nurkhametova 

July 5: Touch-base Zoom meeting with Dr. Swapnil Parve 

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July 6: Zoom meeting with Dr. Dilyara Nurkhametova to discuss the detailed travel 

plan for Dr. Habashi’s travel to Uganda 

July 6: Zoom meeting with Mary Shah, Dr. Dilyara Nurkhametova to discuss an 

ongoing research project 

July 7: Zoom meeting with Wendi Cuscina in preparation of students’ and Dr. Parve’s 

travel to India and administrative plans on Global Health Bridge 

July 8: Zoom meeting with Dr. Habashi in preparation of his trip to Uganda 

July 8: Zoom meeting with Dr. Steve Scholand to discuss the current status of 

Global Health Bridge 

July 9: Zoom meeting with Dr. Hossein Akbarialiabad to discuss the objectives and 

consent form of an ongoing research proposal for submission to IRB for approval 

July 9: Zoom meeting with Dr. Parve to review the first of draft of a descriptive 

manuscript on the content and function of the Global Health Academy 

July 10: Zoom meeting with Dr. Parve to discuss the Global Health Academy and 

his current visa status 

July 10: Follow-up Zoom meeting with Dr. Hossein Akbarialiabad to review an 

ongoing research project 

July 10: In-person meeting with Mitra Sadigh to review three ongoing research 

projects and to discuss the content of Global Health Diaries 

July 11: Touch-base meeting with Wendi Cuscina 

July 11: Touch-base meeting with Dilyara Nurkhametova in preparation for the 

UVMLCOM global health leadership meeting 

July 11: Discussion about global health faculty and publications with Amanda 

Wallace 

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July 12: Weekly touch-base meeting with NH global health leadership 

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July 12: Discussion related to the structure and content of Global Health Bridge 

at Danbury Hospital in September with Dr. Steve Scholand, course director of 

Global Health Bridge at Nuvance Health 

July 12: Zoom meeting with Professor Nelson Sewankambo to review the content 

structure of the panel on colonization/decolonization of the global health 

education at UNGA in September 

July 12: In-person meeting with Dr. Behzad Habibi, a neurologist faculty, to discuss 

possibility of scholars in global health to rotate through the neurology department 

and his willingness to become a Global Health Academy faculty member 

July 13: In-person meeting with Dr. Habashi, a Global Health Academy faculty 

member, in preparation of his trip to Uganda 

July 13: Discussion with Dr. Robert Kalyesubula, founder and president of ACCESS, 

about the panel on colonization/decolonization of global health education at 

UNGA in September 

July 13: Discussion with Dr. Robert Jarrett, founder and president of Hearts 

Around the World, about inviting junior cardiologists from Vietnam and Dominican 

Republic to Danbury Hospital 

July 14: Brief in-person meeting with Ms. Grace Linhard and Ms. Adele Conner 

from the Nuvance Health Foundation to debrief Mr. Almira on future direction of 

the global health program 

July 14: Discussion with Dr. Swapnil Parve on the Global Health Academy and the 

role of the co-directors 

July 14: Follow-up meeting with Dr. Scholand, course director for Global Health 

Bridge, on the invited speakers for the course in September 

July 15: Zoom meeting with Dr. Hossein, a global health faculty member, to discuss 

an ongoing research project 

July 15: Zoom meeting with Professor Nelson Sewankabo in preparing a blueprint 

for the accepted proposed panel at UNGA in September 

July 16: Touch-base meeting with Dr. Parve on establishing a joint master’s degree 

in medical education 

July 17: Reviewing weekly reflections written by students in Uganda with Dr. Dilyara 

Nurkhametova 

July 18: Touch-base with Dr. Dilyara Nurkhametova, assistant director of the 

Nuvance Health Global Health Program 

July 18: Telephone call with Professor Samuel Luboga to discuss the situation of 

our students and faculty in Kampala 

July 19: Update conversation with Dr. Simon Otim in respect to the current situation 

of the program’s students in Naggalama 

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July 19: Zoom meeting with the leadership of the NH Global Health Program 

July 19: Touch-base meeting with Wendi Cuscina, manager of the Global Health 

Program 

July 20: Touch-base meeting with Drs. Dilyara Nurkhametova and Swapnil Parve 

July 20: Zoom meeting with Ramin Sedehi in respect to the panel on decolonization 

of global health education in September (SSUNGA77) 

July 20: Discussion with Jett Choquette about Global Health Bridge at Danbury 

Hospital in early September 

July 21: Discussion around an ongoing research project with the Principal 

Investigator, Mary Shah 

July 23: Meeting with Dr. Swapnil Parve in preparation of his trip to India and 

discussion around registration of the Global Health Academy and establishment of 

an executive committee to oversee the academy’s activities 

July 23: In-person meeting with Mitra Sadigh to discuss her involvement in Global 

Health Bridge at Danbury Hospital on September 1st 

July 25: Meeting with Mr. Elvis Novas, a senior member of the Latinx community in 

Danbury to discuss involvement of a few of its members in Global Health Bridge 

July 25: Zoom meeting with Dr. Steve Winter, senior consultant of the Nuvance 

Health Global Health Program around capacity building of human resources 

July 25: Discussion on the content and structure of the Global Health Academy 

with Dr. John Murphy, CEO, and Ms. Grace Linhard, Chief Development Officer at 

Nuvance Health 

July 26: In-person meeting with one of the medical chief residents at Danbury 

Hospital to discuss Global Health Bridge and the date of a global health conference 

July 26: In-person meeting with the IRB coordinator at Danbury Hospital in respect 

to a new research project 

July 26: Speaking to a medical student who is assisting the organizer of Global 

Health Bridge to delineate her involvement in this course 

July 26: In-person meeting with the coordinator of UVMLCOM at Danbury Hospital 

to discuss the logistics of Global Health Bridge 

July 26: Meeting with Wendi Cuscina, manager of the Global Health Program to 

review the fiscal budget for the upcoming year 

July 27: Zoom meeting with the global health leadership of Nuvance Health to 

discuss the logistics of Global Health Bridge in early September 

July 27: Discussion on Dr. Parve’s travel to India to prepare the site for the first 

cohort of students 

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July 27: Discussion on students’ and Dr. Parve’s travel to India with Wendi Cuscina 

July 27: Meeting with Dr. Scholand in preparation for Global Health Bridge and 

making an appropriate information booklet for the event 

July 27: Zoom meeting with Dr. Menn, the previous dean of Walailak University 

in Thailand, and Dr. Scholand to discuss the future of the exchange program in 

Thailand 

AUC/RUSM 

July 5: Interviews with two candidates for GH electives in September 2022 

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July 8: Touch-base meeting with Dr. Elina Mukhametshina to prepare the 

orientation meeting with students 

July 12: Orientation meeting with three AUC/RUSM students in preparation for 

their GH elective in India this August 

July 19: Touch-base meeting with Dr. Elina Mukhametshina 

July 25: Touch-base meeting with Dr. Elina Mukhametshina 

July 26: An interview with one candidate for the GH elective in November 2022 

As to date, 21 applications from AUC and RUSM have been received for GH 

electives in 2022-2023 and one student has been selected for global health 

elective in Uganda from September 26 - November 5, 2022. 

UVMLCOM 

July 4: Four UVM students: John (Jackson) Burke, Justin Henningsen, William Hsu, 

and Joanna Pierce, started their GH elective in Uganda at St. Stephens and 

Naggalama Hospitals. 

July 3-9: Drs. Mariah McNamara and Andrea Green visit Uganda 

July 11: Global Health Leadership Team meeting is held 

July 18-30: Dr. Bemen Habashi supervise medical students’ education in Uganda 

July 30: UVMLCOM students return to the USA 

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Resources 

Yale Medicine 2008 

Photos and Reflections 2021 

Global Health & the Arts 

Nuvance Health and UVMLCOM Global 

Health Website 

COVID-19 Resource Center 

Nuvance Health and UVMLCOM Annual 

Report 2020 

AUC/RUSM Annual Report 2018 

Cases and Reflections from Mulago 

Climb for a Cause 2018 

Climb for a Cause 2019 

Ebola: Sequences on Light and Dark 

Ebola: Two Doctors Respond to the 2014 

Ebola Epidemic in Liberia: A Personal 

Account 

Global Health Annual Reports 

Global Health Conference 2019 Photos 

Global Health Conference 2019 Videos 

Global Health Conference 2019 Book 

Global Health Diaries and Newsletters 

2015-2016 


2016-2017 


2017-2018 

Global Health Diaries and eMagazines 

2018-2019 

Global Health eMagazines 2020-2021 

Global Health Diaries 2020-2021 

Global Health Reflections and Photos 2017 

and 2018 

Global Health Program Website 

Global Health at WCHN Facebook 

Ho Chi Minh City and Cho Ray Hospital 

The Homestay Model of Global Health 

Program video 

Kasensero Uganda 

Resources 

Global Health Reflections and Photos 2019 

Ethical Dilemmas book 

Katanga video 

Nuvance/MakCHS Global Health 

Information Center Booklet 

Paraiso and the PAP Hospital 

Photographs from Uganda, by 

photojournalist Tyler Sizemore 

Presentations By Global Health Scholars 

Previous issues of the Global Health 


Program Partners 

Publications 

Site Specific Information 

Tropical Medicine Booklets (101, and 

202) 

Tropical Medicine Spanish 101 

Tropical Medicine Courses 

The World of Global Health book 

The World of Global Health Video 

Words of Encouragement 

UVM Larner College of Medicine Blog 

Participant Guide in Global Health, 

Thailand 

Cho Ray International Student Handbook 

DRC Facing a New Normal 

Photos and Reflections 2019 

Coronavirus 2019 Important clinical 

considerations for Patients & Health 

care Providers 

Interviews 

A Connecticut Doctor in Africa, by 

journalist Mackenzie Riggs 

Majid Sadigh, MD Interview Regarding 

Ebola in Liberia (Video) 

My Heart Burns: Three Words Form a 

Memoir (Video) 

Two UVM Docs Combat Ebola in Liberia 

(Article) 

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