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BELIZE

The Belize Cooperative Health Education Program

January 1999- June 2009

  Omni Med launched the Belize Cooperative Health Education Program in January 1999; our first physician volunteer was Radiogist Dr John O'Brien. The program’s name came from the cooperative nature of the venture that originated in both Belize and Boston.  The program started following a visit to Belize with a group from the Hingham Rotary Club, who had been donating medical equipment to Belize for years. Mr. Richard Bridges had been involved in shipping from the US to Central America for years. He and his colleagues from the Orange Walk Rotary Club began to send their empty containers back to Belize filled with medical equipment. Omni Med began as an organization when Mr Bridges invited Dr Tom Durant to advise them. Dr Durant then invited Dr O'Neil. 

Omni Med ran the Belize Cooperative Health Education Program for nearly 10 years, sending a physician to the country roughly 5 times yearly to travel through 6-8 sites around the country in a travelling Medical Grand Rounds format. The Rotary Clubs in Orange Walk, San Ingacio, Belize City, and Dangriga also helped to organize trips, and serve as host families for the visiting physicians. Mrs Loretta Garcia Palacio of Worldcom Technologies, became Omni Med's CEO in Belize and served as coordinator and hostess for all the years of the program's operation. As of 2009, a total of 30 physicians had traveled through the program, giving 1-3 lectures per site during a two-week tour of the country. In the program model, we essentially brought current health education outside the capital city to the entire country.

 

A typical in country visit would involve teaching several didactic and some Socratic-styled educational sessions at Karl Heusner Memorial Hospital, and wtih local private medical groups. The physician would then continue on their teaching trips to the following hospitals: Belmopan, San Ignacio, La Loma Luz, Orange Walk, and Dangriga. Along the way there would be stops off in local health centers and opportunities to spend time with physicians in a similar specialty, or simply desiring to learn more in one area. Depite our initial designs, our Belizean hosts insisted that visiting physicians see some of the sites of their beautiful country during their stays. As such, weekend visits to the Mayan ruins at Xunantunich, river and then hiking tours to Lamanai, and day trips out to the wildlife preserves on the Cayes became standard fare. Ironically, most physicians were so time pressed that they often left the day their teaching responsibilities were finished, and were much appreciative of the brief sight-seeing opportunities they had during the weekend hiatus incorporated into the educational programs.

 

Our program became, in the words of then Belizean Prime Minister Said Musa, “invaluable,” and “an integral part” of the Belizean effort to provide quality health care for all Belizeans. The response from the many physicians who traveled through this program were strongly positive, allowing busy practitioners to share their considerable medical knowledge with colleagues in remote areas during a brief (2 week) excursion throughout the country. Physicians from both academic and non-academic backgrounds participated in the program. Specialties included Neurology, Orthopedics, Hand Surgery, General & Vascular Surgery, Radiology, Asthma & Allergy, Family Practice, Emergency Medicine, Primary Care, Ophthalmology, Endocrinology, Sports Medicine, Internal Medicine, Pediatrics, among others. Several physicians returned multiple times. Other physicians went on to develop other programs. Examples include Dr John Varallo (see Guyana page), Drs. Michael and Katherine Morley (developed programs in Thailand, and then Bhutan with HVO), Dr James Eadie and John O'Brien (see Guyana page), Dr Margo Krasnoff (Dartmouth Hitchcock, Nicaragua, and author of Building Partnerships in the Americas). While we at Omni Med cannot claim credit for anything these wonderful physicians did after leaving us, we hope to have at least igniting a spark, or at least furthered interest in this realm until these physicians were able to achieve their passions. 

During this program's run, we attracted an impressive list of physicians, most of whom would not publicize their service. Among them are the following, some of whom have died in the years since:

Dr Gordon Vineyard (Brigham & Women's Hospital, Surgery, Administration)

Dr Peter (and wife Nancy, PA) Mogielnicki, Professor of Internal Medicine Dartmouth Hitchcock Medical Center, NH

Dr Peter Singer, Endocrinology, Mt Auburn Hospital

Dr Margo Krasnoff, Dartmouth Hitchcock Medical Center, NH

Dr John Varallo, senior advisor at JHPIEGO

Dr James Eadie, Emergency Medicine physician and Partner in Sante Ventures, Texas

Dr Pierre D'Hemecourt, Sports Medicine at Boston Children's Hospital and Medical Director of the Boston Marathon

Dr John O'Brien, Radiologist with experience in Belize, Guyana, Saudi Arabia and now in Albany, New York

Dr Errol Ger, pictured here in surgical attire with our good friend Dr Francis Smith from Karl Heusner Memorial Hospital in Belize City. 

Dr Donald Accetta, Asthma and Allergy, private practice, who returned several times, worked with Dr Lesbia Guerra to change the way all health providers in the Cayo region managed asthma. 

Our program model was not perfect, and we learned, despite many attempts, just how difficult it is to evaluate the impact of ongoing post graduate medical education. Yet, over the course of our program run in Belize, we brought a rough estimate of over 350 lectures to over 5000 practitioners, with many repeats. All while exposing talented US physicians, most of whom had never done a medical mission abroad previously, to a better understanding of the tremendous need to share our profession's talents and knowledge with those in less wealthy places. That so many physicians in this program went on to other global health programs is a testament both to the quality of the program and the quality and orientation of the physicians we attracted. In retrospect, I find it impossible to accurately dissect out how much of each played a role. 

After Awakening Hippocrates and the Practical Guide to global Health Service came out, and we initiated the program in Uganda in 2008, I had little time to continue with the program in Belize. Despite having a great track record and having many great friends throughout the country, we had become less needed. The Belize Medical and Dental Society had built up a strong educational component and many of Belize's physicians had become able to get their continuing medical education abroad or from visiting physicians in Belize City. We collectively made the decision to focus our efforts where our we could make a considerably greater impact, as it turned out, in Uganda. There are many legacies to our model in Belize. Programs in Guyana, Kenya, and Uganda have all built on the considerable experience we acquired in Belize. The practitioners in the country became used to regular, ongoing continuing graduate medical education which is now a part of their medical culture. And, as mentioned above, many physicians involved in the program have carried on with programs of their own. This model worked--it worked very well. It took years to build, perfect, and to maintain. But the model remains. There are scores of countries in which a program model like this can work well. Health volunteers Overseas does this work extremely well in many countries, as does Hospital Albert Schweitzer in Haiti. For those interested in short-term educational models like this one, please see our searchable database in our Center for Global Service. Finally, to Mrs Palacio, who led us so well,  to all of the US physicians who volunteered, to the Rotarians, Ministry of Health personnel, and lay people in Belize who supported us, and to the hundreds of Belizean health providers who came regularly to all of the lectures our visiting physicians put on, we offer a heartfelt thanks. Omni Med as an NGO started with a lecture by Dr John O'Brien on a warm Caribbean night in January 1999 in Belize City. Belize will always be in our hearts here at Omni Med.

Above: Mr Richard Bridges, our good friend; much respected, and greatly missed. Below: Dr Tom Durant, mentor, passionate advocate for human rights, and namesake of Durant Fellows at MGH.

Above: Dr Errol Ger right with Belizean orthopedic surgeon Dr Frances Smith; Below: Dr Don Accetta teaching in a small group at San Ignacio Hospital, Cayo District

Above: Great friends during the program years: Dr Peter Allen, MOH CEO left, and Ms Terry Avilla, right, owner of Terry's Diner in Orange Walk, where it all began. Below: Dr David Dawson, Neurologist from Brigham & Women's hospital in Boston, center left with staff and patient. 

Below left: Drs Ger and Smith in the OR; Below right; left to right, then Minister of Health Coye, Belize President Said Musa, and Omni Med Director, Ms Loretta Garcia-Palacio.

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