Since Omni Med's founding in 1998, we have run programs in four countries: Belize, Guyana, Kenya, and Uganda. Of these, Uganda occupies our complete focus now. The experiences and impacts of these programs have shaped who we are and inform the work we continue to do in Uganda today.
Belize
The Belize Cooperative Health Education Program
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January 1999- June 2009
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
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.
Dr David Dawson, Neurologist from Brigham & Women's hospital in Boston, center left with staff and patient.
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.
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.
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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.
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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:
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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.
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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.
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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.
Kenya
St Mary's Nairobi offers a welcome respite from the harsh conditions of the Kibera Slum directly across from the entrance. The top photo below was taken from St Mary's water tower. Pictured, below, Father, Dr Bill Fryda.
Dr Edwin Wyman, MGH orthopedic surgeon, assisting a young Kenyan colleague in treating a young orphan from Kibera.
I first met Dr Bill Fryda in 1994 when I worked with him and lived in the compound of Nazareth Hospital just outside Nairobi Kenya. During my three months there, I came to know one of the most unique and impressive people I have ever come across. I profiled Father Fryda in Awakening Hippocrates, and count myself among his many admirers.
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Father Fryda was born in the plains of Nebraska (Dances With Wolves country, he says). He became a Catholic priest and then a Mayo Clinic trained oncologist. Upon completion of his medical residency he faced a choice: either become the regional expert on blood disorders, or pursue something far different, as his idol Albert Schweitzer had many years earlier. Dr Fryda chose the latter. He traveled to Tanzania and later to Kenya, where he has spent most of his adult life, serving as both a Maryknoll (Catholic) priest, and physician/ administrator.
Having worked with him closely, he has outstanding clinical and surgical skills (he became a self taught obstetrician, general surgeon and urologist-- "the Prostate Padre"-- and later built a model health facility near the grounds of the Karen Blixen plantation (of Out of Africa fame) near Wilson Airport just outside Nairobi, Kenya, and right next to one of the world's largest slums, Kibera Slum.
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Father Fryda and a talented local Kenyan staff have built St Mary's Mission Hospitals in Nairobi, and Nakuru, Rift Valley, into two very large hospitals that treat the poor slum dwellers of Kibera and surrounding areas with high quality, low cost, comprehensive care.
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During a visit to St Mary's in 2001, Father Fryda led the staff in prayer at the start of a work day in the hospital. "Lord, let us see your face in the faces of all who come through these doors today." Matthew: 25 lived out in real life. Father Fryda inspires and empowers the staff at St Mary's. His vision of affordable high quality Catholic health care delivered with respect in a beautiful setting has become a reality twice over in both hospitals.
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Omni Med is proud of our history with St Mary's. During the first decade of 2000, Omni Med shipped close to $1 million worth of medical supplies to St Mary's, often carried over by visiting volunteers. Johnson and Johnson donated high cost sutures, and Dr Roger Mitty of St Elizabeth's Medical Center in Boston donated thousands of dollars of endoscopes, colonoscopes in such demand in East Africa, where schistosomiasis produces bleeding esophageal varices (swollen vessels) in old and young alike. Dr George Barrett of Milton Hospital made a key connection to a company that donated a full GI suite, worth close to $10,000, to St Marys.
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Drs Edwyn Wyman and Tom Antokwiak came through Omni Med to help offload some of St Mary's high demand for orthopedic care. Dr Antkowiak returned to St Mary's several times. In time, however, Father Fryda has built both St Mary's hospitals into fully self-sufficient models. Omni Med no longer has a direct relationship, though all are encouraged to support Father Dr Fryda, a living legacy of Albert Schweitzer, and St Mary's Mission Hospitals in Nairobi and Nakuru.
Father Bill Fryda, MD, an American icon and an inspirational figure to many.
Guyana
2001 - 2004
Dr James Eadie, second from right front row, with Guyanese medical students
Dr James Eadie, second from right front row, with Guyanese medical students
Dr John Varallo and Maureen Reinsel (above), during first excursions in rural Guyana (below)
Dr John O'Brien at the bedside with Guyanan colleague reviewing CT.
In 2001, Guyanese Minister of Health, Dr Leslie Ramsammy, invited Omni Med to Guyana to reproduce the successful Educational Model we had piloted in Belize. In October 2002, Dr James Eadie was then a Harvard Medical student who had done some of the structural building of Omni Med's program in Belize. Together with Dr John O'Brien, Dr Eadie traveled to Guyana and launched a similar educational program. Following return trips with Drs O'Brien, O'Neil, and Mogielnicki, Dr Eadie was able to build a successful model. Focused on Georgetown Hospital in the capital, the program had visiting physicians spend most of the time there, and then travel to the New Amsterdam Hospital near the border of Suriname, and to other clinics for "grand rounds" styled settings. Subsequently, Dr John Varallo, on Ob-Gyn physician from Washington D.C. joined in the program development. Dr Varallo became interested in the cervical cancer in the country, only to find that no formal screening program existed.
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As Dr Eadie became engrossed in the challenges of a residency in Emergency Medicine at the combined Brigham-MGH program in Boston, Dr Varallo continued to build relationships in Guyana. Frequently accompanied by Dr John O'Brien, Dr Varallo worked with several colleagues at Georgetown Hospital and developed a cervical screening model using direct visual inspection. Omni Med purchased the program's first LEEP machine, in which the precancerous lesions could then be cryogenically frozen and removed, with a 95% success rate of preventing cervical cancers when lesions were found. The program proved highly successful and became the model for Guyana's national cervical screening program. The CDC featured Dr Varallo's work on its website. On September 8, 2008, when President George W Bush highlighted the success of the Volunteers in Prosperity Program, utilizing highly skilled Americans in service abroad, Dr Varallo was singled out for praise.
Dr Varallo teamed up with researchers from JHPIEGO, and eventually, moved the program with him there. While we would have certainly preferred for Dr Varallo to remain with us at Omni Med, we also recognized fully the time and resources he needed to fully develop his vision. Dr Varallo subsequently received an MPH degree from George Washington University, and doubled down on his work in Guyana. His efforts led to a massive expansion of cervical cancer coverage in the country and he was the principle author of the country's cervical cancer prevention and treatment policy and guidelines. He has trained many physicians, nurses and others in a train the trainer model that focuses on outreach to distant rural locations, of which there are many in Guyana. Providers he has trained screen upwards of 5000 women per year and eliminate over 800 pre-cancerous lesions annually. JHPIEGO hired him full-time. Today, he works as a senior technical advisor to JHPIEGO, and has brought cervical cancer screening to Belize, Botswana, Tanzania, Uganda, Guatemala and many other countries.
In 2010, Maureen Reinsel nominated Dr Varallo as a Women't Health Hero." Here is what she wrote:
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"Dr. Varallo works with the most vulnerable women, and inspires others to join him through education and collaboration... As someone who dreams of one day being a women’s health nurse and who works in the field of international public health, I am surrounded by people who spend their days endeavoring to improve health care globally. Nonetheless, Dr. Varallo stands out as someone with a unique level of commitment. He has inspired in me a real passion for preventing cervical cancer, and has earned my admiration through the genuine kindness and the respect that he demonstrates to everyone he works with, from clients to community health workers, from student nurses to the Minister of Health.
Dr. Varallo is my Women’s Health Hero."
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Omni Med has not been involved in Guyana since 2004, but we are all very proud of all that Dr Varallo and his colleagues have done in Guyana and beyond since then.
Dr Varallo lecturing at Georgetown Hospital, Guyana left, and with staff at outreach clinic in Moruca. Below, getting to the outreach through Guyana's forests.
Dr Peter Mogielnicki teaching Georgetown Medical Students