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ENCOURAGING ACTIVISM IN GLOBAL HEALTH THROUGH KNOWLEDGE, INNOVATION AND ENGAGEMENT

The maternal and child health division within the Colorado School of Public Health’s Center for Global Health was designated by the World Health Organization (WHO) as a WHO Collaborating Center for Promoting Family and Child Health.

The division, which is a partnership between Children’s Hospital Colorado and the University of Colorado, Colorado School of Public Health, is one of only two programs in the Americas to receive this designation in maternal and child health.

“This designation means that the center will be more actively engaged in developing transformational maternal and child health interventions and programs which can then be taken to a global scale,” states center director and CU School of Medicine professor of pediatrics and public health Stephen Berman, MD, FAAP. With the new designation, the center’s maternal and child health division will focus on four major program outcomes

in partnership with the WHO and its regional affiliate, the Pan American Health Organization:

Assist countries in reducing health inequality and excessive morbidity and mortality among mothers, infants, children and adolescents; 

Accelerate vaccine research and implementation; 

Train vulnerable communities and countries in disaster preparedness in ways that will meet the needs of children; and 

Train doctors, nurses, midwives and other birth attendants in the Helping Babies Breathe program, to reduce neonatal asphyxia. 

 Although the WHO designation is new, the division’s faculty have a long standing involvement improving health outcomes for mothers and children around the world.

“World-class children’s hospitals extend their efforts to support the health of women and children all over the world. We’re proud that our faculty members have been major architects of several programs developed in partnership with WHO that have and are being implemented world-wide,”

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A designation that will more actively engage the center in transformative maternal and child health interventions and programs which can then be taken to a global scale.

CENTER FOR GLOBAL HEALTH DESIGNATED AS WHO COLLABORATING CENTER FOR PROMOTING FAMILY & CHILD HEALTH……………...…….1

SHARED GOALS: INCREASING RATES OF SURVIVAL FOR MOTHERS AND BABIES........2

A CHILD’S WELL BEING: WHEN A DISASTER HITS…..7

Issue 23 | Aug | 2012

link

Center for Global Health designated as WHO Collaborating Center for Promoting Family and Child Health

Global Health

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The well being of mothers, infants, and children defines the course of the next generation; it determines the function of families and communities, and ultimately affects the economic potential of an area or region. Complications during pregnancy and childbirth remain a leading cause of death and disability among women of reproductive age in developing countries. Likewise, 99% of newborn deaths occur annually in low-and middle-income settings; ¾ of these deaths are due to causes relating to preterm delivery, asphyxia and infection, causes that are largely preventable. Since maternal and child health are critical indicators of the Millennium Development Goals, many of the World Health Organization’s 193 member countries have designated resources to improve outcomes in these areas. As defined by the United Nations Millennium Project, the Millennium Development Goals (MDGs) number 4 and 5 are all about survival of mother and child. MDG 4 is to reduce child mortality by 2/3 between 1990 and 2015. Despite population growth, the number of under-five deaths worldwide fell from more than 12 million in 1990 to 7.6 million in 2010, a decline of 35%. The majority of young lives saved during this time have been between the ages of 1 and 5 years; establishing a similar reduction in mortality in the neonatal period through the first year of life has proven a much greater challenge. MDG 5, to improve the maternal mortality ratio by ¾ within the same time frame, has also seen a 47% decline since 1990.

While these figures demonstrate improvement, redoubled effort will be necessary to reach the remote and inaccessible populations that remain untouched by MDG initiatives. With this backdrop of necessity, the Center for Global Health at the Colorado School of Public Health is eager to contribute to these essential global health goals as a World Health Organization collaborating center to promote family and child health. This collaboration with the World Health Organization (WHO) is an opportunity for the Center for Global Health to upscale and fortify its shared objectives in maternal and child health. Physicians from the Center for Global Health specialize in the steps that are necessary to make MDGs 4 and 5 a reality. An architect of the program Helping Babies Breathe, Susan Niermeyer, M.D., M.P.H., F.A.A.P., Professor of Pediatrics, Section of Neonatology at the University of Colorado School of Medicine and Professor of Epidemiology, Colorado School of Public Health, researches neonatal asphyxia in low-income settings and trains physicians and health workers to facilitate successful deliveries and provide immediate neonatal care. Dr. Niermeyer strives to protect healthy babies through essential newborn care and help babies who do not breathe at birth through basic newborn resuscitation.

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Shared Goals – Increasing Rates of Survival for Mothers and Babies

Co-Directors, Maternal and Child Health Initiative, Center for Global Health at the Colorado School of Public Health Susan Niermeyer, M.D., M.P.H., F.A.A.P. Professor of Pediatrics, Section of Neonatal at the University of Colorado School of Medicine and Professor of Epidemiology at the Colorado School of Public Health Eric A. F. Simoes, M.B., B.S., D.C.H., M.D., Professor of Pediatrics, Section of Pediatric Infectious Disease at the University of Colorado School of Medicine and Professor of Epidemiology at the Colorado school Public Heath Senior Investigator, Center for Global Health at the Colorado School of Public Health Edwin J. Asturias, M.D., Assistant Professor of Pediatrics at the University of Colorado School of Medicine and Assistant Professor of Epidemiology at the Colorado School of Public Health Director, Maternal Health Programs, Center for Global Health at the Colorado School of Public Health Gretchen Heinrichs, M.D., D.T.M.H., Associate Professor of Obstetrics Gynecology at Denver Health and the University of Colorado School of Medicine Fellow—Pediatric Global Health, Center for Global Health at the Colorado School of Public Health Gretchen Domek, M.D., M.Phil, Attending, Department of Pediatrics, Children’s Hospital Colorado Drs. Niermeyer, Heinrichs and Domek were interviewed for this article.

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WHO and its member states work with many partners, in-cluding UN agencies, donors, non-governmental organiza-tions, WHO collaborating centers and the private sector. Only through new ways of work and innovative partnerships can they make a difference and achieve their goals. Last but not least, WHO is people. Over 8,000 public health experts including doctors, epidemiologists, scientists, man-agers, administrators and other professionals from all over the world work for WHO in 147 country offices, six regional offices and the headquarters in Geneva, Switzerland. Now, the Center for Global Health at the Colorado School for Pub-lic Health is considered a part of WHO’s distinguished group.

What is a Collaborating Center? WHO collaborating centers are institutions such as research institutes, parts of universities or academies, which are designated by the Director-General to carry out activities in support of the Organization's programs. Currently there are over 800 WHO collaborating centers in over 80 Member States working with WHO on areas such as nursing, occupational health, communicable diseases, nutrition, mental health, chronic diseases and health technologies. This collaboration really is a win-win relationship as it brings benefits to both parties. WHO gains access to top centers worldwide as well as the institutional capacity to support its global health work, and to ensure its scientific validity. Institutions benefit from enhanced visibility and recognition by national authorities, calling public attention to the health

issues on which they work. The designation also opens up improved opportunities to exchange information and develop technical cooperation with other institutions, and to mobilize additional resources from funding partners. Collaborating centers are encouraged to develop working relations with other centers and national institutions recognized by WHO, by setting up or joining collaborative networks with WHO’s support. Examples of existing technical networks are the Global Network of WHO Collaborating Centers for Nursing and Midwifery Development, and the Network of WHO Collaborating Centers for Occupational Health.

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“In everything we do, WHO relies on the expertise of hundreds of formal WHO

Collaborating Centres, in your countries, and thousands of the best brains in science,

medicine, and public health, in your countries. They give us their time freely and it is my strong

impression that they do so with pride.”

Dr. Margaret Chan, Director-General, address to the Sixty-fourth World Health Assembly, 16

May, 2012

Center for Global Health designated as WHO Collaborating Center for Promoting Family and Child Health

states Children’s Hospital Colorado President and CEO Jim Shmerling, DHA, FACHE. The center’s maternal and child health division is co-directed by Eric Simoes, M.B., B.S., D.C.H., M.D., professor of pedi-atrics, and Susan Niermeyer, M.D., M.P.H., professor of pe-diatrics. Senior investigators include Edwin J. Asturias, M.D., assistant professor of pediatrics, Wayne Sullender, M.D. professor of Pediatrics, and Director of Maternal Health Pro-jects, Gretchen Heinrichs, M.D., D.T.M.H., assistant profes-sor of obstetrics and gynecology. What is the WHO? When diplomats met in San Francisco to form the United Nations in 1945, one of the things they discussed was set-ting up a global health organization. The World Health Or-ganization’s Constitution came into force on April 7, 1948 – a date we now celebrate every year as World Health Day. Delegates from 53 of WHO’s 55 original member states came to the first World Health Assembly in June 1948. They decided that WHO’s top priorities would be malaria, wom-en’s and children’s health, tuberculosis, venereal disease, nutrition and environmental sanitations – many of which we are still working on today. WHO’s work has since grown to also cover health problems that were not even known in 1948, including relatively new diseases such as HIV/AIDS. WHO is the directing and coordinating authority on interna-tional health within the United Nations’ system. WHO ex-perts produce health guidelines and standards, and help countries to address public health issues. WHO also sup-ports and promotes health research. Through WHO, gov-ernments can jointly tackle global health problems and im-prove people’s well-being.

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The Center for Global Health is honored to have the designation of WHO Collaborating Center for the next four years with the World Health Organization. The administration and faculty of the Center are eager to continue their work under the auspices of the WHO; this collaboration marks an exciting new phase for the Center for Global Health and the Colorado School of Public Health. To see other WHO collaborating centers around the world and what work they do go to: http://apps.who.int/whocc/ For additional information on the center and division of maternal and child health, visit http://globalhealth.ucdenver.edu. Want to learn more about the activities the Center will be spearheading? See the articles in the remainder of this issue of the Global Healthlink.

Center for Global Health designated as WHO Collaborating Center for Promoting Family and Child Health

Global Health & Disasters Course November 5-16, 2012, University of Colorado Anschutz Medical Campus

Registration is open for External Participants ONLY (Health Care Professionals)!

This international health course was formally known as the 'Tropical Medicine Course'. It is a two week course offered once a year as part of the University of Colorado School of Medicine Global Health Track. The first four days of the course are the Children in Disasters section of the course and the remaining six days are the Global Health section of the course. This course prepares its participants for international experiences and future global health work. This is an intensive training course which incorporates readings, lectures, small group problem based learning exercises, technical skill sessions and a disaster simulation exercise. The course will be held on the University of Colorado Anschutz Medical Campus. Continuing Medical Education Credit The course has been approved by the American Academy of Family Physicians for 63.25 elective credits. The Children in Disaster portion is eligible for 25.3 credits and the Global Health portion is eligible for 37.95 credits. Want to register for the November 2012 course, check out the draft agenda and learning objectives? Click here.

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(Continued from page 2) Gretchen Heinrichs, M.D., D.T.M.H., Assistant Professor of Obstetrics and Gynecology at Denver Health and University of Colorado School of Medicine, specializes in the obstetric and gynecological aspects of maternal care; training midwives and health workers in low-resources settings, and care of mother and baby through birth and postpartum. She works to help mothers give birth safely. Gretchen Domek, M.D., M.Phil., Global Health Fellow, Center for Global Health and Attending, Department of Pediatrics, Children’s Hospital Colorado, will bring a pediatric perspective to the collaboration by focusing on childhood parasitic infections, community health and teaching thereof, as well as disease prevalence. Her expertise is vital to providing care in the later stages of the birth-to-childhood life-course. Having these specialties within specialties may seem insular, but Dr. Heinrichs speaks to the breadth of this tripartite approach, “Having an OBGYN looking at the project from the birthing mother or birth assistant's perspective [Heinrichs], combined with the knowledge of a neonatologist [Niermeyer], and pediatrician [Domek], who approach the project structure looking out for the system that needs to be in place from the child's perspective will really provide continuity of care to the patients (mother and child) through the birth and postpartum care process. We hope this continuity will improve outcomes.” The high-stakes and risks of labor, delivery, and the first minutes of life are significant in the developing world, but the antenatal period is also essential for equipping women with information about choices and interventions that will help them promote the health of their babies and themselves. From a baby’s perspective, birth and the first five minutes of life are some of the most vulnerable, high-risk moments of a whole lifetime; this is especially so in the resource scarce areas of the world. One of the most significant causes of mortality in newborns is asphyxia, or failure to establish sustained breathing at birth.

Though neonatal resuscitation is widely taught to medical providers in the developed world, neonatal deaths globally occur largely outside of medical facilities in low-and-middle income countries. These pockets have remained unreached by simple life-saving resuscitation techniques. As the rate of under-five deaths declines overall, the proportion that occurs during the neonatal period is increasing. Dr. Susan Niermeyer is a developer of the program Helping Babies Breathe, which has adapted standard neonatal resuscitation techniques to fit resource-limited settings. .

She explains the role of Helping Babies Breathe, “I think maybe the biggest thing that Helping Babies Breathe does is change the expectation; we are fundamentally dealing with babies who fail to establish breathing or adequate breathing. Previously the expectation has been that those babies die. In fact, many babies who don’t breathe are labeled as stillborns, and they are still at birth; they are motionless; they are not breathing, but they may have cardiac activity, and be very amenable to resuscitation.

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Shared Goals – Increasing Rates

of Survival for Mothers and Babies

“This collaboration will advance the Center by increasing cross discipline practice and

implementation, research, and challenge us to pursue the best practices in the design

of interventions.”

Gretchen Heinrichs, M.D., D.T.M.H. Assistant Professor of Obstetrics and

Gynecology at Denver Health and University of Colorado School of Medicine

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(Continued from page 5) It (Helping Babies Breathe) equips people with simple tools and with the understanding of what they can do to change that outcome. It’s a huge paradigm shift. It changes the expectation from ‘this is a stillborn’ or ‘this is a child who’s going to die’ to ‘I can do something to change this outcome and make a healthy survivor.’ Dr. Gretchen Heinrichs shares the same goal of reducing risk for mother and child during the critical moments of birth, and increasing the number of maternal survivors. From a mother’s perspective, labor and delivery are also some of the most high-risk moments of her own life. A doc-tor, nurse or midwife present at birth can prevent and man-age life-threatening complications such as heavy bleeding, or prevent obstetric fistula by properly monitoring and refer-ring women with complicated labors. In this collaboration, Dr. Heinrichs consults with midwives, nurses and traditional birth attendants to determine their needs and train them in appropriate techniques that will help them more success-fully do their job of assisting wom-en to give birth safely. According to recently released statistics by the Millennium De-velopment Project, in developing regions overall, the proportion of deliveries attended by skilled health personnel rose from 55% in 1990 to 65% in 2010. Discussing her goal of increasing attended births in Guate-mala as part of the Center for Global Health’s Trifinio Pro-ject in Guatemala, Dr. Heinrichs envisions the project start-ing small and focused on the birth attendants, delivery and immediate postpartum care and then growing into a larger project to take care of the children of the community under 5 years of age. “In the next months, I look forward to refin-ing the specifics of the project in Guatemala including the scope, the educational priorities, and the physical design of the site.” Dr. Gretchen Domek, who is in Guatemala at the time of this writing, will focus on the childhood illnesses that threat-en the population of children under five years old. She ex-plains her own role as “identifying common childhood para-sitic infections, working with the local community health workers on early childhood developmental screening and teaching techniques, and performing seroepidemiology studies to determine local disease prevalence that will help identify current and future health needs in the community.” Dr. Domek has already established a baseline understand-ing of the Guatemalan birthing experience through a focus group conducted in April 2012 with the comadronas or tradi-tional birth attendants of Guatemala’s southwestern region.

Dr. Domek hopes to expand key primary health interven-tions to improve the survival outcomes of children under five, beginning with birth. Education remains fundamental to improving these out-comes, and the antenatal period is a critical time for estab-lishing health-promoting practices among families. The Millennium Development Goals Report explains that, “Mothers’ education remains a powerful determinant of health inequity. Children of educated mothers – even moth-ers with only primary school education – are more likely to survive than children of mothers with no education.” Dr. Domek’s position in the WHO collaboration will be inclu-sive and supportive, as she applies her training in medical anthropology to bridge the cultural gaps that often exist within the realm of pregnancy, birth, and child rearing.

Drs. Niermeyer, Heinrichs and Domek bring an important threefold perspective to the maternal and child health initia-tives that have qualified the Center for Global Health as a WHO collaborating center. This collaboration is the next phase of an existing relationship be-tween the Center and the WHO. Dr. Niermeyer comments on the evolu-tion of this partnership, and the oppor-tunities that such a partnership brings, “We [at the Center for Global Health] have already been very active collabo-rating with USAID and PAHO in several

Latin American sites, so I really think that area is going to be a focus, and I hope that we can develop some of these collaborations with pediatric researchers around infectious diseases, for example, because that is another huge killer among newborns. Working with obstetrical colleagues to address prematurity, and with other disciplines around fami-ly planning is going to be important; mothers need to have the choice to limit family size and invest in having healthy children.” The investigators look forward approaching their projects inclusively, and using their respective expertise to bolster each others’ work; Dr. Heinrichs believes that “This collabo-ration will advance the Center by increasing cross discipline practice and implementation, research, and challenge us to pursue the best practices in the design of interventions.” Working with the WHO will provide a chance to leverage resources and work creatively to address the needs of those mothers and babies that MDGs 4 and 5 are designed to help, but who still remain at significant risk of death and disability in the birth process due to financial or geographic disparities.

To learn more about the Millennium Development Goals go to: http://www.who.int/topics/millennium_development_goals/en/

To learn more about Helping Babies Breathe go to:

http://www.helpingbabiesbreathe.org/

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University of Colorado School of Medicine and Children’s Hos-pital Colorado physicians empowering the most disaster prone areas of the world on keeping their children safe in a natural disaster.

A Child’s Well-being: When a disaster hits

Winds of the hurricane are roaring up to 125 miles per hour, picking up debris and snapping trees in two like toothpicks. The hurricane slams into Biloxi and Gulfport, Mississippi, with devastating force, destroying much of both cities. That is the report from the National Hurricane Center at 11 a.m. on August 29th as Hurricane Katrina makes her arrival to land. Just a few minutes before that she had passed just to the east of New Orleans, Louisiana where a major levee failed. Water is pouring through the 17th Street Canal, and the city is beginning to flood. Just a mere six days before the National Hurricane Center in Miami, Florida issued its first advisory about the tropical system that turned into the 11th named storm of 2005. Katrina was the sixth strongest hurricane ever recorded and the strongest to ever make landfall in the U.S. An estimat-ed 80% of New Orleans was under water; up to 20 feet deep in places. The final death toll from the devastation totaled 1,836, primarily from Louisiana (1,577) and Missis-sippi (259). Seven years later, after $75 billion estimated in physical damages (the most in history) much rebuilding has taken place thanks to the 80 countries who pledged monetary do-nations or other assistance and to those who have worked so hard to make it a priority. This catastrophic disaster exposed the lack of disaster pre-paredness in the U.S. It prompted and fueled the need for development and implementation of pediatric disaster train-ing in disaster prone communities and countries around the world. From the hurricane devastation it was recognized there had been a lack of communication, coordination, delays in re-covery and responses of local, state and federal disaster authorities that led to increased morbidity and mortality. Children were particularly at risk. In 2005 there were no CDC (Centers for Disease Control and Prevention) guide-lines for pediatric input at the state disaster planning level. The Center for Global Health is the coordinating center for a special training program that focuses on the special needs of children following a disaster called PEDS – Pediatric Ed-ucation in Disasters. This course was in its nascent stage in 2004 and in 2005, in the aftermath of Hurricane Katrina, it was pilot tested for the first time. The PEDS course director is Joseph Wathen, M.D. who is an Associate Professor in the Section of Emergency Medi-cine in the Department of Pediatrics at the University of Col-orado School of Medicine who along with other core faculty (see list below) implement PEDS training in disaster prone countries and communities around the world.

Other core faculty for the course are:

Tien Vu, M.D., Assistant Professor, Section of Emer-gency Medicine in the Department of Pediatrics the University of Colorado School of Medicine,

Eric Tham, M.D. Assistant Professor, Section of Emer-gency Medicine in the Department of Pediatrics the University of Colorado School of Medicine,

Patrick Mahar, M.D., Senior Instructor in the Section of Emergency Medicine in the Department of Pediat-rics at the University of Colorado School of Medi-cine,

Renee King, M.P.H., M.D., Senior Instructor in the De-partment of Emergency Medicine in the School of Medicine at the University of Colorado,

Brian Stafford, M.D., M.P.H. Assistant Professor in the Department of Psychiatry, specializing in Child Psy-chiatry and Behavioral Sciences at the University of Colorado School of Medicine and

Lindsey Cooper, M.D. who just completed her fellow-ship in Pediatric Critical Care at the Children’s Hos-pital Colorado

The Global Healthlink interviewed Steve Berman, M.D., F.A.A.P., Director of the Center for Global Health and the architect of this program. Why was this program needed and what is its goal? Severe natural disasters are occurring with increasing fre-quency throughout the world. In recent years there have been earthquakes in China, Pakistan, Haiti, Chile, Turkey, and Italy; tsunamis in Indonesia and Japan; hurricanes, ty-phoons, and floods throughout Mesoamerica and Asia and fires in the western United States.

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(Continued from page 7) In every one of these disasters, regardless of whether they occurred in a developed or less developed country, inade-quate attention was paid to the special needs of children with respect to both disaster preparedness planning and response activities. Children are among the most vulnerable population groups, together with pregnant women and the frail elderly, be-cause they have unique physiological, psychological and developmental needs. They have a greater risk of exposure from inhaled toxins because they breathe faster than adults and are lower to the ground where heavier gases and toxic material accu-mulate. Children also have a higher risk of dehydration from vomiting and diarrhea. Their higher body surface ar-ea increases the risk for skin exposure to burns and other toxins. Because of their developmental state, children are less able to anticipate haz-ards and escape dan-gers. Psychologically children are emotional-ly vulnerable and often have adaptive stress symptoms that can become chronic and impair their social and emotional develop-ment. The goal of the PEDS program is to train a critical mass of pedia-tricians, other physi-cians and health pro-fessionals in both de-veloped and lesser developed countries to become involved in pediatric disas-ter planning for their hospitals and communities. The train-ing increases the participants’ awareness and competence in pediatric disaster planning and response. When was PEDS developed and what organizations participated? The American Academy of Pediatrics (AAP) with a grant from the Johnson and Johnson Pediatric Institute created a task force in 2004 to develop a training program to address the need for disaster planning and response in lesser de-veloped countries that would consider the unique physical and psychological needs of children. The task force designed Pediatric Education in Disasters (PEDS) with the assistance of the Pan American Health Organization (PAHO – the regional office of the WHO),

several United States Military pediatricians, the Latin Amer-ican Pediatric Association (ALAPE) and the Association for Health Research & Development (ACINDES). The first pilot course that tested 4 modules was held in Guatemala in 2005. Then in 2006 the entire course was piloted in Mexico City. How is the course structured and what areas are cov-ered? The program, usually delivered over 3 or 4 days introduces the participants to relevant material with a manual which is provided 2-3 weeks prior to the course. The key concepts of the course are covered in presenta-tions using standardized PowerPoint slides which are avail-able with the program materials. These key concepts and skills are then reinforced during small group problem based learning exercises that include role playing, case discus-sions, and clinical skill workshops.

Participants are then asked to demonstrate their understanding of these concepts and mas-tery of clinical skills dur-ing a simulation hospital disaster drill involving many pediatric casual-ties. The design of the course emphasizes ac-tive learning concepts, repetitive exposure, and demonstration of compe-tency. The 10 Modules covered in the international course include the following:

1. Disasters and their effects upon the population: Key con-cepts 2. Preventive medicine in humanitarian emergencies 3. Planning and triage in the disaster scenario 4. Pediatric trauma 5. Management of prevalent infections in children following a disaster 6. Diarrhea and dehydration 7. Delivery and immediate neonatal care - Susan Niermey-

er, M.D., M.P.H, F.A.A.P, Professor of Pediatrics at the University of Colorado School of Medicine recently re-vised the neonatal module and its training exercises to incorporate the latest evidence from the “Helping Babies Breathe” program.

8. Nutrition and malnutrition 9. The emotional impact of disasters in children and their families 10. Toxic exposures

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A Child’s Well-being: When a disaster hits

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(Continued from page 8)

Where has this program been introduced? Over the past several years, PEDS national training centers have been established in Latin America (Ecuador, Mexico, Nicaragua, Panama, and Peru); Asia (China, the Philip-pines, and Vietnam); and the Middle East (Qatar). Course materials have been translated from English into Spanish, Chinese, French, and Vietnamese. These national training centers have adopted a “train the trainer model” and are establishing regional training centers to disseminate the program broadly throughout their coun-tries. Courses are planned in the coming year for Haiti, El Salvador, Guatemala, and Cambodia. To date there have been twenty courses with 710 participants. Have the course participants felt that the course was useful? Which areas were most useful? An extensive evaluation of these courses was recently been carried out by Lindsey Cooper, M.D., who just completed her fellowship in Pediatric Critical Care at Children’s Hospi-tal Colorado. Dr. Cooper is moving to the Democratic Re-public of Congo where she will teach the care of the critical-ly ill child to Congolese physicians, nurses and other health care providers. Dr. Cooper found, in the evaluation completed immediately following the course, using a 5 point likert scale, that partici-pants in all courses felt the course was very good to excel-lent. The two modules felt to be most useful overall were Plan-ning/ Triage and Emotional impact, although participants in Mexico also rated neonatal care and toxicology very high. She also found that a large majority of participants use the manual frequently and participants significantly increase their knowledge based on a comparison of pre and post test scores.

The follow up evaluation at least 6 months after the course also documented that 10-20% of the participants became involved in disaster related activities.

The two national training centers that have been most suc-cessful in disseminating the program are located in China and Mexico. Their success appears to be related to their strong organizational infrastructure, faculty commitment, and funding. What are the future plans for PEDS? The Center for Global Health plans to help establish suc-cessful national training centers throughout the world with the assistance of WHO and the AAP. Continuing to evaluate the program will be important for as-sessing the impact, identifying ways in which the materials and training can be improved and determining ways to take PEDS to scale. During the next four years as a WHO Collaborating Center, we will provide technical assistance to Latin American and Caribbean countries that have PEDS training centers to car-ry out at least one regional training course per year. We also wish to introduce the PEDS training course into the medical school curriculum, as well as, pediatric residences in these countries. In addition, the Center, in collaboration with Maimonides University in Argentina, is developing an on-line PEDS course with interactive problem based learning exercises that will be in Spanish and English. We anticipate that the on line course will be used by humanitarian assistance NGOs for training volunteers, as well as educational institu-tions and pediatric residency programs with global health tracks.

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A Child’s Well-being: When a disaster hits

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University of Colorado Denver Center for Global Health

Mail Stop A090, 13199 E Montview Blvd, Suite 310

Aurora, CO 80045 http://globalhealth.ucdenver.edu/

August 29, 2012 Thomas B. Campbell, M.D., F.A.C.P., Professor and Interim Head, 12 noon/ED2S, 2201 Division of Infectious Disease, Department of Medicine Anschutz Medical Campus University of Colorado School of Medicine Kaposi’s Sarcoma in Africa: Challenges in the Era of Antiretroviral Rollout September 2012 Pending October 24, 2012 Donald Krogstad, M.D., Henderson Professor, Department of Tropical Medicine, 12 noon/ED2S, 2201 Tulane School of Public Health and Tropical Medicine Anschutz Medical Campus Challenges and Rewards in the Struggle Against Tropical Disease November 2012 Pending December 5, 2012 Paul Polak, M.D., founder of Colorado-based non-profit International 12 noon/ED2N, 1107 Development enterprises (IDE), Author of the book, Out of Poverty Anschutz Medical Campus Business Solutions to End Poverty—to improve the health and incomes of people living on less than $4 per day

Fall 2012 Global Health Lecture Series

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If you wish to participate in a disaster course, one is planned for November 5-8, 2012 on the University of Colorado Anschutz Medical Campus as part of the annual Global Health and Disasters Course. Check out the Center for Global Health website for registration and course information. For more information on the PEDS course, please contact Steve Berman, M.D., F.A.A.P. at Stephen.berman@childrenscolorado.org. The PEDS manual can be found at: http://www.aap.org/disasters/peds.cfm