on pursuit of a sustainable international service project
TRANSCRIPT
On Pursuit of a Sustainable International Service Project in Otology:
Is “Teach A Man How To Fish” Paradigm Sufficient?
Ashkan Monfared, MDAssociate Prof of Surgery and Neurosurgery,
George Washington University
Global ENT Outreach
Richard Wagner, MDGlobal ENT Outreach
Objectives► Intro:
� Our Organization
► Evolution of GEO and its challenges� Challenges with patients� Challenges with instruments and hospitals� Challenges with the physicians� Challenges with local government
►Analysis of the problem:� Common denominator to all the challenges
►Observations:� New model: self sustaining, community based,
regenerating machinery
No Financial Disclosure
Global ENT Outreach
► Non-profit NGO
► Served in 23 countries
► Cared for over 3000 patients
► Involved with residency/fellowship programs in 6 countries
► Established temporal bone labs in Peru, Paraguay, and Cambodia. Planning two more in 2016.
Mission
� Otology, Hearing
� Goals: ►Provide care
►Educate
►Create self-sustaining program
►Create self-regenerating program
Evolution of GEO Approach
Stage I: Providing care, operate
► Challenges with patients:� Access, money, culture
► Challenges with instruments and hospitals:� Equipment expense,
customs
� Politics of the hospital
► Local Physicians Challenges
Stage II: Educate
►Challenges with the physicians
� Education
►Years of Practice
►Major investment of time
� Willingness to provide care
� Willingness to educate others
►Our attempt at residency programs
� Ethiopia
� El Salvador
Stage III: Analysis
►Root Cause of the challenges
� Patients: access, affordability, culture
� Materials: availability, expense, customs
� MD’s: skills, providing care, dissemination of knowledge, ego
� Common denominator? Money, politics, etc.
►Our method of learning:
� Trail and Error
� Consulting and reflecting on outcome
� Change in approach
Stage IV: Solution
► Long term solution:� Change view of
“development project”
► Short term solution: � Identify need
� Establishing priorities
� Community based ownership
� Self sustaining
� Self regenerating
Capacity Building
Cycle
ExecutionNGO activities
Local ENT participationCommunity assistance
Local Government
PlanningResource Allocation
Establish ResponsibilitiesProgram structure
BudgetEquipment
AnalysisNeeds AssessmentImpact assessment
Key issuesGoals
MonitoringAudiology skillsSurgical cases #
Progress and quality
RefinementsImpact analysisTesting skillsLog reviews
ObservationsPerformance reports
Capacity Building Model
Temporal Bone Labs
Long term solution:
►World is but one country and mankind its citizens
►Development project not a handout
►Change needs to be slow and organic
► Focus on human factor� Visiting surgeon
� Local physicians and allies
� Patients
� Community/politicians/etc
Human beings are limbs of one body,In creation of one soul and essence.
Should one limb be afflicted with the torments of fate,The other limbs would not remain in silence.
If thou hast no sympathy for others’ despair,The human name thou no longer share.
-Saadi Shirazi, 13th century Persian poet