Rural Global Health Partnership Initiative

The Rural Global Health Partnership Initiative continued to thrive in 2020–2021, awarding four new project grants to rural physicians, medical students, and residents who are committed to rural practice. Although the pandemic caused some disruption, most projects were able to pivot successfully and, where possible, adapt to an online format.

The four newly-funded projects are:

• Cultural Safety through Digital Storytelling and Brokered Dialogue, led by Dr. Terri Aldred, which uses a digital approach to capture stories and foster dialogue between Indigenous and First Nations communities in rural BC and the physicians that provide care in those communities. The project will create locally-relevant Indigenous Cultural Safety educational resources. Work on this project has continued virtually during the pandemic.
• Zimbabwe Hernia Partnership, led by Dr. Bret Batchelor, which partners Canadian and Zimbabwe physicians to increase rural surgical capacity in Zimbabwe. Canadian physicians with surgical skills will provide faculty for a hernia repair training program in Karanda Mission Hospital in northern Zimbabwe. The project also supports the National University of Science and Technology of Zimbabwe in creating a general practitioner training program, including surgical skills. Work on this project is on hold until pandemic travel restrictions are lifted.
• Primary Care Partnership to Create Rural Generalist in the Amechi Uwani Community, Nigeria (Phase 2), led by Dr. Onuora Odoh, is improving and sustaining Phase 1 impacts, and expanding activities to continue building community partnership, sustainability, and full-scope rural generalism. In partnership with a local charitable organization, the Rural Primary Health Care Improvement Foundation, the team will expand their services to include maternal and child healthcare, chronic disease care, sickle cell anemia care, vitamin A supplementation, and deworming. Work on this project is on hold due to pandemic restrictions.
• Bhutan-Canada Mental Health Resilience Project, led by Erin Slade, and designed in collaboration with the Kesar Gyalpo University of Medical Sciences, responds to increasing youth suicide rates in Bhutan. The first phase of the project involves a mixed methods study of mental health perspectives amongst post-secondary Bhutanese youth using surveys, focus group discussions, and interviews with local mental health experts and traditional healers. The results of this study will inform the development of a mental health app and may be expanded to include rural BC youth. Work on this project is continuing virtually due to the pandemic.

The Rural Global Health Partnership Initiative also continued supporting several previously-funded grant projects in 2020–2021:

• Grassroot Rural Community-driven Malaria Control Project in Amechi Uwani Community, Nigeria (Phase 1), led by Dr. Onuora Odoh, implemented standard malaria preventive measures, including early and reliable malaria diagnosis, and timely and appropriate laboratory-confirmed Malaria treatment to pregnant women and children under age 12 in their own homes. Local Indigenous youths were recruited and trained as field workers. This phase of the project wrapped up in September, 2020, and reported a 49 percent reduction in malaria incidence and significant knowledge increases about malaria control measures.
• Nutritional Assessment in Rural Kenya for a Community Organization, led by Brianna Creelman, is a collaboration between students in the University of British Columbia (UBC) Global Health Initiative and Pamoja, a non-governmental organization that provides support to rural villages in the Kisumu District, Kenya. Using a five-year longitudinal and annual household survey, the project team assesses household food security and nutrition status in children under 5 years who are beneficiaries of the Pamoja program. The second year of data collection was completed by Pamoja and the Kenyan Ministry of Health this year. Data analysis is ongoing, and the project team is collaborating with partners to publish and disseminate preliminary results.
• Finding Sustainable Solutions for Menstrual Hygiene Management in Spiti Valley, India, led by Emma Loy, is a collaboration between students in the UBC Global Health Initiative and a community-based organization in the Indian Himalayas to increase education and capacity around menstrual hygiene management (MHM) amongst adolescent girls in a partner school. The project team provided MHM education to participants, who also tracked their menstrual experience in a personal diary. Project evaluation showed an increase in participants’ knowledge of menstrual hygiene and reproductive health. In addition, an Indian supplier began providing the school with reusable pads.
• Northern Ghana, led by Dr. Kelly Hadfield, experienced delays due to the COVID-19 pandemic.

Medical students at distributed sites reflected on the similarities in the community engagement process regarding the importance of addressing local priorities in culturally appropriate and sensitive ways. One grant recipient, a medical student, reflected on how her project in Kenya prepared her for rural family practice rotation in Fort Nelson, and how this experience helped her adjust to the practice of medicine in a rural setting:

“First off is the loneliness and outsider feeling one can experience being in a small, new community. Fort Nelson is a town of 2000, where everyone knows everyone. Upon arriving in the community, it was apparent that everyone knew I was not from there. In addition, over half of the population was Indigenous, another factor that made it exceedingly apparent that I was an outsider. This was similar to how I felt in Kenya. Not only did I look different, but I came from a different culture. Having spent time in Kenya made it easier for me to reach out, get to know people, and learn from them. The confidence I gained by putting myself out there in Kenya made it easier for me to do this in my new community. Because of this, I was able to form meaningful relationships within the community. By putting myself out there, various members of the community were happy to take me out hiking and exploring. This helped me to enjoy my time in and get to know the small community without feeling alone. This is a skill that I will carry with me into my future as a physician in a rural setting.”

The Rural Global Health Partnership Initiative also capitalized on opportunities to link rural BC physicians (such as Dr. Odoh, mentioned above) with UBC medical students to assist with the scholarly and advocacy components of projects to contribute to medical undergraduate curricular competencies. This creates an academic link to rural physicians in practice who are not connected in other ways (e.g., rural teaching sites).

In the coming year, the Rural Global Health Partnership Initiative will explore new ways to showcase examples of how its grant supports physicians and communities, both internationally and in BC. Its application process will continue to encourage applicants to demonstrate reciprocal benefits to communities, whether through personal growth, skill acquisition or improvement, or motivation to gain new skills or develop new projects that benefit their medical practice and advocacy.