Global Health Impact Report

IMPACT REPORT INAUGURAL EDITION

DIVISION OF GLOBAL HEALTH DEPARTMENT OF POPULATION HEALTH

Letter From the Dean Dear Colleagues and Friends,

TABLE OF CONTENTS

2 Letter from the Dean 3 About Dell Medical School 4 About the Division of Global Health 7

2023-2024 At A Glance

10

Care

20

Education

32

Research

39 Letter From the Division Chief: Looking Forward 42 Acknowledgements

It is with great pride and excitement that I introduce the inaugural impact report of the Division of Global Health at Dell Medical School. This report highlights the incredible strides we’ve made in advancing global health equity and underscores the critical role our division plays within our institution.

The early establishment of the Division of Global Health at Dell Med highlights the importance of this work. At the new University of Texas Medical Center, anchored by Dell Med, our approach to empowering community health relies on bidirectional engagement and leveraging close community partnerships to advance community-driven solutions — both key to narrowing health disparities and achieving health equity for all. Furthermore, we know that health inequities are not confined by borders, and our work embodies our commitment to addressing these disparities both locally and globally. Through education, research, clinical care and collaborative partnerships, we are shaping a future where every individual, regardless of where they live, has access to high-quality health care.

Our involvement and leadership in the Academic Model Providing Access to Healthcare (AMPATH) Consortium — a global partnership focused on improving health systems in low- and middle-income countries — are central to this mission. AMPATH’s proven model, which integrates medical education, research and clinical services, is a powerful example of what can be achieved when academic institutions partner with communities and health systems to address pressing health needs. Dell Med’s contributions to AMPATH, aligned with our aims of becoming a world-class academic medical center, enable us to influence global health policy and practice medicine in meaningful ways.

One of the most significant examples of our leadership in global health is Dell Med’s role as a key institution for the AMPATH/MAPAS México program. We are spearheading efforts to strengthen health care systems in Mexico and improve health outcomes on both sides of the border. This cross-border collaboration represents a unique opportunity to foster innovation and learning between the United States and Mexico, which in turn contributes to better health care access and equity in both countries.

The work done by the Division of Global Health is not just about making an impact abroad; it’s about bringing those lessons home. The connections we build, the knowledge we share and the innovations we develop through our global health program are vital to improving health care in our own community. By leading the way in global health, Dell Med is not only fulfilling its mission to revolutionize how people get and stay healthy but also setting a new standard for what it means to be a medical school in the 21st century.

As you read through this impact report, I hope you are as inspired as I am by the achievements of the Division of Global Health. Together, we are defining the future of health — locally, nationally and globally — and I look forward to continuing this important work with all of you.

With warm regards,

Claudia F. Lucchinetti, M.D. Dean, Dell Medical School Senior Vice President for Medical Affairs, The University of Texas at Austin Frank and Charmaine Denius Distinguished Dean’s Chair in Medicine 1

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IMPACT REPORT 2023-2024

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ABOUT DELL MEDICAL SCHOOL

On a Mission To Revolutionize How People Get & Stay Healthy Dell Medical School anchors the University of Texas Medical Center — an emerging, integrated academic medical center in the heart of Texas. Working together with our community and powered by cutting-edge technology and digital capabilities, we set the standard for excellence in person-centered patient care, pioneer research with meaningful impact, lead innovation in medical education and catalyze life sciences entrepreneurship.

Who Are We?

ABOUT THE DIVISION OF GLOBAL HEALTH

UT Medical Center builds on the foundation for excellence laid by The University of Texas at Austin and our clinical partners, bringing Austin into focus as a premier destination for health care.

Our vision is defining the future of health — because we know that what starts here changes the world.

The Division of Global Health in the Department of Population Health at Dell Medical School focuses on leveraging education, research and service to improve health and advance health equity for vulnerable populations globally. Its initiatives intersect the missions of Dell Med and Texas Global at The University of Texas at Austin to cultivate globally minded leaders, improve overall health outcomes in Texas and global partner communities, and build cross-disciplinary collaboration to address social and structural determinants of health. As a key member of the AMPATH Consortium, the Division’s partnerships span Central Texas, USA; Eldoret, Kenya; and Puebla, Mexico.

42 Active Faculty

6 Dell Medical School Departments Internal Medicine (General Internal Medicine, Hospital Medicine, Cardiology, Pulmonology, Palliative Care), Neurology, Pediatrics, Psychiatry, Population Health, Women’s Health​

UT Faculty by Department Engaged in Global Health 4% CARDIOLOGY 6% NURSING 6% SURGERY

23% INTERNAL MEDICINE

9% POPULATION HEALTH 11% PSYCHIATRY 12% NEUROLOGY

UT Colleges, Schools, and Units 15% PEDIATRICS

14% OTHER SPECIALTIES*

*Other specialties: Education, Dermatology, Psychology, Emergency Medicine, Latino Studies, Public Affairs, OB/GYN, Oncology, Rheumatology 3 || IMPACT IMPACT REPORT REPORT 2023-2024 2023-2024 3

9 Dell Medical School, Cockrell School of Engineering, College of Education, Teresa Lozano Long Institute of Latin American Studies within the College of Liberal Arts, School of Nursing, College of Natural Sciences, Steve Hicks School of Social Work, Texas Global, Lyndon B. Johnson School of Public Affairs

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What is AMPATH? Dell Medical School is part of the Academic Model Providing Access to Healthcare (AMPATH) Consortium, a global network of 16 academic health centers and four partner sites in Kenya, Ghana, Mexico and Nepal with a shared vision to ensure health for all.

In 2018, Dell Medical School joined the AMPATH Consortium as both a participating member of AMPATH Kenya and the lead institutional partner to adapt AMPATH in Mexico — translated in Spanish as Modelo Académico para Proveer Acceso a Salud (MAPAS). With a focus on training, providing care and strengthening health systems in agrarian communities surrounding the city of Puebla, AMPATH/MAPAS México currently

AMPATH improves the health of people in underserved

reaches a combined population of nearly 3,000 through

communities by working in partnership with academic

an academic partnership model with community-based

health centers, ministries of health and others to

organizations and public sector health facilities. The

strengthen public sector health systems and promote

entire state of Puebla, home to 6.583 million people, is

well-being. Guided by the principle of leading with care,

an ideal partner site in its parallels to health priorities

AMPATH:

in Central Texas, including:

•

Delivers and sustains effective health care services;

•

Reduces health disparities and addresses social

Develops and strengthens human capacity through •

training and education; •

Advances research that improves health, and

•

Strengthens partner institutions.

Diabetes, chronic kidney disease, cardiovascular disease, cancer, maternal health and mental health;

•

determinants of health; •

•

(ABOVE) Uniceve Mobisa (Moi School of Medicine student), Dr. Claire Selinger (Dell Med psychiatry faculty) and Dra. Minou Arévalo Ramírez (BUAP psychiatry faculty) in Austin.

care;

AMPATH Kenya-Based Partners

AMPATH/MAPAS México-Based Partners

Need for training and mentorship for the primary

•

•

Lack of access to medicine and affordable primary

health care workforce.

•

Moi University: This public university in Eldoret,

Benemérita Universidad Autónoma de Puebla

Kenya began a partnership with Indiana University

(BUAP): Puebla’s largest state institution was

in 1989, eventually co-establishing AMPATH in 2001.

founded in 1578. The Facultad de Medicina, or school of medicine, has over 6,000 medical students and

Moi Teaching and Referral Hospital (MTRH):

1,600 postgraduate and allied health professional

Founded in 1917, MTRH is a multispecialty interna-

students in nutrition, radiology and other special-

tional hospital that serves over 25 million people in

ties. Postgraduate training opportunities include 22

Kenya, Uganda, Sudan, Tanzania and the Democratic

residency specialties with over 1,500 residents and

Republic of Congo. It is a key player in the Kenyan

two masters’ programs.

government’s Vision 2030 Bottom-Up Economic Transformation Agenda.

•

Fu n d a c i ó n Co m u n i ta r i a d e Pu e b l a ( FC P) and Fondo Mónica Gendreau (FMG): These local organizations leverage longstanding relationships with rural communities. Both are key facilitators for collaborative health outreach and community engagement.

•

Instituto Nacional de Salud Pública (INSP): Mexico’s national institute of public health is committed to service by offering research results to relevant public health challenges, preventing and controlling diseases and training health professionals to promote healthy living.

IMPACT REPORT REPORT 2023-2024 2023-2024 55 || IMPACT

(LEFT) University partners in the AMPATH Consortium, (RIGHT) Institutions in collaboration to adapt AMPATH for Mexico.

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CLINICAL AND EDUCATIONAL ACTIVITIES IN KENYA WERE COMPLETED BY:

DIVISION OF GLOBAL HEALTH AT A GLANCE

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CARE

EDUCATION

RESEARCH

Expanding access to care in under-resourced communities:

Leading training and exchanges for faculty, fellows, residents, students and community members:

Partnering across communities to better understand and tackle the root causes of chronic diseases:

•

•

56 faculty, clinical staff, trainees and teammates in Kenya since program engagement began in 2017

•

80+ participants in Puebla at Puentes 2023 Research Summit.

1013 individuals received multidisciplinary clinical consultations;

•

39 faculty, researchers, students and trainees in Mexico since program engagement began in 2019

•

Eight Puentes working groups focused on key health challenges and priorities in Mexico and Texas.

479 individuals participated in health education sessions;

•

Four multidisciplinary health outreaches in low-income communities in Puebla, Mexico.

•

•

• •

212 medical providers and trainees involved.

26 community health promoters recruited and trained from two rural communities in Puebla, reaching 119 households (nearly 500 individuals) with health education at home.

•

Four trips between 2023-2024 to Eldoret, Kenya organized by Dell Med’s cardiothoracic surgery team, with 900 patients screened for structural heart disease and 20+ life-saving, open-heart surgeries performed, along with training for Kenyan surgeons.

CLINICAL AND EDUCATIONAL ACTIVITIES IN MEXICO WERE COMPLETED BY:

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Two Kenyan students from Moi University hosted at Dell Med as the first-ever international medical students on a clinical elective.

•

Two Kenyan nursing students from Moi University hosted at UT School of Nursing.

•

Eight AMPATH/MAPAS México Seminars with attendees on diverse topics in global health.

•

Four departments (Internal Medicine, Pediatrics, Neurology, and Psychiatry and Behavioral Sciences) participated in residency electives in both Kenya and Mexico.

•

Three global health enrichment electives for Dell Med students.

•

Two virtual exchange courses on migrant health for medical students from Dell Med and BUAP.

•

Eight Global Health Grand Rounds events covering topics including decolonizing global health, planetary health, and dynamics of power.

•

•

UT Faculty

18 Clinical Staff

Seven AMPATH/MAPAS México Bilateral Innovation Award Grants, awarded to UT and BUAP faculty members for collaborative projects in palliative care, diabetes, health professions education, evaluation, mental health education, community mental health and nutrition.

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One team from Dell Med and Cockrell School of Engineering was awarded an Incubator Grant from UT’s Office of the Vice President for Research to use artificial intelligence innovations with AMPATH Kenya toward advancing echocardiography for cardiovascular disease.

Residents & Fellows

•

One team from Dell Med and the School of Nursing was awarded an Incubator Grant to address diabetes with AMPATH/MAPAS México colleagues from BUAP and INSP.

•

One team from UT Dell Medical School, UT Cockrell School of Engineering and BUAP Medical school awarded a pilot grant from UT’s Center for Health and Environment: Education and Research (CHEER) to investigate the impact of ecological stoves on health in rural Mexico.

8 Fourth-Year Dell Med Students

2 Non-Clinical Staff

21

22

1

4

12

1

1

4

UT Faculty

BUAP Faculty

Kaiser Permanente Faculty

INSP Researchers

Residents

Fellow

Doctoral Student

Medical Students

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IMPACT REPORT 2023-2024

(Cumulatively between 2019 and 2024)

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CARE

9 || IMPACT IMPACT REPORT REPORT 2023-2024 2023-2024 9

10

CARE KENYA

Advancing Patient Care in Internal Medicine, Pediatrics and Neurology Dell Med faculty travel annually to Eldoret to supervise trainees, support new initiatives and deepen clinical and educational partnerships:

Since joining the partnership with Moi University and Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya, in 2018, Dell Medical School’s collaboration

Internal Medicine – Palliative care training collaboration; medical student supervision

brought together faculty, residents, fellows, medical students and staff across six specialties by 2023: cardiology, cardiothoracic surgery, internal medicine, pediatrics, neurology, psychiatry and behavioral sciences.

Heart-to-Heart: Cardiac Surgery Capacity Building and Training Powered by grants from the Thoracic Surgery Foundation, Dr. Robert Neely co-led four clinical teams to MTRH in 2023 and 2024 to enhance the quality

Pediatrics – Course training for MTRH Pediatric Fundamental Critical Care Support; support for Eldoret’s new Pediatric Intensive Care Unit

of cardiac surgical care for patients in Eldoret and surrounding communities. Together with Kenyan counterparts, they screened over 900 patients of all ages for structural heart disease, performed 20+ open-heart surgeries on young adults and trained 100+ clinicians.

STORY Dr. Neely Travels to Kenya for “Every Heartbeat Matters”

(ABOVE) Cardiac surgery capacity building teams partnering with Kenyan counterparts to save lives.

“

Each operation is a high yield opportunity for knowledge sharing.

In addition to helping these young Kenyan patients, we were teaching skills and practices that will apply

(PREVIOUS SPREAD, LEFT TO RIGHT) 1. Dr. Clarissa Johnston supervises internal medicine trainees on clinical rotation at AMPATH Kenya. 2. BUAP pasantes discuss diabetes care with patients in Puebla, Mexico. 3. Kenyan students round with Dr. Tim Mercer at CommUnity Care in Austin alongside Dell Med faculty and students.

to countless other Kenyans in the

Neurology – Stroke assessment research project development; in-person and virtual longitudinal neurologic care and training; training and capacity building in pediatric epilepsy

future.”

– Dr. Robert Neely, cardiothoracic surgeon and clinical team lead

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IMPACT REPORT 2023-2024

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CARE KENYA

“

Despite practicing in a country almost 9,000 miles from my own, pediatric medicine feels familiar here: the confidence of the registrar, the awkward

STORY On Rounding in East Africa published in the Journal of Graduate Medical Education in June 2024

timidness of the medical student, the quiet anxiety of a mother at the bedside, even the bronchiolitis and gastroenteritis. The culture and content of medicine in East Africa is remarkably similar to Central Texas. The language of medicine is truly universal, I realize here, and transcends society and class.

The clinical experience is collaborative in a way I read about but could not appreciate until I experienced it myself.

The discussion is consistently bilateral, and both clinicians leave rounds feeling edified as physicians. Most importantly, our patients benefit from this relationship.”

– Richard Thompson, D.O., Assistant Professor, Department of Pediatrics

(ABOVE) Dell Med faculty, fellows, residents and students at Eldoret’s Moi Teaching and Referral Hospital in 2023.

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IMPACT REPORT 2023-2024

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CARE MEXICO The Division of Global Health partners with Benemérita Universidad Autónoma de Puebla (BUAP) to adapt the AMPATH model for Central Texas and Puebla, Mexico. The AMPATH/MAPAS México care team connects UT, BUAP, INSP and FCP/FMG health experts on common health priorities and challenges.

The program reached nearly 90,000 people by providing medical supplies to rural health centers; training to medical students, practitioners and faculty; health education to community members; and direct care to patients in low-income communities.

A New Generation: Training Community-Focused Physician Leaders

IMPACT OF JORNADAS delivered by pasantes. Pasantes in turn often face challenges in serving their assigned communities, including distance from family support networks and limited supervision. To both address the lack of community trust and invest long-term in the pasantes’ skills and passion for service, the AMPATH/MAPAS México team launched an innovative program in August 2023 to offer social service experience in the AMPATH/MAPAS México clinical program. Pasantes at BUAP’s medical school can now participate in specially designed academic courses on global and community health, professional mentorship, practicums and research projects. They are leading with care, spearheading community health outreach events and training community-based health promoters. From August 2023 to July 2024, 18 pasantes participated in the AMPATH/MAPAS México program. In July 2024, a three-day pilot workshop led by the collaborative

Pasantes are final year medical students completing

health professions education working group began

their year of social service in Mexico, making up the

developing a set of social-emotional competencies for

bulk of the primary health care physician workforce

community-based care, aiming to better prepare 25

in rural, public-sector clinics. Our 2019 community

incoming pasantes for their year ahead.

health needs assessment revealed that patients in rural Puebla face many challenges in accessing public health care, including lack of confidence in services

(BELOW) Dr. Rebecca Cook, Dell Med faculty and AMPATH/MAPAS México Clinical Team Leader, leads pasantes and community members in a first aid workshop in Puebla.

Jornadas/Outreach: Collaborations for Community Care The Jornadas Integrales de Salud, or health outreach events, provide a breadth of essential health care services, promotion activities and education for rural patients. Organized by the AMPATH/MAPAS México care team, university hospital specialists and experts from across BUAP departments held four jornadas between August 2023 and July 2024. Two events in rural Atzitzihuacán, where AMPATH/MAPAS México currently pilots regular health visits, were so well received that BUAP requested jornadas in two additional peri-urban communities.

“

It aligns so well with Dell Med’s efforts to rethink the role of academic medicine in improving health and to move outside of our classrooms and hospitals and into the community for collaboration.” — Dr. Rebecca Cook, clinical team leader for AMPATH/MAPAS México

“

It’s great commitment on the part of the community leaders, the community health

STORY

committee and the AMPATH/ MAPAS México team.” — Patricia

Global Health Partners Kick Off CommunityBased Care Initiatives in Mexico 15 || IMPACT IMPACT REPORT REPORT 2023-2024 2023-2024 15

Vargas, director of Fundación Comunitaria Puebla 16

CARE MEXICO

Eco-Stove Impacts: Intersecting Environment and Health

Countering Cancer: Advancing Education, Prevention and Early Detection of High-Burden Cancers By training trusted community members in Puebla and empowering pasantes to design and implement trainings, AMPATH/MAPAS México addresses immediate cancer risk prevention and supports long-

STORY

term sustainability for the local health workforce.

In Mexico, cervical, breast and prostate cancers have the highest incidence and cancer-related mortality, with significant cancer health disparities

Story: Global Health Trainings Connect Puebla Communities to Critical Health Services & Knowledge

in rural, low-income populations. To address this,

After a 2019 interdisciplinary team of UT and BUAP researchers identified poor ventilation from indoor cooking and its negative impacts on health as a major concern in rural Puebla, Dell Med’s Dr. Rebecca Cook and Dr. Trisha Parekh took aim with their 2023 grant from Dell Med’s Center for Health and Environment: Education and Research (CHEER).

Studying the health impacts of recent eco-stove installations through home visits and health evaluations with 72 women in one of the AMPATH/MAPAS México communities, they found that eco-stoves require less fuel and produce less air pollutants. At a July 2024 participatory workshop with the women involved, the team shared initial findings and eco-stove optimization techniques to minimize exposure to contaminated air. They also presented at academic forums at the first International Congress of EnviroEpiHealth in Puebla in June 2024 and a CHEER seminar at Dell Medical School in March 2024.

the AMPATH/MAPAS México care team launched a two-year project in fall 2023 via community-based education, prevention and early detection efforts.

In addition to training pasantes to complete clinical cancer screenings, the team recruited and trained 26

“

promotores, or community health promoters. These promotores became local change agents, learning how to build local knowledge of common cancers and directing eligible patients to health care screening services. The promotores participated in prevention and early detection trainings for cervical and breast cancer and completed first aid workshops. In just the first year of the project, the care team screened 90 community members for cervical, breast and prostate cancers and conducted 108 visits to promotores for mentorship and follow-up. The new promotores completed 119 home visits, reached 219 women, 164 men and 113 children with health education and promotional activities and referred 32 individuals to the clinic for services, including cervical cancer screening, vaccination or treatment for acute and chronic medical conditions.

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IMPACT REPORT 2023-2024

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I feel like I’m learning many things to be able to discuss with the community and support the doctors. I hope they continue to come and that they don’t forget us.” — Isabella, promotora de salud from Colonia Agrarista I just got my pap smear, so I am more aware of the prevention of certain diseases. There were things I didn’t know in depth or what they were all about. Now that I know them, I can communicate them to neighbors and relatives.”

— Martina, promotora de salud from San Francisco Xochiteopan

(PAGE 17) Pasantes review breast anatomy at a cancer prevention workshop in Puebla.

(THIS PAGE, TOP IMAGE) Pasantes carry research equipment to their next site visit. (BOTTOM IMAGE) The eco-stove team evaluates a rural home kitchen.

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EDUCATION

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EDUCATION KENYA From Austin to Eldoret and Back: Bilateral Trainee Exchange Students from Dell Med and Moi University School of Medicine broadened global health perspectives and built connections in a bilateral exchange elective under AMPATH Kenya.

To date, eight fourth-year Dell Med students completed the spring clinical elective in Kenya.

In its first-ever international medical student exchange in fall 2023, Dell Med received two Moi University students for a month of clinical rotations while UT’s School of Nursing hosted two Moi nursing students. Alongside thirdyear Dell Med residents in internal medicine, pediatrics, neurology and psychiatry completing similar rotations in Kenya, students were accompanied by faculty supervisors from each department. Upon returning home, they expressed powerful insights on working with diverse teams, learning about health contexts in each country and cultivating cultural humility to serve patients.

(PREVIOUS SPREAD, LEFT TO RIGHT) 1. The first ever Moi University School of Medicine students at Dell Med in Austin. 2. Dr. Cook celebrates Día de los Muertos with BUAP pasantes in Puebla. 3. Dell Med students, residents and fellows run a simulation together in Eldoret.

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“

STORY

STORY

STORY

Bringing Global Health Perspectives to Austin

AMPATH Kenya Delivers Fulfilling Experience in Health Care

Building a Two-Way Street: Global Education From Texas to Kenya ... & Back

Our Kenyan colleagues invited us into their health care system to learn, to their tables to

“

We could really see the impact of sustained global health across 30

“

I’m happy to be connected to people from a different cultural background.

enjoy meals together and into their community

years, and it’s a bilateral exchange.

Now I know how to interact with people

to engage and understand population health

The fact that they can come and

with different perspectives from my own.

and community healing. I am forever grateful to

rotate here in the U.S. so that we can

I learned how to take ownership of the

the Moi Teaching and Referral Hospital and Moi

exchange knowledge is really special.

treatment plan, to be secure and not be

University School of Medicine as well as Dell

Just coming back from Kenya and

afraid of saying the wrong thing. Here,

Medical School for providing this opportunity

having that experience really shifted

they encourage you to go ahead and say

to work and study in Kenya. It has forever

the way that I will see and practice

what you’re thinking.”

shifted the way I view global health and global

medicine.”

— Glory Mutheu, 2023 Moi University

responsibility as a future physician.”

— Maliha Khan, Dell Medical School

School of Medicine exchange student at Dell

— Cody Cowley, Dell Medical School student,

student, Class of 2022

Medical School

Class of 2023

(LEFT TO RIGHT) 1. Cody Cowley in a simulation with faculty and fellows. 2. Maliha Khan with Dr. Tim Mercer and students in the inaugural cohort. 3. Glory Mutheu in Austin on cardiology service.

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EDUCATION MEXICO Enhancing Care for Austin’s Spanish-Speaking Patients: Trainees in Puebla In 2022, noting the need in Texas for care providers with Spanish-language skills, the Department of Pediatrics created a three-week language immersion elective in Puebla for six residents annually. To date, twelve pediatric residents and one fellow participated in this transformative experience, inspiring the Department of Psychiatry and Behavioral Sciences to launch a similar program in 2024 for three of their residents. Dell Med students have also joined exchange opportunities in Puebla, including visiting communities with the AMPATH/ MAPAS México care team and forming relationships with BUAP peers, participating in virtual exchange courses on migrant health, conducting a research project on cervical cancer screening and helping Dell Med develop asylum clinics and student electives.

STORY Graham Aufricht: Breaking Down Language Barriers

“

This initiative was born out of my own struggles with Spanish communication and the resulting frustration I experienced in failing to fully connect with my patients who primarily spoke Spanish. Recognizing the critical role language and cultural understanding play in effective health care, I was motivated

Sharing U.S.-Mexico Health Expertise: Seminar Series Connects UT and BUAP

Global Virtual Exchange: Learning About Migrant Health and Physician Advocacy

A global health seminar series, presented jointly and virtually by UT and BUAP experts, expands knowledge on topics impacting patients in Central Texas and Puebla. From August 2023 to July 2024, eight seminars served as a monthly, bilingual learning opportunity to 846 health professionals, trainees and others across institutions and countries — including practitioners from Mexican health facilities. Experts trade challenges and innovations in cervical cancer, community traditions in medicine, breast cancer and oncology, HIV, diabetic emergencies, pediatric oncology, kidney transplants and therapeutic use of THC and psychedelics/MDMA.

Through a Global Virtual Exchange grant from Texas Global, 20 Dell Med students and 29 BUAP students teamed up for a Collaborative Online International Learning course on migrant health in fall 2022 and spring 2024, culminating in op-eds and position papers to connect their learning to the real world.

“

Our Global Virtual Exchange allowed medical students and faculty from both sides of the border to gain a more nuanced and inclusive perspective on migrant health. As global faculty peers,

to establish a medical Spanish and

we developed new strategies to facilitate

cultural immersion elective in Puebla,

multilingual and multicultural group

Mexico, for our pediatric residents. The

dialogue and projects. In a subject

partnership between Dell Med and BUAP

area that is heavily polarized in the

medical school in Puebla, Mexico, aims

media, we were able to create a learning

to develop an interdisciplinary approach

environment based on curiosity, critical

to creating high-quality health care,

analysis of structural influences and

education and research collaborations.

a commitment to learning from the

It serves the mutual interests of

lived experiences of migrants. Medical

medical faculty, students and the local

students learned how to leverage their

community in Puebla. One facet of

role as physicians to advocate for

this project is our language elective,

patients.”

an area where pediatrics is excited to

— Dr. Rebecca Cook, Dell Medical School co-

lead. I firmly believe that this program

instructor for the “Global Health: Exploring

is a critical stride toward delivering the

Two Sides of Migrant Health” course in

highest standard of care to our Spanish-

partnership with BUAP Facultad de Medicina

speaking patients and families in Austin, and I am proud of the positive impact we’re making.” — Dr. Graham Aufricht, pediatric emergency medicine fellow

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IMPACT REPORT 2023-2024

(LEFT TO RIGHT) 1. Graham Aufricht in Austin, 2. BUAP faculty Dra. Minou with Dell Med psychiatry residents during their language immersion elective in Puebla.

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EDUCATION GLOBAL TO LOCAL: AUSTIN Global Health Grand Rounds: Bringing Worldwide Experts to Dell Med The Dell Med Global Health Grand Rounds series is a forum on the most pressing issues in global health.

Invited clinicians, experts and leaders from partner countries and beyond share in-depth knowledge and inspire ongoing involvement in care, education and research. In three years, Grand Rounds hosted eight total events with a cumulative 254 attendees, where experts explored dynamics of power in global health, planetary health and decolonizing global health. Events offered participating clinicians continuing medical education credit (CME), and recordings for both Global Health Grand Rounds and U.S.-Mexico Seminars are available online.

Building a Foundation: First Year-Enrichment Elective In his Foundations in Global Health elective, Division Chief of Global Health Dr. Tim Mercer encourages first-year Dell Med students to learn more about foundational topics in global health, network with other global health faculty at Dell Med, pursue independent study and professional opportunities in global health, and engage with the Global Health Student Interest Group. Since its launch in 2017, over 55 students interested in a global health career track completed the course, with eight students in the 2023–2024 academic year.

(BELOW) Global health leaders and practitioners speak at the inaugural Dell Med student group-led Global to Local conference in 2019.

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IMPACT REPORT 2023-2024

Peer-To-Peer Connections: Global Health Student Ambassadors and Global Health Equity Elective As part of the bilateral exchange program, the Global Health Student Ambassadors elective connects Dell Med students with international medical students visiting Austin for global health, clinical and cultural learning. Launched in fall 2023, two third-year and two fourth-year students accompanied the first-ever visiting Kenyan medical students during their six-week rotation in Austin in this inaugural year. Ambassadors supported visiting students’ adjustments to life in America, clinical sites and intercultural adventures. In a specially created weekly global health equity elective with AMPATH-involved Dell Med faculty, the Ambassadors and visiting Kenyan medical students swapped lessons and innovations from both Kenya and the U.S. on health systems, medical education and the social and structural determinants of health.

Global to Local: Student Interest Group in Action The Dell Med Global Health Student Interest Group, advised by Dr. Tim Mercer, hosts annual events and shares opportunities for local student engagement in global health. In May 2024, the group hosted 28 Dell Med and School of Nursing faculty, students, residents and fellows for a dinner seminar to discuss the timely “Impacts and Implications of Health Care Strikes” in the U.S. and Kenya. Speakers included researcher Michael Scanlon from Indiana University, nurses’ union organizers in Austin, the previous year’s cohort of student Ambassadors and Moi University students, who traded questions and perspectives on the April 2024 nationwide health care workers strike in Kenya.

(BELOW) Division chief Dr. Tim Mercer says farewell to visiting Moi students at the end of their clinical rotation in Austin, along with Dell Med global health staff and student ambassadors.

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STORY Co n t r i b u t i n g to G l o ba l H ea l t h Dialogues at FILUNI

“

Texas and Mexico are neighbors. We share a border. We share a similar disease profile. We share many of the same challenges, and we have a lot to learn from one another. Together we can better address these challenges to solve the pressing global health problems

(ABOVE) Global health student Alexander Chu (center), with peers and teammates in Lima, Peru.

EDUCATION EXPANDING IMPACT Tuberculosis is a top killer in infectious diseases worldwide, despite being preventable and treatable. Dell Med student Alexander Chu wanted to understand how community-based interventions could potentially impact this high burden. In the outskirts of Lima, Peru, Chu took part in an international study — with Dell Med faculty Dr. Tim Mercer and Dr. Brandon Altillo advising — on how providing comprehensive mental health care affects depression and multidrug-resistant tuberculosis treatment outcomes.

“

At the 2023 Feria Internacional del Libro de las Universitarias y los Universitarios (FILUNI) — the annual book festival and conference at the Universidad Nacional Autónoma de México (UNAM) in Mexico City — the AMPATH/ MAPAS México team was part of the largest international delegation in UT’s history. More than 140 representatives from 23 UT units traveled to the event, which attracted 42,000 attendees from 11 countries.

of our day and better improve the health of our communities. For us at UT, forming a collaborative partnership in Mexico is incredibly important, and we are thrilled with the opportunity to work and learn together with our BUAP colleagues. Specifically, our goal is to partner and engage with local communities and the Ministry of Health to transform primary health care in rural lowincome communities, starting in Puebla,

Research can and should be an

to better address chronic illnesses such as

important tool to not just generate

diabetes, heart disease and cancer.”

evidence but also catalyze and

— Dr. Tim Mercer, chief of the Division of Global

drive social change toward reducing inequities. At the heart of my research interests, I am driven

(BELOW) Dell Med’s Dr. Tim Mercer, Dr. Rebecca Cook and Dr. Ricardo Ainslie with Dra. Lis Rosales Baez and dean Dr. Luis Vazquez de Lara Cisneros of BUAP’s Facultad de Medicina present at FILUNI.

Health, Dell Medical School

by meeting individual patients, learning their stories and better understanding their communities.

They all center and remind me of what we’re doing and why we’re doing this.”

— Alexander Chu, Dell Medical School student, Class of 2024

STORY Lessons Learned From a Global Classroom: Improving Tuberculosis & Mental Health Care

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(LEFT) The first-ever cohort of Dell Med students at Moi Teaching and Referral Hospital.

(ABOVE) Student leaders host their annual kickoff event at Dell Med for the Global Health Interest Group.

(RIGHT) The Dell Med cardiology team welcomes their visiting Kenyan medical student.

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RESEARCH

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RESEARCH KENYA Empowering UT Student Researchers and Moi Nursing Students Through Exchange Following years of friendship and mutual learning, the UT School of Nursing completed their firstever student exchange with Moi University in the summer and fall of 2023 to advance patient-centered innovations. Two Moi nursing students were in Austin for six weeks to observe labs, attend classes and present wound care project findings to a global health conference at The University of Texas Medical Branch in Galveston. Earlier in the year, they had been part of a project funded by the UT President’s Award for Global Learning, in which a team of 14 UT undergraduate students – including two nursing students – collaborated with Moi University in Kenya. Together, the students observed Kenyan nurses in action, studied barriers to treatment, built wound prevention prototypes with locally sourced materials, and created training tools in English and Swahili.

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STORY UT Austin School of Nursing Hosts Exchange Students from Kenya

“

Having a connection to the school in Kenya means that our students can have real-life experiences with global health.

Research Relations: Stroke and Heart Disease Studies •

Global health experts at Dell Med and Moi University launched studies to strengthen patient care in low-resource settings and improve workflows at Moi Teaching and Referral Hospital (MTRH). Dell Med neurology faculty and residents are actively working with Moi University clinical teams to develop research on stroke diagnosis and management.

•

Two Dell Med internal medicine faculty members and faculty from UT Cockrell School of Engineering, MTRH and Duke University are using artificial intelligence to create portable models for detecting rheumatic heart disease.

This research is made possible by a Faculty Research Seed Grant from Texas Global and an Incubator Award from the Office of the Vice President for Research.

Finding the similarities between us and Kenya adds to the global profession of nursing. We are able to elevate the visibility of nurses and nursing students

(LEFT) Dell Med students connect with visiting Moi nursing students during their research exchange at UT’s School of Nursing.

from both schools. With my Kenyan colleagues, we are creating nursing leaders for not just Texas or Kenya but for the world.”

– Dr. Julie Zuñiga, wound care research team faculty lead, UT School of Nursing

(PREVIOUS SPREAD, LEFT TO RIGHT) 1. Day one of Puentes, a research summit that joins experts from UT and BUAP to address health challenges.

2. A presentation by the school nutrition and garden development team, which aims to promote health and prevent diabetes. 3. The Mental Health Working Group meets during Puentes to brainstorm interventions and initiatives to address mental health.

(BELOW) Dr. Zuniga and the President’s Award for Global Learning students in Kenya.

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2023 Puentes Presenters and Attendees •

UT Austin’s Dell Medical School, School of Nursing, the Department of Nutritional Sciences in the College of Natural Sciences, the College of Liberal Arts, and the Steve Hicks School of Social Work

•

Benemérita Universidad Autónoma de Puebla’s schools of medicine and nursing, Instituto Nacional de Salud Publica, Secretaria de Salud del Estado de Puebla, Fundacion Comunitaria de Puebla and Fondo Mónica Gendreau

•

AMPATH Global, including leadership from Indiana University, Purdue University, Kaiser Permanente and the Council of Canadian Academies

(ABOVE) Participants pose at the closing of the 2023 Puentes summit at BUAP in Puebla.

RESEARCH MEXICO Puentes: Bridging Health Innovations Across the MexicoTexas Border Since 2019, Puentes — “bridges” — connects UT and Mexican scholars who are tackling common challenges from both sides of the border in a multiday research summit. In October 2023, over 80 health experts from multiple institutions gathered at BUAP to share knowledge and further pursue the community health interests of rural Puebla and Central Texas. After attending context-setting talks on Mexico’s overarching health priorities and presentations of challenges identified by the involved pilot communities, eight cross-institutional working groups came together to trade expertise, highlight real needs in Central Texas and Mexico, and brainstorm innovative, targeted solutions.

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STORY Dell Med’s Division of Global Health & BUAP Teams Build New Bridges in Puebla, Mexico

“

This is an exciting time in the evolution of the AMPATH/MAPAS México partnership. For several years now, we’ve been working to develop our relationships and plan the structure and the goals of this partnership. But today we move into implementation phase, with teams of faculty members poised to roll up their sleeves and get to work.”

— Dr. Tim Mercer, chief of the Division of Global Health at Dell Med

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RESEARCH MEXICO AMPATH/MAPAS México working groups in action For implementation support, many teams applied for AMBIA – the AMPATH Mexico Bilateral Innovation Award — an internal seed fund set up for immediate cross-border collaborations.

Cardiology: The group aimed to assess cardiovascular risk in two rural Puebla communities, as well as facilitate and manage patient treatment through education and job aids to local providers.

Diabetes: As an AMBIA seed grant awardee, this group aimed to identify diabetes knowledge and at-risk patients in rural Puebla communities. An abstract was accepted for presentation at the AMPATH Global Nursing Conference in Eldoret, Kenya, in May 2024.

Evaluation: The group aimed to identify available and scalable public health datasets and data storage resources at BUAP that meet other AMPATH/ MAPAS México Working Groups’ needs for management and analysis.

Health Professions Education: As an AMBIA seed grant awardee, this group developed a workshop in July 2024 focused on improving professional efficacy and career satisfaction for pasantes through social-emotional competency training for community-based work (communication, trust building).

Maternal Health: The group is exploring possibilities in adolescent friendly reproductive health care and interpregnancy care.

Mental Health Bienestar: As an AMBIA seed grant awardee, the group launched a Photovoice project that used photography to boost emotional well-being for youth. Fifty students participated in focus groups, and 20 parents and teachers attended the final exhibit in 2024. They presented at the 2024 UT School of Nursing’s Center for Health Promotion and Disease Prevention Research conference with abstracts submitted to the Council on Social Work Education and the Society for Social Work Research. The team is leading an implementation training in fall 2024 for BUAP professionals, FCP/ FMG partners and community teachers.

Mental Health: As an AMBIA seed grant awardee, the team trained primary health care providers on common mental health topics, such as perinatal depression and anxiety and post-traumatic stress disorder, using the Project ECHO peer teaching model. With 27 mental health clinicians in Puebla and eight in Austin enrolled in the training platform, 100% of post-session surveys found that participants were looking forward to infusing their learning into patient care. An abstract of their work was submitted to the 2024 Academic Psychiatry conference and manuscript to a Mexican medical education journal.

Nutrition: As an AMBIA seed grant awardee, the team also leveraged NIH funds to develop a nutrition education program alongside a hydroponics garden and rainwater collection system at a middle school in rural San Francisco Xochiteopan.

Oncology: The team is designing and implementing a survey on patient knowledge of breast cancer and pre-diagnosis screenings.

Palliative Care: As an AMBIA seed grant awardee, the team planned to conduct focus groups in Puebla and Austin to inform training on culturally appropriate palliative care for Spanish-speaking patients.

STORY Project ECHO & Global Health Converge at Puentes Summit

“

I take care of a lot of patients whose families come from Mexico, particularly in my school-based care clinics for Integral Care.

They’re always delighted to hear about my relationship with Puebla and my commitment to helping Mexico as well as to not to have to use a translator and just speak with me directly. I think it helps build their confidence in me as their child’s provider.”

— Dr. Claire Selinger, psychiatry faculty at Dell Med

(BELOW) Joint BUAP-UT Mental Health Working Group Implemented a PhotoVoice project to explore the perspectives and priorities of youth in their mental health.

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Letter from the Division Chief: Looking Forward As we reflect on our accomplishments and celebrate our global impact, we are constantly looking ahead.

How can we deepen our engagement with our partners? How can we scale our work to new locations or to serve more diverse populations? How can we expand our collaborations to grow our interdisciplinary reach and expertise so we can solve more problems?

AMPATH offers a clear platform and network within which we can deepen our impact and spread our reach. At UT — with the incredible breadth of expertise on these Forty Acres — we have an unparalleled opportunity to tap into a vast community of scholars and practitioners poised to help us tackle the global health challenges of our day. Diabetes and cardiovascular disease alone are affecting close to half of the world’s adult population, especially in the countries where we work. Climate change is affecting all of us but disproportionately those countries — like Kenya and Mexico — whose environments, policies and positionality in the world make them more susceptible to the subsequent health risks. These challenges, among many others, will require us to fully immerse ourselves, providing care for communities in need.

They will require us to think deeply about how to pose questions and test solutions to advance systems of care and advocate for needed policy change. And our students are passionate and ready to learn, to serve and to be advocates for change.

Moving forward, the Division of Global Health at Dell Med is excited about its next phase of growth. We plan to: • Implement a comprehensive health workforce development and care program for non-communicable diseases (diabetes, hypertension and cardiovascular disease risk) in rural Puebla, Mexico; • Build a robust infrastructure in informatics and data science to support care delivery and research efforts with AMPATH/MAPAS México; • Deepen our engagement with AMPATH Kenya in cardiology, cardiothoracic surgery, neurology, internal medicine and pediatrics; • Create new opportunities for our students and trainees through multilateral educational exchange programs across AMPATH sites; and • Launch a University-wide initiative in global health to formalize and grow our interdisciplinary collaborations and reach.

We look forward to the year to come! Thank you for your collaboration and support! As you read through this impact report, I hope you are as inspired as I am by the achievements of the Division of Global Health.

Together, we are defining the future of health — locally, nationally and globally — and I look forward to continuing this important work with all of you.

Sincerely, Tim Mercer, M.D., MPH, FACP Chief, Division of Global Health Dell Medical School The University of Texas at Austin

(ABOVE) The Division of Global Health with BUAP Facultad de Medicina leadership at Dell Med.

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ACKNOWLEDGEMENTS The Division of Global Health thanks the following collaborators and supporters for their generous engagement with this year’s wide-reaching efforts in care, education and research: The University of Texas at Austin, including Dell Med’s Department of Population Health, School of Nursing, the College of Education, the Office of the Vice President for Research, the College of Liberal Arts including the Teresa Lozano Long Institute for Latin American Studies, and Texas Global.

AMPATH Global, Benemérita Universidad Autónoma de Puebla Facultad de Medicina and Facultad de Enfermeria, Fondo Mónica Gendreau, Fundación Comunitaria de Puebla, Instituto Nacional de Salud Publica, Kaiser Permanente, Moi University, Moi Teaching and Referral Hospital, Secretaria de Salud and University of Virginia’s Department of Emergency Medicine.

Astellas Access to Health Initiative, Eli Lilly and Company, and private donors.

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DIVISION OF GLOBAL HEALTH DEPARTMENT OF POPULATION HEALTH DELL MEDICAL SCHOOL THE UNIVERSITY OF TEXAS AT AUSTIN 1601 Trinity St., Bldg. B Austin, Texas 78712 dellmed.utexas.edu @DellMedSchool