1. The Patzcuaro Center of Excellence: Translating Academic Excellence into Community-Based Healthcare in Rural Mexico Heartland Alliance for Human Needs & Human Rights Department of Family & Community Medicine

2. Presentation Outline  Overview of Poverty Medicine Collaborative  Heartland Alliance  Northwestern University  Poverty Medicine  Mujeres Enlazadas (local NGO)  Student Involvement  Future Challenges

3. Presentation Objectives  1) Understand the value of collaborating with a community-based organization to engage in a process of shared learning and programmatic capacity development  2) Learn about how to utilize medical students' strengths in assisting community-based health programs in the developing world  3) Identify mutual areas of interest that bridge academic institutions and primary care facilities in underserved communities both locally and globally.  4) Develop useful transnational educational settings that enable medical students to learn more about the dynamic nature of the communities in which they serve.

4. Heartland Alliance  Human Rights, Service Based Organization  Serving over 200,000 per year  4 Buckets:  Health Care  Housing  Economic Security  Legal Protection  Offices and Programs in the U.S. and 12 other countries worldwide  www.heartlandalliance.org www.heartlandalliance.org

5. Global Health at NUFSM  Center for Global Health  Coordinating body  Office of International Program Development  Structured clinical and public health experiences in four established locations (Mexico, Uganda, South Africa, China)  Office of Medical Education  Traditional study abroad and rotations in developed countries  Department of Family and Community Medicine  Global Health Initiative – travel award for away rotations and public health projects  Technical assistance for Heartland Alliance international operations

6. Affiliated FSM Global Health Programs n Asia: –China –Japan –Taiwan n Europe: –France (3) –Germany –Spain –Sweden n Latin America: –Belize (NGO) –Bolivia (NGO) –México –Guatemala (NGO) –México (NGO) n Africa: –South Africa –Uganda

7. Poverty Medicine n The practice of medicine in populations where low socioeconomic status (specifically Poverty) is the primary determinant of poor health

8. Poverty Medicine Collaborative - History  Initial discussions in 2006  Affiliation agreement in 2007  Poverty Medicine Collaborative in 2008 focusing on Clinical services, Research and Education  As of 2008, staffing of the collaborative includes 0.4 FTE Vice Chair for Community Medicine and Full time Coordinator

9. GOALS  Increasing access to high quality health care for individuals and families living in poverty and danger  Providing training, service and research opportunities for medical students and health care professionals.

10. centers for excellence in poverty medicine Chicagoglobal Rogers Park, Albany Park,Guatemala, Mexico, UptownMalawi, Belize Poverty Medicine Collaborative Department of Family Medicine researchclinical care trainingadvocacy

11. CPMC Centers for Excellence  Bridge between large academic and tertiary care institutions and economically and geographically isolated communities  Each Center of Excellence will offer:  High Quality Health Care  Training Opportunities  Research Opportunities  Capacity Building and Advocacy for Local Communities

12. Center of Excellence: Mexico  Center of Excellence: Patzcuaro, Mexico  Clinical Care: Maternal Services  Clinical Training: 2 students completed electives in Summer ‘09  Research Potential: Maternal and Child Health Needs Assessment, Cervical Cancer, Medical Oppression of Women  Capacity Building & Advocacy: Developing a statewide midwifery model of care and training

17. Mujeres Enlazadas n The mission of Mujeres Enlazadas is to: “…advance the lives of poor women and adolescent girls in the Lake Pátzcuaro area of Michoacán, México through the provision of health and educational services in partnership with the community and in a manner which enhances the dignity of women, with an emphasis on an integration of traditional and occidental health and educational modalities.”

18. Mujeres Enlazadas  Activities  Clinical Care  certified nurse midwife, ob/gyn services  “La Clinica Juchari” dedicated to delivering low-cost, high-quality health care to indigenous people in the area.  Community Outreach  free workshops on health education and conferences in conjunction with local professionals.  Nurse Midwifery Education  intention to open a school in 2010 that will prepare and graduate certified nurse midwives

19. Benefits for Mujeres  Student – led research  Community Needs / Assets Assessment  Technical assistance by PMC staff  Grant-writing and program management  Academic research infrastructure  Assistance with patient intake, community outreach, and health education  Credibility of large academic institution and large NGO

20. Benefits for Students  Cultural Competency  Epidemiological Profile of third world  Clinical Skills  Language training  Exposure to different kinds of healthcare providers (ie. Midwives, TBAs)  Increased understanding of poverty medicine

21. Benefits to PMC  Sustainable community presence  Translation of theory into practice  Research site  Clinical Training  Lessons Learned via Multisectoral collaboration  Capacity-strengthening and leadership development of local health workforce

22. Challenges  Indentifying funding for pre-service nurse midwifery education  Satisfying interests of multiple parties – public, private, community, academia, students  Limited engagement with politically sensitive topics  Participation of students with adequate skill set  Building research capacity to identify needs

23. Questions n Did we leave anything out? –Bechara Choucair, MD bchoucair@heartlandalliance.orgbchoucair@heartlandalliance.org –Adam Koon, MPH a-koon@northwestern.edua-koon@northwestern.edu