Exploring partnerships in India

In 2015, Osler took the world by storm as a five-member clinical team traveled to Punjab, India as part of our Global Health Program. This was the first international tour as part of this Program.

Now we're on the second leg of our journey, and the team is returning for hands-on work. The team is in India from April 14 to April 30, 2016. During the tour, team members will work with a number of health care and hospital partners to deliver on-the-ground care, participate in teaching opportunities, and learn from providers in Punjab.


Global Health India Reflections

June 6

 

It has been one month since the second Global Health team returned from India where they were busy developing partnerships with three hospitals in the Punjab region. Each member has been reflecting on the experience and we wanted to share some of their thoughts in this post-trip blog. We invite you to read their responses to a short Q&A that highlights their most memorable experience on the trip, key learnings, and advice to those who are interested in the program!
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DR. NAVEED MOHAMMAD
Vice-President Medical Affairs
Global Health Program Physician Lead

What was the most memorable moment for you on the Global Health trip?

Signing the Memorandum of Understanding with Apollo and Dayanand Medical College & Hospital (DMCH). The fact that we could do that across such vast distances really reinvigorated my faith in collaboration and partnerships.

Making friends with people from India and Pakistan. I travelled to Pakistan on my own at the end of the trip to explore partnership opportunities with an organization called Childlife. Childlife is doing extraordinary work for the underprivileged in the slums of Karachi and I see great opportunity for us to work with them.

At the end of the day, despite being so far apart we all want the same – the best for the patient!!

What is one thing you learned on the trip that will influence the way you provide care at Osler?

As maligned as the Ontario Health Care System is, it still provides equal access to care for those that really need it, regardless of economic status. In other countries, affordability is a life and death issue. We should be thankful for what we have.

What would you say to someone who is thinking about getting involved in the Global Health Program?

Go for it, be patient, be enthusiastic. It opens your mind, your heart, your eyes and many opportunities to make a difference!

DR. GURJIT BAJWA
Emergency Medicine Physician

What was the most memorable moment for you on the Global Health trip?

My greatest impression is the great burden of disease that exists in the world and the incredible lack of access to care. We are extremely fortunate to have access to the best health care in the world. And we do not have to sell our house to get it. I am incredibly pleased to be part of an organization that is thinking outside of its own confined borders. I can only wish that more organizations and healthcare professionals would think this way. Selfless service is desperately needed in all corners of the world.

What is one thing you learned on the trip that will influence the way you provide care at Osler?

I have always been aware of how socio-economic factors affect health. But seeing it at an extreme has heightened my awareness now. I also now appreciate more the burden of mental health disease in our community and all across the world. I now incorporate more inquiry into these factors during my interviews with my patients. I hope that this will make me a better doctor.

What would you say to someone who is thinking about getting involved in the Global Health Program?

I would highly encourage any person to get involved in some way in one's own community and abroad. This is a great way to develop professionally and personally and, at the same time, make the world a better place. Even if one does not get to participate in an international tour, there are opportunities to get involved at a local level.

DR. DAVID KOCZERGINSKI
Chief of Psychiatry and Medical Director of Mental Health & Addictions

What was the most memorable moment for you on the Global Health trip?

As I reflect on the Global Health trip my most striking memory is the sincere welcome, appreciation and engagement from our clinical partners at both the DMCH and Shaheed Kartar Singh Sarabha (SKSS). We have embarked on two distinctly different relationships, each with opportunity for meaningful sustainable collaboration and impact on patient care across continents.

What is one thing you learned on the trip that will influence the way you provide care at Osler?

I was struck by the impact of health care systems, socioeconomic factors, cultural beliefs and family values on the experience of an ill individual. I will think more about issues of affordability and accessibility of health care, availability of public health, bias related to gender, culture or mental illness, the availability of caring relationships and how all of these factors affect my patient.

What would you say to someone who is thinking about getting involved in the Global Health Program?

The Global Health Program is a unique cultural and professional experience. An unforgettable experience shared with colleagues. An innovative ambitious project for our hospital. Be involved through planning, research, video conferences, or in person education and care.

WENDY ROSS
Clinical Services Manager – Mental Health & Addictions

What was the most memorable moment for you on the Global Health trip?

I have so many memorable moments from the work that we accomplished at each health facility that we went to in India; however, working with the individuals and their families at SKSS in Sarabha Village outside of Ludhiana city during the one day Mental Health and Addictions Camp was very rewarding. Identifying the mental health and addiction problems, as well as helping the individuals and their families to find a solution or resource to help them given the limited resources was most challenging. Nonetheless, they were most grateful for any support and advice that was provided to them.

What also made this experience enriching was that I was able to teach the nursing students about the stages of change that people go through in their journey towards recovery from an addiction (a common problem). The nurses were very interested and grateful for this, adding to my heartfelt memorable moments at Sarahba.

What is one thing you learned on the trip that will influence the way you provide care at Osler?

Where appropriate, it is very important to include the family of many of our patients in the assessment, intervention, and care options. However, if the family member is not a substitute decision maker, we must still obtain consent, unlike in India where privacy is not viewed the same way. Often, it is a family member that will help the patient as that is who the patient is most influenced by. We must understand the dynamic of the family in order to help us provide the best treatment for the patient, and one that the patient will accept more readily.

What would you say to someone who is thinking about getting involved in the Global Health Program?

This was a life changing experience. Not only for the opportunity to provide seva (the Punjabi word for selfless service), but also to be part of the building of health care partnerships that ultimately will enhance care for people living on two different continents. Also, the experiential learning is invaluable, and the camaraderie built with our own colleagues at Osler is irreversible as we have shared such rewarding experiences. This is what you can expect from getting involved.

SHUBJHIT MINHAS
Geriatric Mental Health Nurse – Mental Health & Addictions

What was the most memorable moment for you on the Global Health trip?

Looking back at the Global Health trip, my most memorable moment is without question the two day camp that was held at SKSS. I believe that in those two days I was able to accomplish from a humanitarian perspective something that I may not have ever had the opportunity to achieve.

What is one thing you learned on the trip that will influence the way you provide care at Osler?

I was amazed at how involved family members were in direct patient care and that they were right at the bedside. I believe that the time that family members invest in patient care at the bedside impacts the patient’s healthcare outcomes in a more positive way than the absence or minimal involvement of family in patient care. 

What would you say to someone who is thinking about getting involved in the Global Health Program?

Many of my colleagues that I work with at Osler and even outside have asked me about my experience in India and the overall Global Health Program. I have tremendous feelings and emotions attached with the trip that words fall short at times when I attempt to even begin to describe how incredible these two weeks have been for me. I am at the very beginning of my career, with hopes, determination and a dream to accomplish so much more than I have so far, hence the global health trip has been a stepping stone in that direction and I would absolutely recommend it to those young nurses who are passionate about nursing.

DARRYL YATES
Clinical Director of Mental Health & Additions

What was the most memorable moment for you on the Global Health trip?

At DMCH, standing at the foot of the bed of 17 year old boy with viral pericarditis in the ED-ICU with Drs. Bajwa and Mohammad. I watched the physicians interact with the family knowing that the boy would not live through the day, and afterward coming to understand how this will have long term negative implications for this family not only emotionally but economically.

Also, participating in making ‘Osler history’ with the formal signing of MOUs with DMC Hospital and Apollo Hospitals, which forges formal partnerships between our organizations, creating tremendous potential.

What is one thing you learned on the trip that will influence the way you provide care at Osler?

In all three organizations that we worked with we observed how intimately involved family members are with their loved ones when they are in hospital. There is always at least one family member with patients at all times.

We talk in Ontario/Canada about efforts to include families in patient care and planning services, which is now embedded in throughout the Accreditation Canada standards. I have a whole new appreciation for family involvement and support in patients’ wellbeing and recovery and as a result I will be looking for new and additional ways to incorporate families in the most meaningful ways in the three programs I am responsible for at Osler.

What would you say to someone who is thinking about getting involved in the Global Health Program?

Participating in the Osler Global Health Program was an incredible life experience both professionally and culturally. Any Osler staff or physician who has the opportunity, courage and desire to participate should apply. You will develop relationships with Osler peers and those from abroad like you never imagined! Note: You must have resilience, fortitude and be open minded/flexible to succeed as part of such a team.

DEBORAH CHURCHILL
Manager, Partnerships & Proposals
Osler Foundation

What was the most memorable moment for you on the Global Health trip?

I could probably fill a book with memorable moments from the trip, but if I have to pick just one I think it would be shadowing Dr. Koczerginski, Wendy and Shubhjit while they participated in rounds on the mental health inpatient unit at DMCH. It was such a surreal and intensely moving experience – one that really demonstrated for me both the enormous challenges that exist in mental health care in India, particularly around stigma, as well as the role of the family in the care process (there is a family attendant at the bedside of every patient 24/7) and what we could learn from this important cultural practice to improve the patient experience here at Osler.

What is one thing you learned on the trip that will influence the way you provide care at Osler?

As the only non-clinical member of the team, I obviously won’t be providing direct care to patients at our hospitals! You can breathe a sigh relief now. However, my experience on this trip will absolutely influence the work I do at the Foundation, both in fundraising for the Global Health Program and for the capital and redevelopment needs of our three hospitals. I leave India with a long list of compelling stories to share with our donors and the community at large about the truly unique work we are doing at Osler to improve care on two different but deeply connected continents. I also leave with a better understanding of the meaning of volunteerism and charitable work (Seva) in the Punjabi community and how this influences and inspires philanthropy.

What would you say to someone who is thinking about getting involved in the Global Health Program?

I’d say go for it! If you have the opportunity to participate and believe you would add value to the program you’ll be a better person for doing so. Keep your eyes open for the next call for applications.


Bonus post: Dr. Mohammad's solo trip to Pakistan for future partnerships
April 30

 

Seven members of Osler’s eight-member Global Health team are back home in Canada – jet-lagged and excited to share the incredible experiences (and lots of photos) soon. While most of the team has returned to their regular routine at home – I have had the opportunity to visit neighbouring Pakistan to explore potential partnerships in that country. The team is hosting a Global Health Lunch & Learn Sessions in early June at Osler – stay tuned for more details.
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As this is a new and important exploratory partnership opportunity, I want to share my experiences and photos with you.

The Osler Global Health Program has touched down in Karachi, Pakistan. After some very promising achievements in India during the last 12 months, it is now time to explore how Osler can contribute to, and learn from, health care providers in Pakistan. The focus of the exploratory trip is the health of children and the most poor in Karachi the third largest city in the world!

Leading this important work are two phenomenal not for profit organizations – SINA Health Education and Welfare Trust and Childlife Foundation – who are working together with a shared vision to provide quality primary healthcare to the less-privileged in Pakistan. SINA and Childlife Foundation have done tremendous work in the last nine years to improve access to health care in the poorest parts of Karachi. This includes building two state-of-the-art Pediatric Emergency Departments and 20 free-standing primary care clinics in the most vulnerable slums of the city. Soon they will launch their first water treatment and distribution plants in a local slum.

All of these important services are at minimal to no cost to the patient.


A visit to the ED is free and includes all services. A visit to the clinic can range from 5-30 Pakistani rupees (6 to 35 cents Canadian) depending on how you qualify and, once again, includes all services and drugs. The water treatment plant will sell clean, fresh, treated and filtered drinking water at approximately 1 rupee per litre (1.3 cents per litre). The plan is to open many more such plants.

The two EDs see anywhere from 400 to700 patients per day, with peaks of 1,000 patients during the heat waves of June and July. The EDs have excellent quality assurance and continuing medical education programs, as well as a first-of-its-kind triage system. The EDS utilize order sets, promote hand hygiene, and employ patient concierges and navigators. The demand overwhelms the available resources, but the dedicated ED staff espouse compassionate care for all who arrive. They help the most vulnerable and poor through simple, yet powerful, measures --immunization, hygiene, access to primary care and emergency care -- all at minimal to no cost to the patient.







Together, SINA and Childlife Foundation are currently working on a strategy for the predicted heat wave of June and July, recruiting medical students to go to homes, mosques and schools to distribute pamphlets on how to protect yourself from the heat and how to recognize heat exhaustion and stroke. They have already secured shelters in the slums to be used as cooling and hydration centres and large, refrigerated shipping containers to act as air-conditioned portables to expand the two pediatric EDs during the heat.

SINA and Childlife Foundation would like to partner with Osler in areas such as Quality Assurance, Patient Flow, Research and ED Operations – a modest ask from an impressive group whom I feel we can learn just as much from.

Already SINA and Childlife Foundation have been recognized by Médecins Sans Frontières, have signed an MOU with BRAC, one of the world’s largest NGOs to promote preventive care in the slums of Pakistan using home visits, and have been invited by the Government of Pakistan to take over two more EDs. And they have done all of this through charity and philanthropy. I left this day with renewed hope for the most unfortunate of this city and a tremendous opportunity for Osler to be part of something that is truly making a difference!

Our last day at Apollo Hospital
April 27

 

 

After a much-needed rest day spent visiting the Taj Mahal in Agra, the Global Health team was back at work on April 27 meeting with Indraprastha Apollo Hospital in New Delhi.

Indraprastha Apollo Hospital is a multi-specialty tertiary acute care hospital with 710 beds, 52 specialties, and one of the largest dialysis units in India. It is a flagship hospital of Apollo Hospitals Group, Asia’s largest health care provider with 64 hospitals, established in 1983 by Dr. Prathap Chandra Reddy.
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The team was met by Dr. R.S. Uberoi, the Chief Quality Officer, who gave us a tour of the hospital, before meeting with Professor Anupam Sibal, Group Medical Director of Apollo Hospitals Group, for the signing of an MOU and official launch of this much-anticipated partnership. And, judging by the discussion that took place around the room following the signing, there are plenty of opportunities for collaboration between Osler and Apollo hospitals.





At the very heart of this collaboration will be research, and work has already begun in this regard. A few of the other ideas discussed included: establishing an exchange or elective program for physicians or managers between the two hospitals; having each hospital host grand rounds; adding Apollo’s quarterly journal to Osler’s medical library; creating Apollo clinics at Osler to support the many people who travel from Brampton, Etobicoke and surrounding areas to India each year. And more!

The meeting marked the end of this year’s Global Health tour – and my last blog. Tomorrow we pack up and prepare for the long flight home. It’s been an absolutely phenomenal experience and I hope you’ve enjoyed following the team as we travelled from Amritsar to Ludhiana to Sarabha Village to Delhi. We’ve seen and learned so much about health care, culture, and charitable work along the way– all of which will help us provide better care at home – and look forward to sharing as much as we possibly can with all of you in the coming weeks, months and years.

See you soon!

Osler’s Diabetes Screening Camp 
April 24

 

The line-up of patients was long – and growing steadily – when the Global Health team pulled into the parking lot at SKSS early Sunday morning. Patients had come from all around Sarabha Village to have their blood sugar tested at the one-day diabetes camp. Diabetes is a major concern in the South Asian population, both here in Punjab and at home at Osler, affecting as many as one in seven people.
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In all, the Global Health team of doctors and nurses saw a staggering 300 patients (500 over the two days) at the camp. As many as one-third of the patients also received a glucometer, free of charge, to monitor their blood sugar and better manage their diabetes at home. The glucometers were purchased with donations from several senior-level Osler staff.


To qualify for the glucometer, patients had to have a high blood sugar level, be taking medication for diabetes, and demonstrate that they knew how to use the machine and could afford to buy the strips needed for its ongoing operation.


Diabetes education played an important role throughout the day with the team speaking to patients and SKSS nurses about the impact of good diet, nutrition and exercise. Educational materials from the Canadian Diabetes Association (translated into Punjabi) were given to patients to take home.





The level of need, particularly around diabetes care and prevention, in the village is astounding. Patients waited for hours to see our health care team, lining the hallways and entrance to the hospital. At times it was difficult to make your way through the throngs of people. We helped all those we could, including two adolescents (one pictured here with Dr. Mohammad) with uncontrolled diabetes and in desperate need of care.


It was an unforgettable day and each of us is leaving Sarabha richer for the experience. In today’s video, Dr. Mohammad, Dr. Rajinder Kaur Mahal (SKSS principal), and S. Hoshiar Singh Grewal, (SKSS Chairman), talk about the impact of the camps and the growing partnership between our two hospitals just at the top of this blog post, so be sure to check it out.

Osler’s General Medical and Mental Health Camp at SKSS
April 23

 

The Global Health Team wasn’t exactly sure what to expect when we headed to SKSS on the morning of April 23 for the first of two days of medical camps. Nothing, however, could have fully prepared us for the experience that lay ahead.
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By 1:30 p.m., 205 patients had registered for the general medical and mental health camp. It was the first foreign-run medical camp in the hospital’s history and had clearly attracted a lot of interest. Patients from throughout Sarabha Village came to see Osler’s medical team who, without missing a beat, quickly sprang into action, supported by wonderful and talented nursing students from SKSS.





Kim and Shubhjit did an initial patient assessment then referred patients to either Dr. Mohammad and Dr. Bajwa or Dr. Koczerginski and Wendy depending on whether it was a psychiatric or purely physical issue. For eight hours, our dedicated medical team – working in partnership with SKSS nursing faculty and students – saw patient after patient, providing the same compassionate care they do every day at Osler. The environment was vastly different but the medical issues were much the same, with patients presenting with chest pain, difficulty breathing, body aches, drug use, depression, anxiety, and more.



Dr. Koczerginski and Wendy saw 25 patients during the day – a number that surprised them given the stigma that still exits around mental illness in Punjab and throughout India. The fact that people are reaching out is a positive sign, but there is still much progress to be made with significant obstacles to overcome.

By the end of the day, the team was completely exhausted, but also deeply inspired knowing they had helped the people of Sarabha and gained valuable cultural insights to support patient care back at home.

Our last day at SKSS is April 24 and will consist of an all-day diabetes screening camp. We will post lots of photos so be sure to check back in to see more incredible experiences from the Global Health Team.

The Team Visits a Charitable Hospital in Sarabha Village
April 22

 

On April 22, the Global Health team headed to Shaheed Kartar Singh Sarabha Ayurvedic Medical College & Hospital (SKSS), arriving shortly after 9 a.m. to an official welcome by the entire staff and hospital chairman, Hoshiar Singh Grewal.
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SKSS is a charitable hospital located in Sarabha Village, the birth place of martyr Kartar Singh Sarabha, an Indian Sikh revolutionary whose statue stands at the entrance of the village. Built in 2001, SKSS serves an extremely poor, rural population, providing care at very low or no cost. (Delivering a baby at the hospital, for example, costs 50 rupees, the equivalent of about $1 Canadian.) The hospital offers surgery, medicine, gynaecology and paediatrics, with a separate ICU for very ill and post-operative patients.

In 2006, SKSS started a dedicated nursing college that, today, graduates 150 students annually. The Global Health team had the privilege of speaking to several hundred of SKSS’s nursing students Friday, sharing information about our roles and what we hoped to contribute and learn, medically, culturally and philanthropically, from this experience. We were then invited to watch the Bhangra, a traditional Punjabi folk dance, performed by some of the students!


A sneak peek:The team unloading and organizing medical equipment, supplies and medications we carried from Osler; and planning the details of our "General Medical Check-up" camp (Focus on de-addiction and mental health) for Saturday the 23rd.







On our way back to the hotel, the team stopped to take some photos of the village and villagers. We hope they help to capture some of the beauty and character of Sarabha for those following us back home.

Osler and DMCH Partnership Makes News with Signing of Official MOU

April 21

 

It may have been our last day at DMCH, but the focus was definitely on new beginnings not endings. In front of the Punjabi press, Dr. Mohammad and Dr. Sandeep Puri, Principal from DMCH, signed a Memorandum of Understanding, solidifying our partnership to improve health care, both here in Punjab and at home at Osler. It was a historic moment and a fitting close to a truly memorable five-day visit. The partnership was heavily reported in the Punjabi newspapers and will be shared with everyone when we come home.
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The signing took place during our team’s final presentation to DMCH’s medical leaders, highlighting some of the key learnings from this year’s visit and recommendations for how we could work together to strengthen Emergency Medicine and Mental Health care at both hospitals going forward. The presentations focused on what was learned, the different challenges each organization faces, recommendations and preliminary proposals to collaborate on issues ranging from infection control practices to research projects. “Nobody does anything perfect. The important thing is that we learn from each other,” said Dr. Mohammad, who answered questions from the media on why Osler chose to work with DMCH and to focus on Emergency Medicine and Psychiatry.

Our video today features Wendy’s reflections on our growing partnership with DMCH in one of those two areas – psychiatry. Be sure to have a listen to hear her thoughts!

 

 Following the presentation, Dr. Mohammad thanked DMCH for being such wonderful hosts and told them that we very much look forward to returning the favour soon. DMCH has indicated that they will likely send a small team of three or four members to Osler within the next year.

Tomorrow the team shifts gears and heads to Shaheed Kartar Singh Sarabha Ayurvedic Medical College and Hospital (SKSS) in the Sarabha Village, located about an hour’s drive from Ludhiana. Don’t forget to check back in to see how our first day at this rural charitable hospital goes.

Hands on at DMCH

April 20

 

Today was another great day at DMCH – and probably the most interactive to date. After a quick breakfast, the team headed back to the hospital for a third visit, this time laden with laptops and scores of educational materials that had now travelled more than 11,500 kilometres by plane, car and foot with us. (We each took turns carrying the tube of hand hygiene posters!) It was definitely worth it in the end, though, as I watched Kim lead a staff huddle - their first ever - on hand hygiene to a captivated emergency room nursing team.
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Kim was invited by Meenakshi Pereira, Nursing Superintendent, to conduct the huddle on this topic, identified by both medical teams as an area in need of improvement and one with the potential for significant impact. Kim also organized an on-the-spot hand hygiene audit using Osler materials, then, together with her DMCH colleagues, scored the results. The response to the process was an extremely positive one and something they plan to implement going forward. Like at Osler, hand hygiene compliance rates will be tracked on the thermometer poster, which now hangs prominently across from the nursing station in the Emergency Department.





Meanwhile, at Dr. Mahajan’s request, Dr. Koczerginski shared his presentation on last year’s Global Health exploratory tour to a room of about 25 mental health professionals. The presentation was well received and sparked valuable discussion on a number of different issues, including the link between mental health and culture (for example, high suicide rates in women and gender inequality) as well as the work being done to address these concerns at both hospitals.


The team ended the day with a late-night dinner in the backyard of the home of DMCH’s Secretary, Prem Kumar Gupta – an equivalent position to Osler’s Board Chair. Attended by all department heads it was a wonderful setting and opportunity to build on the growing friendship between our two hospitals.

Be sure to check back in tomorrow to read about our final day at DMCH and hear Wendy’s thoughts on the partnership!

A Day in the Emergency Department at DMCH

April 19

 

The team returned for a second, and perhaps even more intensive, day at DMCH on April 19. Once again, we divided into two groups with Dr. Koczerginski, Shubhjit, Wendy and Darryl observing a psychiatric case conference, and Dr. Mohammad, Dr. Bajwa and I heading to the Emergency Department. Kim spent the day learning more about the role of nurses in the Emergency Department and on the ICUs.
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One of the things that struck me most during my day in the Emergency Department was the constant exchange of knowledge – both successes and challenges – between our two medical teams. There was a genuine desire by both to learn as much as possible from each other. The Osler team was particularly impressed by the efficiencies in triage and complexity of cases seen in the 60-bed Emergency Department, which treats between 80 and 100 patients a day, more in the rainy season when Dengue Fever is a problem.

Be sure to watch today’s video to hear, in their own words, what Dr. Mohammad and Dr. Saurabh Arora, had to say about the partnership so far! We deliberately recorded the video outside the Emergency Department in order to capture the pace and atmosphere around the hospital. I’ve also shared a photo of a row of stretchers lined up outside the Emergency and Trauma entrance, which we all found particularly interesting. Patients are wheeled directly into the Emergency Department from here by an orderly. Pictured adjacent to the stretchers are some of the many family members (attendants) of the patients being cared for in the Emergency Department or other areas of the hospital. More are waiting in a dedicated family attendant room.






 

Family attendants play an important role in patient care in hospitals at DMCH and throughout India. Typically, each patient has at least one family attendant with him/her at all times. You’ll see evidence of this in many of our photos from the hospital. It’s a cultural practice we would like to learn more about given Osler’s large Punjabi population and a need that we are already seeing in our hospitals.

There is no doubt that our relationship with DMCH is growing stronger each day that we spend at the hospital. Dr. Bajwa and Dr. Mohammad are already familiar faces in the Emergency Department and on more than one occasion were asked to consult on patient care. And Kim has been invited to hold the first staff huddle and hand hygiene audit with the Emergency Department nurses tomorrow morning.

I hope you enjoyed today’s post. We’re back at DMCH tomorrow, after which we will be preparing our presentation and joint recommendations to help guide the partnership moving forward.

Bhattian Village & Day One at DMCH

April 18

 

The Global Health team left Amritsar early Sunday morning and headed south to Ludhiana – the largest city north of Delhi, and home to Dayanand Medical College & Hospital (DMCH). A planned detour to see a traditional Punjab village on the way ended up being longer than expected when our van broke down on the highway. Fortunately for us, our driver turned out to be a remarkably skilled mechanic and we arrived safely in the village of Bhattian by early afternoon!
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Bhattian is a typical rural farming village with about 100 families, including that of our own Dr. Gurjit Bajwa. The team had a chance to meet Dr. Bajwa’s family and experience some of the culture and natural beauty of the village before heading out past the acres of golden wheat fields ready for harvest en route to our next destination.


On Monday, we spent a memorable first day at DMCH, one of three hospitals we are partnering with on this trip. 

DMCH is a 1,500 bed tertiary centre – the largest private not-for-profit hospital in Punjab – with super specialties in plastics, urology, neurology, nephrology, cardiology, GI, endocrinology, pulmonary and emergency medicine. The team had an opportunity to meet with most, if not all, of the department heads (professors) in the morning before breaking into two separate groups to tour the psychiatry and emergency departments.





For the next few hours, Dr. Koczerginski, Wendy, Shubhjit and I were given a first-hand look at a typical day on the mental health inpatient ward and outpatient clinic at DMCH. We shadowed Dr. Ranjiv Mahajan and Dr. Navkiran Mahajan, a husband and wife psychiatrist team, on their rounds and in clinic, where as many as 100 patients are seen daily. It was a fascinating day of observation and information gathering which left the team with a lot to think about. We rejoined our colleagues – who had an equally interesting day in the emergency department – for a tour of the Hero Heart Centre at the close of the day.

The team is excited to return tomorrow and to continue to identify ways we can learn from each other to make patient care stronger in both countries. We’ve shared a few photos from the day that we hope captures some of our incredible experiences to date.


Meeting with familiar faces
April 17

The Global Health team touched down in Amritsar, a city of approximately 1.1 million people in the north-western part of India, Saturday morning following a short stop-over in Delhi. We were met at the airport by Chiranji Lal Sharma, the same driver who accompanied the team last year and who was genuinely pleased to see two familiar faces – Dr. Mohammad and Dr. Koczerginski.
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Similar reactions are expected Monday when the team meets with physicians from the Emergency and Psychiatry Departments at Dayanand Medical College and Hospital (DMCH) in Ludhiana. So many other organizations, we were told, visit once and never return again. Not only are we going back to DMCH, but we will be working directly alongside our colleagues there to build a true partnership through the co-development and sharing of best practices in emergency medicine and mental health.



After two days of travelling, Saturday was a much-needed opportunity for the team to acclimatize to the new time zone and prepare for the busy weeks ahead. During the afternoon, we visited the Golden Temple, located about a half an hour drive from our hotel. The Golden Temple is Sikhism’s holiest shrine – a place where everyone, regardless of cast, creed or race is able to seek spiritual solace and religious fulfillment without hindrance. The busiest section of the gold-plated temple is its community kitchen. Run entirely by volunteers, the kitchen is open 24 hours a day, seven days a week and feeds as many as 70,000 pilgrims each day. It symbolizes the Sikh principle of inclusiveness and oneness of humankind.



The visit offered an extraordinary opportunity for members of the Global Health team to learn about a religion practiced by many of Osler’s patients and staff – an invaluable and culturally-enriching experience that will not be forgotten.


Osler’s Global Health Team takes flight
April 14 

Osler global health team ready to leave at airport

 

And we’re off! At the time of this post, if all goes according to plan, Osler’s Global Health team will be well into the first leg of a two-day journey to the city of Amritsar – and the official start of a two-week trip to Punjab, India.
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There are eight of us fortunate enough to be on this year’s Global Health team, led, once again, by Dr. Naveed Mohammad, Osler’s Vice-President of Medical Affairs. The purpose of this year’s trip is to put into action some of the partnership opportunities identified by the exploratory team last year. Based on learnings from that tour, the clinical focus on this trip is in the areas of emergency medicine, child and geriatric psychiatry, and diabetes. We’ve got a truly stellar team in place ready to roll up their sleeves and get to work to improve the patient experience on the ground in India and back at home.

It’s been a busy few weeks leading up to our departure. Visas and vaccinations. Early morning Skype meetings with colleagues in India. Gathering information and supplies to support the initiative. And, of course, a lot of packing!

I think I can safely speak for all of us when I say that the preparation alone has been exciting. I can only imagine how we’re going to feel when we finally arrive in India and take our first steps off the plane. Well, actually, I’m guessing, hot – it’s currently a steamy 38C in Amritsar! But, more seriously, I suspect what each of us will be feeling is inspired and eager to begin this incredible adventure.

We have a lot to give and even more to learn – new models of care, cultural sensitivity and much more – and we will be sharing as much of our experiences throughout the next two weeks with you as we possibly can.

Early Sunday morning, following a day to acclimatize in Amritsar, the team will be making the trek south (approximately three hours by car) to the city of Ludhiana where we will meet with our partners at Dayanand Medical College & Hospital (DMCH). The following five days will be spent working at DMCH – starting with the shadowing of the emergency and psychiatric departments, and ending with the co-development of recommendations for the delivery of care.

Thanks for checking in and be sure to watch for our next post – from Amritsar!

Meet the Global Health Team

   Dr. Gurjit Bajwa, Emergency Medicine Physician – Emergency Medicine
 

Find Deborah on Twitter: @churchill2026

Deborah Churchill, Major Gift Proposal & Grant Writer – Foundation

I was inspired to join the Global Health trip to India by the stories and images shared by the members of the first Osler team to visit India. Each spoke about the trip as an enriching life experience and I saw the current initiative as an opportunity to be a part of something truly meaningful that would have an impact on people’s lives both here and in India. 

I hope to bring a compelling “voice” to the Global Health India trip – to use my expertise as a writer to capture our individual and collective experiences  in order to articulate the value of the program to our community.

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Wendy Ross, Clinical Services Manager – Mental Health & Addictions, Social Worker

I'm really looking forward to the opportunity to learn from the successes of the three diverse health organizations in India in the area of mental health and addictions, and to take these teachings  back to Osler to translate them accordingly throughout our multiple services and programs is of great interest to me. 

Throughout this trip, I'm hoping to learn different models of care to improve our patient and family experiences. In other words, how mental health and addictions is understood and their models of care. I am interested in their assessment, intervention, and care models. The opportunity to shadow the clinical staff will be very worthwhile.

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Find David on Twitter: @D_Kocz

 David Koczerginski, Chief of Psychiatry

It is a privilege and honour to be a part of such a unique hospital initiative. The opportunity to partner with health organizations in India on the ambitious goal of lessening stigma and improving access to care  for those suffering from Mental Illness is exciting, meaningful and consistent with our core values.  

Through ongoing discussion and education I hope to continue the process of lessening stigma and building health systems that place mental illness on a high priority for future growth. I also believe that we have opportunity to learn about cultural and family values which may influence illness presentation and treatment models for our community in the CWLHIN.

 

 Kim Maas-O’Hearn, Clinical Services Manager – Emergency Medicine

Nurses in Emergency Medicine share a similar bond of passion, strive for excellence and performance with compassion for all our patients and their families. This partnership will build that bridge between us to share ways in which each of us can accomplish our goals of going beyond with an incredibly welcoming, compassionate and service excellence team.

I hope to contribute some of our educational tools and learnings, and most importantly for me, instill some of my passion for excellence in patient care with all three hospitals that will be sustainable in a positive and welcoming environment for nursing in India. 

 

Shubhjit Minhas, Geriatric Mental Health Nurse – Mental Health & Addictions

I believe that this trip will allow me to understand the complexities of global health delivery and make tangible contributions to Osler’s commitment in providing exceptional quality care without boundaries. This includes learning about the mental health care delivery model in India, learning about the various mental health treatment modalities and last but not least learning about how I, as a nurse can promote a culturally sensitive clinical environment at Osler. 

Working with the interprofessional teams at three different hospitals in India, and by building collegial relationships with our counterparts, I intend to contribute and educate healthcare professionals and nursing students on their specifically identified needs related to geriatric and child and adolescent psychiatry. This may include developing and sharing tools/resources to best fit the model of care utilized by the hospitals in India.

 naveed mohammad headshot
Find Naveed on Twitter: @naveedm21
 Dr. Naveed Mohammad, Vice President, Medical Affairs

Making a difference to communities that have close connections to the communities we serve at Osler was an inspiring idea for me.  It helped bridge so much of what we were lacking in cultural learnings together while providing an opportunity to contribute to philanthropic work, leadership development, individual growth and cultural training!

I hope our teachings to the local health care professional will provide them with some innovative answers to provide patient centred care.  In return I know their(wherever we go) methods, and our exposure to the culture will help us provide innovative, patients centred and compassionate care at Osler. I travel there with my mind as a blank canvas to be populated with knowledge.

 

Darryl Yates, Clinical Director of Mental Health & Addictions – Support Tour Lead

It is truly an honour for me to represent Osler, Ontario and Canada with our colleagues from across the world, to have an exchange of experiences, models of care and ideas to address common challenges.   

I firmly believe in the opportunity to learn from the experiences and successes of the three partner health organizations in India.  It will be as much a learning opportunity for me as it will be to share knowledge and support the overall global health initiative.


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