Sun Life Financial Osler Global Health Team Blog


Reflections of the journey and renewing our passion for quality care

Having been back for a few days now, two members of the Pakistan team share their reflections on the extraordinary experience of the Sun Life Financial Osler Global Health tour in February.

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Read Team Pakistan's seven-day blog journal

Lindsay Hogeboom:

“It's been a week since we left Pakistan and I find myself still attempting to process all of our experiences and what they mean for me as a registered nurse, as an employee at Osler but also what this means for me personally.

"If I was to choose one thing that truly stood out to me it would be the passion and the desire of those we came into contact with to improve access to healthcare, and improve the overall health of the under privileged population of Karachi.



  "Whether it was through our collaboration with SINA developing the KDOP or through the mock accreditation exercise of the ChildLife Foundation the passion to improve healthcare for the people of Karachi was palpable.

"As an employee at Osler I have been challenged in my thinking and come back with a renewed passion and desire to improve the quality of care as well as the experience of our patients!

"There is a lot we can all learn from the passion of the people of Karachi!” 



Dr. Naveed Mohammad:

“I was born in Karachi, spent part of my childhood in Karachi and have now been there three times for global health work.

"Each time I have gone as an Osler Team member or on personal visits I am amazed at the perseverance of the people of this city of 28 million people.

"Their resourcefulness in the face of sometimes overwhelming odds leaves a lot for us to learn. The health care team at Child Life and SINA display the same passion for their work, their organization and their patients.

"If I could take every health care worker from Ontario on our Global Health Missions, I would. It is truly an experience that builds bonds, collegiality, leadership skills and helps us appreciate how privileged we are to work in our health care system despite its minimal limitations when compared to other parts of the world.”

Day 12

India: Returning home with unique perspectives and everlasting bonds

Here we are, after almost two weeks of spending nearly every waking moment together, the journey comes to an end.
   
Today is one of happiness and sadness. Happy that we’ll be back home with our families, but sad as we’ll miss each other’s daily company.

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We’ve had great dialogue, debate and laughter over the last couple of weeks. Each of us brought our unique perspectives as to what can be learned and achieved through this program.

Although we do not necessarily interact in our day-to-day work back home at Osler, this experience has created an everlasting bond between all of us that will not be forgotten.



As we waited to board the flight, we reminisced about the conversations, interactions, and dedication to quality patient care we experienced with our partners over the last couple of weeks.

The experience from this tour has been described as ‘once in a lifetime’ and the ability to work on the ground with partners in our same field was incredible.

We are very grateful for this opportunity and look forward to continuing this partnership as DMCH visits Canada later this year!



As we get ready to board our flight, most importantly we won’t forget the warmth and kindness of the people of Punjab.

They welcomed us with open arms and offered us a glimpse into their day-to-day lives.

Sat Sri Akal. Thank you.


Day 11

India: Group down to five; visit to ancient wonder does not disappoint 

We started the tour with seven members, but today we were down to five, having already bid farewell to Dr. Gurjit Bajwa and Dr. Navin Kaicker.

 It was bittersweet as we had come together as a group of people who didn’t know much about each other, to a close-knit group that understands each other’s preferences.

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 We had the opportunity to visit Taj Mahal today, one of the Seven Wonders of the Ancient World.

It was a great chance to experience this majestic monument! Commissioned in 1632 by the Mughal emperor Shah Jahan to house the remains of his cherished wife, the Taj Mahal stands on the southern bank of the Yamuna River in Agra, India.

We learned that it took 20 years to build! It is one of the most stunning examples of Mughal architecture, a combination of Indian, Persian and Islamic influences.

The day was perfect with clear blue skies. There are no words to describe the beauty of the Taj Mahal. It is simply breathtaking!

The traditional techniques that were used to build the monument are still being used today in the city of Agra. We had the opportunity to catch a glimpse of the labour intensive process.

 Although we spent a lot of time in transit today, the trip was very fulfilling!


Day 10

India: Travel to Delhi a time to reflect on this great experience and take in the sights 

After a great week with both DMCH and SKSS it was time to leave Ludhiana and travel to Delhi. We left early morning to get a head start on the at least six hour drive back.

With the city traffic and variety of modes of transportation, the drive was exciting and full of vibrant colors!

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 As we travelled across the cities, on the bright, sunny day, we reflected on our time here in India, the work we completed and the great opportunities we had to work side by side with our partners in India.

We arrived in Delhi in the late afternoon and looked forward to getting a bit of rest before we headed out to briefly tour some parts of Delhi, including the India Gate and the Parliament house.

What we won’t forget is the people of Punjab. Their hospitality, passion and dedication to their work and life is touching.

They welcomed us into their culture and gave us insight in to their day-to-day lives.

We are all grateful for the time today to pause and reflect on the value of the Sun Life Financial Osler Global Health Program and Osler’s vision of patient-inspired health care without boundaries.


Day 9

India: Vision of patient-inspired health care without boundaries reaffirmed

As the team headed off to their second camp day at SKSS, they reflected on the great experience yesterday.

Having the chance to interact with the local village community was very fulfilling. It really allowed us to live Osler’s vision of patient-inspired health care without boundaries.

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Today, the Sun Life Financial Osler Global Health Camp’s focus was on diabetes and general health.

Although the weather was rainy and overcast, it did not deter the team from seeing more than 130 patients. The team also had the opportunity to meet with Raj Grewal, Member of Parliament for Brampton East, who was visiting SKSS today.

The pride of the village had returned to his native community and it was great to see him being honoured by them.






The team also felt inspired to have the chance to personally connect with nursing students and faculty.

 Their compassion and dedication to delivering quality care was evident in the way they interacted with all the patients.



The team used many words to describe the day – humbling, amazing, grateful, fulfilling, rewarding, and meaningful!


Day 8 

India: Camp focuses on mental health and general checkups for area villages

Today the team held their first Sun Life Financial Osler Global Health medical camp, this one focusing on mental health and general checkup for the local villages.

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Our team saw more than 100 patients at a steady pace giving us quality time with each patient. The camp for the patients was organized into three different areas: registration, assessment by the nurses and health education allowing for an efficient flow of patients.

Thanks to DMCH, three residents spent the day with the team providing great support.



 The chief complaints ranged from diabetes to hypertension to stress. The value of the camp was demonstrated by the interactions we had with patients and families as well as the comments noted on the bulletin board outside. Patients left feeling satisfied with the camp.



 Overall the day was a success and the team felt energized and inspired by the work completed today. We all felt the love, appreciation and blessings expressed by the patients.



 We are all excited for tomorrow, our second general health camp day!


Day 7

Pakistan: 'Alwida' ChildLife and SINA, farewell Karachi - thanks for the memories

Ah, the last day! While most of us look forward to going home after a week-long work trip, everyone agreed that this week had gone by too quickly!

As previous teams had mentioned, this was a life-changing experience for all of us.

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The team had spent 14 to 15 hours together each day in the last week and this meant sharing stories, medications, phones to watch the Olympics and of course sharing hand sanitizer!



We laughed, we cried, and we tended to anyone that felt sick - which all of us did at one point or another.

Speaking of being sick, Anne had to miss yesterday’s wrap-up session as she wasn’t feeling well so of course the SINA team brought the meeting to her at the hotel.

The level of commitment to KDOP is outstanding on both sides of this partnership. We visited the much loved Mazar-e-Quaid, the final resting place of Muhammad Ali Jinnah (founder of Pakistan).

This architectural masterpiece is surrounded by a tranquil garden, which paired with the marble floors offers the visitors a peaceful place to reflect in the otherwise busy and loud city of Karachi. Each of us stood in awe looking around… that is of course until the local school children asked for selfies.  



As I paused for a moment to reflect, I realized that a blog set in Pakistan by an Indian-Canadian would not be complete until she shares her personal experience in comparison to perceptions.

I was greeted with warmth and intrigue by everyone including our hosts, the hotel staff, the vendors and particularly by the patients and families we met.

Despite the turbulent history of the two neighbouring countries, people of Pakistan showed me that we not only share a strikingly similar tapestry of culture, language, and the love of sweet, spicy and fried delicacies but also our curiosity about each other.  



For some of my well-meaning family and friends who had asked “why” when I announced I had applied to the Global Health Program going to Pakistan, I now have some amazing stories to share. 

Karachi was busy as expected for a large metropolitan city and while calling it home for the last 8 days, we found it safe, clean and full of exciting sights, foods and colors.

Our most favorite part about Karachi definitely was its people! We are leaving thoroughly impressed by the ChildLife and SINA teams’ passion to not only provide quality treatment but also prevention programs leading to the best health outcomes for the under-privileged population.

And with that, we said 'alwida' (goodbye) to Karachi, a city that we have now come to adore!

India: Greetings to our SKSS Partners

Today the team met with Madame Principal and Chairman at Shaheed Kartar Singh Sarabha (SKSS).

SKSS is a hospital that was built in 2001 and serves a rural population. They also have a Nursing College, Dental College and an Ayurvedic College. Students also provide door-to-door community nursing.

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Upon arrival, the Osler team received a very warm welcome. We started the day with a visit to the local gurdwara where religious hymns were sung.

Even Dr. Bajwa had an opportunity to join by playing the ‘tabla’ (Indian drums).



The team then participated in a ribbon cutting and ‘diya’ (lamp) lighting ceremony in the auditorium.

Each team member was presented with a bouquet of roses and the students also performed the traditional ‘bhangra’ dance.



The commitment to the legacy of Shaheed Kartar Singh was very evident in the village. He was among the most famous and reputed martyrs of Punjab.

We visited his house and felt a sense of awe and inspiration from his sacrifice and bravery.



We also had the opportunity to visit a government-run clinic in the village, showcasing primary care in Punjab. We rounded off the afternoon with a knowledge exchange session with the faculty and students at SKSS.

The topics ranged from diabetes, hypertension, autism, and stress management. The passion and commitment to learning by the students was demonstrated by their thoughtful questions and interactive dialogue with the Osler team.

Our collaborative work was also featured in the local newspaper.



We are all looking forward to “giving back” to the villagers over the next two camp days!


Day 6

India: Farewell to DMCH!

Today the team was in high spirits and excited to share observations and recommendations from the time spent at DMCH in the areas of Emergency and Mental Health.

In Mental Health, we continued with the “train-the-trainer” approach on Pinel restraints from yesterday.

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To help in this endeavour, the Osler team created a two-minute instructional video on the correct use of the restraints, which was shared with students and faculty. This will enable the students and staff to continue this training practice and serve as a point of reference for current and future students.

In the Emergency area, the ED team spent time in the department connecting with front line staff, including the nursing supervisor, charge nurse and bedside nurses regarding the changes that will take place with the redevelopment of the layout of the ED. They were happy to discuss the barriers they feel that prevent them from providing better care, such as overcrowding, poor layout for patient flow and managing family expectations.




We ended our afternoon with presentations on observations, strengths and recommendations from Osler to DMCH and vice versa in the areas of Mental Health and Emergency. There was great dialogue and overall all was well received and very much appreciated by the DMCH team. The collaboration between both Osler and DMCH was published in various newspapers.

We are also very excited that the DMCH team will be visiting Osler this summer (June 2018) and we are really looking forward to it!

The team reflected on the last three days spent at DMCH and are looking forward to the time at Shaheed Kartar Singh Sarabha (SKSS). The DMCH team also were generous in providing us with some residents to support us in the SKSS camp days.

Pakistan: Forging new relationships and dressing up for the occasion

Here we are, on the last full working day of our trip and we all reflected on how quickly the time has gone by!

Last night, two pivotal Memorandums of Understanding (MOU) were signed at the Sindh Club in Karachi. One between Osler and ChildLife Foundation and the other between Osler and SINA Health, Education and Welfare Trust.

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These MOUs outline how Osler will continue to collaborate with these two organizations. This formal event provided us with an opportunity to wear beautiful traditional Pakistani outfits.





Today we focused on collaborating further with SINA on the Karachi Diabetes Outreach Program (KDOP) that will be set up at the Jumma Goth Clinic Program.

The team at SINA has done an incredible amount of work on planning this pilot project during the past few days.



The team’s attention to detail is impeccable, as well as the enthusiasm surrounding this pilot. Details related to objectives, approaches, timelines, steering committee, working group (in Karachi) memberships, terms of reference, and frequency of meetings were discussed.

While there is still some work ahead, we are all looking forward to the launch of this pilot project!


Day 5

India: Back to basics at DMCH; positive impact of yoga on anxiety, cardiac patients

Today the team held ‘Back to Basics’ (hand hygiene and positive patient identification) huddles with the nurses and nursing students in both the Emergency and Mental Health departments.

 In addition, written materials were shared with the staff.

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They included: Osler’s least restraint policy, Pinel restraints booklets, code white debriefing reports to College of Nurses of Ontario (CNO), and practice standards on restraints.

The exchange of knowledge and practices was well received by the staff at DMCH.




In the Mental Health Unit, we had the opportunity to watch Dr. Sanjeev Rawat conduct daily bedside yoga with patients.

He also shared that he is involved with ongoing yoga research studies that are showing positive impact on patients with anxiety, as well as cardiac patients.



Later in the afternoon, the Osler team presented topics to DMCH Senior Leaders, students and residents.

The topics were: restraints, history of the ER, order sets, choosing wisely and blood transfusions. Dr. Sandeep Puri, DMCH principal, provided great feedback on each topic, specifically on order sets and how they can be incorporated into their healthcare systems.


Today was a productive day with front-line staff.

Tomorrow the Osler team will be presenting their observations and recommendations to the DMCH Senior Leadership Team.

Pakistan: Exploring ways to improve practice with NICH

Dr. Haider presented on Head Injury in Paediatrics at the National Institute of Child Health (NICH) site. It really is a tale of two cities when you go from a public-funded building to a privately-funded building.

The auditorium at NICH is significantly older and less equipped than DHA Suffa University, but that did not mean the level of engagement from the team was any less. 

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The discussion was lively with many questions related to practice improvement. After the presentation, Dr. Khalid and Dr. Khan of NICH invited us to take tours of the NICU and step down neonatal care areas.




There are 100 spots in total with 60 incubators and 40 cots, which are sometimes shared by three babies at the same time.



There were many things we were impressed by during the tour, including the baby tagging system (to prevent infant abduction), hand washing reminders on the incubators, and provision of free food in the mothers’ waiting area by an NGO.





For the latter half of the day, the team conducted a mock accreditation of the Korangi site of CLF. While there is some room for improvement, it was great to see that without much preparation, they scored well in their very first accreditation exercise.

We shared the results and had a fulsome discussion with CLF’s leadership.


Day 4

Pakistan: Recognizing philanthropic efforts; visit to the DHA Suffa University

At breakfast today we discussed an observation regarding the wives of the doctors and philanthropists associated with Sun Life Financial Osler Global Health program.

They are all actively engaged in the community in supporting better health outcomes for the lower income population.

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Their work includes raising funds for relief efforts, organizing blood drives and charity events to support community initiatives. Day 4 started with a visit to the DHA Suffa University in Karachi.

The auditorium was filled with students who were eager to learn about the Global Health Program and, in particular, about the Karachi Diabetes Outreach Program (KDOP) being developed by SINA with Osler’s partnership.



 There was a large number of female students as well showing how the DHA Suffa University and SINA are living out their core value of diversity.

Dr. Jared Paty’s presentation provided an overview of the Canadian Diabetic guidelines followed by Anne McCarthy’s presentation focused on the steps involved in program development for KDOP.





Follow up questions from the doctors and students showed how keenly interested they are providing quality care and the KDOP initiative.

 At the same time, Dr. Haider was invited to attend a Paediatric Advanced Life Support education session at the DOW University. We spent the afternoon with the team at SINA for further work on program development.

India: Importance of family presence and the exchange of best practices

Today we started our day with DMCH. After discussing ideas with the Senior Management team, the team was split into two groups: Emergency and Mental health.

In the Emergency Department, we were taken aback by the overcrowding which is becoming a universal theme across health care.

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We were quite impressed by the depth of care and adaptability of the emergency medical staff at DMCH. While we saw the importance of family presence in supporting patients, we also heard about the challenges of managing their expectations.



 From a mental health perspective, we were introduced to the 30 bed inpatient unit with a multi-disciplinary team, where we met at the bedside with some patients resulting in enriching discussions.

We focused on a comprehensive biopsychosocial care model. Subsequent to that we spent the rest of the day in the outpatient department interacting with patients and discussing the prevalence of substance abuse in Punjab.

Overall we had a positive educational interaction which included an exchange of best practices.



Overall the day was very interactive and educational!!


Day 3

India: On the road to Ludhiana, magical sunsets and a warm welcome from DMCH

Coming together is a beginning. Keeping together is progress. Working together is success.

Sat Sri Akaal! This is the greeting that is used by followers of the Sikh religion.

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After a restful night, the team is in high spirits and ready to tackle a new day. As we enjoyed the lush green landscape, we continued our team bonding and shared childhood memories and stories as we made the four-hour trek from Amritsar to Ludhiana.
  


 Did you know that the word Punjab means ‘5 rivers’? We were fortunate enough to pass a couple of the rivers along the way.



We also travelled along “GT Road (Grand Trunk)” which is known as the longest road in India. It has been in existence since the Mughal era and runs from Bangladesh all the way to Afghanistan.



The team headed to the city of Ludhiana to meet our Dayanand Medical College and Hospital (DMCH) partners. DMCH is a 1500 bed tertiary centre and is the largest private hospital in Punjab serving a population of over 27 million.

Their vision is to be a model of excellence in healthcare, medical education and research. We received a very warm welcome from our partners and engaged in dialogue about the learnings from the previous years and opportunities and expectations for this year’s tour.

The topics we discussed ranged from volume pressures in the emergency department, advantages and challenges of family presence, and the growing awareness of mental health and addictions.


Tomorrow we will be collaborating with Emergency and Mental Health teams.

Pakistan: Vision centering on patient's needs a very sweet endeavour

The Sun Life Financial Osler Global Health team started the day by visiting the Telemedicine setup at ChildLife Foundation (CLF).

This innovative program provides remote support to all of CLF’s Emergency Departments from 6 p.m. to 6 a.m. daily by a paediatrician.

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The Sun Life Financial Osler Global Health team started the day by visiting the Telemedicine setup at ChildLife Foundation (CLF).

This innovative program provides remote support to all of CLF’s Emergency Departments from 6 p.m. to 6 a.m. daily by a paediatrician.



Through high-quality video and telephone communication, as well as real-time access to the patient’s Emergency Medical Record, a paediatrician can assist and support remote teams through paediatric resuscitation.

Approximately three patients per hour are supported through this state-of-the-art approach to care. Each resuscitation is then utilized for future learning, coaching and auditing of protocol usage. Dr. Mohammad then provided an overview of Osler and the Sun life Financial Osler Global Health Program’s goals to the CLF team.

Following the Osler presentation, Dr. Ahsan (CLF’s CEO) shared CLF’s processes, protocols, quality initiatives and goals for 2018-2020 with the Osler team.

CLF’s focus on employee morale and team cohesiveness is impressive. Surveys are conducted four times/year and the results are utilized to mentor, coach and reward employees. During the lunch hour, we briefly stopped at the Edhi Foundation’s Welfare Centre.



This foundation provides remarkable services free of charge, including ambulance services, care of abandoned children and free tracing of missing people.

After a quick stop to get sweets from a famous sweet shop called Rehmat-e-Shereen (“make life delicious”) to get our sugar levels up, we headed to SINA’s head office.



 In the latter half of the day, we had an engaging discussion regarding the updated process flow map for the Karachi Diabetes Outreach Program that the Osler team is helping SINA develop.

It was inspiring to see the clinical and quality teams from both organizations share their vision for the program while keeping the patient’s needs at the core of the discussion.




Day 2

India: Flight delays, weary travels do not damper team's purpose 

The one constant in healthcare is change. This is also applicable to life as well. One must adapt and adjust to the changing environment.

After more than 45 hours of travelling: flight delays, missed flight connections, the team being split off into different countries, we were finally reunited at our destination as one team of seven.

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However, with very little rest and different airports, the team remains excited and passionate about the next phase of our journey with our partners in India.

Chiranji (our honorary team member/driver of the past three years) was waiting with much anticipation. It was comforting to know he was there and is familiar with our tour’s objectives.
  
Even after the long journey, we visited the Golden Temple – the holiest gurdwara in the Sikh religion. It has been in existence since the 16th Century.



Amritsar means “pool of the nectar”. Luckily we had a tour guide that was able to fast-track us through the lineup, which normally would take over one hour.

Dr. Bajwa and the local gurdwara clerk educated the team on the historical significance of the temple, the stories and devotion of the public that visits.

Easily over 100,000 people visit the site each day. There is also a 24-hour ‘langar’ (open community kitchen) for everyone. Our attention was also brought to the historically important trees that are more than 500 years old that surround the temple and are taken care of by the Punjab Agricultural University (PAU).

In particular, one tree is known as the ‘Dukh Bhanjni Sahib”. It is known as the tree with the gift of healing.



We were also able to see the sunset and the “golden” hues of the temple.

If there is one skill we practiced during the last 45 plus hours of our journey from Toronto – it was resilience; the ability to recover and adapt quickly to the changing conditions and challenges.

   

By the time you read this, we will have had a good night’s rest and will be ready for our next day to visit our partners at Dayanand Medical College and Hospital (DMCH).

- Harpal Panesar

Pakistan: Team tours CLF children’s emergency services

Today started with a visit to Childlife Foundation’s Korangi Emergency Department. Dr. Irfan Habib came to pick us up and once onsite, we met with Dr. Ahson Rabbani, CEO of ChildLife Foundation (CLF).

Dr. Ahson provided an overview of how CLF provides children’s emergency services in partnership with government-funded hospitals.

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They currently have three functioning emergency sites embedded inside government hospitals.

Each site is designed based on the disease spectrum of the population in the area in which they are opening, providing a customized approach to design.



 We first took a tour of the government side of the hospital where we saw many things that concerned our team. Other than logging the patients in on a paper-based register, there was no triage and patients were assessed by doctors with no access to weighing scales, blood pressure monitors, or thermometers.

Lack of resources resulted in patients’ mothers often administering medications themselves. There is no doctor at the hospital after 1 p.m. and patients are required to be admitted to a secondary care hospital.



At the CLF’s Korangi ED, when a patient arrives they obtain a ticket at the door and wait for their turn. If there is a resuscitation patient, they are immediately sent to the resuscitation area.

The patients are triaged into color coded P1, P2 and P3, which is based on WHO’s Emergency Triage and Assessment Tool. The color-coded levels are posted on the wall for the patients to understand. The patient is then triaged based on their original ticket number.

Once triaged, they are put into two categories (P2 or P3), creating two streams of patients. A patient coordinator assesses patients while they wait, watching for status changes, and they are moved through the ED accordingly.

A female security guard was present in the area, greeting patients, assisting them in finding the appropriate location to sit in. This approach helps keep the mothers calm as they wait.

Korangi is a paperless site and medical record numbers are used to keep patient records. At each visit that is within 72 hours, the patient is asked if this is a new visit or a follow up from previous visit, capturing re-admissions.

The team captures the name of the mother and her cell number to conduct follow up surveys and also to share information regarding the care of the child based on WHO’s 156 messages.

There is a project being done by the Agha Khan University with ChildLife Foundation to see if this method to support changed behaviours in this population is effective.

We then visited the CLF ED at the Abbasi Shaheed clinic that is being constructed and scheduled to open in April 2018. There is a progressive plan in place to ramp up the services once it opens up.

Our next stop was the CLF ED at the Civil Hospital Karachi. While the space is structured in the same way as Korangi, space was a challenge due to the volumes.

There were a few fathers present with their children as well in contrast to Korangi where children were accompanied by only mothers.

A few of us were very emotionally affected by this site as we saw mothers with children that were seriously ill and as CHK is only an ED, there are limitations to how much care they can provide.

The last visit of the day was CLF at the National Institute for Child Health. This ED was also extremely busy with significantly more people waiting outside.


Day 1

Pakistan: Exploring possibilities with SINA; kids, candy and the beach

Global Health team

We started the day off with a quick breakfast and headed to Jumma Goth Clinic with Dr. Khalid Pervez. Once there, Dr. Kamran Iqbal and his team provided a tour of the clinic, one of the 26 clinics that SINA operates.

Patients are assigned a registration card based on their socioeconomic status. The fee is 20 Pakistani Rupees for a patient that is below the poverty line and 50 Pakistani Rupees for all others.

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While no patient is turned away, these clinics are primarily situated in areas where 70 per cent of the population lives below the poverty line.

SINA selects its locations based on this criteria in line with their values of access, quality and affordability. For these clinics, 80 per cent of the patients visiting are women and children.

When a patient comes to Jumma Goth, they are triaged, their vital signs are assessed, they see a doctor and, if required, they can fill the prescriptions on-site before leaving.

The doctors utilize protocols to treat all of their patients to ensure standardization, best practice and quality of care.



Each doctor will see a maximum of 50 patients a day to ensure that quality is not compromised.

After visiting Jumma Goth, we headed over to the Majeed Colony IIL Centre and quickly discovered that the operating model is consistent among all 24 clinics. This approach allows SINA to ensure standardization and quality control across all its sites.

The only difference between the two sites is that Majeed Colong IIL Centre has electronic medical records (EMR).



Clinicians have unique credentials that enable real-time access to a patients’ complete medical history at each visit.

Along with the obvious benefits of an EMR, in this population it also serves another purpose as majority of the patients are illiterate and cannot recall their own clinical history or list of medications.



At both sites the team enjoyed handing out candy and interacting with the children waiting with their families. At first, many of the children were very shy and timid; however they quickly warmed up to us.



We ended the day at the SINA head office discussing our observations from the day, as well as starting the preparation work for the diabetic outreach clinic.

We were all impressed by their change management approach, level of coordination and the passion and accountability seen in each member of the team to provide exceptional care to their patients.

We ended the day with a visit to Abdullah Shah Ghazi Mazar and a quick trip to the beach.
  


 - Jyoti Purewal


Arrival: Delays, bonding and spreading the word of our mission

Arrival in Karachi

International travel often comes with unexpected delays. In our case, the delay was another opportunity to bond with the complete Sun Life Financial Osler Global Health Program team.

We boarded the plane at 2 p.m., but did not take off until about 6 p.m., providing us with an opportunity to connect again in the small, intimate setting of an airplane.

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An unexpected benefit of this delay was hearing the interest of members of the public on the plane when asking where we were going. The passion was evident in all of the team members.

It was inspiring to observe them use words and phrases like “collaboration” “learning opportunity” “improving care for our local community” and relating it all back to Osler’s mission of “patient inspired care.” It was also great to hear words of appreciation and positive feedback from our fellow passengers. 



We arrived in Abu Dhabi about 4 hours later than expected and had to say quick goodbyes to our colleagues leaving for India. 

 And then there were 8!

We landed in Karachi around 7 p.m. local time. We often hear about Pakistan being a busy place, but there was a calm and quiet observed by the team unanimously.

Each step was streamlined and we were through customs and had our bags in less than an hour. Well, all of us except for Dr. Mohammad, Dr. Haider and Lindsay, whose luggage was delayed.



 As we drove around in the city, we saw beautifully decorated buses, people on motorbikes without helmets (Dr. Haider refers to this in his presentation later this week!).
  


We also saw many CHHIPA ambulance stops – a welfare organization’s fleet of ambulances that are alert and ready to meet emergency situations.

This is an exemplary example of “right care in the right place at the right time.”

I am writing this from our hotel after having arrived here after about 24 hours from the time we left home! The team is off to get some rest as we are scheduled to meet our Pakistani counterparts early morning tomorrow. 

 Stay tuned!

- Jyoti Purewal


Global Health Team departs

The long (and exciting) journey to India and Pakistan begins

By the time you read this, two teams of Osler staff will have commenced their respective travels to India and Pakistan as part of the Sun Life Financial Osler Global Health Team. 

A total of 15 members are led by Florine Lobo, Osler's Chief Financial Officer and Vice-President of Organizational Performance, for Team India and Dr. Naveed Mohammad, Vice-President of Medical Affairs, for Team Pakistan.

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The program is in line with our vision of ‘patient-inspired care without boundaries’ and is in its fourth year of expanding our global impact through innovative partnerships. It is a great opportunity to leverage our work abroad to gain insights about the patients we serve to help us improve care for our own community.

Team India will be focusing their work on emergency services, mental health and addictions, as well as diabetes, while Team Pakistan will be focusing on emergency services, pediatric medicine and diabetes.

In the weeks prior to departure, both teams were hard at work and connecting with our partners in India and Pakistan to build materials to focus on the areas of interest.

As our teams waited to board, they all had the opportunity to learn about why their colleagues decided to join the Global Health Tour and they participated in some good-natured team rivalry before they split up. 

Follow along as we share our teams' journeys with you over the next two weeks.

- Harpal Panesar

Team Pakistan

Team India

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