Wednesday, December 10, 2014

Get informed about Ebola

One of the primary goals of the Richmond Global Health Alliance is to promote education and to keep supporters engaged in current global health discourse. In an effort to do this, two RGHA volunteers, Ranya Abi-Falah and Meredith Walsh, have compiled information about the Ebola virus and the most recent outbreak in West Africa. 

WHO: Facts to Know about Ebola

Fast facts 
Signs and Symptoms 
Usually manifest within 21 days of exposure
Flu-like symptoms including:
·         Fever
·         Chills
·         Fatigue
·         Joint pain
·         Headache
Also can present with rash, diarrhea, nausea, vomiting, abdominal pain
Hemorrhage: in less than 50% of cases and usually in terminal/late stages
“Red eye”
Dark red discoloration of the soft palate

Direct contact with blood, body fluids, of patients with Ebola virus disease (EVD)
Cannot be transmitted through air, water, pets, or food 

The standard of care is "supportive treatment," which means making sure a patient is kept hydrated  (via IV fluids), that body salts are balanced, that the patient is well oxygenated, and that his/her blood pressure remains within the normal limits. Also, several trial drugs as well as convalescent plasma from recovered Ebola virus disease (EVD) patients have been used to treat patients with EVD during the current outbreak.

PreventionUnless you have been in direct contact with the blood or body fluids of patients with EVD, you have zero risk of contracting the virus. Risk of widespread Ebola infection in the United States is minuscule. 

Several vaccine trials are underway, but no vaccine is yet available for the general public

CDC: The Top 10 Thinkgs you REALLY Need to Know about Ebola 

Ranya is a third year medical student at VCU School of Medicine (Medical College of Virginia), with a special interest in viral pathogenesis. Meredith works as a Communicable Disease Associate for the Epidemiology Office at the Richmond City Health District. She is involved in the public health response to EVD at a local level. Both Ranya and Meredith have traveled with RGHA to Pampas Grande, Peru. 

Sunday, November 9, 2014

My trip to Peru: An experience that I will never forget

By Maggie Byrne

In the summer of 2014, I traveled to the mountains of Peru.  It was an amazing experience that I will never forget.  I traveled with the Richmond Global Health Alliance or RGHA.   It was really fun even though I spoke absolutely no Spanish whatsoever.  We traveled to the small town of Pampas Grande and did many projects including, building greenhouses, providing free medical clinics, spending time with the local children, and doing crafts in their library.  It was really fun to experience a whole different culture, have fun with the kids, see the beautiful landscape and just generally help the town of Pampas Grande and the surrounding villages.

            The culture of Peru is very different from what I am used to in America.  Everyone that I met in Peru was very nice.  Everyone greeted me with a hug even if I had just met them.  This type of greeting was very different from the usual handshake that I am used to in America.  They were also very welcoming and invited us into their homes with open arms.  They always made us something to eat and made sure that we were never hungry.  They were extremely nice to us and that is something that I will never forget.

One of Maggie's favorite photos from her morning hike

            The children were really sweet and it was fun to hang out with them.  I went to the school and did a couple of projects with them, which were amazing.  They were eager to learn the English lessons that I taught using flashcards I had brought with me.  The children taught us how to play some of their games, which were a blast.  One memory that I will never forget happened at their playground.  There were two or three kids on the monkey bars and I started tickling them until they fell off.  I had no idea what I was getting into.  The kids loved it and got back on so I would tickle them again.  Kids were popping out of nowhere to join the game!  It was crazy!  They reminded me of my dog Daisy and her endless energy, because they never got tired and I could not wear them out.  When I tried to stop and go play tag with some other kids, the ones on the monkey bars kept calling my name, Señorita Maggie, Señorita Maggie.  Their was no escaping, so I just kept tickling.  It was really fun and I think I connected with the kids. 

            One day we woke up early and went on a hike.  Going on a hike at 12,000 feet was not the easiest thing to do, but it was really fun.  We hiked on a path for a little while before we reached the top.  The view was amazing!  The mountains stretched for miles and the morning fog covered them like a blanket.  As I looked down, the clouds and sky looked like the ocean.  It was beautiful!

            We did a bunch of projects in Pampas and the surrounding villages.  We built a greenhouse which involved everyone pitching in.  We also visited a greenhouse that RGHA had built in the past, and saw all of the plants that were being grown for the community. It was incredible to see what a big difference RGHA had already made.  Every experience, from the landscape, to the culture, to interacting with the children, was an something that I will never forget.  I hope that I can come back one day and see once again see the impact our small group has had on the lives of the people.

Maggie is the daughter of RGHA co-founder, board member, and legal team director Sean Byrne. She traveled to Peru for the first time this summer.

Tuesday, February 4, 2014

Pippa Carey: Reflections on my Time in Peru

Shortly after I returned from spending my summer with RGHA in Pampas Grande I began my study abroad experience in Copenhagen, Denmark. It was such a drastic change to go from working in an area where quality health care is extremely limited to a welfare state, where all citizens have access to health care that goes far beyond basic needs. While in Copenhagen, I studied public health from a global perspective, and it has made me reflect even further on my time in Peru.

RGHA Student Leader Pippa Carey, in Copenhagen, Denmark, where she studied abroad last semester

The majority of my time in Pampas was spent working in the clinic and on various projects such as the sunscreen project with children either at the school or the library. There were also green houses built and a dental project. Although we have not solidified all of the projects to dedicate our time to each year, we try to meet the needs of the community. Before going in with rigid ideas of what is needed we must ask them what it is that they believe will benefit them the most. As an organization, we must also strive to create sustainable projects that carry on even when we leave. When serving a community, you don’t want to have them remain completely dependent on the support of one week’s stay. Rather, you must help create projects and initiatives that locals can take over and spearhead for the rest of the year. This creates a beneficial partnership.

Pippa and VCU medical student Niyant Jain observing Dr. Erika Soria Leiva in the dental clinic in Pampas Grande, Peru.

During my time in Pampas, I also realized how important is for organizations like RGHA to maintain their relationships with the communities we work in. That means our interactions with the locals must not be limited to the few weeks each summer we are physically present in Pampas but must continue all year round through constant communication and development, even when we are thousands of miles apart.

The trip that I went on was the 4th year that RGHA has gone to Peru. It shows the people in Pampas Grande how dedicated the organization is to serving their community and builds their trust in the organization. Commitment is essential if trips like the one to Pampas are to ever succeed. The number of people visiting the clinic surpassed any previous year. The committed volunteers return each year to help more who have heard about the good work of the organization.  However, commitment does not automatically equal success. When something doesn’t go as planned, it means making the effort to create a change that benefits everyone, and trynig again. In Pampas, that could mean trying a new system when registering patients at the clinic or scratching one program entirely for one that may be more useful. It’s a commitment to trying to get it right.

Commitment and teamwork also go hand in hand. Everyone on the team has to dedicate themselves to give their best and be willing to do whatever job comes their way. This means that no job is too small or insignificant, whether it’s playing with a child while his mother is being examined by the physician or organizing supplies for the school projects. I have seen all of these characteristics with the groups I worked with in Pampas and they inspired me to do the same.

Finally, discovering something to be passionate about is truly a priceless experience, and developing that passion requires commitment, patience and the cultivation of experiences to provide new perspectives on healthcare and service work. All of these things describe my experience with RGHA. My time in Pampas was truly a life changing one that allowed me to see healthcare in a new way and reinforced my future career goals of working in global health. As a new assistant student director of RGHA, I am excited to help plan the upcoming summer trip and continue collaborating with HOMBRE and PAN Peru to serve the Pampas community.

Thursday, November 21, 2013

Congratulations to our new Student Directors!

Mentorship and service education is an essential part of our work as the Richmond Global Health Alliance, and involving students in every aspect of our operations is essential.

We are proud to announce that Meredith Walsh will be serving as our Student Director. She will be joined by Pippa Carey and Abigail Burns.  All three students joined us for our 2013 trip to Pampas Grande and will be an integral part of our team as we grow RGHA and prepare for our 2014 trip.

The University of Richmond Student team travelling to Pampas Grande with PAN Peru, RGHA and Motif members.

Meredith Walsh – Senior – University of Richmond

Meredith is an active student on the University of Richmond campus with leadership roles in the Westhampton College, Global Health and Human Rights Club, and Delta Delta Delta Sorority. She is fluent in Spanish and has shown her interest in global health while not only working with RGHA but also with the World Pediatric Project and Midwives for Haiti. 

Pippa Carey (left) and Meredith Walsh (right) at a café in Cuzco, Peru.

Pippa Carey – Junior – University of Richmond

Pippa is a Health Care and Society major and Chemistry and Spanish minor from Nassau, Bahamas.  She is currently studying abroad in Denmark and has previously studied in Spain.  She serves as the President of the West Indian Lynk and participated in the Sophomore Scholar in Residence Program in Children’s Health working with Dancing Classrooms, Inc. for her capstone project. 

Abby Burns (left) and Meredith Walsh (right) in Cuzco, Peru.

Abby Burns – Junior – University of Richmond

Abby is a Healthcare and Society major and Biology and Spanish minor from Massachussets.  She's an athlete, regularly playing soccer and ice hockey.  At the University of Richmond, she is a Spider Key Society Tour Guide and orientation adviser.  She is currently studying abroad this semester in Spain where her fluency in Spanish is likely thriving.  

Thursday, November 14, 2013

Emily Peron: What I've Learned

When I moved from Pittsburgh to Richmond last summer to join the faculty at the VCU School of Pharmacy, I thought I knew my role. I was a practicing pharmacist, educator, and researcher with a passion for working with older adults wherever they reside. Little did I know that I would soon find myself working with older adults in Pampas Grande, Peru, thousands of feet above sea level and thousands of feet from my new hometown.

Becoming a part of the Richmond Global Health Alliance originally stemmed from my involvement with student pharmacists who were traveling to the Dominican Republic, Honduras, and Peru as part of VCU’s HOMBRE organization (formerly the Honduras Outreach Medical Brigada Relief Effort). As a first-year faculty member, I was not sure if the opportunity to travel internationally for work would present itself again in this way. So, I picked a country, signed up, and showed up. And I learned a few things along the way…

Dr. Emily Peron and Max Stinehour organizing donated medications in the Pampas Grande clinic.

1.      It’s important to show up. One of the most valuable things RGHA does for the people of Pampas Grande is show up. Year after year, residents can count on a team from the Richmond area to live in Pampas Grande, participate in local cultural events, and see hundreds of patients in a week’s time. Although student participants often change from year to year, trip leaders are dedicated individuals who the residents of Pampas Grande have come to know and respect. And, with the help of PAN Peru and local community health workers, the work that we do during these annual medical brigades is able to be maintained and even enhanced over the course of the rest of the year.

2.      Being present is a powerful thing. There is no question that our days in Pampas Grande are busy. One group may be building a greenhouse while another is distributing sunscreen to children with chapped faces and yet another is trying to see all the patients in clinic before darkness sets in. When you are thousands of miles from home and connecting to the internet is the farthest thing from your mind (in part because it’s next to impossible), it’s amazing how present you are in whatever activity is happening at the moment. Mornings spent walking from home to the kitchen to the clinic, afternoons spent dancing and singing at local festivals, nights spent eating and talking over dinner, and especially hours spent seeing patients in the clinic setting, are times spent engaged in the present, listening to and learning from others, and truly focusing on what is important.

3.      Quality healthcare is quality healthcare, and everyone deserves quality healthcare. Although I could probably use more eloquent terms, this statement gets to the heart of what RGHA strives to do. As providers in the clinic in Pampas Grande, we do our best to provide the same care – the same assessments, the same treatments, the same quality of healthcare – as we would to patients in the Richmond area. From a pharmacy standpoint, we travel with a wide range of brand and generic medications purchased from reputable suppliers. Medications arrive in Pampas Grande unopened and with expiration dates that will not come to pass for many months. Evidence-based medical practices are followed, and patients do not get medications without a prescription. Detailed notes are written, and records are kept for years to come. Treating the clinic in Pampas Grande as though it is any other clinic in the Richmond area is a key to the successful engagement of RGHA within the community and a key to ensuring that all patients receive the same quality healthcare we have come to know and expect in the United States.

4.      Committing to a cause can change your life. Leaving Peru, “committed” is the word I would use to describe how I was feeling. It is also the word I would use to describe my colleagues who dedicate their time, energy, and money to HOMBRE, RGHA, PAN Peru, and so many other organizations that work to bring quality healthcare to people everywhere. The individuals who have worked to make the annual trip from Richmond to Pampas Grande a reality are truly extraordinary and committed human beings. They are the kind of people you want in your corner, and they are people I am proud with whom to work year-round to make our two-week trip happen every summer. 
I cannot adequately thank RGHA, HOMBRE, PAN Peru, VCU, and all of the individuals with whom I have worked  over the past year. I was looking forward to our 2014 trip the day I returned to American soil this summer, and I look forward to many, many more summers spent in Pampas Grande.

- Emily

Dr. Emily Peron is an assistant professor at the VCU School of Pharmacy in the Department of Pharmacotherapy & Outcomes Science. She is a board member of both RGHA and HOMBRE. 

Wednesday, November 6, 2013

Sean McKenna on HOMBRE and RGHA

The physicians and nurses and support teams here at the VCU Medical Center are engaged in an array of amazing international medical efforts around the world and throughout the year.  RGHA is truly proud to be a part of this group of people— and joining the HOMBRE team has really had a terrific impact on our work and on the work that I see us doing in the future. This year the HOMBRE team is led by Dr Mark Ryan from Family Medicine and includes two different programs in Honduras (Norte and Pineras), a trip to the Dominican Republic and our trip to Peru.  The VCUMC programs are not limited to these opportunities but for now those are the only programs that are included in “HOMBRE.”

HOMBRE used to stand for Honduras Outreach Medical Brigada Relief Effort, as the program began in Honduras. Since growing to include several other Latin American destinations we are planning to adjust the name and will most likely change Honduras to Healthcare.  Peru brings some great new opportunities and ideas to this group- not only are we the only South American destination but we can also share our incredible experiences with our in-country partners, Pan Peru, and can offer unique perspectives by integrating with already established medical efforts in Pampas Grande and rounding at several Peruvian hospitals.  As the newbies in the group, the challenge is to make sure we bring as much to the table as they have to offer us, which will be a great goal for us to set for ourselves. These guys really have it down and the experience they offer their students is really terrific. By working with them, and by building from their models, I know that our medical student experience will be even better than it already is—which I think is saying a lot.

RGHA and HOMBRE team members at a hospital in Huaraz, Peru (Summer 2013). Photo courtesy of Ranya Abi-Falah (M2, VCU School of Medicine). 

The HOMBRE program just recently completed its selection process, and we now have the names of the medical students and pharmacy student (all first years) that will be joining us in June.  RGHA is very excited to welcome these individuals to the team and will have them write some blog entries over the coming weeks: Kara Keefe, Jackie Britz, Jason Barnes, Sherna Sheth and Sarah Nowalk. These students, along with the students assigned to the other locations, will begin Saturday morning classes in January (1-2/month I think) that will prepare them for the opportunities and challenges of international medical mission work.  Hopefully many of our RGHA team members will be able to attend these classes as well— we are welcome, but it all depends on schedules.

The RGHA team will be busy over the coming months preparing these new students for the trip in June. Soon we will know the names of our UR students as well and will start dividing up the teams into work groups for the different efforts. Hopefully we will be able to get the new medical/pharmacy students up to speed fast and then have them take on leadership roles on different projects. Our trip will run from June 15 to the end of the month, and many of us will hopefully be able to head to Cuzco following those 2 weeks. Dr Mayes has been able to put together some terrific opportunities for our team to participate in his summer study class and to benefit from some of his long-standing connections he has made in nurtured. I for one am definitely hoping that I will finally get to experience Machu Picchu.  Everyone asks and I always have to report that even though I have been to Peru for 7 years now, I have never made it to Cuzco or to the most famous destination in South America.

For now I will leave you with 2 HOMBRE links and will hopefully be posting again soon on our progress and plans.



Dr. Sean McKenna is an Assistant Professor in the Division of Pediatrics at VCU Medical Center. He serves as Chair of RGHA and is a member of the HOMBRE board. He has been visiting Pampas Grande since 2007. 

Friday, November 1, 2013

Sid Dante Explores RGHA Mission, Vision, and Principles

Sean Byrne, Sid Dante, and Sean McKenna at the dedication of a greenhouse behind the secondary school in Pampas Grande, Peru.

Three years into our existence as the Richmond Global Health Alliance, it is worth reviewing our original mission statement and principles.  Each was written with specific intentions, and this blog post will not only explain our initial thoughts but serve as a review of our initial principles as we embark on a strategic planning process led by Mary Grace Apostoli.

Mission Statement:

To support, financially and logistically, the global health and international service efforts by faculty, students and alumni of the University of Richmond and Virginia Commonwealth University.

We opted for a broad mission statement when we started for myriad reasons.  First, we had built a successful team through our return visits to Pampas Grande, Peru but we know that our team was special and could do more.  By not tying our mission specifically to Peru, we allowed ourselves the ability to build and grow even though organizationally we knew we were committed to our work in Pampas Grande for the near future.   Second, one of the roadblocks and frustrations we faced when we started was finding non-profit and administrative support for our project as it transformed from a experiential undergraduate trip to a global health mission.  As we grow, we hope to be available to other groups and projects that are establishing and help them while also learning from their experiences and results.  Finally, we bridge the City of Richmond as one of the few projects that involves the campuses of both VCU and U of R and we wish to further cement our relationship with both schools.


        We are committed in assisting those currently engaged in global health and in encouraging the development of the next generation of global health leaders.  We will involve participants of all experience levels and work to recruit those new to aid, development, and international efforts.

The first part of this principle builds on our hope and goal to eventually be able to support other groups and projects.  However, the second part is why this principle is listed first.  Our project from its inception involved students and was the result of a group of students wishing to help.  As our group has become more professional and increased our capabilities, we have kept students as central to our leadership.  There are multiple opportunities for mentored work and we have two student positions on our Board of Directors designed to offer a practical experience.  Moreover, recruiting both students and those new to aid, development and international efforts not only provides a valuable and novel education experience to those participants but also helps our group.  In areas where those of us who have returned to Pampas for many years may have made excuses for our failure to meet challenges or provide services, those new to aid and to our project bring a fresh perspective.  This leads to new ideas or novel suggestions, but more often it is their enthusiasm that is infectious and keeps those of us in leadership motivated. 

       We desire diversity in thought, ideas and action.  We will not discriminate based on sex, race, religion, creed, or sexual orientation when selecting our partners in global health.  We will not have discriminatory preconditions for our services nor will we engage in proselytizing during our work.

Our non-discriminatory statement is standard and broad but it is fundamentally important to us to have many different views and thoughts.  This leads to creative ways to solve problems and different approaches to the same conflict.  But it not only lets our projects to succeed, it allows us to learn from the other strengths.  In our leadership team we have included physicians and lawyers – two groups that are often portrayed as antagonistic, but in our work we have seen the fruits of collaboration due to different areas of expertise.  In the last part of this principle is a commitment that we will seek to help all and avoid preconditions to our service.  We do not have expectations of those who we try to help.  We will not expect them to sign on to our belief system or meet our cultural norms.   This is important – we are foreigners and outsiders where we work and we embrace the idea that our educational experience outweighs the services we provide.  As outsiders, we will try and learn from those we serve and allow them to learn from us. 

      We believe in the dignity of all human beings.  We will present our work realistically, avoid exploitative imagery and advertising, and maintain an appropriate standard of care across all our activities.  We will seek to strengthen communities with sustainable solutions and not burden them with frivolous requirements.

Our goal is to serve but we must respect those we serve.  Images of children are often used to tweak heart strings and increase fundraising, but these images can be exploitative if staged or designed to highlight aspects of poverty.  Additionally, this means maintaining the privacy of our patients and avoiding photography in clinic even if it means that showcasing our work with patients becomes more difficult.  This also is central to our teaching.  We discuss photography and the perils of disaster tourism with our students and ask them to consider their social media posts. Their trip is not help or save but is instead to learn. 

Maintaining a reasonable standard of care is difficult on mission trips but there are areas and approaches we must take to meet that.  Though there are limitations to the care we can provide due to the medications or technology available, where we can, we must seek to provide the same quality care that we provide to patients in the United States. This means that we must aspire to higher quality care and seek to expand our capabilities every year. This can come in the form of refusing donations of well-intentioned but expired medications. However, at times we may use medications that have an expiration date if our research shows that there is no harm.  Our basic principle is that we would never offer or provide any care that we would not do in the United States.  If a medication or piece of equipment that is expired is something I would prescribe to a family member because the expiration date is arbitrarily placed by the local pharmacy (as is common on all prescriptions) or on equipment that is structurally safe, then we will use it.  However even if it’s the “best” that is offered, we must strive for more.  This means more of my time spent fundraising to buy quality medications and equipment rather than accepting cast-off donations.   

        We value the hard work of our volunteers and donors and the needs of those whom we serve.  We will strive to have minimal overhead to our work, a longitudinal commitment to the people and areas where we work, and an open and inviting culture to all our volunteers and supporters.

This is an organizational principle that has only strengthened as our programming has grown.  Thus far, we are volunteers with professionals and students and the majority of our fundraising comes from our family and friends.  As we continue, we may be able to attract additional sources of funding but we must do it in a responsible manner.  Expansion of our programs or missions will be based on need and not based on our desire to travel more.  This requires us to commit to our projects not only during our mission trip but also throughout the year.  We build projects with many years in mind but also seek to do it in a way that builds the capacity of the town.  Finally, we have to recognize that we will not always succeed.  Having a multi-year commitment allows us to fail but also gives us the ability to change.  To do so, we have to have a culture that allows open and honest discussion and include all in our decision-making process. We have a board but all of our meetings are open and everyone is invited.  In fact, we invite all new volunteers or interested supporters to our meetings to see how we work and to actively participate.  

      We recognize our limits in time, ability and ideas.  We will seek collaborations with other groups, learn from the successes and failures of previous projects, and seek oversight and guidance.   We will regularly debrief our efforts and submit to critical reviews from our partners and experts.

Finally, we end with an expression intended to demonstrate humility.  We may be led by professionals such as doctors, lawyers and pharmacists and our short time has allowed us to develop some small measure of expertise in our work, but we know that much of what we are trying to enact has been done before.  Our goal is not to go it alone or build our organization but to learn and do our best.  This also means that we have to regularly review our own work and debrief and it means that periodically we have to revisit our mission and goals. 


We envision a stable, adaptable and supportive organization that will provide a longitudinal commitment to sustainable projects in international communities.

Our vision follows above.  We seek to be stable so our commitment is long-term, try to be adaptable so that we recognize our successes and failures and work to be supportive in not only our service but also to our volunteers and students.  Being such an organization means that we can meet the objective of sustainability.

Reading and reviewing this mission statement, I continue to be excited for our strategic planning process.  But looking back at our mission statement and our efforts since our founding in 2011 is that we do meet each of this principles as we try to achieve our vision.  As a young group, we still have much to do to see if we become the organization we wish to be, but I believe we can and will.  

-Sid Dante

Sid Dante is a graduate of VCU School of Medicine and is now in his second year of residency at the University of Chicago. Sid has been traveling to Pampas Grande since 2010 and is a member of the RGHA board.

RGHA Medical Projects