Health Sciences Academy of BACH

Child Health International Foundation

US/BELARUS HEALTH SCIENCES EDUCATION ACADEMY

Home
What's New
About Us
Our purpose
Current Projects: Cancer Registry; UCMC; The Academy
Site Contents
Contact Us

FORMED TO ALLEVIATE HEALTH CARE
PLIGHT OF BELARUS
Warren E. Grupe, MD and Thomas P. Foley, Jr, MD

The collapse of the Soviet Union was associated with a serious breakdown in the infrastructure supporting health care and medical education in Belarus. The economic disruption produced by a new independence added more stress on the republic's abilities to respond to the needs of even their healthiest citizens. Immunization rates have fallen, infant mortality has risen, fertility rates have plummeted and common illnesses have become fatal. Something had to be done, independent of the government, to make adequate health care available.

It also became apparent that there was an urgent need to upgrade the capability of many existing health care practitioners, not only in Belarus, but throughout the former Soviet Union, where health care practices may lag behind western standards by as much as 50 years. The typical practitioner, far from urban teaching centers, has not had access to the medical progress made in America during the past 40 years. Despite this professional need, there is currently no efficient mechanism to transfer the advances of contemporary medicine into standard clinical practice. Something had to be done in Belarus, without financial support from the government, to bring knowledge of modern care to a large number of existing practitioners.

The idea for an independent, self-sustaining institution which would combine all aspects of health care and education was first proposed by Dr. Alexei Kubarko, Professor and Rector of the Minsk Medical Institute. A 1994 agreement sanctioned by the Ministry of Health allowed the formation of the US/Belarus Health Sciences Education Academy as the first joint venture for health in Belarus and the first privatized institution for advanced medical education in the former Soviet Union. A counterpart organization, the Child Health International Foundation, was formed as the US partner to bring to the Academy some of the world's best clinical educators from prominent American health sciences centers and academic institutions. This unique joint venture, drawing from the expertise and vision available in both countries, will give Belarusian physicians and nurses the tools they need to reverse the current downward trend in health. The goal of the Academy is to establish an integrated system for patient care and professional education which matches or exceeds European and American standards. The Academy aims to produce a new generation of health care providers which can lead their country's health care reformation. Continuing support from the Child Health International Foundation ensures sustainable links with US medical centers and allows American clinical educators to augment the Belarusian faculty.

This new Academy also provides a fully integrated mechanism to introduce contemporary medical practice in a free and open environment, first to Belarus, then to other republics of the former USSR. Previous experience has already revealed a voracious receptivity to information about American health care practices. This experience has also shown that structured learning which leads to performance-based certification is an accepted vehicle to improve patient care by strengthening links between education and clinical practice. Initially, the Academy has focused on three priority areas: Clinical Care, Continuing Education and Graduate Health Sciences Education.

CLINICAL CARE

As a high priority, the Academy is developing a privatized clinical consultation service based in Minsk to provide exemplary care as a vehicle for health sciences education. The professional staff for this unit will be Belarusian, whose clinical skills have been certified to meet western standards by participating US institutions. US consultants, recruited and supervised by the Child Health International Foundation, supplement the Belarusian staff, provide additional training and furnish direct assistance to solve urgent or complex problems. An independent facility, equipped for ambulatory clinical care with a permanent, full-time staff employed by the Academy, will be the usual location of first contact for most patients. Family Practice, as it exists in the US, will be the model for this facility.

Hospitalization, when required, will be provided in upgraded existing facilities in Minsk with specifically selected staff under the tutelage of American consultants. Access to specified beds and services in these facilities will be arranged by special agreement. Professional personnel will be selected by the Academy and will be responsible to the Academy for the provision and supervision of clinical services. Since they will not be exclusive employees of the Academy, the in-service training provided by the Academy will have an immediate impact on the broadest constituency in Belarus. Limited only by financial resources, exemplary care by Academy providers will be available for everyone and will not be dependent on an individual's ability to pay. This not only assures wide accessibility to the expertise at the Academy, but ensures a broad patient base for the Academy's graduate and continuing education functions. Eventually, the Academy's clinical programs, and the US faculty, will be made available for students from the Minsk Medical Institute.

Where needed, the Academy will select and procure specialized medical and educational equipment, with the understanding that it will be used for the benefit of all patients, not just those supervised by the Academy. Future plans include an emergency transport system and a home care service.

HEALTH SCIENCES EDUCATION

The Academy will initiate multidisciplinary courses designed to enhance the professional capability of health care professionals at all levels. This training will encompass both the continuing education of health professionals already providing health care and the advanced education of recent graduates of medical, nursing and health sciences schools. Academy courses are designed to introduce contemporary health care concepts and content into daily clinical practice. Courses will meet defined goals through the adaptation and translation of standardized educational modules from courses currently implemented in the United States. These courses will be taught in Belarus by both Belarusian and American faculty. Selected Belarusian physicians will be chosen for focused clinical fellowships in the US. Courses of instruction will be implemented through formats that include self directed learning, lectures, workshops, seminars and practical clinical experience. Those who successfully complete a course of study will be certified by the Academy.

To broaden the impact of these courses, the Academy will develop, publish and distribute durable learning materials to accompany each course, including textbooks and organized syllabus material. These learning materials will be retained by participants as a continuing resource. Once field tested and proven, new learning modules will be presented in other areas of Belarus and eventually made available to other republics of the former Soviet Union.

Utilizing its own clinical services, the Academy will also conduct graduate training programs in medical specialties. These training programs, patterned after intern and residency programs in Western Europe and America, will be designed to supplement basic medical education and to prepare the emerging young professional for independent practice. Initially, the Academy will start with a limited number of primary medical specialties such as family practice, internal medicine, obstetrics and pediatrics. Courses will include physicians, nurses and allied health graduates. With the help of American consultants, the Academy will establish standard practices, procedures and policies. Performance-based competence, measured against western standards, will result in individual specialty certification by the Academy. In exceptional circumstances, joint certification through US educational institutions will be arranged.

CONTEMPORARY HEALTH CARE FOR INFANTS & CHILDREN

The health of its children is one of the greatest concerns for Belarus. Severely battered by World War II, in which 25% of households suffered a family loss, the vitality and health of this next generation has been extremely critical. However, the devastation produced by the 1986 Chernobyl nuclear accident created yet a new burden for the country. Of the 1.5 million people exposed to significant radiation in Belarus, 160,000 were young children. Thyroid cancer in children has already increased over 200-fold and an estimated 20,000 more children are at an increased risk to develop cancer in the near future. As much as 40% of the current health care expenditure in Belarus finances problems created by Chernobyl.

To meet the great need of children, the Academy, with the support of the Child Health International Foundation, has given children's health a particularly high priority. Several programs have been initiated which target specific pediatric needs. With a task force of physician and nurse educators from both countries, the Academy has established a non-profit medical publishing capability which translates contemporary pediatric information and adapts it to local culture and conditions. The new learning modules are designed to accommodate the normal work schedule and to stimulate interactive and self-directed learning.

All production is done in Belarus, where the cost is low and the capability to translate and adapt contemporary health related materials already exists through the Minsk Medical Institute. Production in Minsk also establishes the sustainable local capacity necessary to continue publication independently. Because of the long-term cultural ties formed during the Soviet era, these new medical materials developed successfully for Belarus can be used by the rest of the former Soviet Union.

The Academy is also developing a University Children's Medical Center as a referral center for the entire Republic and an international pediatric specialty unit. The Center will consolidate fragmented and duplicated services into a facility which will also be a comprehensive training site for pediatric health professionals. The decor and child sensitive environment will humanize children's health care. The facilities will promote family collaboration in their children's health care as an opportunity for public health education.

In addition to in-patient facilities, the Center will contain an Ambulatory Care Center which includes two unique services. A Day Hospital area will provide highly specialized care which avoids scary overnight hospitalization for the child. A Parent Care Area will allow staff-supervised, parent-provided treatment over several days, allowing staff to train parents for home care as a lower cost transition to home-based care. A multi-media Pediatric Learning Center will foster both public and professional education through conferences, lectures, seminars, workshops and a library.

Several specific pediatric projects have already been initiated under this program, including: a Cancer Registry for children, clinical management of radiation induced thyroid cancer; treatment of the major cause of stomach disease associated with stomach cancer; a reduction in the burden of environmental toxins on children; and a model network for neonatal and perinatal care.

The most immediate need is a constant base of financial support. A commitment to those in need, regardless of their ability to pay, requires a strong financial base. A dedication to high quality clinical education, with the added faculty and institutional costs, requires support. An obligation to young physicians, nurses and allied health professionals requires protection from the vagaries of the local economy and an ability to provide tuition relief. Currently, no support is provided by either the Belarusian or the American governments. It is our hope that the Belarusian-American community in both the US and Canada will recognize, and support, the ground-breaking work of the US/Belarus Health Sciences Education Academy.

The Child Health International Foundation is a publicly funded, non-profit charitable organization. Donations are tax deductible. The Foundation is supported through grants from private foundations, corporations, and individuals dedicated to the good health of children.

For more information, contact The Child Health International Foundation Post Office Box 38472 Pittsburgh, Pennsylvania 15238 USA

Dr. Foley is Professor of Pediatrics at the University of Pittsburgh School of Medicine and President of the Child Health International Foundation. Dr. Grupe is Medical Director of the International Center for the Health Sciences and Secretary/Treasurer of the Child Health International Foundation.