Global health rotations offered through the West Virginia University School of Medicine provide fourth-year medical students with experience in the practice of medicine in a global setting, introduce students to important global health issues and prepare students for global travel. Global rotations include hospital and clinic sites in locations such as Brazil, Fiji, Jamaica, Italy and Rwanda.
For students traveling to Jamaica, Tracy Evans-Gilbert, M.D., a pediatrician specializing in treating children born with HIV, leads experiences in the Cornwall Regional Hospital Department of Pediatrics. Dr. Evans-Gilbert is also a consultant in pediatrics, tropical medicine and public health at the Montego Bay hospital and serves as a senior associate lecturer and researcher at the University of the West Indies in Kingston.
Early in her medical training, Evans-Gilbert developed an interest in health equity after meeting two children infected with HIV at an AIDS hospice. While one of the children died, the other survived because of access to antiretroviral drugs that were not yet available in Jamaica. Evans-Gilbert would later co-author a publication about a multicenter hospital-based description of HIV-infected children in Jamaica and further develop her clinical, epidemiological and research skills at the University of Maryland and Johns Hopkins University through a scholarship provided by the National Institutes of Health Fogarty International Center. As she traveled to present papers about this cohort at international conferences, she made connections with colleagues treating the same condition from resource-rich and resource-limited settings. This dichotomy helped her see healthcare differently and her journey in global health began.
“Global health is a wonderful adventure,” Evans-Gilbert said. “There are many opportunities and much good that can be done in global health. When you step out of your comfort zone and expand the reach of your clinical knowledge, the learning never ends.”
To solidify the experience she gained through her travels and research, Evans-Gilbert pursued a master’s degree in public health and complemented it with the Tropical Medicine course offered at WVU, a program she says was the perfect combination of tropical medicine with global health and epidemiology.
WVU’s Tropical Medicine course is open to healthcare professionals who are interested in continuing education, as well as students from WVU and other institutions. The course focuses on essential skills and competencies in clinical tropical medicine, laboratory skills in a low-technology setting, epidemiology and disease control, and traveler’s health. Due to the COVID-19 pandemic, all course modules are now conducted online.
With great enthusiasm for global health education, Evans-Gilbert has embraced the opportunity for learning and sharing of experiences as a result of COVID-19.
“In the Caribbean, early lockdown measures resulted in a favorable initial experience,” she explained. “I watched as it was unleashed across the globe and immersed myself with training material from the World Health Organization along with open-access publications. We were then in the heat of the pandemic which our colleagues had just experienced, and we had different experiences that we could also share.
“The Caribbean is diverse socioeconomically, so we had similar and different experiences across the 16 islands. Through pediatric collaboration, we were able to share early outbreak impact among children through CARPHA (Caribbean Public Health Agency) and pool data on children hospitalized with COVID.
“I believe this pandemic has brought the scientific community together remarkably, and that global sharing of knowledge will not end here.”
Evans-Gilbert has served as a team leader throughout the pandemic, coordinating regional support and leadership from academia and public health to understand the impact of COVID-19 in children in the Caribbean. Her efforts are helping determine where vulnerabilities exist for targeted interventions and where opportunities exist for creativity and inclusion in healthcare.
“Global health education is a two-way street,” Evans-Gilbert said. “It widens the scope of medicine to a broader world vision of who needs help the most. Additionally, it broadens the scope of knowledge for persons in low and low-middle income countries to improve healthcare in their particular setting. The best part of sharing knowledge is that everybody wins.”
Though there are significant challenges to maintaining a global health focus in education, that is precisely why it is so critical now. Moreover, Evans-Gilbert sees opportunities in those challenges and predicts the educational collaboration will remain even after we emerge from the global crisis.
“I live on an island, but we are not an island when it comes to health – the pandemic revealed that,” said Evans-Gilbert. “Global education and global health should take a more prominent role in health training and expose persons earlier. We learn better when we share what we know, and that can translate to better opportunities for improvement in healthcare and better health outcomes.”