Global Health and Neurology

The Department of Neurology has a Division of Global Health that is led by Jaydeep Bhatt, MD. The division aims to develop and support training and education for neurology practice in low and middle income countries and to improve awareness of global health issues in neurology. In this discipline of Neurology, Dr. Bhatt has significant experience with healthcare delivery in resource limited settings. We are pleased that this program has strong collaborations with NYU’s College of Global Public Health. NYU School of Medicine Department of Population Health and Dr. Jerome Chin, Adjunct Professor in NYU Department of Neurology and president of The Alliance for Stroke Awareness and Prevention Project (ASAPP). Dr. Bhatt’s endeavors complement a larger academic network of domestic and international neurology faculty who are members of the Global Health Section of the American Academy of Neurology. Drs. Bhatt & Chin travel to Kampala, Uganda to participate in a clinical global neurology elective to examine the diagnosis and treatment of neurologic disorders in a resource limited setting with 1-2 neurology residents per year.

 

Perspectives of an NYU Neurology Resident

 

It was the quietness of our wards that struck me the most.; Each held at least 10 hospital beds with patients, with usually more in the corridor between beds. Because bedside care was provided by family, they stayed during the day and night on colorful woven mats on the floor, with food and belongings tucked into bags and baskets nearby.There was a toddler who wandered in an out, her soft giggles audible. Sometimes, entire families stayed during the day and yet you could hear your thoughts. We leaned in close to hear rounds, review scans, and make plans at just above a whisper.

In order to modernize the central national hospital facilities, hospital services were divided and relocated 4 smaller community hospitals with surgical services and radiology remaining on the main campus. Patients were transported from the ED in Mulago to the neurology wards 40 minutes away at Kirrudu. Hospital CT scans were also a 40 minute ambulance ride away. The transition meant that we were actually practicing neurology as if there were only one CT scanner. In Kirrudu, I saw neuropathology of every kind, in all stages of development - neurotuberculosis, neurocystercercosis, PML, myasthenia, a multitude of large hemorrhagic strokes from uncontrolled hypertension, epilepsy.Above all, the neurologic exam and history drove decision making.

The experience offered a multitude of lessons in neurology, but also in improvisation, in making do with less rather than more. It has profoundly influenced my perspective on neurology, global health, health systems, and on my present and future role as a physician within these systems. I am incredibly thankful for the opportunity.

Bonnie Wong, MD - Neurology Resident PGY-3


 

Alexandra Lloyd-Smith's Experience

The opportunity to practice neurology at Mulago Hospital in Kampala, Uganda was life changing and will have an everlasting positive effect on my career as a neurologist. Mulago is Uganda’s national referral hospital. Patients from each corner of the country travel by various means of transportation for neurological evaluation. Together with their families and friends, they carry basic personal belongings including bed sheets and utensils in preparation for their admission. Everyone was unique and had beautiful life stories to share.

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