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

Our time at Kirrudu Hospital required, above all things, humility. In my years as a resident at NYU many amazing mentors have taught me both the science of clinical neurology and the best approach to clinical practice for that cultural context. Practicing and teaching on the neurology ward in Kampala required a radical reorganization of the approach to patient care. This undoubtedly taught me to become a much better neurologist and clinician, and I would enthusiastically recommend any senior neurology resident work in a resource-limited setting, especially at this essential time in their training. It was an amazing opportunity to crystallize my clinical acumen and fund of knowledge.  While taking care of patients in New York, many clinical decisions are made with the benefit of data and imaging. Because patients and families were constantly required to fund raise for imaging and even basic lab studies, the threshold for ordering tests was much higher than at home. As I was forced to rely on my history and exam taking skills, I found that I did not need to wait for confirmatory testing to form a diagnosis and plan. Many senior neurologists have told me it reminds them of “the good old bad old days.”

Above all else the patient stories from Kampala will stay with me. Many cases from the Ward live on in my memory, but some of the most remarkable were so-called “fourth quarter” cases which may have presented to medical attention much earlier in the US. Access to care remains a major barrier for Ugandans and for this reason, among others, patients presented with more advanced disease than I was typically accustomed to seeing at home. I was also struck by the active role played by families in bathing, clothing and monitoring their loved ones when they were in the hospital.  The devotion of the interns, medical students and house officers was also remarkable, especially in the face of extremely trying circumstances with limited supplies and institutional support. This limitation extended even to basic items such as gloves and common medications. In fact, the day after we left the country, a national physician strike was called by the Ugandan Medical Association. As we flew back to New York via Dubai I was left both encouraged by the doctors’ desire to improve care for their patients in the long term and concerned about the fate of specific patients in the short term.

Undoubtedly our time in Uganda represented an essential experience in my training at NYU. Adidng to the experience on the ward were weekly public health screenings performed under the auspices of Dr. Jerome Chin’s non-profit ASAPP. We also made an outing to Nkokonjero Providence Home, a residential facility for children with chronic neurologic conditions run by the Catholic Church in the small town of Nkokonjero, Uganda. Contact with these children demonstrated that life for Ugandan children with epilepsy or congenital microcephaly remains fully-lived outside of the doctor’s office. I am extremely grateful to the neurology department for providing the opportunity and funding to pursue such an experience during my time as a trainee. I hope to incorporate this kind of work into my attending practice.

Scott Grossman, 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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Bonnie Wong's Experience

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.

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