HEAL Initiative Aims to Address Global Shortage of Health Care Workers

Faculty and fellows participating in the HEAL initiative in Hinche, Haiti. From left to right: Robin Tittle, HEAL co-founder Phuoc Le, HEAL co-founder Sriram Shamasunder, Jacquelin Pierre and Varun Verma. Photo by Sheila Menezes

Major disasters such as the 2010 Haiti earthquake or the 2014 Ebola outbreak in West Africa often highlight the need for well-trained health care workers across the world. But those needs exist every day, even when the headlines fade.

A 2013 WHO report estimated that the shortage of health care workers across the world amounted to about 7.2 million, a number that has nearly doubled since 2007. More than 70 percent of that deficit is in resource-poor locations in Southeast Asia and Africa.

In response to that growing need, a group of UCSF physicians last year founded the HEAL Initiative, an innovative two-year fellowship program that aims to scale up training of committed health care providers from the U.S. and abroad.

This summer, the HEAL Initiative welcomes its first inaugural class of fellows. Twenty-two inter-professional fellows, including physicians, social workers, dentists and physician assistants, from six countries and the Navajo Nation, have gathered in San Francisco for a crash course in global health delivered by experienced experts.

During the three-week boot camp, fellows are being trained in global health delivery, health equity, social justice, clinical practice in low resource settings and culturally competent care. Participants in the boot camp talk through challenging ethical scenarios, go through emergency simulations and get ultrasound training. “You can access an ultrasound anywhere in the world, so it’s gaining ground as a global health tool,” explained Sriram Shamasunder, assistant professor in the School of Medicine and co-founder of the HEAL initiative. “On the field, you can use it to investigate so many issues: if someone’s bleeding in their belly, or you need to extract fluid from a lung, for example.”

A HEAL Initiative fellow wraps the arm of a volunteer pretending to be injured during a training exercise

A HEAL Initiative fellow treats a head wound of a volunteer pretending to be injured during a training exerciseHEAL Initiative fellows train in emergency response at a mock refugee camp set up in the Presidio. Photos courtesy of HEAL Initiative

In one exercise, conducted in a large tree-filled field in the Presidio, the fellows descended upon a simulated Syrian refugee camp along the Syrian-Turkish border. Dozens of Bay Area volunteers played the parts of refugees, complete with prepared scripts and fake wounds and blood. Teams of fellows, each led by a faculty member, learned to evaluate the situation: to understand people’s needs, make plans based on available resources, and hone clinical skills such as treating lacerations or fractures on the field.

“Participants described it as overwhelming and emotionally difficult, but they recognize that such training is essential to deal with disasters – natural or manmade --  anywhere in the world,” says Phuoc Le, also an assistant professor in the School of Medicine and co-founder of the HEAL initiative.

After the boot camp, fellows will continue their training working in underserved sites across the world, including Navajo Nation, Liberia, Haiti, India, Mexico, Malawi and Nepal. Many of the fellows are from Malawi and Navajo nation and serve these populations, the HEAL initiative gives them the opportunity to use freshly honed skills to better care for the communities they are a part of. At the conclusion of the fellowship, fellows will complete two years of work experience in resource-poor settings locally and abroad, intensive mentorship from global health experts, and a master’s degree in public health from UC Berkeley.