UCSF HEAL Initiative

The Health Equity, Action, and Leadership (HEAL) Initiative is a Global Health training program started in 2015 in affiliation with the University of California, San Francisco (UCSF) Department of Medicine.

HEAL’s mission is to “train and transform frontline health professionals through building a community dedicated to serving the underserved as their lifelong choice.” To do so, HEAL runs a two-year fellowship program that strengthens the capacity of global health leaders through both immersive, hands-on training, as well as academic curriculum. HEAL has several components that distinguish it from other academic Global Health fellowships, including underserved sites in the United States and across the world, an incredibly diverse cohort of health professionals from numerous countries, and an innovative financing model that makes the program less reliant on funding cycles.

Because HEAL recognizes that social change is possible only when genuine solidarity is formed with the communities where it works, each class of fellows is composed of rotating fellows (U.S. trained physicians and nurse practitioners) and site fellows (health professionals from the communities where the partner sites are located).

Rotating fellows split their time between two of HEAL’s 17 partner sites in 9 countries and the Navajo Nation, partnering with site fellows at each. Fellows also attend two global health training conferences, both of which teach global health topics with an emphasis on social medicine and health equity. Additionally, HEAL provides fellows with financial support for professional development opportunities, including a funded graduate degree.

History

HEAL’s origin lies in post-earthquake Haiti, where its founders, Drs. Sriram Shamasunder and Phuoc Le, met as colleagues for Partners in Health. The chronic emergency that followed the 2010 earthquake reminded them of what they had witnessed as medical volunteers in rural Liberia, India, and Navajo Nation: “the will to serve must be combined with the expertise to do so.” Dr. Shamasunder also gave a TED x Berkeley talk that inspired HEAL’s approach to Global Health. They became committed to initiate a training program that would provide global health professionals with the tangible skills and critical mindset necessary for building local capacities in poor areas for the long term. HEAL ran its first official class of 20 fellows in July 2015. There have now been 103 HEAL fellows since 2015, with half of them being either Native American or from low and middle income countries (LMIC).

HEAL Values

• Humility
• Solidarity
• Health Equity
• Attention to Structural Violence
• Transforming through Community
• Work is Everywhere
• Immersion
• Relentless Incrementalism

Curriculum

HEAL’s curriculum stems from three crucial tenants of global health practice:

1. Local health professional capacity must be supported.
2. The American health professionals who commit themselves to this mission must deeply understand the local context and have both the clinical and non-clinical skills to truly improve care.
3. The relationships between individuals and institutions must be reciprocal, long-term and equitable.

To communicate these ideals, HEAL runs three robust training conferences for fellows over two years. The first, Global Health Training, takes place in the Santa Cruz Mountains at the beginning of the fellows’ program and UC Berkeley. After completion of their first and second years, fellows travel to Dine College on the Navajo Nation for the Mid Fellowship Retreat and Commencement program for outgoing fellows. Among other concepts, these trainings stress the importance of structural competency, community engagement, advocacy, and leadership, as well as specific medical skills necessary to practice in limited resource settings. Because HEAL believes that global health work can be more damaging than helpful to local communities when health professionals aren’t equipped with necessary expertise, these training programs are designed to give fellows the knowledge and mindset to increase access to healthcare in the world’s poorest areas.

Funding

As part of the annual President’s Budget, Congress appropriates a sum of money to Indian Health Services (IHS), a federal agency responsible for providing health services to American Indians and Alaska Natives. IHS is then responsible for hiring physicians at the hospitals and clinics on reservations throughout the country. However, IHS is often unable to fill the number of positions the hospitals and clinics need due to a strong a shortage of physicians in these areas. As a result, Indian Health Services is forced to contract out to for-profit agencies that provide short-term physicians at a high rate. These physicians, known as locum tenens, are not from the communities they serve, stay for a short period of time, and rarely continue any form of involvement when their contract expires. This is the case in the Navajo Nation, where the HEAL Initiative works. HEAL offers an alternative to these for-profit agencies at a competitive price. The money that would be spent on locum tenens is instead paid to HEAL, which sends two rotating fellows to the hospital or clinic in return, as well as the ability for two site fellows to participate in the fellowship and receive the opportunity for funded graduate education. The profit that HEAL runs from this transaction is then used to fund the fellowship program at its other sites across the world. This funding from IHS covers the majority of the HEAL Initiative expenditures. Philanthropy and funding from UCSF are also used, but constitute a less sizeable source of revenue.

Current Work

HEAL currently has 17 partner sites in 9 countries and the Navajo Nation.

Malawi:

• Abwenzi Pa Za Umoyo

Rwanda:

• University of Global Health Equity

Mali:

• Muso

Liberia:

• Last Mile Health

Mexico:

• Companeros en Salud

Haiti:

• Zanmi Lasante

Navajo Nation:

• Chinle Health Center
• Northern Navajo Medical Center (Shiprock)
• Gallup Medical Center
• Tsehootsooi Medical Center (Fort Defiance)
• Tuba City Regional Healthcare Corporation

India:

• Tribal Health Initiative
• Sewa Rural
• Jan Swasthya Sahyog

Nepal:

• Possible

United States:

• UCSF Division of Hospital Medicine
• Natividad Medical Center

References

This article "UCSF HEAL Initiative" is from Wikipedia. The list of its authors can be seen in its historical and/or the page Edithistory:UCSF HEAL Initiative. Articles copied from Draft Namespace on Wikipedia could be seen on the Draft Namespace of Wikipedia and not main one.

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