A shared mission
Learning together through Stanford-Zimbabwe health care partnerships
For 11 months of her Stanford Medicine pathology residency, Megan Fitzpatrick, MD, lived in a tiny rural village in Zimbabwe. There on a fellowship starting in 2016, she conducted medical research at a hospital that was a five-hour drive on dirt roads outside the capital city of Harare.
A Zimbabwean clinic’s aim is to vanquish dire ear, nose and throat ailments in children.
Her work aimed to prevent cervical cancer, a major contributor to the deaths of the country’s women. To optimize prevention efforts, she collected vaginal swabs from local women to study subtypes of the human papillomavirus, which causes cervical cancer. She also held workshops to train community health workers on how to explain cervical cancer to the women there.
Fitzpatrick is one among many Stanford students, scientists, physicians, surgeons and global health experts who have traveled to sub-Saharan African countries to learn and to help developing countries advance their medical education systems. Partnerships between Stanford researchers and the University of Zimbabwe stretch back to the 1980s and provide learning opportunities for both.
During her time in Zimbabwe, Fitzpatrick was able to join a conference on interesting cases with University of Zimbabwe pathology residents. “I saw cases of things we don’t often see here, such as schistosomiasis, a parasite that mimics cervical cancer,” she said.
Michele Barry, MD, the medical school’s senior associate dean for global health and the director of Stanford’s Center for Innovation in Global Health, began working in 1988 in Zimbabwe, formerly known as Rhodesia, soon after it gained its independence from the British. Her goal was to help rebuild the medical education system following the bloody civil war that drove medical professionals away. After its independence, the country experienced decades of political instability and corruption.
“There was a brain drain; many left for South Africa,” said Barry. “But we continued and built relationships that have lasted.”
Clemence Chidziva, MD, an ENT surgeon and professor of otolaryngology at the University of Zimbabwe, came to Stanford in 2015 for a monthlong exchange program to learn how to set up a clinical research program. That year, he also recruited Peter Koltai, MD, a professor of otolaryngology at Stanford, to help create a pediatric otolaryngology training program at the University of Zimbabwe and establish an ENT clinic for children, which opened in March 2017.
“We were not doing any clinical research,” Chidziva said of the time before the collaboration. “Now, we have publications coming out of our clinic. We’ve established a record-keeping method necessary for conducting research.”
Crucial support for Stanford’s efforts in Zimbabwe came from the President’s Emergency Plan for AIDS Relief and the National Institutes of Health, which provided a $10 million grant to improve education and research in Africa. The funds enabled Stanford, the University of Zimbabwe and dozens of other institutions to train future Zimbabwean educators, improve technology at the Zimbabwean medical school, develop faculty medical specialists and mentor future researchers.
The NIH initiative, which ended in 2015, sparked numerous Stanford efforts in Zimbabwe that continue today, including Koltai’s work to help build the clinic; HIV/AIDS research by David Katzenstein, MD, professor emeritus of infectious disease; and surgical training by Sherry Wren, MD, professor of surgery.
In 2012, Wren established a general surgical rotation project that brought Stanford residents to Zimbabwe and Zimbabwean residents to Stanford. In 2015, she and Zimbabwean medical student Annete Bongiwe Moyo (who has since graduated) launched Zimbabwe’s first mentorship group and surgical skills training program for female medical students.
Stanford’s global health center recently received a new NIH grant to help the University of Zimbabwe College of Health Sciences build teams of health care providers from a wide range of professions.
Wren, whose work in Zimbabwe has branched out into other African nations, said working in Zimbabwe provides valuable insights for Stanford residents, who have trained in a high-tech environment with the most current medical devices on hand and experts nearby to help.
“It’s important for our residents to see how to deliver surgical care in a resource-limited environment,” Wren said.