United States Trailing In Global Humanitarian Responsiveness

July 15th, 2016 by Nicholas Comninellis
Posted in Disaster Management|



International humanitarian response to recent large-scale disasters is widely regarded as unnecessarily inadequate, especially in light of advancements in disaster management understanding and available response resources. This unnecessary inadequacy is manifested in several forms: 1. Insufficient rapid assessment of disaster status and immediate relief needs prior to emergency response, resulting in frequent interventions that are inappropriate, 2. Poor communication and coordination between disaster responders, resulting in both duplication and omission of critical response elements, 3. Insufficient basic skills among disaster responders, resulting in under par acute injury and disease management, sanitation and preventive health measure, and provision of essential human needs (shelter, water, food, reunification), 4. Host government’s failure to recognize the skill, preparation, and capacity of EMTs (Emergency Medical Teams), resulting in denial of entry and participation of these EMTs that have potential to provide significant aid, 5. Insufficient attention to post-disaster on-going healthcare needs, infrastructure rebuilding, and disaster prevention, resulting in post-disaster epidemics, hunger, and recurrent disaster.


In response to these enumerated inadequacies, the WHO at the May 2016 World Health Assembly announced the process of developing and launching internationally-recognized EMTs as a critical component of rectification. At the time of this writing, over 64 nations have either launched or are developing accredited teams to provide surge support to nations by delivering emergency clinical care to sudden-onset disasters and outbreak-affected populations. Neither the United States government nor large-capacity US based NGOs have yet committed to adopting the EMT concept, leaving our nation of altruism on the sidelines of this critical international humanitarian development.


Reasons for this lack of progress stem from issues of funding and of leadership. The US Government continue to struggle to find funding for high-profile Zika concerns, let alone equipping EMTs. Similarly, funding of NGOs is crisis centered, rather than anticipatory such as is required for EMTs. Parallel to these funding concerns, organizational leadership, however well intended, is largely driven by funding and urgently felt needs – rather than by the future-oriented prospect of EMTs role.


What will be the United State’s response to trailing other nations in global humanitarian responsiveness?


Honesty And Truth Telling Within Chinese Healthcare

July 8th, 2016 by Nicholas Comninellis
Posted in Cross-Cultural Healthcare Pearls|



Astute observations from Eva Holsinger, my pediatrician colleague here in northeastern China: “Do you want your doctor to tell you everything, right away, as soon as she knows something bad is coming at you? Take it another step: who do you want the doctor to tell first: you, or your family? In the US and other places like northern Europe, the answer to the former is umm maybe now but for sure eventually, and the second one is not even a question with HIPAA laws and all the other ways we strive to protect our privacy.


“My experience here in China has been vastly different. From our early days in 2009 we quickly heard about how often serious diagnoses are not disclosed to the patient, but to the other relatives, and they decide when and if to tell the patient. Of course I was aghast and fumed about patient autonomy, rights, lying to the patient, and more. There are many questions surrounding this that I can’t begin to answer, beginning with how..and why…and what on earth…and strong adjectives that I might quickly jump to using like insufferable and paternalistic.


“However… A friend was telling me about her father’s recent diagnosis with advanced lung cancer, and how she and her sister want to tell him but their mother does not. The mother has declined chemotherapy for him and they are telling him that his illness cannot be cured but he should eat healthy foods and take good care of his health. Every weekend the three adult kids come home with their families and have a good family time together. The dad says he didn’t have it so good until he got sick. She is pretty sure he suspects.


“My friend says they will go along with their mother because she will be around a lot longer and they don’t want to upset her too much since they have to deal with her. As we talked and she described their family’s situation I had a sudden a-ha moment. In the Chinese culture parents take care of children when they are young, and the expectation is that the children will take care of the parents when they are old and/or sick. In addition, major decisions about a young person’s life-college, career, spouse-are often all made by the senior decision makers in the family. When they age, the roles are flipped to some degree.


“In the US a big deal is made about living wills, health care power of attorneys, DNR statuses. We entrust our decision making to our designated loved ones only at the very end of the journey when we can’t make the decision ourselves. I wonder if the same choice is made but much earlier in the process here-at the beginning of the diagnosis, not at the end of life.


“There is an element of trust that seems very deep-trusting that your spouse and children will do their utmost to decide what is best but not only for you but for the family as a whole. I may not necessarily agree with that method in every regard, but that doesn’t mean it is less valid than my western perspective. Can family members be loving, honest and truthful without the element of naked and complete disclosure that we value so much in the west? Can doctors work within this system and still make sure that the needs of the actual patient are met appropriately?


“These are some of the bigger cross-cultural issues we are grappling with as we, a group of western-trained doctors, attempt to teach and mentor a group of young Chinese physicians.”


Join the INMED Course At Massachusetts General Hospital!

July 1st, 2016 by Nicholas Comninellis
Posted in INMED Action Steps For You|



We must do better at doing good was the overwhelming evaluation of organizations responding to Haiti’s earthquake. Massachusetts General Hospital (MGH) Global Health, Harvard Humanitarian Initiative, Heart to Heart International, among others, are working in partnership with INMED to substantially improve the quality of both disaster response and sustainable community health improvement.


An essential element of doing better at doing good is you – the person who steps forward into such laudable service. Right now INMED is offering several opportunities to enhance your effectiveness via the INMED International Medicine and International Public Health Hybrid Courses. The 2016 Boston MA Courses are hosted by MGH and begin online Monday July 4, with in-classroom on Sep 16-18. Also starting very soon are identical INMED Courses in Glendale CA, Pittsburgh PA and Long Island NY. Please join in!

Lana Borden Teaching Nursing in Zambia

June 23rd, 2016 by Nicholas Comninellis
Posted in Healthcare Education, INMED Grads In Action|



In 2013 Lana Borden, an RN from Kansas City’s Children’s Mercy Hospital, we recognized with the INMED Diploma in International Public Health, which included her formative service-learning experience at Mushili Health Center in Zambia, southern Africa.


“In January I was in the Copperbelt area of Zambia again,” says Lana “to visit nursing colleges and interview for professorship. A private college called Nkana wants me to return for an internship as a sort of working interview and orientation process with the dean of nurses. I would be working alongside 6 other nursing “tutors” to train about 350 students through their three year nursing program. This was just the sort of thing I was hoping to do, as I believe the impact of training the next generation of nurses from the beginning of their studies will have an exponential effect on healthcare in Zambia. Doctors are scarce, especially in rural areas, and nurses are often the primary healthcare providers in their communities. INMED’s public health program was instrumental in getting me started on this journey.


“As a Christian and missions-minded nurse, I am excited at the opportunity to earn a living in the country I’ll be serving, although some may think it unusual. It is similar to the way the apostle Paul was able to generate income with his tent making trade as he traveled abroad and shared the gospel. It will be a challenging endeavor, but I am excited for what may be to come.”


Transformation In Healthcare Education

June 10th, 2016 by Nicholas Comninellis
Posted in Healthcare Education|



Paul Larson, INMED Faculty and family medicine instructor at the University of Pittsburgh, notes how in 1956 Benjamin Bloom and collaborators developed a framework for classifying educational objectives. This image describes categories of behavioral learning of increasing cognitive complexity. In its most primitive form, learning is confined to recitation. With increasing maturity, learning expands toward application of what is learned, analysis of the validity of that information, and even to creation of new information.


This model of understanding has lead to tremendous shifts in healthcare education; moving the field from knowledge-orientation toward competency-accomplishment. Associated with this transformation has been the role of the teacher. She or he is no longer simply a source of information, but rather one who facilitates learning through creation of effective learning opportunities. Hence, the Bloom’s Taxonomy impacts both the Learner and the Teacher.



Why Construct A Ship Underway At Sea?

June 3rd, 2016 by Nicholas Comninellis
Posted in INMED Action Steps For You|



Sounds like nonsense. Why construct a ship while plowing the waves at sea? Wouldn’t it be more efficient to pull into a dry dock for a few months of focused building? The fact is, however, that once the hull is complete and engine installed the ship can start hauling passengers. 2003 was the year of INMED’s basic construction. Since then, the demand for ‘passenger service’ has been so steady that the we have not enjoyed the luxury of making people wait for our services. After all, equipping well-meaning healthcare personnel to serve the world most marginalized is one of the very most compelling payloads to bear.


During the coming year watch for several new additions presently being built onto INMED’s ship:


  • Establishment of a scholarship fund to facilitating healthcare students earning an INMED Diploma.
  • Expansion of the INMED Conference to address a broader audience of healthcare professionals and students.
  • Concentrated analysis of the impact of INMED training on the careers of our graduates.
  • Provision of augmented assistance for schools and programs to obtain global health accreditation
  • Introduction of healthcare education training to the core INMED curriculum.


Constructing a ship at sea has particular challenges: rough waves, extreme temperatures, exposed pilot house. But this also carries special benefits: the enthusiasm of the travelers and the joy of those in the harbors who great them.


2017 INMED Humanitarian Health Conference

May 27th, 2016 by Nicholas Comninellis
Posted in Global Health News & Inspiration, INMED Action Steps For You|

2017 HHC Image


At this moment 400+ individuals and 28 exhibiting organizations are taking part in the 11th annual INMED Exploring Medical Missions Conference. When first conceived in 2006, this event was primarily intended to bring together well-meaning volunteers with sending organizations, most often for shorter-term commitments. Since that time, the developments within INMED and the healthcare professions have shifted focus toward longer-term personal investments and toward those health interventions that are more comprehensive and potentially sustainable in nature.


In step with these developments, we at INMED are pleased to announce the new identity of this event: the INMED Humanitarian Health Conference. Look for the 2017 event to be inclusive of all healthcare professions, interactive and personal in nature, and populated by both inspired individuals and inspirational organizations. Given the previous frequent overlap with graduation events, the INMED Humanitarian Health Conference  will also be earlier in the year: Friday and Saturday morning, March 24-25, 2017. Please save the dates and join us!

Tomorrows International Health Volunteers

May 20th, 2016 by Nicholas Comninellis
Posted in Global Health News & Inspiration|



What do you want to do with your life? Let me introduce you to some who already know: The 200 graduate and undergrad students, photographed here at the event, who received scholarships to participate in this year’s INMED Exploring Medical Missions Conference.


One is Jordan Crawford, whom I originally met through Joe White of Kanakuk Kamps. “As Joe and I talked about medicine, missions, purpose,” says Jordan, “Joe was convinced that he needed to connect us. He briefly told me about INMED I was more than intrigued to learn more.”


My extreme gratitude goes out to the fifty-two individuals who provided funding – and the associated vision-casting – for these students. I hope you’ll save the dates of March 24-25 to join INMED again for our 2017 event: the INMED Humanitarian Health Conference.


Kim & Ted Higgins – 2016 INMED Award For Compassionate Service To Humanity Recipients

May 13th, 2016 by Nicholas Comninellis
Posted in Global Health News & Inspiration|

higgins-ted-kimThis award was established by the INMED Board of Directors to recognize people who demonstrate care and concern for those in need, who give selflessly of their time and resources, and who inspire others to take similar action. The 2016 INMED Award For Compassionate Service To Humanity Recipients are Kim & Ted Higgins.


As a general surgery resident at Yale University, Ted leaped at the opportunity to serve under mentors for six months at Hospital Albert Schweitzer in Haiti. Inspired through that experience, Ted and his wife, Kim, embarked on a twenty-five-year schedule of providing surgical care in Haiti and Dominican Republic – a pattern of service that continues even today. With the vision of further expanding continuity care for residents of these nations, the Higgins mastermined and funded establishment of the Higgins Brothers Surgical Center in partnership with Haiti Christian Missions. With a parallel vision of inspiring future international healthcare volunteers, the Higgins have both funded and provided their expertise for the INMED conference event since its inception.

Tom Kettler – 2016 INMED National Healthcare Service Award Recipient

May 6th, 2016 by Nicholas Comninellis
Posted in Global Health News & Inspiration, INMED Training Sites In Action|

kettler-tomMany health care professionals within their own nations are sacrificing personal comfort in order to care for their neglected neighbors. The award recipients listed below are role models in providing health care for their own people. The Institute for International Medicine is touched to announce the 2016 INMED National Healthcare Service Award Recipient: Tom Kettler.


Known to hundreds of patients in Stanley, Kansas, as a quality family physician, Dr. Kettler has remained unswerving in his commitment to Kansas City’s most needy populous: those residing in the urban core. There was once no primary care facility available in the immediate neighborhood – a particular obstacle for the numerous patients without transportation. After years of vision casting and overcoming financial challenges, in 2009 Dr. Kettler saw his vision birthed into reality with the formal opening of Hope Family Care Clinic (HFCC) at 3027 Prospect Ave.


But the young HFCC required nurturing. For two years Dr. Kettler himself staffed the clinic part-time on top of his normal medical responsibilities in Stanley. This year when HFCC became under staffed he again returned to this role. Says Kettler, “My Christian faith was primary in my pursuit of a medical career. I enjoy helping others and the challenge of solving problems. Medicine is a great field for life-long learning and service to others.”