April 29th, 2022 by Nicholas Comninellis
Posted in INMED Action Steps For You|

Who trains the healthcare professionals who will go on to serve with Doctors Without Borders, Samaritans Purse, the United Nations, or International Medical Corps? Mainstream healthcare education does not prepare them for work in low-resource and international settings. Quite the opposite, in fact.

Barriers to effective, longer-term service in international health are enormous: unknown diseases, strange languages and customs, and work often without the benefit of laboratory, imaging, pharmacy, or consultants. Added to these are personal fatigue, financial limitations, and strained interpersonal relationships.

How do successful global health volunteers overcome these barriers and go on to serve with esteemed organizations with distinction? Training is critical, both to acquire the necessary skills and to coach future volunteers through the complex personal journeys. Throughout the year, INMED provides training and coaching through our Professional Diploma and Master’s Degree in International Health (MIH) programs, with over 1,200 graduates since 2004.

Julie Rosá is INMED’s most recent graduate. She is a family physician from Hiawatha, Kansas. Over the last year Dr. Rosá completed the MIH degree, including her scholarly project about developing a family medicine residency in the Middle East. Later this year, she and her husband will be moving to Kanad Hospital in UAE to launch such a new residency program.

June 8-9, INMED training and coaching go into light speed with one-day course in Ultrasound, OB Ultrasound, Helping Babies Breathe, Essential Care for Every Baby, Helping Mothers Survive, and Hands-On Skills for Low-Resource Healthcare. June 10-11, we enter hyperdrive with the 17th annual Humanitarian Health Conference in-person in Kansas City – an event to inspire, equip and connect participants with sending organizations and global health careers.

Who trains tomorrow’s international doctors and nurses? It’s INMED!

April 8th, 2022 by Nicholas Comninellis
Posted in International Health News & Inspiration|

Frodo: “I wish none of this had happened.” Gandalf: “So do all who live to see such times, but that is not for them to decide. All we have to decide is what to do with the time that is given to us.”

In 1989 I arrived in the capital city of Angola, southern Africa, to begin making good on my commitment. Those were wild days of civil war: roads littered with landmines, nightly military attacks on citizens and foreigners alike, wide-spread hunger, and epidemics of cholera and typhoid. Travel to the interior was especially risky. Yet it was to churches in the interior city of Huambo to whom I had made my pledge to launch a new healthcare project.

Mercifully, Mission Aviation Fellowship had just stationed a plane in Angola, upon which so much of my initiative depended. The pilot, an older man, was very warm, competent, and engaging in character. After several days I finally discerned that he was John Testrake – the hero of TWA Flight 847, hijacked in 1985 from Athens to Beirut and Algiers; the pilot who negotiated the release of his passengers all the while with a gun to his head.

Years later, Testrake’s grandson was my student at the University of Missouri-Kansas City School of Medicine. “My grandfather died when I was young. What was it like?” questioned the young man. “John Testrake,” I replied, “was a man of deep spiritual faith, fulfilling his ‘routine’ duties with excellence. Then, when suddenly confronted by crisis, he decidedly led with wisdom and valor.”

Whether negotiating with terrorists, traversing the African outback, or confronting any myriad of challenges, may you and I decide with similar wisdom and valor what to do with the time that is given to us.

March 31st, 2022 by Nicholas Comninellis
Posted in International Public Health|

Are you distressed over the millions of Ukrainians bombed out of their homes? Do you feel a burden in your soul to act on their behalf? Then join INMED’s Refugee Care Simulation at the Humanitarian Health Conference in Kansas City on June 10-11.

Day One of this event will reinforce your understanding of worldwide health challenges and connect you with quality local and international organizations with whom you can serve. Day Two will be the Refugee Care Simulation, giving you a practical experience to apply your knowledge of refugee needs into a complex crisis paralleling what is unfolding today in Eastern Europe.

The INMED Refugee Care Simulation will explore all four phases: Pre-Emergency (negotiation and mitigation), Emergency (shelter and nutrition), Maintenance (schooling and jobs), and Resolution (repatriation and resettlement). This event will also highlight the mental, physical, and healthcare needs of refugees, and ways you can assist even from a distance.

Best of all, the Humanitarian Health Conference will introduce you to colleagues and classmates who share your distress and enthusiasm to assist these most vulnerable people. So act now, Register for the HHC, and meet us in Kansas City on June 10-11!

March 25th, 2022 by Nicholas Comninellis
Posted in International Public Health|

How long does one remain a refugee?  Imagine abandoning your home over fear of losing your life, and then often living without family, possessions, livelihood, or ability to plan for your future. Even with significant assistance, such a limbo existence must be as short as possible. Now we consider Refugee Care, Phase 4, the Resolution Phase.

Today, the refugee crisis surrounding Ukraine is solidly within Phase 2–3: the Emergency Phase and the Maintenance Phase. In the future, long-term solutions must be explored for these 10 million displaced people.

What are the options? In brief, they include repatriation to one’s country of origin, integration in the host country, or resettlement in a third country. Repatriation to ones home country is usually preferred. Most often, people want to return to their own language, culture, neighborhood, and even house.  One recent example includes Angolans who fled that nation’s civil war returning to Angola from bordering nations.

Integration into the host country is less common. Following ISIS takeover over eastern Syria, hundreds of thousands fled into northern Iraq. While ISIS no longer controls territory, many Syrians continue to be threatened by ISIS elements. They have no intention of ever returning to Syria, and some are being granted permanent resident status in Iraq.

A small proportion of refugees will ultimately be settled in a third nation, such as the Germany or Sweden. Many Vietnamese people fleeing the 1975 fall of Saigon, for example, entered neighboring nations and were ultimately given resident status in the United States.

The anticipated stages of refugee care – Pre-Emergent, Emergency, Maintenance, and Resolution – may prove to be not so predictable. New crises can spark recurrent waves of migration. Instability within host countries may force relocation of refugees. Diplomatic setbacks frequently delay the resolution phase. Nevertheless, such stages provide a critical roadmap for providing care for these most vulnerable people.

March 18th, 2022 by Nicholas Comninellis
Posted in International Public Health|

The emergency phase of refugee care requires immediate shelter, nutrition, and medical intervention. If the displacement extends beyond a period of weeks, additional human needs must be addressed. Phase 3, the Maintenance Phase, has begun.

Since the Russian invasion of Ukraine, as of this writing, some 4 million refugees have sought safety in Europe, and another 6 million are internally displaced – that is, still within Ukraine but far from home. With multitudes of destroyed homes and decimated infrastructure, even if cease-fire and security are sustained, months or years of development will be required before these communities again become habitable.

Put yourself in the place of a refugee care leader, with thousands of vulnerable people relying upon you. What will be their longer-term needs? Children will need schooling to advance their skills. Adults will need jobs to earn income and occupy themselves. Serious mental health needs must be addressed. PTSD, depression, and psychotic disorders are exacerbated by displacement. Security within refugee settlements must be assured, for such people are understandably prone to conflict with one another and vulnerable to outsiders. Location of settlements is critical. Rural areas provide abundant space, but lack infrastructure like water, jobs, and schools. For these reasons, urban areas are often preferred. But urban settlements are accompanied by increased risk of conflict between refugees and local citizens, who may see the former as competing for resources in education and employment.

Refugee care in the maintenance phase demands true grit. The intense investment of resources and emotional energy of the emergency phase has predictably dwindled. Yet, the ongoing needs of refugees are substantial. And simultaneously, some skilled person – perhaps yourself – must also be negotiating a pathway into the Resolution Phase.

March 11th, 2022 by Nicholas Comninellis
Posted in International Public Health|

Despite skilled negotiation when conflict appears imminent, the pre-emergency phase, diplomatic forces often fail. Conflict irrupts. Civilians are threatened with violence, repression, hunger, and disease. Faced with little alternative, they flee their homes seeking immediate safety, commonly traveling by foot with only the barest of possessions or provisions.

On Thursday, February 20, 2022, Russian forces invaded Ukraine with air, ground, and see offensives. Threatened with their lives, at least 1 million Ukrainians – almost exclusively women and children – fled the country westward towards safety in the European Union. Entering the fourth week of war, the number of international refugees has swelled to over 3 million.

Now begins the Emergency Phase. Imagine yourself tasked with the responsibility to provide care for tens of thousands displaced persons arriving every day. What can you anticipate they will need? Immediately, shelter from the elements. In the case of Ukrainians, protection from the bitter cold. They will be hungry. Food insecurity is a hallmark of refugee flight. Many will be acutely ill with pneumonia, dysentery, and traumatic injuries. Those with chronic diseases, such as heart failure and chronic lung disease, will be without their medications and suffering exacerbations.

You as the refugee care leader must also be prepared to deliver their babies, care for their newborns, and manage the emergency complications. Yes, refugee women will deliver on schedule just like the rest of humanity. And you must also prevent and monitor for acute contagious diseases which flourish among marginalized people in close living quarters: measles, scabies, COVID-19.

If the crisis continues for weeks or months, and people are not able to return to their homes, then a new set of needs must also be addressed as we next into the Maintenance Phase.

March 4th, 2022 by Nicholas Comninellis
Posted in International Public Health|

This winter I am teaching the INMED International Refugee Care Course. In January and February, we explored the notable crises in Venezuela, Yemen, Syria, and surrounding nations. 12 days ago, as hundreds of thousands of women and children fled Ukraine, an INMED learner remarked with angst, “My gosh, we are seeing a refugee crisis unfold in real time!”

Refugee crises, sadly, have to become so pervasive that an entire discipline has been created to equip leaders in refugee care. In these coming weeks, we will explore the four recognized phases: Pre-Emergency, Emergency, Maintenance, and Resolution.

The first phase is Pre-Emergency. This is when we see potential danger and take decisive action to mitigate the risk that vulnerable people will be forced from their homes. Think back to the rhetoric between Russia, Ukraine, and world leaders during the months of January and February 2022. Threats were exchanged. Mediators were engaged. Offers were floated. Promises were made.

Indeed, the pre-emergency phase calls for diligent observation to identify hazardous situations and immediately intervene with negotiation and mitigation. Organizations like the International Crisis Group, Carter Center, and Stockholm International Peace Research Institute purposely monitor and mobilize to such hazards. The United Nations itself was founded with the mission of “the maintenance of international peace and security.”

The pre-emergency phase is also the time to organize humanitarian responders, position supplies, and develop action plans. Because if negotiation fails, conflict ensues, and people flee for safety, we now enter into the Emergency Phase.

February 25th, 2022 by Nicholas Comninellis
Posted in International Health News & Inspiration|

Amid the mushrooming violence throughout Ukraine, who of all is most likely to suffer? The soldiers? Indeed, some have died. The political and business personnel? Certainly, some have already lost fortunes. However, all modern wars are characterized by one frightening consistency: the most vulnerable are most likely to perish. Quoting the British Medical Journal, “In many war zones, violent deaths are often only a tiny proportion of overall deaths. Populations face a deterioration of their already poor health status, and excess deaths from infectious diseases will usually greatly outnumber deaths due to direct violence.” While the invasion of Ukraine only occurred days ago, analysts are already forecasting massive civilian mortality from trauma, cold, pneumonia and diarrhea, and soon, all compounded by starvation.

I witnessed this heart wrenching truth firsthand. In the 1990s I served in the nation of Angola, in southern Africa, best known for its ongoing civil war since 1962. My primary care clinics consistently cared for children suffering from measles, pregnant women febrile from malaria, and them all hungry with chronic malnutrition. Where were the men? Either fighting the war or already in the grave. The vision for INMED to equip healthcare professionals to serve the world’s vulnerable people was born in the context of the Angola Civil War.

What can you do this week on behalf of Ukrainian people? First, consider an immediate gift to the United Nations High Commissioner for Refugees. UNHCR is responsible for coordinating multinational aid for Ukrainians who continue to flee for their lives. UNHCR is almost entirely funded by donations, and I vouch from personal experience in Iraq with the quality of their humanitarian service. Second, offer your time and talent to a refugee care agency in your home city. Refugees typically arrive no money, language skill, or friends. Your assist would be treasured. In the United States, contact the Office of Refugee Resettlement.

Finally, consider a long-term investment into the lives of those who are refugees, displaced, chronically ill, or impoverished. The INMED Master’s Degree in International Health (MIH) provides a deep learning experience into the skills necessary to effectively care for and empower such people. Included in the MIH are courses in disaster management, refugee care, and even healthcare for marginalized Americans.

As you proceed today, please remember the family photo posted above. This Ukrainian mother and baby are at extreme risk for death from trauma, cold, pneumonia and diarrhea, and soon, starvation. Our actions today can preserve their lives.

January 28th, 2022 by Nicholas Comninellis
Posted in INMED Action Steps For You|

“Let us not lose heart in doing good!” This admonition from Paul of Tarsus, an early follower of Christ, for millennia has inspired people throughout calamity, conflict, and most recently, Covid. Please join me in Kansas City on June 10-11 for the 17th annual Humanitarian Health Conference – an event affirming that we, too, have not lost heart in doing good.

Be inspired through plenary presentations by Sam Fabiano of the Pan-African College of Christian Surgeons and Sean Mark of Kansas City’s University Health/Truman Medical Center. Be equipped through breakout session tracks in community health, patient care, career development, and hands-on skills in ultrasound, newborn resuscitation, and cervical cancer screening. Become connected with the local and international service organizations with whom you can explore volunteer options face-to-face.

Also, come early to the HHC! On Wednesday, June 8, we are offering Professional Qualification Courses in Helping Mothers Survive, Essential Care for Every Baby and Small Babies, and Obstetrics Ultrasound for Primary Care. Thursday, June 9, take in Helping Babies Breathe, Hands-On Skills for Low-Resource Healthcare, and Ultrasound for Primary Care.

One final element of “not losing heart in doing good” deserves special attention: the stellar people whom you will meet and with whom you may serve for years in the future. So, save the date in your calendar and register now for the 2022 Humanitarian Health Conference!

January 21st, 2022 by Nicholas Comninellis
Posted in INMED Action Steps For You|

The INMED Master’s Degree in International Health (MIH) shares some broad elements in common with a Master’s Degree in Public Health (MPH), including skills in epidemiology, biostatistics, behavioral and environmental sciences, and public health  management. The MIH, however, is distinctively focused on mobilizing and equipping healthcare professionals on behalf of marginalized people: those who are poor, undereducated, minorities, disabled, elderly, veterans, refugees, migrants, chronically ill, and victims of war or disaster. To this end, the MIH emphasizing the skill in diseases of poverty, maternal-newborn health, international public health interventions, cross-cultural skills, disaster management, health leadership, and health professions education.

Another MIH distinctive include an International Service-Learning Experience at one of INMED’s renowned Training Sites. This experience in one of twenty-five nations gives learners  substantial professional growth opportunity by applying their skills on behalf of low-resource and cross-cultural communities, with the benefit of on-site supervision.

A third MIH distinctive is the reasonable tuition. Currently at just $8704 total tuition, the MIH is substantially less expensive than MPH degrees which typically range from $16,000 to $60,000 in tuition and fees. The only additional MIH expense is cost of travel associated with the International Service-Learning Experience.

In short, an MPH degree is a solid credential in the broad field of public health. The Master’s Degree in International Health degree is specially focused on skills and experience to promote the wellbeing of low-resources people.