Global Health Pawns, or What is Lost in the Global Health Gains?
Daniel Palazuelos, MD, MPH, is an affiliate of the Department of Global Health and Social Medicine Program in Global Primary Care and Social Change and a tutor in the required HMS I course, Introduction to Social Medicine and Global Health. Dr. Palazuelos is a global health implementor-educator who holds positions at Harvard Medical School, the Brigham and Women's Hospital (BWH), and Partners In Health (PIH). These include: clinical work as an attending on the BWH wards for 10 weeks a year with the hospitalist service; management support for, and mentorship of, the Global Health Equity (GHE) residents at the BWH; clinical and research mentorship in the PIH projects in Mexico and Guatemala; accompaniment of community health worker (CHW) projects across all PIH sites through a quality improvement (QI) task force that hosts summits, authors papers, represents PIH at national and international meetings, and awards internal QI micro-grants. For years, he worked to create the strategy for, and successfully launch, the new health care system strengthening PIH project in Mexico, Compañeros en Salud-Mexico. It is envisioned not only as a service provider for local people in the Sierra Madre Mountains of Chiapas, but also as a platform for both U.S. and Mexican medical trainees to learn about global health and to conduct implementation research. In addition to an emphasis on extensive preparation and on-site mentorship, this program offers collaborators the capacity to support intensive and logistically complex research efforts. Noteworthy examples include: a stepped-wedge unidirectional crossover study of the effectiveness of CHW accompaniment on diabetes and hypertension treatment adherence and clinical outcomes, and a user perception study of how a multifaceted educational intervention has affected local staff career choices.
Denise Octavia Smith, MBA, CHW, PN is founding executive director, National Association of Community Health Workers.