Nov 7, 2025 | AIGH
The Arnhold Institute for Global Health’s New York City (NYC) Partnership is excited to announce the recipients of its 2025 Pilot Project Awards. These awards, selected through a rigorous review based on the National Institutes of Health guidelines, provide up to $25,000 in pilot funding for one year to implement projects that address community health needs in Queens. They are awarded to collaborative teams from Mount Sinai, NYC Health + Hospitals (H+H)/Elmhurst and NYC H+H/Queens for research, care improvement, and training projects.
Previous award recipients have addressed a wide range of health concerns affecting Queens community members. For example, a project funded in 2024 is examining barriers to health care for Latinx immigrant workers in Queens. A participant in this project noted, “I follow my grandmother’s remedies…to avoid going to the doctor because it’s very expensive, and if you already have your bills to pay and you add another one for going to a doctor, you won’t be able to make ends meet with what you earn.”
Led by Homero Harari, ScD, Associate Professor, and Laura Sirbu, MD, Assistant Professor, Mount Sinai’s Department of Environmental Medicine, as well as Adina Valceanu, MD, an internist at NYC H+H/Queens, the project is responding to the community’s needs by aiming to improve health care access and outcomes for these workers.
“There has been a great response from our population,” Dr. Harari says. “We hope that our project will unveil ways to further enhance the collaboration between Mount Sinai and the NYC H+H network and improve occupational health care in working New Yorkers.”
The projects selected in 2025 also aim to address community needs and improve health outcomes. The five projects are:
Dave A. Holson, MD, MPH
They Don’t Believe Us: Changing the narrative for patients with sickle cell disease with an acute painful episode presenting to the emergency department through the implementation and evaluation of a standardized pain protocol
Sickle cell disease (SCD) is a genetic blood disorder that causes severe, chronic pain due to abnormally shaped blood cells that block blood flow to organs and tissues. It affects about 8,000 people in New York City and is most common among people with African ancestry. When people with SCD can no longer control their pain at home—known as an “acute pain crisis”—they go to the emergency department (ED). These patients often experience long wait times to receive pain medications in the ED and feel their reported pain is not taken seriously. This project aims to improve the timeliness of addressing pain in patients with the disease in an acute pain crisis seeking care at the NYC H+H/Queens ED. The team will survey physicians, nurses, and staff to gauge their understanding, comfort, and approach to managing SCD pain crises in the ED. They will also show study participants a video about sickle cell disease to highlight the stigma associated with the disease and hold group discussions. The team hopes to implement, evaluate, and improve pain protocols for these patients.
Devin Madden, PhD, MPH
Hope Bodega: An Equity-Centered Resiliency Research Project and Intervention
Hope Bodega uses storytelling to combat social isolation and discuss mental health. By using community members’ stories about hope, grounded in their cherished objects, Hope Bodega offers insights into marginalized communities’ relationships to adversity, resilience, and well-being. This project will formally analyze participants’ stories and evaluate Hope Bodega’s impact on well-being in collaboration with NYC H+H/Elmhurst’s Women and Children’s Division and the Institute for Health Equity Research at Mount Sinai, along with Queens-based community advocates focused on reproductive justice, and a community-based partner, Ancient Song.
Sarah Nowlin, PhD, MSN, RN
Postpartum Transitions in Healthcare (PATH)
Hypertensive disorders in pregnancy (HDP)—like gestational hypertension—can lead to physiological changes that increase long-term risk of cardiovascular disease and may contribute to racial and ethnic disparities in health. This project will test a text message-based tool called Postpartum Transitions in Healthcare (PATH). PATH, which will be co-designed with its target community, aims to better engage postpartum people in health care. It will send automated text messages with science-based postpartum health advice to women with HDP receiving care at NYC H+H/Elmhurst. It will also reward behaviors like attending scheduled appointments, to help postpartum people stay in care and take good care of their health. If this small pilot shows that PATH works, the team will use the data to inform the design of a larger future trial.
Harnessing Optimism and Perseverance in the Face of Long COVID~Español (HOPE-LC~Español)
Eric Watson, PhD, and Amelia Hicks, PhD
Long COVID is a chronic condition that disproportionately affects the Hispanic/Latinx community due to their greater exposure to COVID-19 and barriers to health care. It can lead to difficulties with memory and attention, fatigue, depression, anxiety, social withdrawal, and stress related to the unpredictability of symptoms and their impact on work, family, and quality of life. Treatment options are needed to address the psychological impact of living with Long COVID. This project will culturally and linguistically adapt a group therapy program developed by Drs. Watson and Hicks called Harnessing Optimism and Perseverance in the Face of Long COVID (HOPE-LC) to address the emotional and behavioral challenges for those living with Long COVID.
In partnership with NYC H+H/Elmhurst and NYC H+H/Queens, the team will translate the program into Spanish to reach underserved Spanish-speaking communities in Queens. They will refine program materials, engage community advisors, and implement a telehealth-based health care strategy tailored to the needs of the under- and uninsured Spanish-speaking population. If the program works to treat the psychosocial effects of Long COVID, the team will use the data to scale up the program.
The Impact on Health Care Utilization and Care Experience Following the Medicaid Expansion Among Older Immigrant Adults in New York State
Ellerie Weber, PhD, MBA, and Mehak Paul, MBBS, MPH
In 2024, New York expanded Medicaid eligibility to include low-income, undocumented New Yorkers aged 65 and older. This project will examine the impact of Medicaid expansion on health care utilization and the care experience for these newly eligible patients at NYC H+H/Elmhurst. The study team will analyze medical record data to understand how these patients use health care. They will also interview patients, social workers, and Medicaid managed care executives to understand their perspectives and experiences during the Medicaid expansion. This project will provide insight into the patients’ experiences, measure potential impacts on their health and health outcomes, aid in advocacy for further Medicaid expansion, and improve policy implementation.
The NYC Partnership is a collaboration among the Arnhold Institute for Global Health, the Global Health Institute at NYC H+H/Elmhurst, NYC H+H/Elmhurst and NYC H+H/ Queens. The NYC Partnership looks forward to working with these teams!
Payal Ram is the Program Manager for the New York City Partnership at the Arnhold Institute for Global Health and the Department of Global Health and Health System Design at the Icahn School of Medicine at Mount Sinai and the Global Health Institute at NYC Health + Hospitals/Elmhurst.
Updated on Oct 2, 2025 | AIGH, Featured
Sunset view from a valley hike
As a fourth-year medical student at the Icahn School of Medicine at Mount Sinai, I spent one month in February in Nepal for my clinical elective. This experience was humbling, challenging, and deeply meaningful, undoubtedly shaping my career in medicine.
The Role of Family and Spirituality in Patient Care
I split my time between the pediatric and psychiatry departments at Dhulikhel Hospital, each offering a unique lens into health care delivery in a resource-limited setting. One of the most striking differences I observed, particularly in psychiatry, was the active role of family members in patient care even within the secure psychiatric unit.
Unlike in the United States, family members in Nepal were allowed to remain with patients throughout the entire day. I witnessed firsthand how this level of involvement improved patient outcomes, elevated morale, and deepened the family’s understanding of mental illness. While one might assume this model could compromise safety, staff reported surprisingly few security issues.
Another aspect that stood out to me was the integration of religious and spiritual beliefs into psychiatric treatment. Religion was one of the strongest protective factors for patients experiencing depression, making it imperative for providers to build upon those beliefs to create a safety plan for patients. It was a powerful reminder of the impact of culture on medical treatment and patient-provider trust, a factor often overlooked in medicine in the United States.
The view of Kathmandu from the top of Swayambhunath Temple
Engaging With Nepali Culture
Outside of the hospital, we experienced Nepali culture in countless meaningful ways. Each afternoon, we ate traditional meals like momos, a type of dumpling, and thalis, a variety of dishes served together on a single platter, at small canteens and cafes near the hospital. We visited historic temples and witnessed funeral processions and religious rituals along the Bagmati River. Observing these ceremonies was particularly moving as we were able to see how spirituality, grief, and community are such a visible part of everyday life.
Each evening, we hiked along trails adjacent to small huts, farms, and croplands. This was one of the most peaceful ways to spend the close of the day, among the sounds of the birds, goats, and dogs that would follow us deep into the valley.
The Impact of International Exchange
My time in Nepal was truly inspiring not just within the hospital but also through meeting incredibly caring people and experiencing delicious food and breathtaking nature. It was a privilege to experience both the medical and cultural aspects of the country. I hope to visit again one day as a physician!
Author Salonee Shah, MD, right, shown with Abhi Mogili and Cecilia Katzenstein. They are recent graduates of the Icahn School of Medicine at Mount Sinai. Dr. Shah completed her clinical elective at AMPATH Nepal through funding provided by the Arnhold Institute for Global Health at Mount Sinai. She is a psychiatry resident at Baylor College of Medicine in Houston and plans to pursue a child and adolescent psychiatry fellowship. Her goal is to eventually work with refugee and immigrant families in trauma-focused care.
Sep 18, 2025 | AIGH
Alfin “Didi” Vicencio, MD, left, and Sameera Thapa, MD, discuss an interesting chest CT finding in Mount Sinai’s pediatric pulmonology clinic.
When Sameera Thapa, MD, met Alfin “Didi” Vicencio, MD, they were both trying to improve care for children with lung diseases, but in very different ways.
Dr. Thapa, a pediatrician at Dhulikhel Hospital in Nepal, wanted to provide better care for children with lung diseases in the town of Dhulikhel without having to refer them to more specialized centers hours away. Dr. Vicencio, then a Professor of Pediatric Pulmonology at the Icahn School of Medicine at Mount Sinai and now Chair of Pediatrics at Hackensack Meridien Health, North Region, is part of a group expanding techniques used to treat children bronchoscopically—through a scope inserted into the airway that can be used to both diagnose the problem and treat it on the spot.
Dr. Vicencio describes meeting Dr. Thapa as “serendipitous,” occurring in 2022 when he traveled to Nepal as part of a delegation from Mount Sinai to explore potential avenues within the new AMPATH Nepal partnership. They bonded over their shared passion for pediatric pulmonology, and they began to work together with the goal of transforming care for Nepali children with lung disease. They hope ultimately to bring to Nepal the most advanced pediatric bronchoscopy techniques in the world.
In 2024, having learned more about how their goals for pulmonary medicine intersected, Dr. Vicencio asked Dr. Thapa to be an author on an editorial in the medical journal Pediatric Pulmonology arguing for wider implementation of the new bronchoscopy techniques. They and their co-authors used Dr. Thapa’s experience in Nepal as a case study, pointing out that these advanced techniques can be especially useful in managing complications related to tuberculosis, a disease more prevalent in Nepal than in high-income countries. It makes perfect sense, they argued, to expand the reach of these techniques to low-resource settings.
Also in 2024, Dr. Thapa and Dr. Vicencio received a pilot grant from AMPATH Nepal that will help advance pediatric pulmonary care at Dhulikhel Hospital. The grant enabled Dr. Thapa to come to Mount Sinai in the spring of 2025 to observe and learn directly from Dr. Vicencio and his team, including attending the advanced pediatric bronchoscopy course he taught. In her view, the most important aspect of her observership at Mount Sinai was witnessing what could be achieved when clinical expertise is supported by the right infrastructure. Reflecting on her experience on rounds in the newborn ICU at Mount Sinai, she remarked, “Everyone was so optimistic, discussing what can be done even in the most critical cases.” This spirit of possibility left a strong impression—one she carried home.
However, she is realistic about the limitations in Nepal. Despite meaningful progress in the medical field, Nepal continues to face structural challenges, including inconsistent electricity access in many communities, which renders some of the advanced interventions she observed in the United States currently impractical. There are some experiences, though, that she can immediately draw on to treat her own patients. She hopes to implement strategies to better manage ventilators for very sick babies and take lessons from Mount Sinai’s multi-specialty “aerodigestive clinic,” where specialists co-manage complex feeding and breathing problems.
As she begins the second phase of her pilot project, where she will screen children in her local community for respiratory conditions, she will also identify more patients with asthma and other respiratory conditions. She hopes to apply her experience at Mount Sinai when caring for them. She also hopes to learn bronchoscopy herself, to be able to make basic pulmonary diagnoses and increase the services available at Dhulikhel Hospital.
Alexandra Coria, MD, is Assistant Professor of Pediatrics and Global Health, and Senior Technical Communications and Research Translation Specialist at the Arnhold Institute for Global Health at Ichan School of Medicine at Mount Sinai.
Updated on Aug 26, 2025 | AIGH
Videos used in the HADITHI study helped children understand why they need to take medicines to keep themselves healthy.
In July, 2025, the World Health Organization (WHO) released a new publication highlighting key research that will help health care providers tell children and adolescents that they have HIV.
In this Q&A, Rachel Vreeman, MD, MS, Director of the Arnhold Institute for Global Health at Mount Sinai, explains how research conducted through AMPATH Kenya contributed to the development of the WHO’s new guidance.
“This is a great example of how our approach to research—prioritizing close, equitable collaboration with our Kenyan colleagues and centering the voices and needs of youth—results in best practices and can influence policy globally,” she said.
What is the AMPATH Kenya partnership, and what is the Institute’s role with it?
The AMPATH Kenya partnership is a strong collaboration among Moi University and Moi Teaching and Referral Hospital in Eldoret, Kenya, the Kenyan government, and a global consortium of universities that includes Mount Sinai. Within AMPATH Kenya, the Arnhold Institute supports and leads activities to improve youth health in Kenya, including clinical programs, research, and capacity-building for adolescent health.
Medications used to treat pediatric HIV. A major part of the disclosure process is helping children understand why they need to take medications every day.
What is the new World Health Organization guidance document?
The guidance released this year summarizes key research on ways to tell children and adolescents about their HIV status in a safe and empowering way, known in the pediatric HIV field as “disclosure.” The WHO document helps health care providers and HIV programs understand what has worked in different contexts. I’m proud to note that research from the AMPATH Kenya partnership—work testing a new disclosure program for children ages 10 to 15—was highlighted as one of those key studies. I was a lead author on that study, along with my Kenyan counterpart Dr. Winstone Nyandiko, Professor of Pediatrics and Child Health. Now, this program to support disclosure is not only recommended nationally for Kenya, but is also part of what the WHO recommends globally. In addition to this intervention program, the WHO also cited AMPATH Kenya’s qualitative research describing other HIV disclosure practices for children.
Tell us more about what makes your study unique.
We named our study the HADITHI intervention, which is short for “Helping AMPATH Disclose Information and Talk about HIV Infection.” Hadithi also means “story” in Kiswahili, the language most of our Kenyan patients speak, because stories were what the initiative was all about. There are a lot of stories that people tell about HIV, many of them stigmatizing. So when you tell someone that they have HIV, especially a child, you’re playing a role in how they understand their own life story—is it happy or sad, shameful or empowering? The framing is very important. In this counseling we did in the program, we also used stories told by Kenyans to help the children understand their HIV status in a culturally sensitive way.
One other important element of the HADITHI study was our use of peer support groups in helping patients learn about and accept their diagnosis. In fact, peer support for adolescents continues to be a cornerstone of Mount Sinai’s work in HIV in Kenya. In the WHO guidance document, peer support was specifically identified as a key feature of disclosure interventions in this age group.
Why is the way disclosure is conducted for children so important?
When a child is living with HIV, at some point—often when they’re quite young, six or so, but sometimes not until they’re adolescents—their families and doctors must start the process of telling them their diagnosis. Eventually, they need to understand why they have to take medicines every day for the rest of their lives. And, they need to get this information in a developmentally appropriate way that fits the child’s age. Often, they’ve already heard a lot of rumors and misinformation about people living with HIV, and may be afraid of being a person with HIV. The process of telling them must therefore be done very carefully, in a way that reassures them that they can still live a long, happy, productive life. That is the process of disclosure, and it can take months or years of preparation and gradual teaching.
It’s so important that disclosure is done well, especially because many children get HIV from their mothers. We need to protect the bond between the mother and the child and empower the child or adolescent to feel good about themselves and begin to accept responsibility for taking care of their own health.
What does it mean to the Arnhold Institute and to you personally that this research was cited by the WHO?
As a career researcher in Kenya and a passionate advocate for children and adolescents, I am immensely proud to have contributed to this work at a global level. We at the Arnhold Institute and AMPATH Kenya are truly doing innovative and impactful work for children, and as a pediatrician, I can’t think of anything more rewarding than that.
Rachel Vreeman, MD, MS is a pediatrician, Director of the Arnhold Institute for Global Health, and Professor and Chair of Global Health at the Icahn School of Medicine at Mount Sinai.
Jul 30, 2025 | AIGH
The course participants with instructors Rachel Fischer, MD, left, and Melanie Brown, MD, MSc.
Mental health problems affect one in 10 adults in Nepal over their lifetime. The burden of mental health disorders has risen as the country recovers from a decade-long internal conflict, the 2015 earthquake, and the global COVID-19 pandemic.
In response to this urgent need, three psychiatry experts from Mount Sinai—Jan Schuetz-Mueller, MD, Rachel Fischer, MD, and Melanie Brown, MD, MSc—recently taught an intensive week-long course in global mental health for Nepali students (public health, nursing, medicine, and physiotherapy), faculty, and researchers at Dhulikhel Hospital Kathmandu University Hospital and Kathmandu University School of Medical Sciences. The comprehensive course equipped participants with essential skills to recognize, respond to, and research mental health challenges, and emphasized how to scale up services sustainably to meet the needs of low-resource communities of Nepal.
Dr. Brown explains the difference between psychosis and schizophrenia to course participants.
Using the skills and knowledge they learned from the course, participants researched current resources and needs and proposed solutions to improve existing health services to meet each region’s specific mental health needs in Nepal.
For example, from their experience at their placements at Dhulikhel Hospital’s rural community outreach centers, students identified unique local mental health challenges, such as mass hysteria outbreaks among school children. The participants proposed ways to train personnel to face these challenges, including training female community health volunteers in psychological support techniques so that they can better support those experiencing mental health problems in rural communities.
Feedback on the training was overwhelmingly positive. One student commented, “It increased my interest toward mental health issues globally.” Another shared, “What I find most inspiring about the course is its unwavering commitment to develop, train, and educate the students. This holistic approach not only addresses immediate mental health needs but also fosters the generation of health care professionals equipped to make a long-lasting impact on global mental health disparities.”
The Mount Sinai facilitators were likewise highly impressed by the high quality of the students’ work throughout the course, their engagement, and insight. The facilitators left inspired by the passion and aptitude of the next generation of Nepali mental health leaders and with a greater appreciation of Nepali culture that will help them treat their Nepali patients better in New York City.
Nepali students in the global mental health course
The course resulted from a productive collaboration between the Department of Public Health and Community Programs at Dhulikhel Hospital, Kathmandu University School of Medical Sciences, and the Department of Psychiatry at the Icahn School of Medicine at Mount Sinai. Across specialties, including critical care, neurology, and pediatrics, about 50 Mount Sinai experts have traveled to Dhulikhel Hospital to contribute expertise through Mount Sinai’s AMPATH Nepal partnership.
We hope this initiative will continue to inspire students in Nepal to engage in the field of mental health and contribute to meaningful and lasting improvements. We look forward to strengthening this valuable partnership in the years to come.
Biraj Man Karmacharya, PhD, is an Administrative Director at Dhulikhel Hospital, Chief Administrative Officer of Kathmandu University School of Medical Sciences and Director of the Masters of Science in Public Health Program and Department of Public Health and Community Programs
Akina Shrestha, PhD, is an Associate Professor in the Department of Public Health, Kathmandu University School of Medical Sciences, Nepal
Melanie Brown, MD MSc, was Chief Resident in Psychiatry at Mount Sinai Morningside and Mount Sinai West during the course, and is now a Fellow in Consult-Liaison Psychiatry at the New York University Grossman School of Medicine
Jun 26, 2025 | AIGH
Madeline Fields, MD, and Lara Marcuse, MD, Professors of Neurology at the Icahn School of Medicine at Mount Sinai and Co-Directors of the Mount Sinai Epilepsy Center, recently traveled to Nepal to expand neurological care for underserved communities.
Their mission was to collaborate with the Intensive Care Unit at Dhulikhel Hospital to establish a self-sustaining EEG program and to provide advanced EEG education at two other hospitals in the region. An EEG (electroencephalography) is a test that measures electrical activity in the brain and is used to diagnose conditions such as epilepsy and brain tumors. This initiative aims to improve access to timely neurological and epilepsy care for communities across Nepal.
The AMPATH Nepal Partnership
The effort is part AMPATH Nepal, a partnership of Dhulikhel Hospital, Kathmandu University School of Medical Sciences, and a consortium of global academic health centers led by the Arnhold Institute for Global Health at Mount Sinai. The partnership focuses on improving access to high-quality health care for underserved populations in rural Nepal.
The work to establish continuous EEG services in Dhulikhel Hospital’s ICU is part of a collaboration with Cappi Lay, MD, Assistant Professor of Neurosurgery and Emergency Medicine at the Icahn School of Medicine at Mount Sinai, Co-Director of the Mount Sinai NSICU, and Director of the Institute for Critical Care Medicine’s Global Critical Care Program. Dr. Lay has been working with the Dhulikhel Hospital team to improve ICU services.
A Warm Welcome and Hospital Collaboration
Dr. Fields and Dr. Marcuse were warmly welcomed and treated with great hospitality from the moment they arrived at Dhulikhel Hospital. They joined the hospital’s morning report, where physicians gathered to discuss details of hospitalized and overnight admitted patients. Sujata Phuyal, the lead nurse for the EEG program, guided them on tours of multiple units throughout the hospital including the Pediatric ICU, Neuro ICU, Medical ICU, maternity floor and dialysis unit.
Establishing the EEG Program
With the support from Dhulikhel Hospital’s IT team, especially Sushil Napit, a portable EEG machine and review station were set up in the hospital’s ICU. The training for nurses and physicians included demonstrating the steps involved in connecting a patient to the EEG machine. This process is both time and labor-intensive, requiring precise placement of the EEG wires to a patient’s scalp, allowing the doctors to observe brain waves and to identify and monitor seizure activity.
Dr. Fields and Dr. Marcuse calibrated all EEG machines to ensure accurate data collection and created EEG report templates for both adult and pediatric neurologists. These templates will help the Dhulikhel Hospital team learn how to write and interpret EEGs, ultimately enhancing their analytic skills and improving patient care.
“The most important part of this work is the people who make the machines and processes work,” Dr. Marcuse said. “The doctors and nurses in Nepal are highly skilled professionals who excel in patient care. They have a strong educational background, and there is an opportunity to further enhance their expertise with additional resources and knowledge.”
Dr. Fields added, “It is an honor to work with the physicians in Nepal and to use this essential tool to better serve their patients and communities.”
Educational Outreach and Training
During their visit, Dr. Fields and Dr. Marcuse delivered multiple lectures at Dhulikhel Hospital for nurses, physicians, and visiting medical students. They covered EEG basics, examining complex epilepsy cases, seizure analysis through patient videos and brain wave data, and EEG testing in the neurocritical care setting.
Beyond Dhulikhel Hospital, they presented on epilepsy surgery at the Annapurna Neurological Institute & Allied Sciences and conducted a continuing medical education (CME) course at the Kathmandu Medical College titled, EEG and Epilepsy CME. The session covered emergent seizure treatment, EEG fundamentals, advanced treatment options, and concluded with complex epilepsy case studies.
The heartfelt welcome and friendliness extended by people at all these institutions made their experience exceptionally rewarding and memorable.
Expanding Sustainable Epilepsy Care
Looking ahead, Dr. Fields and Dr. Marcuse aim to develop an epilepsy education and treatment program led by nurses and community organizers, expanding it through Dhulikhel Hospital’s 18 outreach centers. This would reach the rural populations unable to visit the main hospital campus, raise awareness, and reduce stigma associated with epilepsy, encouraging more people to seek epilepsy care.
Through the AMPATH Nepal partnership, Dr. Fields, Dr. Marcuse, and other Mount Sinai neurologists are developing programs to improve education and patient care. These initiatives include neurology training for residents at Dhulikhel Hospital and Kathmandu University School of Medical Sciences, EEG technician training, and establishing an infrastructure for sustainable educational initiatives.
Dr. Fields and Dr. Marcuse look forward to returning to Nepal to continue working with their colleagues on the shared vision of improving epilepsy care and equipping local physicians to provide equitable health care to their communities.
Ankita Kureel is a Program Manager for the Department of Neurology at the Icahn School of Medicine at Mount Sinai.
Madeline Fields, MD, is a Professor of Neurology at the Icahn School of Medicine at Mount Sinai and Co-Director of the Mount Sinai Epilepsy Center.
Lara Marcuse, MD, is a Professor of Neurology at the Icahn School of Medicine at Mount Sinai and Co-Director of the Mount Sinai Epilepsy Center.
