Updated on Apr 23, 2025 | AIGH
A child receives a health screening in school in Guyana.
The Arnhold Institute for Global Health is proud to present Inside a National Healthcare Collaboration, a compelling documentary highlighting Mount Sinai’s groundbreaking partnership with the Government of Guyana and Hess Corporation to strengthen the health system across Guyana.
The film’s trailer premiered during a milestone signing ceremony in Georgetown, Guyana, where His Excellency Dr. Irfaan Ali, President of Guyana, announced a five-year extension of the National Healthcare Initiative. This renewed commitment aims to transform Guyana’s public health system with world-class health care services accessible to all citizens, especially those in vulnerable communities. Following the ceremony, President Ali officially launched the full documentary.
Inside a National Health Collaboration chronicles the first phase of this ambitious effort—from the rollout of school-based health screenings to the launch of a cutting-edge pathology lab that has significantly reduced the time it takes for patients to receive a diagnosis and begin lifesaving treatment. The film also highlights advancements in community-based diabetes care, improvements in the quality of care at the country’s largest hospital, and progress toward developing new digital health systems, including a national electronic health record system.
Produced by Mount Sinai, the documentary features interviews with President Ali, Mount Sinai experts—including from the Arnhold Institute for Global Health and Mount Sinai International—along with Guyanese partners. It tells the human stories behind this health transformation and offers a powerful look at how the collaboration is reshaping health care in Guyana and improving lives for generations to come.
Updated on Mar 18, 2025 | AIGH
Rose House, MD, MS, right, and her team conduct a needs assessment at one of the rural health facilities participating in Project ECHO.
Our AMPATH Nepal partnership has launched a new program to improve access to emergency care in remote regions of Nepal. Through a transformative model called Project ECHO (short for “Extension for Community Healthcare Outcomes”), Nepal’s health workers will learn from and collaborate with experts in emergency medicine (EM) from around the globe.
AMPATH Nepal includes Dhulikhel Hospital, Kathmandu University School of Medical Sciences, and Mount Sinai as the lead partner for the AMPATH Consortium of 18 universities around the world.
The Need to Grow Emergency Medicine Capacity in Nepal
Though some general practitioners in Nepal receive emergency care training as part of their residency, there is a gap when it comes to formal, specialized EM education, especially in rural areas. Health care providers often lack the training and experience to effectively manage emergency situations. Rural areas face additional hurdles, like difficult terrain, long travel times to referral hospitals, and financial constraints that hinder patients from accessing advanced care. As a result, health care workers must often make critical decisions with limited resources, sometimes with little support or guidance from more experienced professionals. Through Project ECHO, AMPATH Nepal will start to fill this gap.
Bridging the Health Care Gap with Project ECHO
Project ECHO is about breaking down geographical and resource-based barriers to expert medical knowledge. It was born in 2003 at the University of New Mexico Health Sciences Center with a simple idea: empower health care providers in underserved communities by connecting them with expert teams through videoconferencing. Providers in rural or underserved regions—referred to as “spokes”—are linked with specialist teams, or “hubs,” located in regional, national, or even global centers. As a platform for long-term continuous learning, case discussions, and expert consultations, ECHO helps bridge gaps in education, reduce isolation of rural health care workers, and improve patient care.
The ECHO model has reached more than 900 partners and 1.5 million learners across more than 190 countries, improving provider knowledge, patient outcomes, and cost savings. Project ECHO is a World Health Organization collaborating partner to enhance community emergency preparedness and response globally.
Launching the Nepali EM ECHO
Our first step in launching an EM ECHO involved a comprehensive needs assessment. By engaging with rural communities and health care providers, we identified the most common and complex cases encountered. The needs assessment also evaluated local resources, internet connectivity, and the existing health care protocols to ensure the model’s success in rural settings.
Based on these needs, the capacity of the outreach centers, and desired topics of discussion, we tailored our ECHO education sessions to local realities, focusing on the topics that will have the greatest impact. The curriculum will focus on urgent topics and foundational EM skills, including critical areas such as airway management, breathing, and circulation (the ABCs of emergency care).
Local and International Expert Engagement
A key aspect of this initiative is the involvement of both local and international emergency medicine experts. Local specialists from Dhulikhel Hospital play a crucial role in leading and guiding the ECHO sessions. Faculty from the Icahn School of Medicine at Mount Sinai are also lending their expertise to further enhance the program’s impact.
A Critical Step Forward for Nepal’s Health Care System
The launch of Project ECHO for Emergency Medicine in Nepal represents a critical step forward in the country’s health care development. By leveraging technology and expert collaboration, we can overcome many of the challenges facing rural health care providers, empowering them to deliver better care in even the most remote areas. This initiative has the potential not only to improve patient outcomes but also to strengthen the capacity of Nepal’s entire health care system, serving as a global model to address challenges in emergency medicine training and education.
Rose House, MD, MS
AMPATH Nepal Partnership Director, Arnhold Institute for Global Health
Associate Professor of Emergency Medicine, Pediatrics and Global Health
Icahn School of Medicine at Mount Sinai
Updated on Jan 15, 2025 | AIGH
Physicians at Dhulikhel Hospital in Nepal receive simulation training in newborn resuscitation.
The Arnhold Institute for Global Health at Mount Sinai has announced that the Laerdal Foundation has awarded $49,800 to support the launch of INSPIRE-Nepal. This initiative, which stands for Increasing Neonatal Survival Program Incorporating Reinforced Education and Distance-learning, will enhance neonatal resuscitation training for health care providers in Nepal, with a focus on rural and remote areas.
With the support of the Laerdal Foundation, the INSPIRE-Nepal initiative represents a vital step toward reducing neonatal deaths and improving outcomes in Nepal.
A Global Health Challenge
Neonatal mortality rates (newborn deaths) remain alarmingly high in Nepal, especially in remote regions. The Helping Babies Breathe program, an evidence-based training that teaches skills in resuscitating newborns who don’t breathe on their own after birth, has proven to decrease neonatal deaths globally. However, a critical challenge remains: Health care providers’ skills in neonatal resuscitation begin to decline within seven months after their initial training. This skills loss poses a significant barrier to sustaining improvements in neonatal outcomes, particularly in areas with limited access to continuing education.
Dhulikhel Hospital in Nepal and its 18 outreach centers handle more than 3,500 deliveries every year. However, there is no regular training program for neonatal resuscitation. This gap leaves providers without the support they need to retain their life-saving skills.
A Collaborative Solution
Our INSPIRE-Nepal project seeks to address this gap by combining in-person training, system strengthening, and distance-learning to create a sustainable solution that will continually reinforce neonatal resuscitation skills. Our project has three goals:
- Enhance Provider Knowledge, Skills, and Attitudes: INSPIRE-Nepal will provide health care workers with neonatal resuscitation training, systemize post-resuscitation screening and referrals, and assess facility readiness at Dhulikhel Hospital and its outreach centers.
- Provide Virtual Training to Sustain Learning Through Project ECHO: Using the Extension for Community Healthcare Outcomes model (Project ECHO), a telementoring and education program, health care providers will receive monthly, case-based sessions to reinforce their neonatal resuscitation skills. This approach will evaluate the retention of provider knowledge, skills, and attitudes 12 months post-training.
- Reduce Neonatal Mortality and Stillbirth Rates: By combining education with ongoing support, we aim to reduce stillbirths and the rates of newborn deaths on the first day of life, creating a model that can be used in other low-resource settings.
Why It Matters
Remote areas often face both high neonatal death rates and limited access to training and resources. We offer a practical solution by providing continuous training through Project ECHO to maintain skills and improve neonatal care. Our project offers a scalable and sustainable solution to mitigate loss of skills, ensuring providers are equipped to deliver high-quality neonatal care when it matters most. With the support of the Laerdal Foundation, we can transform care for the most vulnerable newborns.
Led by Rose House, MD, the INSPIRE-Nepal team includes John Kulesa, MD, Neha Limaye, MD, Diana Lee, MD, and Katherine Anderson, MD, from Mount Sinai; and Srijana Dongol, MD, and Anamika Mahato, MD, from Dhulikhel Hospital.
Established in 2022, AMPATH Nepal is a global health partnership led by Mount Sinai, Dhulikhel Hospital, and Kathmandu University School of Medical Sciences in Nepal.
Rose House, MD, MS
AMPATH Nepal Partnership Director
Associate Professor, Arnhold Institute for Global Health
Department of Global Health and Health System Design
Icahn School of Medicine at Mount Sinai
Nov 20, 2024 | AIGH, Community
Rt. Honorable Prime Minister KP Sharma Oli, during his visit to New York for the 79th United Nations General Assembly, made a notable stop at The Mount Sinai Hospital to acknowledge the critical work being done through AMPATH Nepal.
In his address, Prime Minister Oli emphasized the challenge of health inequity that exists across the globe. He pointed out how, despite advancements in science and technology, many resource-limited countries like Nepal struggle to provide equitable healthcare services. Due to financial constraints and limited infrastructure, millions of people in poorer countries are denied access to essential and quality health care. The Prime Minister called for greater international cooperation and partnerships to bridge this gap, noting that access to quality health services should not be a privilege limited to wealthy nations.
“Despite gradual improvement in Nepal’s health sector with the implementation of Sustainable Development Goals, the partnership of the international community is necessary for modern and infrastructure-equipped health services,” he said. “I would like to thank Mount Sinai Hospital for its collaboration with Kathmandu University and Dhulikhel Hospital in training, research, and resource mobilization to support Nepal’s health sector.”
AMPATH (Academic Model Providing Access to Healthcare) Nepal plays a pivotal role in addressing these challenges. With partners such as Mount Sinai, Dhulikhel Hospital, and Kathmandu University School of Medical Sciences, AMPATH Nepal is leading the way to improve care and strengthen health care systems, advance research, and enhance training for healthcare professionals.
Biraj Karmacharya, PhD, Administrative Director of Dhulikhel Hospital (DH) and Co-Director of AMPATH Nepal, expressed enthusiasm for the Prime Minister’s recognition. “The government of Nepal has always been one of the strongest allies of Dhulikhel Hospital. The visit of PM Oli is a testament to the fact that the government support to the endeavors of DH and this partnership is unwavering. We will continue to harness this unique support to enhance our impact at a larger national level.”
Rajeev Shrestha, Chief of Research and Development Division at Dhulikhel Hospital, also echoed the Prime Minister’s sentiments, noting that AMPATH’s efforts are bolstering Nepal’s ability to manage and treat chronic illnesses. By expanding specialist services and bringing international expertise to local health care settings in Nepal, AMPATH is helping to address significant unmet needs in the population. AMPATH’s work in Nepal includes specialized treatment programs focused on non-communicable diseases like heart disease, kidney disease, and cancer—critical areas of need given that more than 70 percent of deaths in Nepal are attributed to these conditions.
This visit by Prime Minister Oli highlighted the importance of collaborative efforts in health care. Nepal’s commitment to universal health care, combined with the support of international partners like Mount Sinai, is paving the way for sustainable improvements in the country’s health system.
The partnership reflects a model for global cooperation, where academic health centers and governments work together to deliver high-quality health care, train the next generation of health professionals, and ensure that no one is left behind in the pursuit of health and well-being. Prime Minister Oli’s recognition of these efforts serves as a reminder of the power of global partnerships in building a more equitable health care system for all.
Rose House, MD, MS
AMPATH Nepal Partnership Director
Associate Professor, Arnhold Institute for Global Health
Department of Global Health and Health System Design
Icahn School of Medicine at Mount Sinai
Rachel Vreeman, MD, MS, is a pediatrician, Chair of the Department of Global Health, and Director of the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai.
New York City’s migrant crisis has resulted in children in street situations selling candy and other items in the subway and begging on the streets with their families. Children in street situations rely on the street to live and/or work by themselves or with friends or family. These children often face social, health, and economic disparities and human rights violations. Their presence in NYC requires attention and interventions to ensure their well-being. This necessitates accurate data on these children’s social, economic, and health circumstances. This project will characterize the circumstances of children in street situations aged 5 to 17 years through a field-based survey of these children; a cross-sectional survey of a sample of these children, who will also receive a well child checkup at NYC Health + Hospitals/Elmhurst and be enrolled in NYC Care or Child Health Plus; and in-depth interviews with a sample of parents of these children.
Elevated blood pressure detected during an emergency department (ED) visit can be a predictor of chronic uncontrolled hypertension. There is variability in hypertension management in the ED. This project will develop a novel intervention that will use electronic health records to identify patients in the ED at NYC Health + Hospitals/Elmhurst with sustained asymptomatic hypertension and provide them a tailored risk communication intervention led by an ED nurse. These patients will be referred to a digitally inclusive remote patient monitoring program that does not require Wi-Fi and is supported by clinical pharmacists for up to 12 months, regardless of insurance status, to further manage their hypertension.