International Programs

WONDOOR Reduces Maternal and Neonatal Mortality Rates While Training OB-GYN Residents in the U.S. and Internationally

With increased morbidity and mortality in women and babies worldwide, many programs across the U.S. are trying to determine how to train U.S. OB-GYN residents as global health providers as well as incorporate them into a sustainable education program abroad. It is the goal of University Hospitals unique global health program, WONDOOR, to collaboratively reduce maternal and neonatal morbidity and mortality rates through academic enrichment in under-resourced communities both in the U.S. and internationally.

Guyanese People Caring for Guyanese People

Guyana has the 49th highest Maternal Mortality Ratio (MMR) in the world ranking with 270 per 100,000 live births. Compare this to the rate for the U.S. of 24 per 100,000 live births. WONDOOR has designed and implemented a sustainable and self-perpetuating residency program that will raise the level of care. This four-year program will help train citizens of Guyana in obstetrics and gynecology for long-term success.

Some important reasons why UH collaborated with the Ministry of Health-Guyana, The University of Guyana, and Georgetown Public Hospital in Guyana for our WONDOOR program include the following:

• As a country Guyana is very committed to improve the healthcare of its women
• Guyana committed to place an operative theater within the women's hospital
• The country is very diverse – the people, their culture, their religious practices.
• It is a stable state, a very organized and structured democratic political system.

Current Residents from Guyana

Geremias Rangel, MD
Born in Angola, Dr. Rangel studied human medicine in Cuba and worked in Guyana. Dr. Rangel has a humble personality, is full of life and believes in the existence of an almighty god. As a father and a physician, he believes in delivering the best of healthcare to each and every one regardless of race, gender or sexual orientation. He has worked in Guyana for over 14 years before seeing the realization of the specialty program and is proud to be included and to be taught by many professionals from all over the world; to improve his capacity and to better the delivery of obstetrics and gynecology to the women of Guyana. The highlights of the obstetric program are too numerous to mention since he has learnt from each individual sub-specialty and who has molded his academic and surgical skills, and furthermore, he is open for much more knowledge and experience.

Shivani Samlall, MD
Dr. Samlall grew up in a rural area of Guyana where she was “a constant witness” to the discrepancies in healthcare available to people leaving in rural areas compared to those living in the city. By the time she graduated from high school she was determined to be a doctor and received a scholarship to study medicine in Cuba. This experience highlighted to her many of the needs that existed in the Guyanese health system and reinforced her commitment to make a difference in her community. Dr. Samlall’s career mission is to improve the quality and timeliness of healthcare available to the women of Guyana. Highlights of her experience in the residency program thus far include practicing evidence based medicine, which has proven to be effective not only for critical cases, but in our overall delivery of patient care and the quality of lecturers that contribute to it. “Our group has been privileged to work with renowned and personable specialists in their respective fields from various US institutions…Knowing that the program meets such high standards inspires confidence in me as a team leader and every time I interact with a patient, as I know that I am providing the best care I possibly can.”

Anita Ramlall, MD
From a small village on East Bank of the Demerara River, Anita graduated in 2008 from University of Guyana School of Medicine. Coming from a large family, obstetrics and gynecology has always been a personal desire, originating from her mom's struggle during and after pregnancy. Without the knowledge of or access to contraception, she stood in the face of unknown danger, putting her entire family at risk. The Ob/Gyn Residency has given her hope that from now on, no mother that she cares for will remain ignorant about the wonders of contraception. The curriculum is vigorous and exciting. “Everyday we learn how to provide and improve the standard of care for our mothers of this beautiful land of Guyana. With the recent influx of modern equipment and infrastructure that the program has brought, and being exposed to evidence based medicine taught by some of the most renowned specialist from the developed world I am confident that I, my colleagues and mentors, the department of obstetrics and gynecology and the Georgetown Public Hospital at large will continue to shine as one of the greatest example of services ever available here in Guyana.”

Ademola Biala, MD
Ademola was born, raised and schooled in Northern Nigeria, West Africa. He attained his medical degree at Ahmadu Bello University, Zaria, before traveling to the West Indies in pursuit of more knowledge and self fulfillment. His passion for alleviating the plight of the less-privileged in society guided his footsteps to the stairway of human medicine and eventually, up the stairs to hallway of women’s health. He has dedicated two-thirds of his post graduate life to this dynamic and interesting field. The Ob/Gyn Residency program at Georgetown Hospital has finally taught him medicine as it should be (evidence-based), honed his surgical skills but most importantly, enabled him to meet some of the best minds the field has to offer. In putting this knowledge (and skills) to work in Guyana, he believes he is (and will be) helping, in more ways than one, to lend a hand to creating a healthier, wealthier and egalitarian society in the growing nation of Guyana.

Natasha France, MD
Dr. France is from New Amsterdam, a small town in Guyana. After obtaining a scholarship from the Government of Guyana and China, she attended medical school for six years in Guangzhou, China. Dr. France recognized that there was there was a serious brain drain in her country. She decided to pursue Ob/GYN residency training in Guyana because she has a vivid interest in working with women and she hopes to contribute to the continuing improvement in healthcare in her country. She hopes that the residency program will have a positive impact on the maternal and neonatal morbidity and mortality so Guyana can attain the millennium development goals in 2015.

“With the implementation of the residency program the residents are constantly being updated with the developments in the field of Ob/GYN. We can incorporate some of those changes immediately and if not, we are making plans on how we can incorporate them in the future. The medicine we practice is now evidence based and so far we have even had some of the people who have contributed to the “evidence” come to teach us. It’s pretty awesome and inspiring.”

In addition to residency, Dr. France lives with her cats Sparks and Mr. Cuddles, presently is learning Portuguese and hopes to be involved more in community service once time permits.