Doha, Qatar
I arrived in Doha late last Tuesday night (January 7). Fridays and Saturdays are the official weekend here in Qatar, so I had just two full work days to conduct my business. Accompanying me on this leg of my trip to Qatar is Dr. Cliff Brubaker, Dean of Pitt’s School of Health and Rehabilitation Sciences. We also linked up with Mr. George Fechter, formerly Pitt’s Health Sciences Associate Vice Chancellor for External Relations, who is in Doha as a visiting lecturer.
For almost two years now UPMC has had a contract with the Hamad Medical Corporation, through the Qatar government, to provide education, training and services to Qatar’s emergency medical system for the entire country. UPMC Project Director Dr. Walt Stoy and his team of 20 mostly American expatriates have been terrific hosts for our visit. Walt is Professor of Emergency Medicine at Pitt, in Cliff’s School of Health and Rehabilitation Sciences. A long time Pittsburgher, he received his PhD in Education, specializing in instructional design and technology. Like many on his team, Walt shuttles back and forth between Pittsburgh and Doha at least once a month. He works and talks at a frenetic pace, pausing every few seconds to peer over his salt and pepper walrus moustache to check his blackberry. At dinner his physician colleagues grab for their hand-held radios 24/7 to reply to field teams of emergency medical technicians calling in to seek management advice about this or that horrific calamity. A cardiac arrest case, then a broken skull, then a tension pneumothorax, and on it goes. What a pace!
Qatar, on the Southwest shore of the Persian Gulf, is an Arab Emirate with a total population of about 1 million, of whom only about 200,000 are citizens. Most of the population are expatriate guest workers, supported by Qatar’s extraordinary income from natural gas. Because so many of the guest workers are male, the gender ratio is almost 2 to 1 males to females, the most skewed in the world. Most of the expatriate men come from India, the Philippines, or other Asian countries to work as construction laborers. The citizenry is 90% Sunni and 10% Shiite Muslims. Although Qatar is liberal compared to many Islamic Arab countries, Qatari women typically wear a full black traditional dress with head cover and face cover. It is not acceptable to photograph Muslim women here, so I have been very careful not to include them in my snapshots. Nor does a man put forth a hand to shake hands with a woman, western style. One merely nods his head and touches his chest.
That said, the Qataris are friendly people who readily exchange greetings and smiles with strangers, even on the street. In conversation, Qataris can be quite direct, a refreshing difference from other cultures where determining if you have just been told “yes” or “no” can be difficult. Perhaps the most striking feature of modern Qatar society is the infrastructure: the roads are paved, the air is clear, and hospitals are spotless. Of course, this reflects huge investments by the Qatar government over the past few years. The real problem faced by Qatar is trained and educated professional workforce. Although Qataris hold the highest positions in government and business, essentially all of the technocrats are foreigners. One good example of this is the UPMC team. Outside of natural gas, Qatar has few natural resources to support its economy, so an educated citizenry will be essential to sustained national well-being when the gas reserves become depleted in a few decades.
Qatar’s solution has been the creation of “Education City,” a unique 2,500-acre campus on the outskirts of Doha which hosts branch campuses of leading universities from around the world, mostly from North America. Our Pittsburgh colleagues from Carnegie Mellon University run two programs, one in computer science and one in business. Others include the Weil Cornell Medical School; the University of Calgary School of Nursing; the Georgetown School of Foreign Service, and five other programs. Each matriculates around 50 students per year, largely from nearby counties, with a sizable fraction from Qatar itself. We met with Weil Cornell Dean Daniel Alonso, a gracious and gentlemanly pathologist who has led the Cornell program since its inception six years ago. He is justifiably proud of his first crop of graduates this year (theirs is a “2+4” or six year curriculum).
A sincere public thank you to our CMU brothers and sisters; the Carnegie Mellon team was especially open and helpful. CMU-Q Dean Chuck Thorpe, Strategic Initiatives Director Anqi Qian, and Associate Dean Mohamed Dobashi all provided experienced insights into Qatar practices and politics. And through its long-term excellent relations with the Qatar Foundation, the Pittsburgh CMU President’s office provided us with some important Qatari contacts.
The Hamad General Hospital, where Walt Stoy and his team are headquartered, is an active modern general hospital. The Emergency Department is incredibly busy, averaging about 1,000 new patient visits each day. Yes, that’s 1,000 per day, almost one every minute! It is probably the busiest ED in the world. Physically the Emergency Department is divided into two separate and equal services, one for males and one for females. Most of the visits are by guest workers (laborers) so 80% of the patients are males. Layout, logistics, staffing, and training are all potential nightmares, but the place seems under control, even efficient, in no small part thanks to the improvements instituted by the UPMC team. Like the workforce at large, most of the ED physicians are expats from Egypt, Jordan/Palestine, India, Iraq, and other countries in the region; a substantial portion of the nurses are from the Philippines. ED data and statistical records are improving in quantity and quality, and a new electronic medical record is being implemented.
Outside Hamad General Hospital, there are five more hospitals in the Hamad Medical Corporation system. On the weekend (Friday), on a trip to the countryside, we unannounced dropped in on a visit to the ED at Al Khor Hospital, about 50 km north of Doha. The intervening roadside landscape had been flat, bleak, and uninhabited, interspersed with frequent “warning - camel crossing” signs. I expected a grim, dirty, marginally functional health unit, much as I had seen upcountry in many other provincial hospitals in other countries. I was shocked to find a modern, computerized, well equipped, well staffed, and clean facility. Everyone wore “UPMC – HMC” name tags, Purell hand sanitizers dotted the walls, and prominent posters reminded the ED staff to treat patients with respect, introduce themselves, and explain what was going on to the patients. Hallways, waiting rooms, and public restrooms were spotless! I would have been confident to have myself or my family treated there (or at least, substantially less concerned than at most comparable locations elsewhere in the world).
There could be real training opportunities for University of Pittsburgh health sciences students and residents in a number of capacities in emergency medicine, especially in recording and analyzing the impact of newly implemented policies during such a time of change.
I can also see several global health opportunities here. The first is in the area of rehabilitation. The program directors Cliff and I met were quite interested in training opportunities for their own faculty and professional staff, as well as trainees. Because Qatar usually does not send expatriates abroad for training, yet most faculty and professional staff are not Qatari, we were advised that the greatest demand would be in on-line and in-country short courses that awarded a completion certificate or similar non-degree recognition of achievement. Cliff and I came away encouraged about the prospects. We also met with directors of pharmacy, nursing, and other health specialties, who echoed these perceptions of training requirements.
Of course, I also looked into the prospects for research and training in public health. Currently there is no School of Public Health in the country. Most of the reliable health statistics are compiled from analysis of hospital records of the Hamad Medical Corporation; although there is an extensive primary care system throughout the country, record keeping is minimal and data are lacking. Professor Abdulbari Bener, Head of the Departement of Epidemiology and Medical Statistics, puts out a fine national Annual Health Report. He recognizes needs for training and support for public health programs. Importantly, just three months ago an expat (American) Gail Fraser Chanpong was appointed Director of Public Health for the National Health Authority, with a mandate for action and a budget to match. Gail is a DrPH with substantial international experience in Trinidad, Indonesia, and Tanzania. It’s a good bet that she will be able to help substantially strengthen Public Health programs in Qatar.
Qatar rightly sees itself as a model progressive Islamic Arab state. The Qataris are justifiably proud of their global TV news station Al Jazeera (the very term Al Jazeera means “the peninsula,” referring to the Peninsula of Qatar) The Qatari’s are making some bold and visionary moves to modernize their infrastructure and education systems. It strikes me that as the USA strategically moves to restore its relationships with the Islamic world, Qatar, and especially health initiatives with Qatar, could serve as a keystone for such a strategy.
For almost two years now UPMC has had a contract with the Hamad Medical Corporation, through the Qatar government, to provide education, training and services to Qatar’s emergency medical system for the entire country. UPMC Project Director Dr. Walt Stoy and his team of 20 mostly American expatriates have been terrific hosts for our visit. Walt is Professor of Emergency Medicine at Pitt, in Cliff’s School of Health and Rehabilitation Sciences. A long time Pittsburgher, he received his PhD in Education, specializing in instructional design and technology. Like many on his team, Walt shuttles back and forth between Pittsburgh and Doha at least once a month. He works and talks at a frenetic pace, pausing every few seconds to peer over his salt and pepper walrus moustache to check his blackberry. At dinner his physician colleagues grab for their hand-held radios 24/7 to reply to field teams of emergency medical technicians calling in to seek management advice about this or that horrific calamity. A cardiac arrest case, then a broken skull, then a tension pneumothorax, and on it goes. What a pace!
Qatar, on the Southwest shore of the Persian Gulf, is an Arab Emirate with a total population of about 1 million, of whom only about 200,000 are citizens. Most of the population are expatriate guest workers, supported by Qatar’s extraordinary income from natural gas. Because so many of the guest workers are male, the gender ratio is almost 2 to 1 males to females, the most skewed in the world. Most of the expatriate men come from India, the Philippines, or other Asian countries to work as construction laborers. The citizenry is 90% Sunni and 10% Shiite Muslims. Although Qatar is liberal compared to many Islamic Arab countries, Qatari women typically wear a full black traditional dress with head cover and face cover. It is not acceptable to photograph Muslim women here, so I have been very careful not to include them in my snapshots. Nor does a man put forth a hand to shake hands with a woman, western style. One merely nods his head and touches his chest.
That said, the Qataris are friendly people who readily exchange greetings and smiles with strangers, even on the street. In conversation, Qataris can be quite direct, a refreshing difference from other cultures where determining if you have just been told “yes” or “no” can be difficult. Perhaps the most striking feature of modern Qatar society is the infrastructure: the roads are paved, the air is clear, and hospitals are spotless. Of course, this reflects huge investments by the Qatar government over the past few years. The real problem faced by Qatar is trained and educated professional workforce. Although Qataris hold the highest positions in government and business, essentially all of the technocrats are foreigners. One good example of this is the UPMC team. Outside of natural gas, Qatar has few natural resources to support its economy, so an educated citizenry will be essential to sustained national well-being when the gas reserves become depleted in a few decades.
Qatar’s solution has been the creation of “Education City,” a unique 2,500-acre campus on the outskirts of Doha which hosts branch campuses of leading universities from around the world, mostly from North America. Our Pittsburgh colleagues from Carnegie Mellon University run two programs, one in computer science and one in business. Others include the Weil Cornell Medical School; the University of Calgary School of Nursing; the Georgetown School of Foreign Service, and five other programs. Each matriculates around 50 students per year, largely from nearby counties, with a sizable fraction from Qatar itself. We met with Weil Cornell Dean Daniel Alonso, a gracious and gentlemanly pathologist who has led the Cornell program since its inception six years ago. He is justifiably proud of his first crop of graduates this year (theirs is a “2+4” or six year curriculum).
A sincere public thank you to our CMU brothers and sisters; the Carnegie Mellon team was especially open and helpful. CMU-Q Dean Chuck Thorpe, Strategic Initiatives Director Anqi Qian, and Associate Dean Mohamed Dobashi all provided experienced insights into Qatar practices and politics. And through its long-term excellent relations with the Qatar Foundation, the Pittsburgh CMU President’s office provided us with some important Qatari contacts.
The Hamad General Hospital, where Walt Stoy and his team are headquartered, is an active modern general hospital. The Emergency Department is incredibly busy, averaging about 1,000 new patient visits each day. Yes, that’s 1,000 per day, almost one every minute! It is probably the busiest ED in the world. Physically the Emergency Department is divided into two separate and equal services, one for males and one for females. Most of the visits are by guest workers (laborers) so 80% of the patients are males. Layout, logistics, staffing, and training are all potential nightmares, but the place seems under control, even efficient, in no small part thanks to the improvements instituted by the UPMC team. Like the workforce at large, most of the ED physicians are expats from Egypt, Jordan/Palestine, India, Iraq, and other countries in the region; a substantial portion of the nurses are from the Philippines. ED data and statistical records are improving in quantity and quality, and a new electronic medical record is being implemented.
Outside Hamad General Hospital, there are five more hospitals in the Hamad Medical Corporation system. On the weekend (Friday), on a trip to the countryside, we unannounced dropped in on a visit to the ED at Al Khor Hospital, about 50 km north of Doha. The intervening roadside landscape had been flat, bleak, and uninhabited, interspersed with frequent “warning - camel crossing” signs. I expected a grim, dirty, marginally functional health unit, much as I had seen upcountry in many other provincial hospitals in other countries. I was shocked to find a modern, computerized, well equipped, well staffed, and clean facility. Everyone wore “UPMC – HMC” name tags, Purell hand sanitizers dotted the walls, and prominent posters reminded the ED staff to treat patients with respect, introduce themselves, and explain what was going on to the patients. Hallways, waiting rooms, and public restrooms were spotless! I would have been confident to have myself or my family treated there (or at least, substantially less concerned than at most comparable locations elsewhere in the world).
There could be real training opportunities for University of Pittsburgh health sciences students and residents in a number of capacities in emergency medicine, especially in recording and analyzing the impact of newly implemented policies during such a time of change.
I can also see several global health opportunities here. The first is in the area of rehabilitation. The program directors Cliff and I met were quite interested in training opportunities for their own faculty and professional staff, as well as trainees. Because Qatar usually does not send expatriates abroad for training, yet most faculty and professional staff are not Qatari, we were advised that the greatest demand would be in on-line and in-country short courses that awarded a completion certificate or similar non-degree recognition of achievement. Cliff and I came away encouraged about the prospects. We also met with directors of pharmacy, nursing, and other health specialties, who echoed these perceptions of training requirements.
Of course, I also looked into the prospects for research and training in public health. Currently there is no School of Public Health in the country. Most of the reliable health statistics are compiled from analysis of hospital records of the Hamad Medical Corporation; although there is an extensive primary care system throughout the country, record keeping is minimal and data are lacking. Professor Abdulbari Bener, Head of the Departement of Epidemiology and Medical Statistics, puts out a fine national Annual Health Report. He recognizes needs for training and support for public health programs. Importantly, just three months ago an expat (American) Gail Fraser Chanpong was appointed Director of Public Health for the National Health Authority, with a mandate for action and a budget to match. Gail is a DrPH with substantial international experience in Trinidad, Indonesia, and Tanzania. It’s a good bet that she will be able to help substantially strengthen Public Health programs in Qatar.
Qatar rightly sees itself as a model progressive Islamic Arab state. The Qataris are justifiably proud of their global TV news station Al Jazeera (the very term Al Jazeera means “the peninsula,” referring to the Peninsula of Qatar) The Qatari’s are making some bold and visionary moves to modernize their infrastructure and education systems. It strikes me that as the USA strategically moves to restore its relationships with the Islamic world, Qatar, and especially health initiatives with Qatar, could serve as a keystone for such a strategy.
Construction cranes are everywhere in Doha.
Modern, well equipped, and staffed Emergency Department at Hamad General Hospital
Camel-crossing warning highway sign
Chuck Thorpe, Dean of CMU-Qatar
posted by Don Burke @ 8:35 AM
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