Nicholas Comninellis’ Presentations
Nicholas Comninellis, Dean of the Institute for International Medicine, offers presentations for healthcare professionals, healthcare profession students, and undergraduates. Please Contact INMED to explore potential opportunities.
Dr. Comninellis’ most popular presentations include:
International Refugee Care – Displaced But Not Forgotten
Abstract: International refugee care is a pressing global issue. Today’s world has more refugees seeking asylum than at any time since the end of WWII. 86% of refugees are hosted in developing countries, severely straining existing social infrastructures. This presentation will introduce the principles of international refugee care, including the four recognized phases: Pre-Emergency/Mitigation Phase, Emergency Phase, Post-Emergency/Maintenance Phase, and Repatriation Phase. Throughout these phases, refugee leaders must attend to concern over security, location of settlements, mental stress, dependency, and host-guest relations.
Post-Covid Global Health
Abstract: The Covid-19 Pandemic has collapsed economies, devastated healthcare systems, overwhelmed hospitals, and killed millions of people. In the wake of the Pandemic, what is the way forward towards global health? This presentation unveils a roadmap for removing the risk factors that obstruct global health and promoting the interventions that protect populations. This presentation also explores the roles of education and economic development in achieving health for all.
Serving The Forgotten
M3 Conference presentation of “Serving the Forgotten”
Abstract: Leaders in government, ethics, and healthcare agree on the imperative of health for all people. But while enormous gains have been made towards this end, today there exist multitudes of forgotten people who suffer preventable diseases and receive no healthcare. These forgotten people often include immigrants, refugees, minorities, elderly, disabled, non-English speakers, urban and rural poor, and victims of disaster and war. In their defense, health leaders must become effective advocates – rallying resources on their behalf. Health leaders must also prioritize prevention and treatment of forgotten diseases like measles, leprosy, vitamin A deficiency, polio and tetanus.
Emergency Pandemic Control
Humanitarian Health Conference presentation of “Emergency Pandemic Control”
Abstract: Rapidly increasing international trade and travel predictably increases the likelihood of rapid transmission of infectious diseases. The devastation caused by the 1918 Spanish influenza epidemic, and the worldwide alarm prompted by the 2004 SARS epidemic provide important insights into today’s concerns surrounding COVID-19. Epidemic investigation is based upon finding evidence-based answers to critical questions, including identifying the infectious agent, the mode of transmission, incubation period, and effective modalities for prevention, diagnosis, and treatment. Emergency pandemic control also often requires deliberate intervention to address special ethical challenges: disease-associated racism, resistance to local and international cooperation, and extreme stress placed upon low-resource health systems.
Controversies In Short-Term Medical Missions
TEDx Talk presentation of “Controversies in Short-Term Medical Missions”
Abstract: Short-term medical missions are a popular phenomena among North American healthcare professionals. Beyond a gesture of compassion, however, serious questions may surround the professional ethics and actual effectiveness of this practice. Short-term medical missions are often further complicated by concerns connected with limited time commitment, inadequate resources, unfamiliar cultural context, and lack of continuity following departure. A key element in assuring that such missions are ethical, effective, and culturally relevant is national partnerships: cooperation with healthcare professionals, healthcare institutions and/or educational institutions in the host nation. Such partnership may involve provision of materials, instruction, and/or special services – always in collaboration with, and ideally, under the direction of national leaders. Another key element is continuity of commitment over a period of years, especially when such periods of service are of short duration.
UNICEF and DOCARE presentation of “Controversies in Short-Term Medical Missions”
Humanitarian Health Conference presentation of “Universal Donors”
Abstract: What is your blood type? Type O Negative is the “universal donor” – the rarest and also the most useful of all blood types. Healthcare professionals possess skills to protect and restore health. But like people contemplating blood donation, they often hold back from service to those in greatest distress. Concerns often expressed are fear over personal safety, finances, children’s education, and family life, unfamiliar disease, cultural barriers, and inadequate medical resources. The presentation addresses these fears with the aim of aiding healthcare professionals themselves to become “universal donors” on behalf of the world’s most poor.
The Unsung Power of Applied Learning
Video excerpt from the presentation “The Unsung Power of Applied Learning.”
Abstract: INMED President Nicholas Comninellis describes his early failure on location in southern Africa to apply what he learned at the Walter Reed tropical medicine school to actual patient care. This failure to launch from didactic learning to performance is pervasive throughout education. The key element to successful transition is often practical, real-life experience, ideally in the presence of a dedicated mentor. INMED, the Institute for International Medicine, makes full use of this model, combining online and in-classroom education with on-the-field service-learning experiences with INMED facility residing in twenty-five developing nations.
Launching Your International Healthcare Career
Humanitarian Health Conference presentation of “Launching Your International Healthcare Career”
Abstract: Healthcare professionals enjoy a strong record of service to forgotten people. However, this career track is associate with high turnover, especially in international and cross-cultural settings. Unique professional skills are required, for the diseases may be different, medical resources minimal, cultural context challenging, and leadership skills insufficient. This presentation first addresses the principles of wise decision making. Next, professional decisions are addressed, including the selection of a professional specialty, a community to serve, a sending organization, and language learning needs. Finally, personal decisions are explored, including money management, personal health, spiritual health, family relationships, and legal guidance.
UNICEF and DOCARE presentation of “Launching Your International Healthcare Career”
The Power of Exemplary Role Models
Excerpt from the video presentation “The Power of Exemplary Role Models”
Abstract: Personal role models can profoundly impact our values and aspirations, resulting in exceptional inspiration or devastating iniquity. Nicholas Comninellis explores the power of role models and how these impact development of social movements, citing illustrations from his personal life and the genesis of INMED. Deliberate selection and rejection of persons to emulate and with whom to partner is a vital life skill. Dr. Comninellis concludes with a challenge for personal integrity and action on behalf of the world’s most forgotten people.
M3 Conference presentation of “The Power of Exemplary Role Models”
Low-Resource High-Risk Maternal Care
Humanitarian Health Conference presentation of “High-Risk, Low-Resource Maternal Care”
Abstract: Surviving motherhood is a genuine concern. Maternal and newborn deaths make up the 6th and 7th leading causes of Disability Adjusted Life Years (DALYs) lost in the world’s poorest nations. Post-partum hemorrhage (PPH), eclampsia-preeclampsia, abortion complications and failure to progress are the leading maternal causes of death. Major modes of decreasing maternal morbidity and mortality are to reduce family size and to provide quality obstetric care at time of delivery. Breastfeeding is the most natural, available contraceptive, with multiple additional benefits. Management of PPH requires immediate evaluation and intervention, particularly against atony. Basic newborn resuscitation should be universally available. Healthcare professionals must advocate for the provision of these essential services to safeguard mothers and newborns.
UNICEF and DOCARE presentation of “High Risk Low-Resource Maternal Care”
Fighting The Diseases Of Poverty
Humanitarian Health Conference presentation of “Fighting the Diseases of Poverty”
Abstract: Poverty and health are intimately associated. The nations of poverty are also home to the lowest life expectancy, greatest child mortality, and highest number of preventable deaths. Three interventions are especially effective. First, we must promote economic development, for history demonstrates that as overall income increases so does health status. Second, we must stand against military conflict, for in nations so embattled over 90 percent of deaths are from hunger and infectious diseases. Third, we must advocate those specific interventions that have proven most effective against the leading diseases of poverty, such as the provision of safe drinking water and mosquito nets to prevent malaria, though these priorities may be inconsistent with the standard medical paradigm.
From Inspiration To Mobilization
Abstract: It is human nature to defend. Whom will you defend? It is human nature to step up to a challenge. What challenge will you choose? Today we witness marvelous progress in healthcare: robotic surgery, miracle cancer drugs, vision correction procedures. Yet on the perimeter of our communities both in North America and abroad live multitudes of people who are barred from these innovations because of poverty, illiteracy, culture, and distance. Healthcare professionals often possess a virtuous desire to serve the poorest of the poor. But how do we move from feelings of inspiration to deliberate steps of action? This presentation takes advantage of popular stories of individuals who move from inspiration to mobilization.
From Rescue To Resilience
Abstract: Disasters and epidemic disease continue to mark this new century: Haiti’s earthquake, Pakistan’s flood, measles’ blight, and Zimbabwe’s cholera. The heartening response from many is to donate personal time, talent, and treasures to provide rescue and assistance to those in distress. But even well-intentioned efforts have their limitations. We must move beyond the rescue mentality and pursue those interventions that actually build more resilient communities. These interventions often include economic development, improvements in basic literacy, and proven effective health interventions. We must also invest in equipping local healthcare personnel to provide for their own.
Health Through The Eyes Of Culture
Abstract: Many culturally influenced behaviors have important health consequences. As we better understand culture, we can become more effective health promoters. “Culture” itself is an integrated system of learned behavior patterns. Most cultures contain a broad mixture of both “scientific” and “traditional” viewpoints. Cultures can be effectively understood in terms of their perspectives on human nature, the relationship of humans to nature, their sense of time, their perspective on activity, and influence of social relationships. To effectively promote health in a new cultural context, one must apply the most basic principles of cultural adaptation: Observe, Understand and Adjust. Frequently say to your national colleagues, “Help me to understand why…” Asking questions maintains self-respect and creates ownership. Improvement in health behavior is a process built on trust and relationship. This presentation includes case studies and interactive use of role-playing to enhance the learning experience.
Low-Resource HIV Care
Abstract: HIV remains the leading cause of Years Of Life Lost in the world’s poorest nations. Effective means are available to both prevent HIV infection and to effectively treat HIV and AIDS. However, bias and lack of dedicated leadership often obstruct these life-saving interventions from reaching the most marginalized communities. We healthcare leaders must redouble our efforts to overcome these barriers. The ABCs of HIV prevention continue to be an effective message. HIV screening is now more accessible than ever. Prevention of Mother-To-Child HIV transmission is particularly effective if adequate detection and appropriate management are provided. Treatment of HIV and AIDS is facilitated by simpler protocols and more widely available trained personnel.
Tropical Medicine Case Studies – Nonsurgical
Abstract: Effective management of disease in low-resource settings is particularly challenging for practitioners accustomed to both diseases of excess and abundant healthcare resources. Clinicians do well to begin by first understanding the epidemiology of the particular community. What, for example, are the most common causes of fever or diarrhea? Armed with a general understanding of probabilities, clinicians then must apply astute attention to history and physical examination, with minimal reliance upon laboratory or radiological evidence. Treatment options must also be modified to conform to local and often extremely limited resources. Finally, clinicians must be keen to use each patient care opportunity to both hone their skills and to transmit those skills to others. This presentation includes use of interactive case studies to enhance the learning experience.
Tropical Medicine Case Studies – Surgical
Abstract: Effective management of disease in low-resource settings is particularly challenging for practitioners accustomed to both diseases of excess and abundant healthcare resources. Clinicians do well to begin by first understanding the epidemiology of the particular community. What, for example, are the most common causes of infection or abdominal pain? Armed with a general understanding of probabilities, clinicians then must apply astute attention to history and physical examination, with minimal reliance upon laboratory or radiological evidence. Treatment options must also be modified to conform to local and often extremely limited resources. Finally, clinicians must be keen to use each patient care opportunity to both hone their skills and to transmit those skills to others. This presentation includes use of interactive case studies to enhance the learning experience.
Tropical Fever Evaluation
Abstract: Evaluation of fever among patients in a tropical setting is one of the most daunting clinical challenges, stemming from unfamiliar causes, unusual causes, limited laboratory and imaging, cultural misunderstanding, time pressure, and out of practice clinical skills. A rational approach to febrile tropical-locale patients begins with knowledge of local epidemiology to assess particular risks. Next, clues can be gleaned from the history, such as freshwater exposure (schistosomiasis) and painful eye movement (dengue). Physical exam may reveal pathognomonic signs like conjunctival injection (leptospirosis) and Koplick’s spots (measles). Laboratory and imaging are usually very limited, but access to the proliferation of rapid tests holds much promise. Most importantly, results of basic malaria tests and neutrophil count can readily rule in or out numerous causes of tropical fever. This presentation includes case studies and interactive use of role-playing to enhance the learning experience.
Emergency Obstetrical Skills
Abstract: 98 percent of maternal deaths worldwide occur in low-resource communities, and are almost entirely preventable. System-wide improvements in contraception, prenatal care, and obstetrics hold promise to improve such outcomes. Equipping of midwives and community health workers is an important component. Everyone who delivers babies must recognize the most common obstetrical emergencies, and be able to manage appropriately. This session includes the use of manikins and hands—on skills to increase competency in treating postpartum hemorrhage, shoulder dystocia, and breech presentation.
Health Leadership for Low-Resource Communities
Abstract: The Health field is in crisis for lack of wise leadership, yet leadership skills are rarely taught. Health leaders in limited-resource communities must design and implement health systems that are both effective and efficient. A “health system” is a design for effective interventions based on health needs and on available resources. A variety of interventions may promote health but are either inappropriate or inefficient. To design a health system, first assess needs and resources. Second, plan appropriate interventions. Third, assure these are carried out. This three-step process is cyclical and continuous. Four levels of Interventions are commonly considered: population-oriented, disease oriented, primary care, and hospital care.
Health is Wealth
Abstract: Health is an ongoing crisis throughout the world. Cost is high and growing. Access is limited for those separated by distance or insufficient finances. And, quality care is difficult to assure. This is an age for heroes in healthcare who realize that the outcome aim is not simply more healthcare services. Rather, it is a system of care that results in healthier lives. A useful strategy is to revisit how care in incentivized: to pay for healthcare based on value of care, rather than on volume of care alone – so called Value Based Reimbursement. Practically speaking, how can we measure quality? By compliance with practice guidelines: evidence-based best practices, clinical markers (Hgb A1c), patient case management, preventive care, and use of health information systems. The latter make possible the tracking of compliance. Professionals providing primary care are well suited for quality-based care reimbursement because their patients already receive continuous and comprehensive care. Primary care is research-proven to improve quality and length of life, and to reduce overall costs. From multiple perspectives, indeed, Health is Wealth, and we do well to incentivize this fact.
Appropriate Technology For Global Health
Abstract: Healthcare is chronically in crisis – especially in low-resource settings. Improved health and healthcare demand skilled leadership, with attention to health systems. One ethical principle for developing successful health systems is the effective use of limited resources. This includes the appropriate application of technology. What principles can be used to determine whether a technology is appropriate or not? Reliability, sustainability, and acceptability. Some appropriate uses of technology in low-resource health systems often include rapid diagnostic tests, mobile health information systems, ultrasound imaging, and adherence to the use of WHO & National Essential Drugs. Collaboration with local partners and hosts is also essential. Their guidance greatly increases the likelihood that technology will be used appropriately. This presentation includes interactive use of role-playing to enhance the learning experience.
Global Health Education – Multiplying Skill Capacity
Abstract: This session addresses the palpable issues of global health education, both to enhance the skill of North American personnel being sent and the skill of local hosts whose capacity needs to grow. Competency-based learning is emphasized throughout, with a focus on effective teaching and learning that is participatory, interactive, and case-based. Realistic outcome measurements will be suggested, with the adoption of locally-relevant criteria. Reference is made to the experience of INMED, with 600+ graduates over 12 years. During this presentation, participants will create their own framework by which to assess and/or design their own unique global health education programs.
Health Of You, The Traveler
Abstract: Contrary to most perceptions, the leading causes of death among Americans who travel abroad are injuries and chronic diseases that they were suffering at the time of travel. Advanced preparation includes attention to injury prevention, adequate control of chronic disease, and measures to prevent infectious diseases. The latter include routine vaccinations, special vaccinations, emergency medications, and measures to prevent insect-borne diseases like malaria and dengue. Travel insurance and identification of reputable local medical care providers should be arranged prior to departure. Travelers are wise to also consider their own mental health in advance.
Please contact INMED to explore any of these presentation options.
Dr. Comninellis’ biography is available here.