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t m c » p u l s e | m a r c h 2 0 1 5 32 Global Perspective Through innovation, education and collaboration, Baylor Global Initiatives seeks to transform health and patient care worldwide I n the United States, a grave diagnosis—cancer, diabetes, dementia—can bring fear and anxiety, but it's also often accompanied by a distinct plan for medical care. Chemotherapy, insulin injections, medications—there are strategies for moving forward. In the far-flung corners of the world, however, the story is often different. How can a patient in Sub-Saharan Africa access cancer screening? Will a diabetic patient in northern China be able to regularly check his blood sugar? How will a dementia patient in rural Honduras have access to caretakers if physicians and nurses are scarce? These are just a few of the types of questions Baylor Global Initiatives at Baylor College of Medicine strives to answer. Health care costs in the U.S. number in the multi- trillions, a number incomprehensible to a large portion of the world. In many under-resourced regions, the health care solutions the U.S. relies upon are simply not feasible. Physicians, nurses and researchers must take a problem that is relatively easy to solve in the U.S. and look at it in a new light. The creativity and collaboration global health problems require led Sharmila Anandasabapathy, M.D., director of Baylor Global Initiatives, to devote her career to looking at medicine on a worldwide scale. "I went from doing high-tech, high-cost devices in the U.S., to realizing that those approaches and those technologies did not work in other parts of the world," she said. "If we were going to have any impact on global cancer mortality, we had to change both the devices that we were using and the environment and systems in which those devices were being unfolded." Anandasabapathy, also a professor at Baylor and director of the Baylor Global Innovation Center, was formerly Chief of Endoscopy at The Mount Sinai Hospital in New York City. A number of experiences caring for patients in other countries inspired her to globalize her focus. "We do health care in a very expensive way in this country and it's not exactly appropriate for other areas," she said. "If you start with a blank slate, and you have the opportunity to do this in other countries, you actually have the opportunity to be more innovative in your approaches to health care." For example, she explained, a procedure tradition- ally done by a gastrointestinal endoscopist with nine years of experience is not practical in areas of the world where such health care workers are not available. In those situations, creativity is a must and thinking outside of the box can provide solutions that not only B y S h e a C o n n e l l y There's a can-do spirit here, and that is perfect because you have to have that spirit to address global health. Otherwise the problems seem so overwhelming. — SHARMILA ANANDASABAPATHY, M.D. Professor and Director of Baylor Global Initiatives and Baylor Innovation Center