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SUMMARY OF ACCOMPLISHMENTS
Partnership data through September 1998:
Exchanges both ways 264
Partner exchange days 5,611 ( = 15.4 years)
In-kind contributions $3,827,382
AID/AIHA $823,0281992
Two visits for purposes of gathering information and beginning to plan the activities of the partnership
1993
Casarella, W: Radiology in Tbilisi; The Legacy of 70 years of Soviet Government. Am. J. Radiol. 1993: 161; 23-25.
Atlanta-Tbilisi supplied an on-site representative, Ms. Sherry Carlin, during the second year of the partnership. Ms. Carlin worked closely with the Ministry of Health and nongovernmental organizations in assessing the state of the health system and in planning for change.
1994
President Eduard Shevardnadze issued Decree 400 on December 23, 1994, establishing the State Health Care Fund, ensuring licensure of medical facilities, creating registration and quality control of medications and supplies, and certifying and licensing health care providers. The Partnership, especially the Emory School of Public Health and Ms. Carlin, was quite involved in the studies and planning leading up to this.
The partnership arranged a series of exchanges for faculty, deans and administrators from Tbilisi State Medical University (TSMU). During each exchange the Georgian faculty and administrators observed teaching methodologies for pathology and anatomy and completed a review of medical school curricula. As a result, the Georgian faculty and administrators worked with faculty from the Emory University School of Medicine to begin revisions to the TSMU curriculum.
Tbilisi State Medical University (TSMU) and Morehouse School of Medicine Multimedia Center trained their Georgian partners in improved practices of library science and upgrading access to medical literature. Cataloging standards used in the US and Western Europe were introduced and staff at TSMU were trained in these procedures.
1995
An endoscopic laboratory donated by the Atlanta partners was installed at City Hospital No. 2 for modern diagnosis and treatment of gastrointestinal disease. A gastroenterologist was trained in current practice of endoscopy during a month visit to Emory University School of Medicine prior to the installation of the laboratory.
A program of medical student exchanges was established between Emory University School of Medicine and Tbilisi State Medical University (TSMU). Thirty medical students from TSMU have spent four to six months on clinical clerkships at Emory. Twenty Emory students have spent one month each in Tbilisi, each with a specific health care project. Examples of topics covered include assessment of iodine deficiency in newborns, prevalence of HIV in patients with tuberculosis, and technical support for the legal basis of medicine. 1995 through present
Twenty-three graduates of Tbilisi State Medical University (TSMU) were accepted into residency programs at Emory University School of Medicine: internal medicine; psychiatry; radiation oncology; transitional medicine. Further sub specialization has been or is being accomplished in: neurology; surgery; infectious diseases; cardiology; geriatrics; and endocrinology. 1995 through present
Seven Georgians have obtained their Masters of Public Health degree at Emory School of Public Health. 1995 through present
The National Emergency Medical Services Training Center was opened on October 23, 1995 and continues to train personnel from throughout Georgia in pre-hospital emergency care and life support. Since the opening of the center through September 1998, 60 training courses have been held, 56 in the training center and four at remote sites in the Zugdidi-Samegrelo region, the Gali-Abkhazia region, the Gudauri region and the Supsa region. The center has trained 1,492 people, including physicians, nurses, and a range of lay persons. It has conducted 22 training programs for non-physicians and children and coordinated special programs for governmental guards, car drivers, mountain guides and four-day courses in First Aid for pipeline companies. The center created a database to record information on all trainees and training programs. The distribution of trainees by region and by age are tracked. The Center has carried out numerous special projects such as: Healthy Generation, providing first aid training for school pupils; introduction to first aid and self service training; Medical Information Bank, a Database for Emergency Service and Disaster Medicine; First aid training for refugees from Abkhazia; and Trauma Prevention Project. The EMS staff in Tbilisi produced three different manuals in First Aid and emergency care, one for medical personnel, one for non-physicians, and one for students. The EMS Center also produced the first color illustrated textbook, First Aid, in Georgian and Russian languages. The EMS Training Center negotiated a contract with the Western Road Pipeline project to provide training for its personnel. The contract will assist the center in covering operational costs, an important element of center sustainablility. 1995 through present.
1996
The US partners donated and installed electronic fetal monitoring equipment and completed training in the use of fetal monitoring in obstetrics at hospitals in Tbilisi and Kutaisi.
US partners trained their Georgian counterparts to be trainers in neonatal care and resuscitation. The Georgians then translated the training manual into Georgian and established their own outreach training group, called Neonatus.
A series of training seminars as part of Health Management Reform were conducted in Borjormi by AIHA and the Association of University Programs in Health Administration for 55 health care managers from throughout Georgia. Emory School of Public Health participated.
The Georgian Nursing Association was established with the aid and encouragement of the Atlanta-Tbilisi partnership.
A national conference on nursing leadership was held. Nurse educators, who had been trained through the partnership program, conducted continuing education sessions with their American colleagues. Nurses from partnership and regional hospitals attended the conference.
The Partnership cosponsored five National Health Policy Workshops in Georgia focusing on health care reform, health care policy and human resources.
As a result of the National Health Policy Workshops the World Bank initiated its investigation of designing their Georgia Health Project as part of the overall loan to Georgia in 1996.
The partners helped incorporate a national health promotion plan into the Georgian Health Project of the World Bank.
A professor from Emory School of Medicine delivered a report entitled, The New Tuberculosis: Clinical and Molecular Epidemiology, on August 8, 1996, at a conference on public health surveillance information systems which was sponsored by the Ministry of Health Republic of Georgia, USAID, and the US Centers for Disease Control and Prevention (CDC).In collaboration with the Woodruff Health Sciences Center Library at Emory University, the Tbilisi partners opened the National Information Learning Center (NILC) in December 1996. The NILC provides Internet access to the world's major biomedical databases and selected full-text resources, as well as on-site materials, reference services, document delivery and training in the use of MEDLINE and Internet resources for students, faculty, practitioners and government officials.
1997
The partners established the National Mammography Project as a vital intervention for early detection of breast cancer. In September, the Crawford W. Long Hospital of Emory University donated a mammography unit to the Institute of Diagnostic Imaging, establishing the first modern mammography unit in the Caucasus.
The Emergency Medical Services Training Center developed and launched its own web page.
A second national nursing conference was held, training nurses in physical assessment and skills development. A team of three US and four Georgian nurses conducted the three-day conference. Thirty-eight nurses attended and successfully completed the conference.
The partnership developed a series of continuing education courses for nurses, including those addressing practical clinical skills, leadership and managerial skills. Courses were developed by a team of US and Georgian nurses and were conducted both in Atlanta and Tbilisi to build the capacity of the Georgian nurses to train their colleagues. Nursing delegations completed intense train-the-trainer exchanges at Grady Health System. During 1997, 54 nurses completed the Nursing Leadership course and 30 nurses completed the partnership-designed nursing skills courses. 1997 and subsequently
The Minister of Health created the position of Chief of Nursing in the Ministry and selected a partnership nurse to serve in this position.In order to formalize nursing education, Tbilisi State University (TSU) worked with educators from Georgia State University and Grady Hospital to create a university-level nursing school. The School of Nursing will be the first university-level nursing program in Georgia. TSU has identified space for the program and potential faculty. 1997-2001
In September, a complete set of radiological teaching files consisting of approximately 1,500 separate cases and films were transferred to the Institute of Diagnostic Imaging, in Tbilisi, Georgia. These files will serve as the core-teaching curriculum at the Institute of Diagnostic Imaging and as the basis for the oral portion of subsequent radiological board exams.
A prosthetics lab from Fitzsimmons Army Hospital was donated to the Traumatology Hospital in Tbilisi. The combined production of all prostheses facilities in Georgia (ICRC, Atlanta-Tbilisi donated factory, and Otto Bock from Germany) is less than 500 per year, which is far below the need. A plan has been designed to use CAD-CAM technology to produce up to twenty prostheses a day. Digital stump measurement was piloted successfully, making it possible to measure stumps for fit with a laptop computer anywhere in Georgia or the Caucasuses and transmit the data electronically to a central site. 1997 and subsequently
The Atlanta-Tbilisi Partnership, including representatives from the US Centers for Disease Control (CDC) and Emory University, organized and facilitated two breakout sessions on micronutrient deficiencies, during the AIHA's Fifth Annual Partnership Conference for NIS held in October in Atlanta.
A meeting was held in Bethesda under the auspices of the Fogarty International Institute of the National Institutes of Health, attended by Minister of Health Jorbenadze, Deputy Minister Gamkrelidze, and other scientific leaders of Georgia. A follow up visit was made to Tbilisi by Dr. Richard Krause of the Fogarty, accompanying Atlanta-Tbilisi partnership members. At this latter meeting Dr. Krause gave an assessment of the state of biomedical research in Georgia, and made explicit recommendations for the future. A third meeting was held in Tbilisi in 1998, with leading scientists working in AIDS from the NIH. Invited members of this group were Atlanta-Tbilisi partners working with AIDS and tuberculosis in Georgia. Three grants, totaling $385,000, have been obtained from the NIH and the World AIDS Foundation by joint proposals of Georgian and U.S. Atlanta-Tbilisi partners for research in AIDS and tuberculosis. 1997 and 1998
1998 - present
The Caucasus School of Business (CSB) was formed by Georgia State University (GSU) and three institutions in Tbilisi: Tbilisi State University; Georgian Technical University; and Tbilisi State Institute of Economic Relations. The main purpose was to establish a program for training a new generation of managers to assist Georgia's transition from a planned economy to a free market economy. The program will serve not only Georgia but also the Transcaucasus region and the neighboring countries. The partnership between Robinson College of Business (RCB), Georgia State University (GSU) and the Georgian Universities led to the design and implementation of a Master of Business Administration (MBA) and Bachelor of Business Administration (BBA) and Management Development Programs (MDP) whose purpose was to develop and train faculty and top level administrators, and establish modern library, computer laboratory, and communication and audiovisual facilities. The partnership between GSU and CSB is funded by two grants from the US Government Agencies (the Eurasia Foundation- USAID ($ 314,552) and the Bureau of Cultural Affairs of the State Department ($300,00)). The grants will expire at the end of the year 2001. In January 1991 there are 70 MBA students and 125 BBA students. Founded October, 1998
In March, the partnership conducted the third national nursing conference. A joint team of US and Georgian instructors conducted the three-day Skills Development Continuing Education Seminar. Thirty-four nurses from several republican hospitals successfully completed the training program.
In May, the partners opened the Nursing Learning Resource Center (NRC), located in the World Bank Continuing Education Center. The NRC serves as a center for continuous education and training for Georgian nurses.
The US/NIH-Georgian Joint Symposium: Research Opportunities in HIV/AIDS, Emerging Infectious Diseases and Immunodeficiencies was held in Tbilisi, May 11-16. US partners were invited to make presentations during a special session on Tuberculosis and to moderate a session which included presentations on tuberculosis given by Georgian physicians and scientists.
The Georgian Ministry of Health and the Program Against Micronutrient Malnutrition at the Emory University School of Public Health held the Multi-Sectoral Management Course Workshop for Program Managers, Implementors, and Stakeholders for the Elimination of Iodine Deficiency in June. This workshop trained officials from several NIS countries in the public health approach to eliminate and monitor iodine deficiency disorders. The Atlanta-Tbilisi partners shared their concerns about the nature and extent of iodine deficiency in the population with the Ministry of Health. At the request of the Minister of Health, the partners provided the Ministry with a detailed briefing document containing information on the public health and economic burden of iodine deficiency as well as possible solutions. The recommended solution for elimination of the iodine deficiency was the implementation of public health programs to encourage universal consumption of iodized salt. The Minister briefed the Cabinet on iodine deficiency in Georgia, which led to a Decree from the Head of State mandating the universal iodination of salt. A team of consultants from the Program Against Micronutrient Malnutrition of the Emory University School of Public Health and the US Centers for Disease Control and Prevention traveled to Georgia to work with officials from the Ministry of Health and Parliament. An action plan to eliminate iodine deficiency in Georgia was designed and incorporated into the health program of the Georgian Parliament and Ministry of Health. The program was funded initially by the Georgian Government. At the request of the Parliament, the Atlanta partners assisted the government to identify other sources of funding. The partners facilitated negotiations with Kiwanis International and UNICEF which led to cooperative efforts and a donation of $103,000 towards the iodination project. The Georgian Ministry of Health brought the issue of micronutrient malnutrition to the attention of the CIS Council of Health Ministers. He emphasized the need for an intra-CIS agreement on the trade of iodized salt for the elimination of iodine deficiency. The Atlanta-Tbilisi Health Partnership helped to produce this document which officials expect to be signed at the next meeting of the CIS Council of Health Ministers. In addition, the CDC and Emory University representatives contributed to AIHA's CommonHealth magazine an article on iodine and iron deficiencies in order to build NIS-wide awareness of the impact of micronutrient malnutrition and cooperation for elimination programs. 1998 and subsequently
The partners conducted an initial study of thyroid-stimulating hormone levels in neonate cord blood samples in three areas of Georgia to determine the extent of iodine deficiency in the population. The study indicated that iodine deficiency is indeed a serious health issue.
A two-week visit to Atlanta in August by the Director of the Georgian National Tuberculosis Program was supported by a CRDF grant. The visit provided an opportunity to meet with Emory University staff and to go over the progress of the CRDF grant. In addition, the Director met with the leaders of the Division of TB Elimination at CDC, the directors of the US Georgia TB Control program and local county health departments. The Director had an opportunity to see how programs have been implemented and how surveillance systems are set up in the US. A Georgian microbiologist from the National Tuberculosis Institute Laboratory was trained at Grady Memorial Hospital, the US State of Georgia Public Health Laboratory and CDC in modern techniques of AFB (TB) cultures. He trained other microbiologists and, as a result, the Georgian TB Institute laboratory's ability to perform TB cultures and susceptibility testing has been upgraded. Drug susceptibility information will be of great use to TB control programs and in implementing effective control programs. 1998 through present
The Tbilisi partners organized four in-country lectures on HIV/AIDS for physicians at the Ministry of Health, the Infectious Diseases hospital in Tbilisi, the Dusheti District Hospital and the Pasanauri District Hospital. In addition, two lectures were given on HIV/AIDS to medical students in Georgia. The partnership conducted a survey of knowledge, attitudes and behavior among high school students in Tbilisi in April. The results of this study were presented at the XII International Conference on AIDS.The Tbilisi partners received a $50,000 grant from the World AIDS Foundation to support a counseling and testing center in Tbilisi. 1998 through present.
Five issues of the Georgian Medical Journal were published and distributed to medical personnel throughout Georgia to disseminate medical and pharmaceutical information. The continuation of the journal is pending alternative funding and revenues. The journal provided the foundation for the development of an on-line medical and pharmaceutical information bulletin which is disseminated through the NILC.
In January 1998 the Rector of Georgian Technical University, the President of Georgia Tech-Lorraine, a satellite campus of the Georgia Institute of Technology in Atlanta and the co-director of Atlanta-Tbilisi met at the campus of Georgia Tech-Lorraine in Metz, France. A Strategic Plan for the Active Engagement of Higher Education and Applied Research in the Long Range Economic Development of the Informatics, Electrical Energy and Telecommunications Sectors of the Republic of Georgia was developed. Implementation is planned for the future, when funding is available.
Collaboration with the Partnership for Peace Information Management System PIMS) and International Medical Programs began in 1998 and is continuing through the present. PIMS is run out of the Pentagon, and supplies Internet access via satellite to the ministries of defense of many Eastern European countries, particularly the Newly Independent States. Atlanta-Tbilisi teamed with them to develop templates for updating military medical care professionals in modern medicine, especially as it applies to military and natural catastrophes. A 2 megabyte LAN was established in Tbilisi, with the NILC as its hub, connecting the Military Hospital, Military Medical School and several other institutions. A series of programs using video-streaming between the US and Georgia are being delivered now (2001): cardiology; tuberculosis; field trauma. 1998 through present
Uniformed Services University of Health Sciences started a productive collaboration with the NILC, later involving PIMS also. The library section of USUHS provides access to online databases to the NILC, document delivery and other services. PIMS and USUHS are collaborating in a number of ventures involving the NILC.
More detail:
The First Six Years: Report to AIHA [PDF document]
Tbilisi, Georgia--Atlanta, Georgia (1992-1999): AIHA Summary Report [PDF document]
Report for 1999-2000 [PDF document]
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