National Information Learning Center	Women and Children
Medical Education	Biomedical Research and Scholarly Activities
Business Education	AIDS
Distance Education	Prosthetics
Tuberculosis	Micronutrient Malnutrition
Nursing Education	Healthcare Policy and Healthcare Management
Emergency Medical Services Training Center

Medical Education
	Problems: Antiquated medical curriculum, circa 1930's Students have little clinical involvement; mostly observers Little or no exposure to modern technology and its results Students ill-prepared for medicine of year 2000
	Solutions: Twenty-three graduates of Tbilisi State Medical University (TSMU) were accepted into residency programs at Emory University School of Medicine Thirty medical students from Tbilisi have spent four to six months each as students at Emory University School of Medicine Twenty medical students from Emory have spent one to two months in Tbilisi. Seven Georgians have obtained their MPH at Emory School of Public Health. Curriculum reform: faculty from Georgia spent time at Emory observing the medical curriculum, and faculty from Emory visited Georgia, contributing to the first significant medical curriculum reform in seventy years.
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Distance Education
	Problems: Minimal access to information outside of Georgia Distance and difficulty of travel make visiting academicians scarce Urgent need for sessions by and with professors and other experts not in Georgia
	Solutions: National Information Learning Center Partnership for Peace Information Management System collaboration International Medical Programs courses
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Business Education
	Problems: Economy in chaos Few managers able to operate in a market economy 70% of population live below subsistence minimum Foreign investment per capita, $37: compared with $112 across former Soviet Union Transition from Soviet planned economy to free market economy
	Solutions: Formation of the Caucasus School of Business
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Tuberculosis
	Problems: A major public health problem in the Republic of Georgia Incidence of 100 cases per 100,000 population Prevalence of 200 cases per 100,000 High rates among internally displaced persons Emergence of multidrug resistant tuberculosis Children affected in great numbers Lack of infrastructure, poor laboratory support No directly observed therapy
	Solutions: Technical training at Grady and Emory of microbiologists and physicians from the Republic of Georgia Needs assessment and plans, many of which are being implemented improved infrastructure and implementation of DOT's better diagnosis and laboratory capacity identification of drug resistance
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Nursing Education
	Problems: No respect for nurses or nursing Minimal education of nurses with few resources No university level education of nurses No licensure for nurses
	Solutions: Core curriculum developed for practicing nurses Georgian Nurses Association founded Chief Nurse position/infrastructure created by Ministry of Health Training of nurse educators in Atlanta Plans, facilities and money for School of Nursing at Tbilisi State University
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Emergency Medical Services Training Center
	Problems: Trauma a significant cause of death and disability High incidence of cardiovascular disease, especially heart attacks Concept of 'first responders' not present in former Soviet Union Enormous potential for catastrophes: earthquakes; oil pipeline rupture; nuclear accidents.
	Solution: Emergency Medicine Training Service center opened by partnership October 23, 1995
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Women and Children
	Problems: Birth rate 1.2 Precipitous decline since 1987 Live births: 1987: 100,000 1999: 58,000 with 21,000 reported abortions (Figures from Jordania Institute) High rate of sexually transmitted diseases Birth control principally by abortion Pregnancy related mortality/morbidity higher than most of Europe Infant mortality high
	Solution: Opening of the Women's Wellness and Primary Care Center in Kutaisi in March, 2000
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Biomedical Research and Scholarly Activities
	Problems: Research infrastructure virtually nonexistent: academic, technology, information buildings, financial support
	Solutions: Georgian medical scientists visited the Fogarty International Institute of the NIH Fogarty leaders made two visits to Georgia and produced recommendations Cooperative grants are being funded between US and Georgia by the Civilian Research and Development Foundation
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AIDS
	Problems: Explosive increase in IV drug abuse beginning in early 1990's 1994: estimated 100,000 IV drug users with 1400 in prisons Dramatic increase in sexually transmitted diseases Unprotected sex and low level of safe sex education Inadequate surveillance of blood supply Adjacent to countries with high incidence of HIV
	Solutions: World AIDS Foundation grant for support of counseling and testing center in Tbilisi AIDS International Training and Research Grant: $300,000 Study of HIV seroprevalence among patients with tuberculosis Lectures and seminars Training of Georgian personnel in Atlanta Close relationship with personnel of Georgia AIDS Center
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Prosthetics
	Problems: 10,000 amputees; roughly 5,000 from land mines 77% age 20-65, most are breadwinners 300 cheap short lasting prostheses produced per year Waiting list years long Measuring time for stumps lengthy and inaccurate
	Solutions: Fitzsimmons Army Hospital prosthetics laboratory donated Digital stump measuring piloted successfully Detailed survey of needs done CAD CAM technology proposal prepared
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Micronutrient Malnutrition
	Problem: Emory student discovered 60% of Georgian newborns have significant hypothyroidism
	Solution: Team from Emory University School of Public Health and the National Centers for Disease Control worked with the Ministry of Health to eliminate iodine deficiency
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Healthcare Policy and Management Reform
	Problems: Transition away from Soviet system occurring very slowly 30,000 physicians in a country with a need for about 10,000 Licensure and credentialing for physicians and nurses just beginning Facilities completely inadequate: old, deteriorating, inadequately equipped Lack of trained healthcare managers
	Solutions: Workshops on healthcare management and reform Onsite representative for one year Extensive work by Emory School of Public Health Decree 400 by President Shevardnadze that established licensure and certification
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Last Update: April 26, 2001