Pillar of Care

Naz Karim, MD/MHA ’11, a global emergency medical fellow at Brown University’s Alpert Medical School, is helping to develop a prehospital care system for the Sub-Saharan African nation, Rwanda.

Dr. Naz Karim’s desire to connect with people throughout her academic career, including at Rosalind Franklin University, which in 2011 awarded her a dual degree in medicine and health administration, intensified her aspiration to care for the world’s most vulnerable human beings.

“I experienced a sense of community firsthand as I worked in interdisciplinary teams at RFU,” Dr. Karim said. “I was keenly aware of how a healthcare community of professionals composed of pharmacists, nurses, health administrators, physicians and everyone who cares for patients can improve health outcomes by working together.”

As a global emergency medical fellow at Brown University’s Alpert Medical School, Dr. Karim is part of an interprofessional team working to develop prehospital care, or acute emergency services, in Rwanda.

The sub-Saharan African nation has made dramatic improvements in health over the past decade. During several trips to the country, which is still recovering from a 1994 genocide that took the lives of more than one million people, Dr. Karim has conducted research to assess prehospital process indicators and compare them to emergency department (ED) outcomes. Her team created a trauma registry system that followed hospital patients throughout their ED treatment to understand outcomes.

“If we find that critical actions are not taken, like administering oxygen to hypoxic (oxygen deficient) patients or fluid to people in shock, we will provide training for prehospital providers,” Dr. Karim said. “But the best part of my research, and the most important, is asking, ‘Is the program you created efficient? Is it effective?’ We assess the efficacy of a training intervention by measuring patient outcomes.”

But the best part of my research, and the most important, is asking, ‘Is the program you created efficient? Is it effective?’’’ NAZ KARIM, MD/MHA ‘11

The fellowship also includes a clinical component. Dr. Karim is a staff physician in the ED at The Miriam Hospital in Providence, RI, where she earned the “Patients’ Hero” recognition for her exceptional bedside manner. She’s working to obtain a medical license in Rwanda where, during visits, she attends daily rounds at the Centre Hospitalier Universitaire de Kigali.

Dr. Karim has also taken on a teaching role – writing, lecturing and demonstrating on numerous trauma topics, including diagnosing deadly emergencies using ultrasound, spinal cord trauma, and emergency transport and road traffic injuries abroad. Fellowship work has also taken her to Kenya and Nicaragua. She traveled to Ecuador where she presented to the National Congress of International Emergency and Disaster and to Switzerland to present before the International Committee of the Red Cross and the World Health Organization.

“The cultural component and interdisciplinary work of the MHA I earned at RFU has been a great asset in an international setting,” said Dr. Karim, who noted that learning to respond to cultural cues has changed the way she practices. For example, Rwandans are loath to cry out even when their pain is intense, and imaging is often unavailable.

The cultural component and interdisciplinary work of the MHA I earned at RFU has been a great asset in an international setting.” Naz Karim, MD/MHA ‘11

 “You have to be a very good clinician in low-income countries,” said Dr. Karim, who hopes to one day open an urgent care clinic in rural India. “Every time I return home, I realize I’m less dependent on CT scans and more reliant on the essential clinical skills – a thorough history and physical exam – I learned at Chicago Medical School.”

Dr. Karim’s academic and career trajectory has been fueled, from girlhood, by hard work and self-motivation. She grew up in a Chicago suburb with neither indulgence nor encouragement.

“It was either become something or end up poor and on the street,” she said. “It was utter willpower, and nothing else to fall back on.”

Working her way through the University of Texas at Austin, Dr. Karim consistently earned academic honors. She kept two jobs in medical school, including one as a waitress at Soldier Field Stadium VIP suites, and still earned a string of awards for leadership, mentorship and service. During her emergency medicine residency at West Virginia University Hospital, she received the Patient Advocate Award and helped lead a Healthcare Disparities Committee.

Rwanda has made health a key pillar of development through a strategic plan that emphasizes robust primary care, performance-based financing and focus on vulnerable populations. Dr. Karim sees a special power in the plan’s pledge of transparency.

“They’ve studied their infrastructure,” she said. “They know where they need to improve: more nurses, the creation of emergency medicine departments. Ninety percent of traumatic injuries across the world occur in low- and middle- income countries. Rwandan leaders understand that. They’re taking steps to fix it.”

This story first appeared in the Spring 2016 issue of Helix.