A DECADE OF HEALing
Message from the Co-Founder & Executive Director
I arrived in Haiti a week after the catastrophic 2010 earthquake. Thousands of people had fled Port-au-Prince to this tiny hospital in Saint-Marc. I was trying to arrange a transfer for a patient with a severe spinal cord injury and I was told to find Dr. Phouc Le, a last year Harvard resident in Global Health under Paul Farmer. I met him in a field where he was leading the triage effort to get patients with terrible spinal cord injuries to a higher level of care.
The disaster relief effort was a microcosm of everything right and wrong in global health work. Outside health providers arrived in Haiti with extraordinary goodwill. At the same time, they didn’t understand the history and context of the healthcare system they were suddenly thrust into, and were quickly overwhelmed by the scale of suffering. Over the following months, it became clear: while places like Haiti need some outside healthcare providers, they equally need an investment in the capacity of the local healthcare workforce, and those two groups needed to work in solidarity.
We launched the UCSF HEAL Initiative in 2015 to build cohorts of local and outside healthcare providers who train together and build a shared community of practice. Ultimately, HEAL Fellows experience more connection and support, which leads to increased access and better patient care in the most underserved parts of the world.
I am so proud of the work we have done at HEAL over the last ten years and the extraordinary impact we’ve achieved. Time markers like a decade compel one to consider the future. We are walking the path where our fellows have guided us. We are running HEAL cohorts now for health workers in places like Malawi, Mexico, Navajo Nation, and California. As I write, we are gathering alumni leaders from all corners of the world to train them to run HEAL’s model in their countries. For me, the HEAL vision is clear: a world where health workers thrive in underserved communities while expanding access to world-class care.
Sriram Shamasunder, MD, DTM&H
HEAL Co-Founder & Executive Director
OUR FIRST DECADE
At HEAL, we believe that healthcare is a basic human right. That lens is finally coming into focus for US-based medical institutions that have experienced differential health outcomes laid bare by crises like the COVID-19 pandemic. HEAL’s first decade has been marked by extensive learnings from our fellows, alumni, and site partners, to ensure the most underserved parts of the world have access to the culturally competent healthcare they deserve.
HEAL launches our inaugural program with 20 fellows working across the globe. The program starts with a kick-off training in the Santa Cruz mountains and a final retreat in Navajo Nation. The hunger of isolated and overworked frontline health workers to learn from one another is immediately clear.
Recognizing that fellows need more time to learn from each other in person, HEAL launches mid-fellowship retreats that combine workshops, community building, and training to build a shared community of practice.
HEAL engages our first group of alumni to mentor our newest cohort of 35 fellows. We conduct our first site exchanges in the Global South, so fellows can learn from each other's local health system.
Based on fellow feedback, HEAL makes a hard decision to sunset our India and Haiti partner sites, focusing resources on fewer sites that best support fellows’ transformation.
In response to fellow requests, HEAL sets aside funding for fellows and alumni to lead their own regional gatherings with agendas that combine a mix of mentorship and training applied to their particular cultural contexts.
As the pandemic hits, medical centers in Navajo Nation are at risk of closure, while the Bay Area’s low COVID caseload means that UCSF providers are under-worked. HEAL coordinates a huge number of nurses, doctors, and public health workers to work in Navajo Nation during COVID surges, in response to requests from our Indian Health Service partner site colleagues. Ultimately, HEAL is awarded Navajo Nation Volunteer Organization of the Year and is nationally recognized for its response.
HEAL develops a new 5-year plan to improve healthcare delivery in underserved communities across the globe by increasing investment in local providers and focusing on health provider shortage areas across California. HEAL fellows and alumni convene in-person for the first time since the pandemic in Malawi, Mexico, and Navajo Nation.
As visa issues and other barriers prevent some fellows from traveling to the US, HEAL brings our health training to partner sites across Africa and Mexico. We bring on our first alumni as HEAL staff to run our program in Navajo Nation.
Urged by our Mexican fellows, HEAL recruits our first monolingual Spanish-speaking cohort of local nurses and midwives in Chiapas, Mexico. In the same year, we convene our largest training yet, after years of COVID restrictions. HEAL becomes a center of excellence under the UC Global Health Institute and receives the UC Chancellor’s Award for Public Service.
HEAL launches our second all-local fellow cohort of Indigenous nurses in Navajo Nation and Zuni, led by Indigenous alumni Dr. Adriann Begay and Cristina Rivera Carpenter.
HEAL convenes and trains health workers from around the world so they can effectively bring the HEAL model to their local communities. Our inaugural California Program in Riverside, Central Valley, and San Diego is set to launch in July.
Our Innovative Model
HEAL trains and transforms healthcare workers in resource denied communities to better meet patient needs. How do we do it?
We identify and partner with healthcare institutions and local governments around the world that serve marginalized communities, need to fill healthcare vacancies and share HEAL’s values.
We recruit healthcare workers who reflect the cultural backgrounds of the communities in which we work and who are passionate and committed about caring for the underserved.
We provide intensive training in advocacy, leadership, and power dynamics to shift health workers’ approach to healthcare to address the root causes of disease, not just the symptoms.
We pair fellows with mentors from similar cultural backgrounds who provide tailored guidance to help set and achieve professional goals.
We connect healthcare workers with a global community of peers facing similar barriers and create a space to share ideas, develop collaborative solutions, and offer mutual support.
Watch “HEAL Roots” for a deeper understanding of our transformational model.
HEAL’s financial model leverages existing government contracts, clinical revenue, and strategic philanthropy to drive the retention of skilled and culturally competent healthcare workers in low-income communities.
WHERE WE PARTNER
Chiapas, Mexico | Compañeros En Salud (Partners in Health, Mexico)
Mexico provides universal healthcare, but that doesn't help residents who can’t access medical centers. In Chiapas, Mexico quality healthcare sites are few and far between, and the recent increase in organized crime has caused some healthcare workers to flee the state. Treating patients with few resources makes simply showing up to work a daunting task. To combat this, HEAL partners with Compañeros En Salud (Partners in Health, Mexico) to connect local healthcare workers with mentorship and a community of healthcare workers serving in similar settings across the world. Increased community support and professional development have resulted in a 60% retention rate for local HEAL Fellows in Chiapas, ensuring that local residents have access to the quality healthcare they deserve.
Gallup, New Mexico | Gallup Indian Medical Center
“When are you going to leave?” That was the question posed to one of HEAL’s first fellows when she stepped into a treatment room in Navajo Nation. This question reflects a harsh reality: Indian Health Services faces a 25% healthcare provider vacancy rate, relying on costly, short-term staff with little stake in Indigenous communities. HEAL changes that, by cultivating local health workers and bringing in committed healthcare talent to join them. The numbers speak for themselves: 1 of 4 HEAL physicians brought into Navajo Nation stay on as full-time staff, improving the continuity of care and trust within the community, ultimately benefiting the majority Indigenous population who live there. “The HEAL Program has been essential in enhancing access to quality healthcare for our Native Patients,” says Kevin Gaines, MD, CDR, U.S. Public Health Service, Chief Medical Officer, Navajo Area Indian Health Service, “they collaborate with us not only on staffing, but in refining our systems.”
Riverside, California, USA | Riverside University Health System
Due to the rise of e-commerce, the Inland Empire (Riverside and San Bernardino Counties) has experienced exponential growth in warehouses and trucking, causing a severe decline in air quality. The region is now home to the highest concentrations of ozone in the United States. Warehouse workers, children, and the elderly bear the brunt of these environmental factors, facing increased risks of respiratory and chronic illnesses. Riverside University Health System (RUHS) is at the forefront of addressing this public health crisis, serving a region marked by significant environmental and health challenges through a network of community health centers. By partnering with HEAL, RUHS is recruiting healthcare workers to pioneer community-led solutions to address structural barriers to health for all residents—particularly immigrant and Indigenous populations who are disproportionately impacted.
Neno, Malawi | Abwenzi Pa Za Umoyo (Partners In Health, Malawi)
HIV/AIDS is the leading cause of death in Malawi. In rural areas like Neno, Malawi limited access to care makes HIV/AIDS and comorbidities like non-communicable diseases (NCDs) harder to treat. HEAL partners with Abwenzi Pa Za Umoyo (Partners In Health, Malawi) and the Ministry of Health (MOH) to support local healthcare workers in providing quality care to people living with HIV/AIDS and NCDs in the district. HEAL Fellows in Neno are part of a team working in HIV and NCDs care delivery and conducted research on how to make HIV/AIDS and heart disease (common comorbidity) care more accessible in resource-denied areas. Their recommendations, like using affordable medications and combining HIV/AIDS treatments with heart disease prevention, offer practical ways to reduce preventable deaths. By sharing these solutions with the MOH in Malawi and HEAL’s global community, HEAL Fellows are strengthening healthcare in Neno and beyond.
Our Impact
At HEAL, we know that retaining healthcare workers improves continuity of care, which leads to positive patient outcomes. In the last decade, HEAL has:
Trained 213 Healthcare Workers in 19+ communities around the world
90%
of fellows say that HEAL has transformed how they approach their day-to-day work
2 in 3
fellows continue to serve at their underserved sites following fellowship completion
$2.7M
invested in professional development for healthcare workers treating underserved patients
These healthcare workers provided world class care to ~800,000 underserved patients
Fellow Stories of Transformation
Where We're Going
Lessons Learned
The Next 10 Years
Resource-denied communities across the world need healthcare professionals willing to immerse themselves where they work, so they can best address social determinants of health and eliminate unnecessary suffering. We will continue to bring the HEAL model to local healthcare professionals because that is the most effective way to ensure patients in the most underserved parts of the world can access the quality care they deserve.
In the next 10 years HEAL will:
- Strengthen our local cohorts in Malawi, Mexico, and Navajo Nation
- Expand our work in other resource-denied communities, including South Asia and East Africa
- Bring our work to communities across California and three other states
- Build a model to facilitate US expansion
- Facilitate the training of future fellows by our global alumni, thereby strengthening the international HEAL community
In addition, HEAL has a lofty goal: to embed early career training for healthcare workers around leadership, advocacy, and power dynamics in the poorest communities around the world. To that end, we will engage international and US state governments to pay for the HEAL model as part of their healthcare workforce training and delivery systems.
FINANCES
Over the past ten years, a diverse network of supporters has championed the vision of accessible and transformative healthcare for everyone. We are so grateful for their support.
Major Funders
American Association of the Order of St. Lazarus
Resnik Family Foundation
Stuart & Jesse Abelson Foundation
