And we have a new group of leaders for the UNC School of Medicine and UNC Health Care.

Not everyone is new, to be sure, but we’ve tapped some new leaders and moved others into new roles and new titles.

• Marschall Runge, MD, PhD, is Executive Dean, my principal deputy for the School of Medicine, and his focus is the academic affairs of the school. He is leading the effort to create a new strategic plan for the School. In addition, he will be the director of the NC TraCS Institute and PI for UNC’s CTSA grant. He remains chair of the Department of Medicine.

• Kevin FitzGerald, MPA, is Vice Dean for Finance and Administration, the principal leader of the School focusing on management and operations across all our missions. He continues to be our liaison to the NC General Assembly.

• Terry Magnuson, PhD, is Vice Dean for Research, the principal research leader for the School. He remains chair of the Department of Genetics. He oversees graduate education in the basic medical sciences, working closely with Warren Newton. He is leading the effort to create a new research plan for the School.

• Warren Newton, MD, MPH, is Vice Dean for Education, the principal education leader for the School. His primary focus is medical student education, but is also charged with integrating all our medical school activities, including allied health education, continuing medical education, graduate medical education and graduate education in the basic medical sciences. He remains chair of the Department of Family Medicine.

• Allen Daugird, MD, MBA, is President of UNC Physicians and Associates, the principal leader of the School’s faculty practice plan.

• Rick Pillsbury, MD, is Chair of the Executive Committee of UNC P&A, the new group of chairs who are Al Daugird’s principal advisory group. He remains chair of the Department of Otolaryngology / Head and Neck Surgery.

• Paul Godley, MD, PhD, is Executive Associate Dean for Faculty Affairs, the principal leader in the dean’s office focused on developing our faculty and working with them to assure their success.

• Amelia Drake, MD, is Executive Associate Dean for Academic Programs, directly assisting Marschall Runge, Kevin FitzGerald and me with key tasks in leading the School’s academic initiatives.

• Tony Lindsey, MD, is Executive Associate Dean for Clinical Affairs and Chief of Staff of UNC Hospitals, working with Marschall Runge, Gary Park and others to advance our clinical and quality activities.

• Chris Ellington, MBA, is Executive Vice President and Chief Financial Officer of UNC Hospitals, the principal financial leader of the Hospitals.

• Brian Goldstein, MD, MBA, is Executive Vice President and Chief Operating Officer of UNC Hospitals, the principal operations leader of the Hospitals.

We have a very good team in place — with these leaders and the others who continue in their important roles.

And we are off to a good and fast start to the new academic year.

I am proud that our organization is taking steps to foster collaboration between various partners, and pleased we are afforded opportunities to learn from one another. Without working together, better health care for women would be significantly harder to achieve. Although there may be changes in health care in the coming months and years, the way we advance the care we are able to provide will not change – it will always be driven through coordination among providers, and continued progress in access, research and health education. These topics are what the panelists spent most of their time covering.

Women’s health is particularly important, because making continued progress to keep women healthy throughout their various life stages is vital to ensuring the long-term health of our communities. And by its very nature, women’s health care demands multi-disciplinary, coordinated care.

During the panel, we shared our collegial approach to advancing the care we provide to patients with the audience.

For example, over the past 10 years, the UNC Center for Maternal and Infant Health has supported multi-disciplinary care teams remotely and in-person and that trend continues to grow. As academic medical centers, we are able to benefit from our access to a multitude of specialty caregivers. Women’s care teams can include care coordinators, genetic counselors, sonographers, and maternal-fetal medicine, general ob/gyn, neonatology, genetics, pediatric surgery, pediatric cardiology and pathology practitioners.

Women’s health care at UNC has been leading the way for coordinated women’s health care by working closely with public health departments throughout the state, especially to support mothers from pre-conception to birth. And we work closely with referring providers on complex cases. We are also continuing to develop infrastructure and resources – such as technology and a site, called mombaby.org which gives providers resources for care to better support the discipline throughout the state. The UNC Center for Women’s Health Research also works to advance women’s health research, prevention and health education efforts.

I look forward to our continued work with our staff and health care leaders across the country as we work to provide patients with the best care possible.

For more information about our work with women’s health, please visit he Department of Obstetrics & Gynecology’s website, follow the department on Twitter, read its blog or visit its Facebook page.

The governing board of the UNC System, which has 17 campuses, including this one in Chapel Hill, elected him officially yesterday.

Ross is currently the president of Davidson College — and he has deep roots in our state and its leadership.

I believe he will be an effective leader for all of UNC, including the UNC School of Medicine and UNC Health Care.

I very much look forward to getting to know him and to working with and for him.

He starts January 1, 2011.

Meanwhile, we have four more months of Erskine Bowles’ exemplary leadership. He has been superb, at a distance and up close.

Speaking personally, he is the best boss I have ever had.

Thank you, Erskine, for all you have done for our institution and for me.

I welcome this — and see it as a chance for us to prepare ourselves and the institution for the next phase of our work together.

Last month, Etta Pisano left UNC to go to the Medical University of South Carolina, where she will become dean of the College of Medicine, July 1. We celebrate her accomplishments and all that she has given us. We wish her the best in this new endeavor.

This means we need to fill her position here — Vice Dean for Academic Affairs of the med school. Separately, she has also served as director of the NC TraCS Institute, which manages our NIH-CTSA grant. So we need to identify the right person to do that as well.

This spring we also launched searches for two other senior positions — Executive Associate Dean for Faculty Affairs and Faculty Development, which Gene Orringer has ably done for almost fifteen years, and Executive Associate Dean for Research, which Bill Marzluff has ably done for fifteen years. We are very grateful for their service and accomplishments, and they will continue to contribute as leaders among the faculty.

We posted these positions and yesterday the posting closed. I am in the process of interviewing people.

I am really grateful that a number of talented people have stepped forward and offered themselves for these important roles. That is not easy to do — and I thank them.

I am seeking wide input on these decisions — believing that we have a unique opportunity to position the School for success.

We want to continue our path of excellence and leadership — our aspiration is to be the leading public medical school and leading public academic medical center in America.

We want people who work well together as a team — but who each are strong and talented in their respective areas, not timid or quiet.

We want a diverse team of people — we have made progress in recent years in diversifying the School and the UNC Health Care System, but we have much more we can and ought to do in this area.

We have lots of challenges — but also lots of opportunities. I believe these new leadership decisions are major opportunities.

Stay tuned.

This is of Will making bricks at the Dufatanye Co-op.

Will with the pitcher he made at the Co-op.

The entrance to the faculty of medicine (the med school) at the National University of Rwanda in Butare.

The rector of NUR (our chancellor’s counterpart), Prof. Silas Lwakabamba

Bishop Nathan Gasatura, his wife, Florence, their son, Daniel, and Will and me, in their home

St. Paul’s Cathedral, Butare

Godfrey Kalema, his wife, Diane, a student, Theonest (with the UNC hat I gave him!) and Will, near the Dufatanye Co-op

John, who drove us all over Rwanda, and Will — in the Kigali Airport, just before we left

Will and I are the Hotel des Mille Collines, made famous by the film, “Hotel Rwanda.” It is a very nice upscale hotel. We stopped here because we are early for the airport, and we are using the WiFi connection here for a couple of hours.

For the past two days I have been in Butare, which is the home of the National University of Rwanda. It is a university town — think “the Chapel Hill of Rwanda.”

It is also home for St. Paul’s Cathedral, the main Anglican church in the diocese of Butare. It is the sister congregation for our church back in Chapel Hill.

I visited with Bishop Nathan Gasatura and his wife Florence — whom I first met when they were visiting Chapel Hill about a year and a half ago. They are very warm and engaging people. He has long been a church and NGO leader, and she is a nurse. Florence got her masters in nursing in Scotland several years ago. When she was in Chapel Hill recently, she toured the North Carolina Cancer Hospital.

Florence took me around the medical school — and I was also hosted by the vice dean. I had met the dean in Kigali last week. We saw the entire complex — and I am quite impressed with what they do with limited resources.

We also visited the teaching hospital in Butare, which is known by its French acronym CHUB. It is about 500 beds — and, again, I was very impressed with what they are doing. A major challenge for them is physician recruitment and retention, especially for specialists. For example, they told me there are no oncologists in the nation of Rwanda, and only a hand full of orthopedists, ophthalmologists, ENTs, etc.

Yesterday afternoon Will came back from his day at the Dufatanye Co-op, dirty, sweaty and tired, but very happy — he has some great pictures that they took of him making bricks! He also made a clay pot — like he learned to do in his ceramics class at Wingate University! He says they were fascinated with his making it.

Last evening we ate at Nathan and Florence’s house — it was a delicious meal of traditional Rwandese food. The dish I’ve grown to love is rice with what we would call English peas and carrots, with a sauce poured over it that looks like thin tomato soup. It is very tasty and filling.

I think I’ve lost a few pounds on this trip — because I’m eating good food but not many snacks.

I really feel great.

Today I visited a bit with the leaders at St. Paul’s Cathedral and then we started back to Kigali.

We stopped en route at Nyanza, to say thanks and farewell to Godfrey and Diane, his wife, at the Dufatanye Co-op. They gave us some gifts to take back, Rwandan crafts.

So … A few hours from now we hope to be on the plane headed home.

This has been a wonderful experience.

I will be able to post some pictures in a day or so.

Stay tuned.

One of the places I saw was the Hotel des Milles Collines, which was featured in the film “Hotel Rwanda.”

On Saturday evening, I had a dinner meeting with the leader of the Anglican Church in Rwanda, Archbishop Emmanuel Kolini and several others. Our church in Chapel Hill is under his jurisdiction.

Dinner Saturday, Archbishop Emmanuel Kolini is far left

On Sunday morning, I went to the English service at the Anglican cathedral, St. Etienne, and heard the dean preach. He is Rev. Antoine Rutayisire. After the service, he introduced me to Dr. Richard Sezibera, one of the members at St. Etienne, who is the minister of health of Rwanda. We had a short visit and he invited me to meet with him in a couple of days.

left: Rev. (Dean) Antoine Rutayisire, Dr. Richard Sezibera

Sunday afternoon, Will and I went to Nyanza, and visited the Dufatanye Cooperative, which is a local NGO that supports and provides opportunity for a number of people who are living with HIV infection. It was founded and now run by my new friend, Godfrey Kalema.

The people at Dufatanye are very poor, but they have done truly impressive things together – they raise a number of crops, tend goats, rabbits, cows, raise fish in ponds, and make bricks and roof tiles.

Dufantanye Cooperative

Godfrey Kalema with finished tiles and bricks

Bricks air drying

Bricks awaiting the kiln

Godfrey with finished bricks

Cows at the Dufatanye Cooperative

I have gone on to Butare, where the National University of Rwanda is located, including the med school. I am visiting there today.

Another beautiful day in Rwanda!

Patrick is a surgeon, with an active medical practice, who is now the acting dean of the med school. We shared insights about the opportunities and challenges of managing a school of medicine at a public university. He is very much a leader in the health sector of Rwanda, and works closely with the Minister of Health and others.

From him, as from others I have met, I gained important insights about Rwanda — its past, present and future. He is a very impressive person in every respect.

Lunch with CDC Rwanda team

CDC’s global health mission has grown and developed very substantially since the time I was director (1990-93). In those days we had a global focus, and world-wide reach and impact, but it is now so much greater. With PEPFAR (The President’s Emergency Fund for AIDS/HIV Relief) and other US government programs, CDC now has many more people and much more resources on the ground around the world, including here in Rwanda.

Ambassador Stuart Symington

I was also able to see the US Ambassador, Stuart Symington, and to visit briefly with him. I am very proud of what CDC and the US Government more generally are doing in Rwanda.

Neonatal unit in CHUK

Today I had the privilege of meeting with several health leaders here in Kigali.

I was introduced to them via my friend, Nathan Thielman, MD, who is a faculty member at Duke Med School. Nathan is an internist who does work in infectious diseases, HIV/AIDS, and global health.

I visited with two Ob/Gyn physicians with whom he is collaborating here in a project to lower Rwanda’s maternal mortality rate. It is currently about 350 maternal deaths per 100,000 live births.

I met Dr. Stephen Rusila, who is head of research at the Central Teaching Hospital of Kigali. It goes by its French acronym, CHUK.

The med school in Rwanda is in Butare, where it is a part of the National University of Rwanda. In North Carolina terms, Butare is the smallish university town — the Chapel Hill, and Kigali is the large, capital city — the Raleigh, or even Charlotte. All med students get their basic science teaching in Butare, but a sizeable number get clinical training at the Central Teaching Hospital in Kigali, much like we send students for clinical rotations to AHEC sites across North Carolina.

I also met Dr. Janvier Rwamwejo, who is on the staff of King Faisal Hospital — it is widely said to be the finest hospital in the country.

We talked about their project — and the efforts to train mid-wives and other health workers to recognize problem pregnancies and to manage them or refer them.

The infant mortality rate in Rwanda is estimated to be 65 per 1000 live births this year. That is in the middle of the range of the various African countries’ rates. By contrast, the US rate this year is between 6 and 7 deaths, before one year of age, per 1000 live births.

Tomorrow I am meeting with the dean of the Faculty of Medicine of the National University of Rwanda, and the next day with the Minister of Health. This is proving to be a very enlightening and very pleasant visit.

I added some local beauty to my hotel room today — I bought some flowers from the shop in the hotel lobby — the arrangement is not nearly as attractive as those my wife does — but it still brightens up the room!

I am now also posting photos to my Flickr page. You can see them here.

Shyira Hospital

In many respects they lack much of what we take for granted in the US — for example, they only have electricity for two hours each evening, when the generator is running.

But in other respects, they have so much that we lack — peacefulness and even solitude. We went to bed shortly after the lights went out at 8:30pm, and got up before 6:00am, fully rested. The hospital starts its day at 7:00am.

Caleb King translating for me

Today, after morning report, I gave a talk, at the Kings’ invitation. Caleb translated — into French, which the staff understand. They also speak some English and everyone is fluent in Kinyarwanda, the national language.
I used a talk I gave a couple of years ago at Duke — on spirituality and health. I think it all went fine.

Both yesterday and today we spent time rounding on the wards — peds, adult medicine and obstetrics.

Will with a kindergarten class

Today Will put together home-made Play-Doh, and taught the kindergartners how to make things. He is having a great time at Shyira.

This evening I left him there and returned to Kigali, where I’ll spend the next couple of days.