Rachel T. Moresky, MD, MPH, focuses on developing an evidence base for best practices in emergency care systems in resource-limited settings around the world. Dr. Moresky's clinical, engineering and public health expertise has driven her work in humanitarian assistance, disaster response, and innovative educational and health-systems interventions to strengthen acute care delivery in sub-Saharan Africa, Southeast Asia and Eastern Europe. Dr. Moresky's current research centers on the development of data-driven national programs and toolkits to support the assessment and implementation of quality acute care in resource-limited settings. Her commitment to forming international partnerships led to the creation of the sidHARTe - Strengthening Emergency Systems Program which partners with governments and local institutions through technical assistance, implementation support and science, capacity building and national policy development. In 2005, Dr. Moresky became the founding director of the Columbia University International Emergency Medicine Fellowship at New York-Presbyterian, Columbia University Emergency Medicine Department. Dr. Moresky combines her field experience in international health systems, humanitarian assistance, and disaster response, to mentor future leaders in emergency care systems and humanitarian action. The fellowship has a partnership with Doctors without Borders/Medecins San Frontiers (MSF). Over the last 20 years, Dr. Moresky has partnered and implemented projects with Ministries of Health, WHO, USAID, MSF, IRC and other NGOs. In 2017, Dr. Moresky received the Global Emergency Medicine Association Presidential Lifetime Achievement Award from the Society of Academic Emergency Medicine.
BS, 1991, Brown University
MD, 1998, Technion Faculty of Medicine
MPH, 2003, Harvard School of Public Health
Faculty, Global Health Initiative
Associate Professor, Heilbrunn Department of Population and Family Health
Founding Director, sidHARTe - Strengthening Emergency Systems
Founding Director, International Emergency Medicine Fellowship
Honors & Awards
Society for Academic Emergency Medicine, Global Emergency Medicine, Presidential Lifetime Achievement Award
Areas of Expertise
Child Health and Development, Infant Mortality, Community-Based Healthcare, Injury Prevention, Underserved Populations, Violence, Health Worker Education, Physician Education, Global Health, Refugee Health, Rural Health, Health Systems Strengthening, Healthcare Workers, Public Health Infrastructure, Epidemics, Infectious Disease
Select Global Activities
The sidHARTe Post-Graduate Diploma (PGD) course in Emergency and Critical Care Medicine Program & Rwanda Human Resources for Health (HRH) Program, Rwanda: In 2011, the Rwandan Ministries of Health and Education invited sidHARTe to assist the University of Rwanda's College of Medicine and Health Sciences in the development of a groundbreaking Post-Graduate Diploma (PGD) course in Emergency and Critical Care Medicine. Designed for general practitioners (GPs), the PGD is a two-year part-time program that gives doctors the opportunity to have a combination of classroom-based learning and hands-on clinical practice in emergency care. The unique part-time nature of the course allows GPs to continue to provide patient care in their district hospitals while participating in the program in Kigali. This incentivizes graduates to remain committed to their district hospitals. The course is designed for sustainability. As such, a subset of graduating GPs from the PGD program will continue their training in a four-year residency in Emergency Medicine, the cornerstone of the Human Resources for Health (HRH) program. This group will serve as both advocates and future instructors for the development of Emergency Medicine in Rwanda. The remainder of the PGD graduates will return to their district hospital, where they will apply their new skills to strengthen emergency services and frontline care in underserved, rural areas. sidHARTe and Columbia University are implementing partners in both the PGD course and the HRH academic consortium. The PGD and the MMed are part of Rwanda's overall Human Resources for Health strategy to build the health education infrastructure and workforce by training Rwandan clinicians and health educators. sidHARTe also supports the Rwanda Emergency Care Association (RECA) founded by Dr. Mbanjumucyo Gabin, Emergency and Critical Care Medicine Resident. RECA's Executive and Management Committees are largely made up of current Emergency and Critical Care Medicine residents and aims to promote and improve emergency care through teaching, research and education.
The sidHARTe CPAP Ghana Survival Study, Ghana: The CPAP Ghana Survival Study was designed to measure the impact continuous positive airway pressure (CPAP), a low-cost, low-technology medical device, has on mortality in children 1 to 59 months of age presenting with acute respiratory distress in a low-resource setting. The emergency wards of two district hospitals located in the Brong-Ahafo and Ashanti regions of Ghana serve as the trial sites. In total, 2,200 participants were enrolled. Secondary outcomes include improvement in respiratory rate in children receiving CPAP compared with those who do not and identifying the etiology of respiratory distress using multiplex PCR for viral respiratory pathogens and rapid malaria antigen testing. After adjustment for study site, time, and clinically important variables, 2-week mortality in the CPAP group versus the control group was significantly decreased in children 1 year of age and younger. CPAP is safe and improves respiratory rate in a non-tertiary setting in a lower-middle-income country. The CPAP Ghana Survival Study was a collaborative effort between Columbia University, Ghana Health Service, Center for Global Health Research, and the Kwame Nkrumah School of Science and Technology (KNUST). The sidHARTe CPAP Kenya and Rwanda program, Kenya: The CPAP Kenya and Rwanda program aims to introduce a pragmatic, sustainable CPAP training curriculum into two East African countries. To date, 77 clinicians in Kenya and Rwanda have been successfully trained to teach other healthcare providers to effectively use CPAP. Monitoring and evaluation of skills and knowledge testing demonstrate successful training fidelity at 12 months. The local CPAP instructors have trained over 125 additional clinicians which has resulted in over 800 documented uses of CPAP in 20 hospitals in Kenya and Rwanda. Lessons learned from the training and monitoring and evaluation have been incorporated into the training package. The training into the Rwanda and Kenyan Pediatric Associations national guidelines and lead the charge in proliferating the CPAP training program with the WHO ETAT+ program.
The sidHARTe CPAP Kenya and Rwanda program , Kenya: The CPAP Kenya and Rwanda program aims to introduce a pragmatic, sustainable CPAP training curriculum into two East African countries. To date 77 clinicians in Kenya and Rwanda have been successfully trained to teach other healthcare providers to effectively use CPAP. Monitoring and evaluation with skills and knowledge testing demonstrates successful training fidelity at 12 months. The local CPAP instructors have trained over 125 additional clinicians which has resulted in over 800 documented uses of CPAP in 20 hospitals in Kenya and Rwanda. Lessons learned from the trainings and monitoring and evaluation have been incorporated into the training package which will be available open-source in early 2016. The training program is currently being incorporated into the Kenyan and Rwandan Pediatric Associations who will develop national guidelines and lead the charge in proliferating the CPAP training program throughout their respective countries.
Broccoli, M.C., Moresky, R., Dixon J., Muya, I., Taubman, C., Wallis, L.A. & Calvello Hynes, E.J. (2018). Defining quality indicators for emergency care delivery: findings of an expert consensus process by emergency care practitioners in Africa. BMJ: Accepted.
Wilson, P. T., Baiden, F., Brooks, J. C., Morris, M. C., Giessler, K., Punguyire, D., Apio, G., Agyeman-Ampromfi, A., Lopez-Pintado, S., Sylverken, J., Nyarko-Jectey, K., Tagbor, H. & Moresky, R.T. (2017). Continuous positive airway pressure for children with undifferentiated respiratory distress in Ghana: an open-label, cluster, crossover trial. The Lancet Global Health, 5(6): e615-e623.
CioÃƒÂ¨-PeÃƒÂ±a, E.C., Granados, J.C., Wrightsmith, L.L., Henriquez-Vigil, A.L. & Moresky, R.T. (2016). Development and Implementation of a Hospital-based Trauma Response System in an Urban Hospital in San Salvador, El Salvador. Trauma, 19(2): 118-126.
Niyogi, A., Barbra V., Rubenstein B.L., Hubbard, S.J., Baiden, F. & Moresky, R.T. (2015). In-service training of physician assistants in acute care in Ghana: Challenges, successes, and lessons learned. African Journal of Emergency Medicine, 5(3): 114-119.
de Ramirez, S.S., Doll, J., Carle, S., Anest, T., Arii, M., Hsieh, Y.H., Okongo, M., Moresky, R.T., Sachs, S.E. & Millin, M. (2014). Emergency response in resource poor-settings: a review of a newly-implemented EMS system in rural Uganda. Prehospital and disaster medicine, 29(3): 311-6.
Moresky, R.T., Bisanzo, M., Rubenstein, B.L., Hubbard, S.J., Cohen, H., Ouyang, H., Duber, H.C. & Marsh, R.H. (2013). A Research Agenda for Acute Care Services Delivery in Low- and Middle-income Countries. Academic Emergency Medicine, 20(12): 1264 -71.
Calvello, E., Reynolds, T., Hirshon, J.M., Buckle, C., Moresky, R.T., O'Neill, J. & Wallis, L.A. (2013). Emergency care in sub-Saharan Africa: Results of a consensus conference. African Journal of Emergency Medicine, 3(1): 42-8.
Wilson, P.T., Morris, M.C., Biagas, K.V., Otupiri, E. & Moresky, R.T. (2013). A Prospective, Randomized Clinical Trial Evaluating the Effectiveness of Nasal Continuous Positive Airway Pressure in Children with Acute Heterogeneous Respiratory Distress Presenting to a Developing Country's Emergency Ward. The Journal of Pediatrics, 162(5): 988-92.
Choo, S., Perry, H., Hesse, A.A., Abantanga, F., Sory, E., Osen, H., Fleischer-Djoleto, C., Moresky, R., McCord, C.W., Cherian, M. & Abdullah, F. (2010). Assessment of capacity for surgery, obstetrics and anesthesia in 17 Ghanaian hospitals using a WHO assessment tool. Tropical Medicine and International Health, 5(9): 1109-1115.
Moresky, R.T., Eliades, M.J., Bhimani, M.A., Bunney, E.B. & Van Rooyen, M.J. (2001) Preparing international relief workers for health care in the field: An evaluation of organizational practices. Pre-hospital and Disaster Medicine, 16(4): 257-262.