Rachel T. Moresky, MD, MPH, focuses on developing an evidence base for best practices in emergency medicine in resource-limited settings around the world. Dr. Moresky's clinical and public health expertise have driven her work in humanitarian assistance, disaster response, as well as the design of educational and health-systems process interventions to strengthen acute care delivery at all levels of the health care system in sub-Saharan Africa. Dr. Moresky's current research centers on the development of tools to support delivery of acute care in resource limited settings including task- shifting emergency care, injury surveillance, healthcare-seeking behavior and child survival. Her commitment to forming international partnerships that improve emergency medical care in rural settings led to the creation of the Systems Improvement at District Hospitals and Regional Training of Emergency Care (sidHARTe) Program, a joint initiative between Columbia University and the Ministries of Health in Ghana and Rwanda to improve the quality of care delivered to undifferentiated, acutely ill patients. As the founding director of the Columbia University International Emergency Medicine Fellowship at NewYork-Presbyterian Hospital of Columbia and Cornell, Division of Emergency Medicine, Dr. Moresky combines her field experience in international health systems, humanitarian assistance, and disaster mitigation and response, to mentor future leaders in international emergency medicine and humanitarian action. Over the last 15 years, Dr. Moresky has partnered and implemented projects with Ministries of Health, WHO, USAID, and other NGOs mainly in East and West Africa, Southeast Asia and Eastern Europe. In addition, Dr. Moresky completed a two-year International Emergency Medicine Fellowship at Brigham and Women's Hospital, Harvard University.
BS, 1991, Brown University
MD, 1998, Technion Faculty of Medicine
MPH, 2003, Harvard School of Public Health
Director, Systems Improvement at District Hospitals and Regional Training of Emergency Care (sidHARTe) Program
Areas of Expertise
Child Health and Development, Infant Mortality, Underserved Populations, 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 Master of Medicine (MMed) 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 directly to the district 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 is 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. To date 1,900 participants have been enrolled in the study with a target enrolment of 2,200. 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. The results of the study will be available in early 2016 with the ultimate goal of contributing to the prevention of deaths in neonatal, infant and pediatric patients on a global scale. The CPAP Ghana Survival Study is a collaborative effort between Columbia University, Ghana Health Service, Center for Global Health Research, Ghana 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 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.
Niyogi, A, Barbra V, Rubenstein BL, Hubbard SJ, Baiden F, Moresky RT. In-service training of physician assistants in acute care in Ghana: Challenges, successes, and lessons learned. African Journal of Emergency Medicine , Volume 5 , Issue 3 , 2015: 114-119.
Punguyire D, Baiden F, Nyuzaghl J, Hultgren A, Berko Y, Brenner S, Soghoian S, Adjei G, Niyogi A, Moresky R. Presentation, management, and outcome of snake-bite in two district hospitals in Ghana. The Pan African Medical Journal. 2014;19:219.
de Ramirez SS, Doll J, Carle S, Anest T, Arii M, Hsieh YH, Okongo M, Moresky R, Sachs SE, Millin M. Emergency response in resource poor-settings: a review of a newly-implemented EMS system in rural Uganda. Prehosp Disaster Med 2014;29(3):311-6.
Wilson, PT, Brooks, JC, Otupiri, E, Moresky, RT, Morris, MC. Aftermath of a Clinical Trial: Evaluating the Sustainability of a Medical Device Intervention in Ghana. J Trop Pediatr 2014;60(1):33-9.
Moresky RT, Bisanzo M, Rubenstein BL, Hubbard SJ, Cohen H, Ouyang H, Duber HC, Marsh RH. A Research Agenda for Acute Care Services Delivery in Low- and Middle-income Countries. Acad Emerg Med 2013;20(12):1264 -71.
Calvello E, Reynolds T, Hirshon JM, Buckle C, Moresky RT, O'Neill J, Wallis LA. Emergency care in sub-Saharan Africa: Results of a consensus conference. Afr J Emerg Med 2013(3): 42-8.
Wilson PT, Morris MC, Biagas KV, Otupiri E, Moresky RT 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 2012
Choo S, Perry H, Hesse AA, Abantanga F, Sory E, Osen H, Fleischer-Djoleto C, Moresky R, McCord CW, Cherian M, and Abdullah F. 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 2010
Moresky RT, Eliades MJ, Bhimani MA, Bunney EB, Van Rooyen MJ Preparing international relief workers for health care in the field: An evaluation of organizational practices. Pre-hospital and Disaster Medicine 16(4) 257-262 2001