Anesthesia: Getting a Heads-up About Migraines Genetics: Making Ends Meet: New Way Found to Mend DNA, Protect Against Cancer Emergency Medicine: Harvard Answers Call for Emergency Care in Middle East Public Health: Bloom Opens Yearlong Series on Future of Global Public Health Bacteria Dispose of Electron Waste by Exterior Shuttle Laparoscopy Guides Treatment for Pancreatic Cancer With or Without Spine, Organisms Use GATA to Have Guts Moderate Drinking Linked to Lower Risk of Diabetes HMS Faculty Council Examines Child Care, Research Conduct Varmus Gives Keynote Talk at Soma Weiss Day A Preview of Alumni Week Events Ebert Speaker Says Minority Applicants to Medical, Dental Schools Must Increase HMS Staff Member Recognized as Outstanding Volunteer Grant to Establish Neuro-oncology Center at Dana–Farber Honors and Advances Exploring the Science of Change Front Page

EMERGENCY MEDICINE Harvard Answers Call for Emergency Care in Middle East In the U.S., it is easy to take for granted the specialists who care for us in medical emergencies. But emergency medicine as a specialty has only existed for the past 20 years, and in many parts of the world it is still nearly nonexistent. The Harvard Medical International Center for Emergency Medicine, composed of faculty members from the Departments of Emergency Medicine at six Harvard-affiliated hospitals, is attempting to bridge that gap by helping international leaders in emergency care develop regional programs. As part of its most recent initiative, HMS faculty members spent 10 days in Jordan, Israel, and Palestine to promote regional collaboration, despite the political conflicts. Ethiopian health care workers participate in a demonstration of airway techniques on a dummy. The session was part of a visit to Ethiopia by members of the HMI Center for Emergency Medicine in December of last year, which focused on working with local health practitioners and policy-makers to improve pre-hospital care. The visit, which took place in early April, included conferences in Israel and Jordan and a roundtable discussion among leaders in emergency medicine from Israel, Turkey, Ethiopia, Jordan, and some European nations. According to Mark Davis, director of the center and HMS instructor in medicine at Beth Israel Deaconess, the participants were generally eager to work together, and saw medicine as a natural vehicle for cooperation. "If you can create a safe structure for communication, there's a lot of willingness to make it happen," he says. Instability Increases Need The center, a collaborative effort between Harvard Medical International and the Division of Emergency Medicine at HMS, is working to address the growing desire for more efficient emergency services throughout the world. The health concerns generally associated with the developed world, such as cardiovascular disease and injuries from traffic accidents, are also among the leading causes of death and disability in developing nations and are expected to increase. In the Middle East, war and traffic injuries are among the top 10 causes of death and disability. The volatility of the region adds to its needs for emergency systems, with the possibility of casualties from terrorist acts or chemical warfare a concern for local physicians. A group from the conference in Israel also visited the West Bank town of Hebron, a site of violent conflict between Palestinians and Israelis in the past, which has only recently come under complete Palestinian control. Davis observed that much needs to be done to develop the area, but he found potential for collaboration even in this center of tension. The Palestinians, because they lack a tertiary care center, often rely on Israel's Hadassah Medical Center for specialized care and medical training, and the doctors in Hebron were eager to establish more formal relationships with Hadassah and the hospitals of Jordan. "In the area of medicine, they've been working together for years," Davis says. "There's now a framework in place that allows them to take their natural inclination to work together on behalf of patients and put it into practice." A Worldwide Web Jonathan Burstein, HMS assistant professor of medicine and director of disaster medicine at BID, was impressed by the eagerness of physicians from Israel and Jordan to work together at a conference in Aqaba, Jordan, which lies less than a mile from the Israeli city of Eilat. Physicians from the two cities noted that although living a stone's throw away from each other, they did not even know each other's phone numbers if they needed help in an emergency. At the conference they were able to talk about regional disaster response and sharing medical resources for the first time. And they did exchange numbers. "Little things like that are the bridge to better relations," says Burstein, "more than the high-level diplomacy." In addition to its work in the Middle East, the center has led conferences and education programs in Ethiopia, and has worked with groups from Colombia, China, India, and Japan. It also provides a one-year fellowship for future international leaders in emergency medicine to gain research and clinical experience at the Harvard teaching hospitals. According to Gary Setnik, director of the HMS division of emergency medicine and chairman of emergency medicine at Mount Auburn Hospital, the U.S. health care system increasingly emphasizes ambulatory care and relies on emergency departments to treat acute problems. "It is the safety net for the American health care system," says Setnik. The center has been asked to support the development of similar capabilities where they currently are lacking elsewhere in the world. —Courtney Humphries