Behind the White Coat: A conversation with international child health expert Ronald Barr
Following his induction into the Faculty of Health Sciences Community of Distinction and a recently invited lecture at the Hospital de Amor in Barretos, Sâo Paulo state, Brazil, we sat down with pediatric cancer specialist Ronald Barr to explore his work in international child health. Our discussion covered his journey in the field, his current projects, and what opportunities lie ahead.
Department of Pediatrics (PD): For those who might not know, what is international child health?
Dr. Ronald Barr (RB): International health encompasses health professionals or organizations from one region providing direct healthcare or contributing to health sector development in another region or nation.
PD: What inspired you to focus your career on international child health (ICH)?
RB: My interest in international child health began in the early 1970s when I was working in Nairobi, Kenya to help establish the first medical school in the country. More recently, my focus has been on children with cancer in low- and middle-income countries, particularly in India, Brazil, and the countries of Central America.
PD: How does the ICH Committee in Pediatrics contribute to the field?
RB: Our Department has approximately 30 faculty members interested in ICH, supported by a core committee dedicated to advancing this field.
An example of our impact is our collaboration with Guyana. This work was initiated over a decade ago and is facilitated by Dr. Narendra Singh, a Department member and Guyanese citizen, who is highly knowledgeable about the needs and opportunities in the country.
For several years, McMaster medical residents, particularly in pediatrics, have spent time in Guyana on training opportunities, and Guyanese medical fellows have come to McMaster and Hamilton hospitals for specialist training. The Faculty of Health Sciences recognized the importance of this relationship by signing a Memorandum of Understanding in July 2021. The agreement recognizes the mutual interest in academic development through collaborative research and education of post-graduate health professionals.
PD: What is the nature of your current projects in Brazil?
RB: My main project in Brazil is in collaboration with the International Initiative in Pediatrics and Nutrition (IIPAN), which is based at Columbia University Irving Medical Center in New York. The project is a study of nutrition in children with cancer who are enrolled in nine centres spanning the five geographical regions of the country, reflecting the ethnic, cultural, and socioeconomic diversity in this very large land mass. Additional studies in the design phase will examine the intestinal microbiome and metabolome in these children in collaboration with local investigators and colleagues at the International Agency for Research on Cancer in Lyon, France.
As the Associate Director of IIPAN, I work to foster the education of clinical nutritionists in Brazil so that they can assume leadership roles in future education and research. To date, we have one who has achieved a PhD, and two others are on that career path.
PD: In your opinion, what is the future for primary health care in low- and middle-income countries (LMICs)?
RB: There is an immense need for practitioners in primary health care in LMICs. Children constitute more than 25% of the global population, and almost 90% live in LMICs, so pediatricians are well placed to contribute to the education of primary healthcare providers and so enhance the health and welfare of children worldwide.
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