Dr. Ravinder Mamtani Vice Dean for Population Health and Lifestyle Medicine at WCM-Q
Professor of Population Health Sciences, Professor of Medicine (Center for Global Health)
“We excel in population health education, research, and awareness programs”
Weill Cornell Medicine-Qatar (WCM-Q) has an excellent reputation in terms of medical education and research. It offers professional development programs to equip professionals with skills and knowledge in the areas of research, cultural competence, emotional intelligence, clinical nutrition, integrative medicine, student wellness and lifestyle medicine. ‘Hospitals’ magazine interviewed Dr. Ravinder Mamtani, Professor of Population Health Sciences, Professor of Medicine (Center for Global Health), and Vice Dean for Population Health and Lifestyle Medicine at WCM-Q.
Weill Cornell Medicine-Qatar (WCM-Q) has an excellent reputation. It has done very well in terms of medical education and research. What prompted the school to focus on public health programs?
Yes, with the great support WCM-Q receives from Qatar Foundation and Weill Cornell Medicine in the US, the college has performed exceptionally well. We are proud to say that we are producing truly excellent physicians and that a significant proportion of our graduates are Qatari nationals, while our research program has also thrived. But we have always felt that our mission at WCM-Q is not only confined to training doctors and conducting cutting-edge research; but also, to engaging with the community and empowering people with the knowledge to protect and enhance their own health and the health of their families.
Life expectancy in Qatar today is close to 81 years, which is excellent and reflects the care Qatar has taken to develop a 21st-century healthcare sector. However, just like other high-income countries such as the US, the UK, and many countries in Europe, in Qatar, there are public health challenges associated with non-communicable diseases such as obesity and type 2 diabetes. It is Dean Javaid Sheikh’s vision that WCM-Q supports Qatar in its well-balanced national strategy by developing, implementing and/or contributing to projects to prevent disease and promote health through organized societal efforts – this is how we define public health. We are, therefore, grateful to the dean for establishing the Institute for Population Health (IPH).
Talking about the establishment of the Institute for Population Health (IPH), which we know has done a lot of work in Qatar, can you please explain the nature and content of your population health initiatives?
In line with the mission and vision of WCM-Q and the aims of the National Health Strategy for Qatar put forward by the Ministry of Public Health (MOPH), we in the IPH, support and participate in programs that are aimed at reducing early death and increasing life expectancy, preventing disease, and at promoting health, including quality of life. We do this by developing and implementing need-based education programs for healthcare professionals and students, by conducting need-based public health research, and by developing and/or participating in community engagement programs.
In education, we offer professional development programs to equip professionals with skills and knowledge in the areas of research, cultural competence, emotional intelligence, clinical nutrition, integrative medicine, student wellness and lifestyle medicine. In research, we conduct studies, perform scientific reviews, and write commentaries on epidemiology and public health aspects of chronic diseases, infectious diseases, and motor vehicle injuries; global/regional health; emerging healthcare trends; and contemporary public health topics such as telehealth and lifestyle medicine. And in community engagement, we deliver information and awareness campaigns on a wide variety of health issues to diverse audiences, including the general public, major corporations, schoolchildren, women’s support groups and more. These messages are shared via scheduled lectures and talks, and through our social media channels, which have a strong and growing following.
There have been several reports about public health preparedness in the face of the COVID pandemic. Can you please elaborate on how much attention we are paying to public health around the world?
From a global standpoint, it is clear that the COVID-19 pandemic has fundamentally changed how both the public and the healthcare professions perceive public health. The pandemic caused huge disruption to the healthcare sector in many ways, including by delaying care to patients with chronic illnesses. It also caused a surge in mental health issues, such as depression and anxiety, and it created confusion and ambiguity over simple preventive measures such as wearing masks. There was disruption to schools and universities, which impacted education but also affected the health and nutrition of children, particularly from low- and middle-income nations.
It is apparent from these challenges that the pandemic caught healthcare systems across the world off-guard. I believe it revealed a problem we in the IPH have been aware of for some time, which is that public health remains neglected in many countries – we actually published research demonstrating this in the Journal of Global Health in 2021. Preventive medicine, health policy and lifestyle medicine are barely studied in most medical school curricula, public health research funding is limited, and our study showed that OECD nations spend only 2.8 percent of their total health expenditure on public health. And yet a recent review in the Journal of Epidemiology and Community Health (a British Medical Journal publication) concluded that public health interventions are extremely cost-effective and offer a return-on-investment (ROI) ratio of approximately 14:1. At WCM-Q we have incorporated public health education into our curriculum, which we feel is of great importance.
In thinking about your programs, it is clear that WCM-Q has made tremendous progress in a short period of time. Are there other activities and or programs we can undertake to further promote health and improve the quality of life of people in the region and beyond?
One of our most successful education initiatives is our Certificate of Lifestyle Medicine course for healthcare professionals. Why did we develop this? Well, the science is clear that most chronic illnesses such as diabetes, obesity, heart disease and certain mental health issues are driven by unhealthy lifestyles such as poor diet, smoking, lack of physical activity, stress, poor sleep, and social isolation, among other behaviors. The certificate program provides a set of competencies to healthcare professionals that allow them to assess the ways in which an individual’s lifestyle is affecting their health and shows them how to design effective interventions to prevent, treat and sometimes even reverse these illnesses through lifestyle changes. We will continue to expand this popular course to meet the growing demand.
We are also in the early stages of developing a new certificate course that will address population health and wellbeing. The course will be designed to equip participants who have an interest in contributing to public health initiatives with the necessary skills and knowledge to do so. We believe this course will further boost Qatar’s position as a regional and global leader in terms of setting high standards of health and wellness among nationals and residents.
In addition, we aim to extend our existing initiatives and lend support to develop new projects focused on improving health literacy among children. We believe an awareness of health and wellness should be considered foundational knowledge for children from the very earliest years of their formal education and that these lessons should be reinforced as they grow in order to promote lifelong self-care and healthy lifestyle habits. We teach children how to read and write, how to treat one another with respect, we teach them the sciences and math – why shouldn’t we teach them how to care for their own health? We feel there is a great opportunity to reach out to the younger generation to help them learn the skills required to stay healthy and avoid the devastating impact of lifestyle-related diseases like type-2 diabetes. Health and wellness should become a required curriculum in schools.
How does the IPH ensure its public health initiatives are effective and target the most pressing health concerns facing Qatar and the wider region?
All our initiatives and activities are designed in response to an identified need or set of needs. We achieve this in a number of ways. In terms of our activities for healthcare professionals, we evaluate participants’ responses to our questionnaires and adjust our offerings accordingly. We also conduct surveys among our community of healthcare professionals to identify any practice gaps in need of attention. And we also undertake exhaustive reviews of peer-reviewed literature to ascertain the evolving needs of healthcare professionals and generate new activities or changes to existing ones.
For our work with the community, we are engaged in a constant dialogue with participants, both through informal conversations and discussions and through formalized post-event questionnaires. In addition, we take into account the findings of relevant peer-reviewed scientific literature, and we pay close attention to the discussions taking place among our participants on our social media channels. All these inputs combine to give us an accurate understanding of how we can target our public health initiatives for maximum effect.
Do you have any final comments, particularly on the COVID-19 pandemic and its future?
COVID-19 has taught us so many lessons from nations all over the world. We discovered that many nations are not well prepared for public health crises and that our responses are heavily dependent on supply lines that can be easily disrupted. We also gained an appreciation of the impact of biodiversity decline, habitat destruction and the health of animals and how these factors impact human health – this points to a ‘One Health’ approach, whereby we perceive public health as a function of the health of our shared environment. Furthermore, we saw how pandemics can exacerbate social and economic problems, plunging many people into poverty, and that misinformation and disinformation can hamper effective responses to public health emergencies. Thankfully, the response in Qatar to the pandemic was extremely effective and we were spared much of the pain and suffering that were witnessed in many other countries.
Looking forward, it seems clear that COVID will not disappear but will likely follow a pattern similar to influenza, with intermittent outbreaks of varying severity as new mutations emerge. It will become part of a new health-disease paradigm norm, and we will have to work hard to neither downplay nor overstate the risk of new illnesses. To quote the American global health law expert Lawrence Gostin of Georgetown University, writing in a recent issue of the Journal of American Medical Association Forum: “There will not be a single moment when social life suddenly goes back to normal. Instead, gradually, over time, most people will view COVID-19 as a background risk and abandon the trappings of pandemic caution.” In the IPH, we hope and believe we can help to build upon the strong foundation of public health that already exists in Qatar, so that any future challenges can be overcome, guided by science and evidence.