Solidarity, humility and connectivity in the face of coronavirus
Alfaisal’s department of family and community medicine is evaluating Saudi Arabia’s response to the pandemic and promoting a holistic approach to the challenges it raises
In 2012, the department of family and community medicine at Alfaisal’s School of Medicine was founded. The department, led by Dr Baraa Alghalyini, equips students with a thorough grounding in the holistic preventive role of family medicine and primary care. Since it began operating, the department has established a wide mission beyond teaching and research, encompassing community engagement, health promotion and social accountability.
The department’s approach is “integrated across the lifespan curriculum”, with public health as the backdrop, says Dr Alghalyini. This means the department has met a need for a unifying approach to family medicine and public health, aligning with other medical courses and empowering general practitioners and family physicians in a system that tends to elevate specialists. The department also works with external bodies including the Saudi Food and Drug Authority, the Saudi Commission for Health Specialities and the Saudi Microbiome Society.
Dr Alghalyini trained at the University of Toronto, Canada, obtaining her Canadian certification in family medicine and a master’s in public health before working as a consultant family physician and chair of the department of family and community medicine at Alfaisal. “We went through the process of revising the curriculum and devising the introduction to public medicine course,” she says. “Soon, we offered the family medicine course to third-year students. The focus of both courses is to prepare students to get a sense of the community engagement role of primary care and family medicine.”
A personal mission drives Dr Alghalyini. “I try to communicate the beauty of family and community medicine not just to the new generation of doctors but also the public…I strongly believe implementing this platform is an answer to many of the challenges the healthcare system faces.”
Over the years, the department has run many initiatives to reach the community – and schools, in particular – including regular health promotion exhibitions on campus. These exhibitions are organised and created by students and are built around themes such as mental, occupational and environmental health and wellness. Due to the Covid-19 pandemic, this year’s exhibition took on a hybrid format. Students presented their projects on stage and were aired live via the university’s health promotion hub. Only the parents of presenting students were allowed to attend the exhibition on campus.
The community education theme – and especially the need to combat medical misinformation spread by social media – is reflected in the Alfaisal mini medical school series, presented to the public at Alfaisal’s auditoriums before the pandemic, and via YouTube since. The pandemic, and the Saudi response to it, has highlighted the importance of community engagement in health education and the role the department of family and community medicine can play.
Dr Alghalyini praises the Saudi government’s response. “During the first wave, all were given an opportunity to be swabbed and treated for free, regardless of status, income, religion or nationality…This should be a role model for the entire world.”
From the very start of the pandemic, the department identified a key research area in the fight against the virus: how the community complied with measures taken to combat Covid. “The starting point was what can be learned from the experience of other countries. But what works elsewhere may not work in Saudi Arabia…Is there something we do at the local level to enhance compliance and the sustainability of the new norm?” Dr Alghalyini says. “Ask the community. You need to build common ground. This can only be done with a sense of engagement, of community empowerment…by understanding their concerns.”
Thus, in the early stages of the country’s first lockdown, which took place during Ramadan, the department conducted a study of about 900 participants (around 65 per cent of whom were female) to get a sense of the Saudi perception of precautionary measures and to evaluate their effectiveness. “We believed that understanding and involving social and cultural factors would support compliance and how future waves and pandemics would be responded to,” Dr Alghalyini says.
The sense of solidarity and social responsibility was overwhelmingly present. There were some distinctions by gender: for example, men were more likely to use a face mask, socially distance and wash their hands, while women were more likely to use gloves. Overall, the majority reported that they would follow precautionary measures, and most were committed to home quarantine if necessary.
The department is using its international relationships to prepare for a post-Covid world and future pandemics. It is collaborating with the Besrour Center for Global Family Medicine at the College of Family Physicians of Canada to produce the Family Medicine Pivot programme. The programme aims to outline how family physicians have adapted to pandemic-related challenges and requests the creation of a platform for family physicians to refer to, not just during the pandemic but for any changes that may require rapid and timely adaptation. Programme dissemination will be supported by the College of Family Physicians of Canada in collaboration with the World Health Organisation.
The emergency medicine department at King Faisal Specialist Hospital and Research Centre's is working on another pandemic-related project. They are measuring the effectiveness of the severe acute respiratory index scores, used by the Saudi Ministry of Health during outbreaks of Middle East respiratory syndrome (MERS), to evaluate emergency patients. “We want to measure the effectiveness of this score in predicting Covid infected patients upon presentation to the emergency department and outcomes in terms of hospital stay, recovery, antibody response and others,” Dr Alghalyini says. She is an affiliated physician at the hospital’s emergency department and a medical advisor to the crisis management committee, which was created by Alfaisal leadership in preparation for any on-campus pandemic outbreaks and to engage with students’ concerns.
Going forward, the department will continue to grow and build its community engagement and to develop its curriculum. “We are creating a social accountability office at the university, although this is at a very early stage,” Dr Alghalyini says. The department’s mission remains central. “We start at the grassroots level and highlight important principles of equity, diversity and inclusivity,” Dr Alghalyini says. “An open-minded practitioner is the key. Family and community medicine is not only about making a diagnosis. It is about having a holistic and broad vision.”
Find out more about the department of family and community medicine at Alfaisal University.