Dr. Hannah Wild came to the UW Department of Surgery with decades of experience in the riskiest areas around the world, and when her residency took her to Burkina Faso, the UW Office of Global Affairs (OGA) was there. OGA supports UW international travel abroad by maintaining the global travel registry and providing guidance around health and safety abroad. The new Administrative Policy Statement (APS) 75.1 that requires UW employees to register all official UW international travel went into effect in July.
The Global Travel Health and Safety team are no strangers to intrepid itineraries — from conferences in Geneva to surgery for victims of explosive violence in the Sahel.
Registering travel to Switzerland takes an average of two minutes and travel to Kenya, an average of five minutes. But travel to a Department of State Level 4: Do Not Travel region in West Africa? That’s a different conversation entirely and one required for Dr. Wild’s itinerary. It’s also a conversation that is a privilege to be part of; it’s not everyday that someone has an opportunity to support doctors who are working with local partners to provide life-saving surgical care in austere settings.
Dr. Wild approached her international travel registration process with valid skepticism: “While I came in with the belief [of the value] in working effectively with University risk management, I think there was a degree of apprehension that the main incentive would be to shut down any work that wasn’t risk free.” Year-long travel to some of the most insecure places on earth constituted a longer travel waiver review process, including approvals from the International Travel Risk Assessment and Safety Committee and Provost Tricia Serio.
As an R1 research University at the forefront of global initiatives, the goal is to simplify and support travel, including registration and approving meaningful projects. We, of course, understand the value of improving access to surgical trauma in low resource settings. In fact, it was one of the driving factors for Dr. Wild’s choice of a residency at Harborview, with its significant exposure to high acuity trauma.
Unsurprisingly, at the start of the review process, our exposure to the specific needs of emergency care related to explosive violence was limited. Working with Dr. Wild, harsh realities and the bridge that UW is building unfolded:
“In modern conflict, explosive mechanisms are increasingly common.” Think improvised explosive devices, air-launched explosives in populated areas, and highly lethal modern weapons like thermobarics, often called aerosol bombs or fuel-air explosives.
Unlike small arms (e.g., gunshot wounds), explosives have a highly indiscriminate nature. When they fall in areas of conflict, they have a disproportionate impact on civilians, including women and children. Imagine civilians, ten-year-olds or expectant mothers, injured in regions without access to organized trauma systems. Further work is also needed to adapt trauma care guidance from high-resource settings to low-resource environments; for example, bleeding control strategies that do not rely solely on tourniquets, which can cause unnecessary limb loss in settings with prolonged evacuation times.
As a child, Dr. Wild was “captivated in the worst possible way” during the Rwandan genocide, leading her down a path to medical school at Stanford, and years with nomadic pastoralists in the disputed Ilemi Triangle, a place affected by intertribal warfare and cattle raiding. She continued to work in Ethiopia and South Sudan, including a Gates Grand Challenges grant piloting novel methods to include neglected nomadic populations in demographic and health surveys.
Eventually, her focus on casualty care in low-resource settings would lead her to the doorstep of UW Global Travel Health and Safety, the last hurdle before the work that would “totally change [her] life and future plans.” That work will involve splitting time between the U.S. and the Sahel. The goal is to adapt and pilot trauma care interventions to improve casualty care in the region, then use this model to implement and scale in low-resource conflict settings globally, all while maintaining standards of care and best practices that the UW implements.
“For better or worse, knowing that such things are going on in the world … it’s meaningful to feel a sense of purpose and try to fulfill it.”
At the end of the day, this is at the heart of why the Office of Global Affairs exists. Whether it’s developing digital systems to improve the quality of HIV/AIDS services
in Jamaica (during a hurricane!) or studying the rapid retreat of Antarctic sea ice due to climate change, the work of UW employees spans the globe. Being boundless means encouraging the expertise of every department to spill over into the creation of a more equitable world.
UW Global Health and Safety has the honor of working with UW employees around the world and for Dr. Wild, it involved support before, during and after her travel. She described the high-risk travel review process as being “very easy, self-explanatory, clear, and not overly burdensome.”
While abroad, Dr. Wild received regular health and safety check-ins via WhatsApp, the most accessible means of communication in her location. She was sent alerts regarding security incidents in the region because, “when you’re in the field and away from central news cycles, you’re not always the first to know when something is going on. [The UW team] was so on top of it.”
When asked about the APS policy change moving from a recommendation to a requirement to register travel, Hannah shared:
“I think the new requirement to register is a good thing. It’s the opposite of obstructionism and it can only benefit the University to understand where employees are at any given time. I would encourage everyone to see that UW Global Health and Safety is very experienced and willing to hear people out based on the specifics of each situation and proposed work.”
Help us help you, no matter where in the world your time at the UW takes you. Register your travel for all official (sponsored, affiliated, or funded by UW) international travel here.
Any questions? Please contact us at travelemergency@uw.edu
By Maddie Macmath, UW Global Travel Health & Safety / Quotes provided through interview with Dr. Hannah Wild