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More Than Meets the Eye – Part 1

by Helen Fosam

Isn’t it amazing that you think you have known someone well for two decades? But you don’t know them as well as you thought. 

I would describe this soft-spoken, incredibly generous friend, Janet, as a sister from another mother. Our children grew up together and related like brothers and sisters. But, as life went on, our children grew up and chartered their paths, and the strong bond that held us together soon dissolved. So, we went our separate ways, and our focus gradually transitioned from our children to our careers—Janet’s a nurse practitioner, me a medical writer. 

Six months ago, in August 2022, an exciting thing happened. After several years of being incommunicado, I received a phone call from Janet to tell me that she had received a mailer about a MiLHO Initiative. She said that the information about the online continuing medical education courses for healthcare professionals in Africa drew her attention to read further. She read further and saw that the mailer was from me, her long-time friend Helen Fosam. Three hours must have passed as we caught up on where we had left off several years ago. She shared that she had started the Kindred Health Mission incorporated (or KHMI), a non-profit philanthropic organization dedicated to providing healthcare access to the African underserved and displaced people. Janet and her team of local healthcare professionals in Africa provide free medical outreach programs in different African countries. 

Janet told me that the seeds for KHMI were planted decades ago. But, unknown to me, KHMI was in the making when our children met to play together when our families chatted over dinner, celebrated events, or mourned the loss of a loved one. Janet said she called me because she was intrigued by the Missing Link to Improved Health Outcomes (MiLHO) Initiative. Its mission was exactly what she was looking to create for her healthcare professionals who provide selfless care as part of the KHMI team. She explained that KHMI is registered in several African countries and expanding to touch lives globally.

I was inspired as Janet shared her story. I saw my friend in a new light. I saw the side of her I did not know. Likewise, Janet saw the side of me she did not know. The exciting thing is that each of our missions is interconnected and related, one a continuation of the other. So then, I asked Janet for permission to interview her to document the incredible work she’s doing. But, true to form, she insisted on also interviewing me about the MiLHO Initiative to tell the world about the fantastic work I’m doing. 

Here is a snippet of Janet’s questions and my interview answers. Janet and me. On a mission to touch lives and make a small difference in the world.

Helen, I’m curious about the acronym MiLHO. How did you come up with that?

MiLHO stands for the Missing Link to Improved Health Outcomes. 

Why the name? The link between medical practice and optimal patient outcomes is continuing medical education/professional development. When CME/CPD is missing, patients receive suboptimal care and health outcomes. The MiLHO Initiative addresses that Missing Link through online continuing medical education courses for healthcare professionals, specifically in low-resource countries. In addition, we focus on accessibility, affordability, and relevance to healthcare professionals’ unique local practice environment. 

When did you start MiLHO, and why?

The initial idea percolated in 2015 when a colleague in Nigeria shared a personal situation involving a family member needing healthcare and how needless deaths could be avoided if healthcare practitioners had access to CME/CPD to update their knowledge and skills. Similar accounts from several people of poor health outcomes and unnecessary deaths and my independent research were consistent with what my colleague in Nigeria told me. As a result, I started the MiLHO initiative to address the need to increase access to CME/CPD for healthcare professionals in low-resource countries. 

Whom is MiLHO targeted to, and why?

The primary target audience is what I call the foot soldiers of health care – the primary care physicians, nurses, pharmacists, and dentists. For these practitioners, access to CME/CPD can be more challenging with respect to time and resources. In the village setting, where often there is perhaps a few or only one doctor or nurse, and indeed likely no specialists, responsible for wide-ranging- disease presentations, it becomes necessary to give them the knowledge they need, including the understanding of when it is appropriate to make a referral to the specialist. My target is for MiLHO to reach all healthcare professionals in low-resource countries, initially in all 54 countries in Africa. Later expanding to Latin America and Asia. 

I’ve noticed that MiLHO courses have a very African focus. Can you explain why and how you achieve that?

MiLHO’s approach is, according to the saying, “the wearer knows where the shoe hurts.” Therefore, we intentionally use writers, editors, and subject matter experts from Africa because they know where the shoe hurts. In addition, they understand the unique challenges of health care and healthcare practice in Africa. 

How do you ensure the credibility and quality of MiLHO courses?

We have built several layers of checks and balances: 

  • Initial content review by senior medical writer 
  • Secondary editorial review
  • Subject matter expert review 
  • CPD certification after an independent review 
  • The final layer of check will be accreditation in African countries, which we are actively    pursuing. 

What sets the MiLHO courses apart?

We strive for the relevance of the course to medical practice in the local setting. 

We focus on the lived experiences of healthcare professionals and their patients. 

We collaborate with medical writers and subject matter experts from low- and middle-resource countries, and 

Currently, we ensure the credibility of our courses with CPD certification (and, when available, accreditation). 

What challenges are MiLHO currently facing?

  • Accreditation 
  • Talent 
  • Finances 
  • I can also throw in collaboration – we don’t want to reinvent the wheel or want to work in a silo. We don’t want to repeat what already exists. We want to learn from each other. 

What drives your passion?

My passion is partly by a personal medical emergency that resulted in my optimal outcomes. My outcome had something to do with the medical team’s expertise being up-to-date with their clinical knowledge and skills through CME/CPD. 

My passion is also driven by the knowledge that HCPs in low-resource countries have limited access to CME/CPD, so outcomes like mine are more of an exception than the rule. 

To give back to a society that has given me so much. 

How can people support the MiLHO Initiative?

  • Personnel in different countries in Africa to assist with accreditation. 
  • Individuals from Africa or of African descent with expertise in medical writing, editing, and subject matter expertise to contribute to content development. 
  • People to take MiLHO courses to support our fund-raising to continue providing our services. 

How can people learn more about the MiLHO Initiative?

Visit the MiLHO website:  

Contact us: 

Helen Fosam is the founder of the Missing Link to Improved Health Outcomes (MiLHO) Initiative. The initiative focuses on creating online continuing medical education courses for healthcare professionals in Africa.