These UCLA surgeons are redefining global health
September/October 2025 | Volume 24 Number 5
Photo courtesy of Dr. Catherine JuillardDr. Catherine Juillard
Cameroon sits on Nigeria’s border at the junction of east and central Africa. Its population of nearly 31 million people reside primarily in the west and north while the interior is sparsely inhabited. Eight of its 10 regions are francophone, the remaining two anglophone.
“When I was a surgery resident and first started looking into global health research, I found published data from about four countries in Africa on injury work done in lower income settings—and they were all from anglophone countries,” says Catherine Juillard, MD, MPH, a trauma surgeon and critical care physician at the University of California, Los Angeles (UCLA). A conversation about this with Africans suggested that an existing language bias leads to this imbalance. “So I thought, ‘Okay, the francophone world is my niche,’ and I reached out to Dr. Martin Monono at Cameroon’s Ministry of Health, and that's how our work there began.”
Just as translating from French to English is effortless for Juillard, it’s also easy to translate much of her trauma research work from Cameroon to the U.S.
“In the U.S., we have what we call trauma deserts—swaths of the country that are not well serviced. So if something works in Cameroon, the same proof of concept could be applied to these U.S. areas that lack access to accredited trauma centers.”
A web of teamwork
For years Juillard has been working with her co-primary investigator Dr. Alain Mefire-Chichom of University of Buea in Cameroon alongside various colleagues and trainees from their universities. The two currently receive funding from the NIH Common Fund’s Harnessing Data Science for Health Discovery and Innovation in Africa (DS-I Africa) program as well as Fogarty’s Global Trauma and Injury Research Training Program.
Meanwhile, S. Ariane Christie, MD, an assistant professor in residence at UCLA’s David Geffen School of Medicine, joins them in their research while leading related projects supported by an
International Research Scientist Development Award (IRSDA) and a grant from Fogarty’s
Mobile Health: Technology and Outcomes in Low- and Middle-Income Countries (mHealth) program.
“It's really hard to untangle all the different pilot projects and main projects and side projects and the people involved, but everything works together,” says Juillard. The UCLA team’s main objective is to train a cohort of Cameroonians, a mix of MPH and PhD students and postdocs, who work on at least one project, and sometimes a portfolio of projects, as a way of building research capacity in the African country.
Photo courtesy of Dr. Ariane ChristieDr. Ariane Christie
Christie notes that UCLA has developed a strong model of co-mentoring U.S. and African trainees and bidirectional learning opportunities, so that Cameroonian trainees frequently partner with U.S. trainees and researchers (and vice versa). With trainees arriving from across the nation and the world, UCLA plants the “seeds of investigation and innovation in multiple contexts” while enhancing the skills of its global health trainees so they can start their own programs in other universities, other parts of the world.
Among the trainees Juillard mentors is Dr. Serge Ngekeng, a postdoc who is looking at the relationship between alcohol and road traffic injury while also studying the UCLA Healing, Empowering, and Liberating (HEaL) Trauma Program to learn how to adapt it to the Cameroonian context. The HEaL program, which Juillard founded, takes a whole-person approach to recovery from injury and trauma. Another of her mentees is Dr. Odette Kibu, who studies PTSD in trauma patients, “an understudied area in our own country,” says Juillard. “So she’s exploring some interventions that are potentially cross-cutting.”
Meanwhile, Christie mentors Elvis Tanue, a postdoc fellow, who is developing a prehospital system for matching trauma centers and patients which helps first responders understand where to transport injured patients. Dr. Frida Nganje, an MPH student, works on a traumatic brain injury project for which she interviewed 16 of the 22 neurosurgeons in Cameroon to try to identify targets for improving traumatic brain injury (TBI) care. Another trainee, Vanessa Tabe, is helping to develop a first aid training program for school-aged kids to scale general health literacy in Cameroon.
“Constantly, everything that we do is to build this capacity both within Cameroon and globally. The possible direct applications to other countries and the U.S. are huge,” says Christie.
Translating innovations
Every trauma patient who rolls into an emergency department in a high-income setting receives an ultrasound “within about two minutes” to detect and identify the location of bleeding, explains Christie. “In Cameroon, not only is this not done, but most of the really critically injured patients don't get any imaging at all.” Her mHealth project trains trauma providers in Cameroon to use a phone-based ultrasound—a handheld probe connected to a phone—to detect internal bleeding or other life-threatening injuries early enough to save lives.
Specifically, her project addresses the fact that, in the U.S., it takes months of constant practice with an expert to learn how to use the device and interpret results. “In Cameroon, we don't have time for that. We don't have experts for that. We need to take these providers away for about five hours and send them back in knowing how to do this,” says Christie. So she and her team developed a new curriculum, one that is whittled down to “just the things you need, nothing that you don't” so that trainees can use the device without undergoing a long apprenticeship.
An organic transfer of this curriculum to the U.S. is already occurring. In the US, being able to perform and interpret ultrasound to detect life threatening injury is a core skill needed to become a board-certified surgeon. Christie heard from UCLA residents that they want shorter training for the eFAST, so she offered them her new curriculum.
“This is something that we didn’t design for American residents, but it may offer an advantage over the traditional curriculum used in the U.S.,” says Christie. “We're going to formally test it with them and see if this actually decreases the time it takes to get a competent resident.”
Data streams
Juillard describes the Cameroon Trauma Registry, a product of her DS-I Africa grant and one of the largest multi-site trauma registries on the continent, as “a behemoth and a constant labor of love.” Ten hospitals have contributed data from more than 15,000 patients, including follow-up reports on some patients spanning up to six months. “We have an ability to understand a lot about trauma care in diverse settings in a way that we don't even have in the U.S.”
Both Cameroonian and American investigators and trainees have begun to explore all kinds of questions using this registry.
For example, Christie posed the query: What happens if providers treat an injured patient with regular IV fluid instead of blood? Standard trauma care in the U.S. requires giving patients blood, though it’s well known that many rural hospitals lack access to a blood supply. Of course, there are protocols in place for “the person who gets hit by a car on a country road” and other traumas that occur where a supply is unavailable, but these practices are theoretical, says Juillard: “We don't actually know the real answers, because we don't have data for that.”
Christie’s analysis of Cameroon Trauma Registry data showed that giving IV fluid provides a survival advantage over giving blood in the Cameroon setting, where blood scarcity, quality, and delays and administration issues likely offset the known superiority of giving blood under ideal conditions. Christie says this work highlights the need for research to learn what is best to do when conditions are not ideal, since the answers may be different than what is assumed based on experiments conducted under ideal conditions and these answers matter a great deal to patients. Also, blood is scarce in most of the world.
“So this was a valid question that the Cameron Trauma Registry data could answer that also has application in the U.S.,” says Juillard.
Christie adds, “A lot of our work focuses on modular, readily translatable solutions. As we're innovating, we’re always thinking,
What other ways could we plug this in? The last thing we want to do is reinvent the wheel—that’s inefficient. Sometimes there’s a direct plug-in to something in U.S., and sometimes it's in another lower resource setting.”
Surgical global health
Juillard’s love of global health began when she became a rural health volunteer for the U.S. Peace Corps in Senegal, West Africa. While taking public transportation there, her bus driver hit a tree. “I didn't even realize how serious a car crash it was and thankfully I came out injured but pretty much okay, though a lot of people didn't,” she recalls. Years later, after graduating from medical school and starting her MPH, she took an injury prevention course at Johns Hopkins. “I realized—and it was a lightbulb moment—that epidemiology, all the tools of epidemiology, can be used for this problem of injury prevention.”
“When I started, there was no such thing as ‘surgical global health’ and injury care was the forgotten stepcousin of public health,” says Juillard. While there’s more acceptance today, she still encounters “a cognitive bias about what is and isn't viable, what is and isn’t bona fide public health research.”
A case in point is Christie’s IRSDA project, which aims to increase access to quality prehospital trauma care in Cameroon by using an implementation science approach to develop and evaluate a data-driven lay first-responder program. “Is that strictly speaking surgery? No. But you can't have emergency surgical care without a prehospital system,” says Christie.
Juillard believes this research will benefit many patients and improve overall healthcare in Cameroon. Clearly, then, it’s
global health.
Juillard says, “I've had people come to me and say, ‘I want to be a cardiothoracic surgeon, but how can I do global health doing that?’ So I tell them, ‘Whatever you think is important is probably important to somebody else. If you're passionate about something and you think it matters, it probably has a place in global health.’”
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Updated November 19, 2025
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