Short- term experiences in global health (STEGH), also known as short-term medical missions continue to be a popular mode of engagement in global health activities for students, healthcare providers, and religious groups, driven primarily by organizations from high-income countries. While STEGH have the potential to be beneficial, a large proportion of these do not sustainably benefit the communities they intend to serve, may undermine local health systems, operate without appropriate licenses, go beyond their intended purposes, and may cause harm to patients. With heightened calls to “decolonize” global health, and to achieve ethical, sustainable, and practical engagements, there is a need to establish strong guiding principles for global health engagements. The Advocacy for Global Health Partnerships (AGHP), a multi-sectoral coalition, was established to reflect on and address the concerns relating to STEGH. Towards this end, AGHP created the Brocher Declaration to lay out six main principles that should guide ethical and appropriate STEGH practices. A variety of organizations have accepted the Declaration and are using it to provide guidance for effective implementation of appropriate global health efforts. The Declaration joins broader efforts to promote equity in global health and a critical reevaluation of volunteer-centric, charity-based missions. The current state of the world’s health demands a new model of collaboration – one that sparks deep discussions of shared innovation and builds ethical partnerships to address pressing issues in global health.

A retrospective review of cleft lip operations at our hospital during 1991-2000 showed that on average 17 patients per year were operated on for cleft lip and palate and that each year saw an increasing number of patients being treated. The purpose of this study was to determine the change that had occurred in the number of patients treated for cleft lip and palate during the five-year period from 2001-2005. This is a retrospective review of cleft lip and palate operations carried out under general anesthesia at the Komfo Anokye Teaching Hospital. Operating room records were the source of data. Patients treated under local anesthesia were excluded. Information collected included age, gender, and diagnosis. The results were displayed in tables and graphs. A total of 344 patients were operated for cleft lip and palate during the five-year period, i.e. 69 operations per year. The patients comprised 58% males and 42% females and ranged in age from 1 month to 32 years with a mean age of 3.9 years. Unilateral cleft lip operations constituted 78% of all operations. Each succeeding year saw an increase in the number of operations being carried out year during the five-year period. The marked increase in the number of cleft operations per year in our hospital during the period under study was probably due to greater awareness in the community; free surgeries provided by local surgeons with financial support from a US-based NGO; and free operations by a visiting surgical team. Financial, logistical and training support to cleft teams in developing countries is likely to lead to more surgeries for children with cleft.

The US Government funded Medical Education Partnership Initiative (MEPI) and the Nursing - Education - Partnership Initiative (NEPI) were large undertakings that introduced major creative changes and - innovations in the approach to education of health professions and research in the participating medical and nursing institutions. The African-led MEPI Principal Investigators' (PI) Council which provided strong leadership resolved not to lose momentum but to scale up beyond the MEPI and NEPI institutions and continue with shared learning and the transformative changes that had emerged. The Council started a multi-professional platform which would facilitate and support inter-professional collaboration as the best way forward in the post-MEPI and NEPI period. The African Forum for Research and Education in Africa (AFREhealth) was started and will have to show the value addition it brings and how it will ensure its own sustainability while strengthening South to South partnerships.

Background: The development of the face occurs during the early days of intrauterine life by the formation of facial processes from the first Pharyngeal arch. Derangement in these well‐organized fusion events results in Orofacial clefts (OFC). Van der Woude syndrome (VWS) is one of the most common causes of syndromic cleft lip and/or palate accounting for 2% of all cases. Mutations in the IRF6 gene account for 70% of cases with the majority of these mutations located in the DNA‐binding (exon 3, 4) or protein‐binding domains (exon 7–9). The current study was designed to update the list of IRF6 variants reported for VWS by compiling all the published mutations from 2013 to date as well as including the previously unreported VWS cases from Africa and Puerto Rico.Methods: We used PubMed with the search terms; "Van der Woude syndrome," “Popliteal pterygium syndrome,” "IRF6," and "Orofacial cleft" to identify eligible studies. We compiled the CADD score for all the mutations to determine the percentage of deleterious variants.Results: Twenty‐one new mutations were identified from nine papers. The majority of these mutations were in exon 4. Mutations in exon 3 and 4 had CADD scores between 20 and 30 and mutations in exon 7–9 had CADD scores between 30 and 40. The presence of higher CADD scores in the protein‐binding domain (exon 7–9) further confirms the crucial role played by this domain in the function of IRF6. In the new cases, we identified five IRF6 mutations, three novel missense mutations (p.Phe36Tyr, p.Lys109Thr, and p.Gln438Leu), and two previously reported nonsense mutations (p.Ser424*and p.Arg250*).Conclusion: Mutations in the protein and DNA‐binding domains of IRF6 ranked among the top 0.1% and 1% most deleterious genetic mutations, respectively. Overall, these findings expand the range of VWS mutations and are important for diagnostic and counseling purposes.

We aimed to determine the incidence of childhood burn injuries in rural Ghana and describe modifiable household risk factors to inform prevention initiatives. We performed a cluster-randomized, population-based survey of caregivers of children in a rural district in Ghana, representing 2713 households and 14,032 children. Caregivers were interviewed regarding childhood burn injuries within the past 6 months and household risk factors. 357 households were sampled. Most used an open fire with biomass fuel for cooking (85.8%). Households rarely cooked in a separate kitchen (10%). Stove height was commonly within reach of children under five years (<1 m; 96.0%). The weighted annualized incidence of CBI was 63 per 1000 child-years (6.4% of children per year); reported mean age was 4.4 years (SD 4.0). The most common etiology was flame burn. Older age (OR 0.89, 95% CI 0.8-1.0) and households with an older sibling ≥12 years (OR 0.58, 95% CI 0.3-1.3) seemed to be associated with lower odds of CBI. Childhood burn injury is common in rural Ghana. Opportunities exist to reduce the risk of childhood burn injury childhood burns in rural settings by supporting the transition to safer cooking arrangements, child barrier apparatuses in homes without older children, and/or development of formal childcare programs.