Navigating New Terrain: Establishing Emergency Medicine in Bhutan and Malaysia (AWAEM- and GEMA-Sponsored)

In this session, SAEM’s Global Emergency Medicine Travel Awardees will share their experiences establishing emergency medicine in Bhutan and Malaysia. Bhutan’s unique cultural beliefs and geographical features influence emergency care, and clinical cases will illustrate how these factors shape access to services. In Malaysia, diverse terrain and climate create challenges for both patient care and healthcare worker safety. Case studies will focus on initiatives developed in Sarawak and Kelantan to enhance emergency medical services. This session offers valuable insights for those interested in global health and emergency medicine, highlighting the innovative strategies used to address country-specific needs.

Learning Objectives:

Upon completion of this session, participants should be able to:
  • Evaluate the role of Bhutan and Malaysia's unique geographical and environmental challenges, including terrain and climate, on the accessibility and delivery of emergency medical services.
  • Analyze how cultural practices and beliefs influence patterns of injury, illness presentation, and patient care in the emergency setting.
  • Identify and evaluate specific strategies designed to tackle these challenges related to providing emergency care in resource limited settings.
  • Understand the challenges with establishing Emergency Medicine by international physicians and identify approaches to building successful relationships in global health settings.

Presenters:

  • Rachel Shing, MD
  • Rmaah Memon, MD
  • Xiang Yun Yang, MB, BCH, BAO, MMED, LLM
  • Sweta Giri, MBBS, MD
Authors

  • Rachel Shing, MD

    Boston Medical Center Department of Emergency Medicine

    Dr. Rachel Shing is an Emergency Medicine physician with fellowship training in Emergency Clinical Ultrasound and Global Health from Boston Medical Center. Dr. Shing completed her residency at the University of California in Los Angeles. Her research interests include point of care ultrasound use in resource limited settings and using novel technology to facilitate POCUS education to build POCUS user capacity. She has extensive experience teaching point of care ultrasound internationally and has taught in Haiti, Ghana, Namibia and South Africa. Her current work is focused on using teleultrasound for POCUS training of doctors working at district hospitals in Northern Namibia in order to increase acccess to diagnostic imaging for patients.

  • Rmaah Memon, MD

    Fellow 2024-2026

    University of Pennsylvania Health System

    Rmaah Memon obtained both her undergraduate and medical degree through the Six-Year BA/MD Program at the University of Missouri-Kansas City and is a PGY-4 at the Harvard Affiliated Emergency Medicine Residency Program at MGH/BWH. Her interests include emergency medicine capacity building and curriculum development in low- and middle-income countries, and she has worked on capacity building projects in Pakistan and Iraq during residency. Her prior work has also focused on improving access to refugee care through the implementation of health screening fairs. She has an interest in digital education and telehealth, and is currently leading a telemedicine initiative in Pakistan, primarily aiming to connect physicians in larger urban areas in Pakistan to patients who live in more rural areas. 

  • Xiang Yun Yang, MB, BCH, BAO, MMED, LLM

    Sarikei Hospital

    Dr. Xiang Yun Yang is an esteemed Emergency Physician and the Head of the Emergency and Trauma Department at Sarikei Hospital, Sarawak. She graduated with an MB BCh BAO from Penang Medical College, National University of Ireland and later completed a Master of Medicine in Emergency Medicine at Universiti Sains Malaysia. With a career deeply rooted in rural medicine, Dr. Yang has made significant contributions to interfacility patient transfer, aeromedical, and water emergency medical services (EMS). Her expertise in aquatic life support stems from her experiences medical rescue in her flood-prone homestate. Dr. Yang has co-founded the Basic Transport Medicine Course and contributed to healthcare policy, earning recognition for her pioneering work in improving patient safety and care in remote areas. Additionally, with a Master’s in Healthcare and Medical Law, she has contributed to shaping healthcare policies and local protocols for patient transfer in Sarawak, Malaysia. She is currently working on her PhD on Medical Education at the University Malaysia Sarawak (UNIMAS).

  • Sweta Giri, MBBS, MD

    Khesar Gyalpo University of Medical Sciences of Bhutan

    Dr. Sweta Giri is an Emergency Physician based in Thimphu, the capital city of Bhutan. She obtained her medical degree from the University of Colombo in Sri Lanka. Dr. Sweta worked as a medical doctor in the Emergency Department for 3 years when she realized that emergency medicine was her calling and went on to pursue a Master's Degree in Emergency Medicine from the Khesar Gyalpo University of Medical Sciences of Bhutan. She graduated in 2023, becoming the country’s second female emergency physician.

    Recognised for her dedication and commitment to the field of Emergency Medicine, she was appointed as the Program Director for the Emergency Medicine residency program shortly after completing her training. Dr. Sweta is additionally a Senior Lecturer at the medical university, works as a flight physician for the Bhutan Emergency Aeromedical Services and also serves as the Managing Editor of Bhutan's only medical journal, the Bhutan Health Journal.

    Her professional interests include critical care, simulation education, research and quality improvement.

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