About GHEM

At GHEM (Global Health Emergency Medicine), we are dedicated to improving access to emergency health care in low-resource settings. We develop and implement education and research initiatives, which are informed by clinical practice. Our activities translate into academic outputs and aim to inform health policy development, benefitting those in Canada and abroad.

The GHEM Model

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Clinical Practice

Our GHEM team are experts in their field. We practice in a range of settings including large urban teaching hospitals and trauma centres, as well as rural health centres in war-torn and epidemic-ravaged communities. Our patient experiences have shaped our skills as physicians, teachers and researchers.
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Education & Research

Based at the University of Toronto, we embrace our role as both teachers and learners in all aspects of our work. GHEM projects include innovative approaches to education and locally-driven operational research, which improves the health care workforce and system. Project teams are multi-disciplinary, international and collaborative.
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Outputs

GHEM activities are funnelled into academic outputs that benefit local and international partners. By providing Toronto-based clinicians with international opportunities and presenting our work at conferences and meetings, we are helping to build a new generation of EM practitioners working to improve global health. We are also creating open-access resources that connects our international partners to high quality and relevant information, enabling them to become expert practitioners and advocates in the field of emergency medicine.

Our Team

GHEM Executive Committee

Cheryl Hunchak

Cheryl Hunchak

TAAAC-EM Curriculum Director

Cheryl Hunchak (MD, CCFP(EM), MPH) practices emergency medicine at Mount Sinai Hospital in Toronto.  She is an Assistant Professor in the Department of Family and Community Medicine at the University of Toronto and completed her CCFP and CCFP(EM) training at the University of Toronto as well as a Master of Public Health in International Health from the Harvard School of Public Health. She is a founding member and previous Co-Director of GHEM, a founding Co-Editor of the Teaching Modules project, and currently the Curriculum Director for TAAAC-EM project. Her research interests include the adaptation and implementation of emergency medicine curricula in low-resource health systems, the impact of emergency medicine education on health outcomes and predictors of early ED mortality in low-resource settings.
Megan Landes

Megan Landes

GHEM Director & TAAAC-EM Co-Director

Megan Landes (MD, MSc, CCFP(EM)) is an attending staff doctor in the Emergency Department of theUniversity Health Network (UHN), the University of Toronto’s largest downtown teaching hospital and during the past five years has worked clinically in Lesotho, Malawi and Ethiopia in both emergency medicine and HIV services. She is an Assistant Professor in the Department of Family and Community Medicine. She specializes in operational research around the prevention of mother to child transmission of HIV in sub-Saharan Africa, and is a Research Scientist with Dignitas International in Malawi. Additionally, her research interests include the delivery of emergency medicine services in low-resource settings and she is a founding member of the Global Health Emergency Medicine (GHEM) group at the University of Toronto. She is the co-director of the Toronto Addis Ababa Academic Collaboration in Emergency Medicine (TAAAC-EM) which is working with Addis Ababa University to deliver Ethiopia’s first emergency medicine residency program.
James Maskalyk

James Maskalyk

TAAAC-EM Co-Director

James Maskalyk (MD, FRCP(EM)) practices emergency medicine at St. Michael’s hospital, where he received 2012’s “inner-city health, social responsibility” prize. He is an award winning teacher at the University of Toronto and with Dr. Megan Landes directs, TAAAC-EM, a project that works with Ethiopian partners at Addis Ababa University to train East Africa’s first emergency physicians. He has been active in global health work since 2001, when he did his first field work as a physician in Cambodia. He is a member of Médecins Sans Frontieres (MSF), an organization for which he has worked as both a journalist and a physician, most recently, in Dadaab Kenya, home to the world’s largest refugee camp. He was MSF’s first official blogger, and from this, he published a bestselling book about his experience as a field physician entitled, “Six Months in Sudan”. He is a founding member of GHEM, and it’s current director.  His academic interests include medicine in low-resource settings, health and conflict, publication ethics, and humanitarian action.
Lisa Puchalski Ritchie

Lisa Puchalski Ritchie

GHEM & TAAAC-EM Research Director

Lisa Puchalski Ritchie (MD, FRCPC(EM), DTM&H, PhD) is an emergency physician practicing at University Health Network, a Scientist at the Li Ka Shing Knowledge Institute in the Knowledge Translation Program, and an Assistant Professor in the Department of Medicine at the University of Toronto. She is a founding member of the Global Health Emergency Medicine group (GHEM) at the University of Toronto, and the Research Director for GHEM and TAAAC-EM.   She is a clinical epidemiologist with a research focus on the use of knowledge translation strategies to improve health care delivery and outcomes in resource limited health care settings.
Margaret Salmon

Margaret Salmon

Innovations & Technology Transfers for Extreme Affordibility (ITTea) Committee Lead

Formerly a resident of Alaska, Margaret Salmon (MD, MPH) spent 15 years as an entrepreneur before joining the medical community. She went on to graduate from University of Washington School of Medicine with a Master in Public Health from Harvard (specializing in humanitarian aid at Harvard Humanitarian Initiative) and eventually to complete her emergency medicine residency at University of California San Francisco. Concentrating on the humanitarian arena, she now specializes in the health needs of populations caught in conflict. With extensive experience in Democratic Republic of Congo and Ethiopia, Margaret publishes widely on bringing low-cost technologic solutions to immediate healthcare problems. She and her research partner and brother, Dr. Christian Salmon have pioneered the introduction of regional anesthesia into low-resource settings, the local manufacture of commercial ultrasound gel alternatives and the use of ultrasound in conflict. Now she is co-Director of ITTea, Innovations and Technology Transfers for Enhanced Affordability. Currently an attending in the emergency department with University Health Network and Assistant Professor at the University of Toronto, Margaret is also the principal investigator of Grants Foundation’s Grand Challenges Exploration Program, Round 11 addressing improving lives of women who are small farmers.

GHEM Staff

Elayna Fremes

Elayna Fremes

Program Coordinator

Elayna Fremes (MPH) serves as the Program Manager for the Global Health in Emergency Medicine (GHEM) group and the Toronto Addis Ababa Academic Collaboration in Emergency Medicine (TAAAC-EM). She works with all of the GHEM Executive and General Members to ensure the smooth and efficient operation of all GHEM projects and committees. Prior to working with GHEM, Elayna spent 5 years at the Global Health Division in the Dalla Lana School of Public Health at the University of Toronto. In this role she led and managed a number of different global health education programs for various different audiences. She completed her undergraduate degree in Peace and Conflict Studies at the University of Toronto and completed her Masters of Public Health (MPH) at the University of Waterloo.
Prakash Singh

Prakash Singh

Finance Manager

Prakash Singh (MBA, CPA, CGA) serves as the Finance Manager for the Global Health in Emergency Medicine (GHEM) group. He has over fifteen years of experience of internal control, management of finance and administration working with public accounting firms and various international development agencies including: German Agency for International Cooperation (GIZ), Options Consultancy Services, Save the Children Canada, Journalists for Human Rights and Dignitas International. Prakash has an Executive MBA degree from Pokhara University, Nepal, and his CPA, CGA certification from CPA Ontario.

 GHEM Members

Ross Claybo

Ross Claybo

Dr. Ross Claybo (MD, FRCPC(EM)) is an attending emergency physician practicing at Markham Stouffville Hospital and North York General Hospital in Toronto, and Lecturer with the Department of Medicine at the University of Toronto. He received his MD from the University of Saskatchewan and was one of the original graduates from the emergency medicine residency program at the University of Toronto. Ross has had over thirty years’ experience teaching and mentoring medical students and residents in emergency medicine both locally and abroad. He was involved for many years training and preparing the first national emergency residents and faculty within the Gulf Arab states while living in the Middle East. He has more recently participated in the TAAAC-EM project in training physicians in Addis Ababa, Ethiopia and assisting with faculty development of its first emergency medicine graduates. Ross has an ongoing interest in emergency medicine education with a particular interest in its application to international settings. He is also has a special interest in career development of junior faculty in the specialty and maintaining overall physician wellness and satisfaction within the field.
David MacKinnon

David MacKinnon

TAAAC-EM Post-Graduate Director

Dr. David MacKinnon (MD, CCFP(EM)) graduated from medical school at the University of Western Ontario (MD) and completed Residency training at Queen’s University in combined Family & Emergency Medicine (CCFP-EM). He is currently a staff Emergency Physician and Trauma Team Leader at St. Michael’s Hospital and also the Deputy Chief of the Emergency Department there. Dave also serves as the Postgraduate Coordinator for the Toronto-Addis Ababa Academic Collaboration in Emergency Medicine (TAAAC-EM) and is a member of the Global Health in Emergency Medicine group at the University of Toronto. His interests include trauma, education, Quality Improvement and resource utilization in medicine.
Nazanin Meshkat

Nazanin Meshkat

Nazanin Meshkat (MD, FRCPC(EM), MHSc) is a staff emergency doctor at the University Health Network, and an Assistant Professor at the University of Toronto. Dr. Meshkat also holds a Masters in Health Administration from the University of Toronto. Dr. Meshkat’s global health care experience includes working as an emergency physician in Iran and conducting a maternal health survey in Maharashtra, India. Through her field work with Médecins Sans Frontieres, she traveled to Papua New Guinea where she was involved in developing a program for victims of gender-based violence. In Canada, she has worked with street youth in London, Ontario, and also as an advisor to the International Affairs Directorate for Health Canada. Her latest contribution to the Toronto Addis Ababa Academic Collaboration (TAAAC-EM) both as the curriculum co-coordinator and clinician, has led to the launch of the first emergency medicine residency program in Ethiopia. Dr. Meshkat is a fellow at the Centre for Innovation in Complex Care (CICC) and a principal investigator of the TEAM (Transitioning Emergency Atrial Fibrillation Management) study. She is the co-editor of the Emergency Medicine Radiology Database (EMRaD) and GHEM’s Teaching Module project.
David Ng

David Ng

David Ng is an emergency physician at Toronto East General Hospital and University Health Network and also a lecturer with the University of Toronto.  He has an interest in medical education and the way in which different people live and experience health care throughout Canada and the world.  In addition to working extensively in various rural hospitals in Southern Ontario he has also been ship doctor in the Antarctic, locummed as an emergency physician at Baffin Island Hospital, Iqaluit, and helped to teach emergency medicine in Ethiopia as part of the Toronto Addis Ababa Academic Collaboration. He is most interested in working with learners to develop the solid approaches and skill set of emergency medicine.
Anna Nowacki

Anna Nowacki

Anna Nowacki (MD, FRCPC(EM)) is a lecturer at the University of Toronto and practices emergency medicine at the University Health Network. She completed her residency training at the University of Toronto and did her sub-specialty training in Global Health and Tropical Medicine at the Prince Leopold Tropical Medicine Institute in Antwerp, Belgium. Her involvement with TAAAC-EM started during a teaching trip in 2011. Since then she has taken part in various TAAAC-EM projects some of which included videoconferencing teaching sessions, and the development of teaching modules and clinical pathways.Dr. Nowacki’s recent publications include a review of EM residency programs in low and middle income countries with co-authors Drs. Megan Landes, Aklilu Azazh and Lisa Puchalski Ritchie. Her current interests are in medical education with special focus on postgraduate training in low-resource settings and toxicology.
Julia Wytsma

Julia Wytsma

Julia Wytsma (MD, CCFP(EM)) is a staff emergency physician at Credit Valley Hospital (Trillium Health Partners) and Georgetown Hospital. She completed her Rural Family Medicine residency, Emergency Medicine fellowship and Global Health Certificate Course at the University of Toronto. Her contributions to TAAAC-EM began during her residency training through teaching trips and more recently include implementation work for the Trauma Registry project at Tikur Anbessa Specialized Hospital. Her ongoing work with this project includes logistical support, education, and data quality analysis and improvements.
Edward Xie

Edward Xie

Edward Xie MD, CCFP(EM), DTM&H is an emergency physician at University Healthy Network and a clinical lecturer at the University of Toronto. He completed family medicine training in Toronto, his emergency medicine fellowship at McGill University, and a Diploma of Tropical Medicine at the Gorgas Memorial Institute. With the GHEM team, he has been involved in developing teaching modules and is editor of the Infectious Disease modules section. His interests include working with vulnerable populations in Canada, social determinants of health, and tropical diseases.