by Carole Bartoo

It’s a two-way street when doctors in the U.S. take their expertise to developing countries. Mario Rojas, M.D., a neonatologist at Vanderbilt Children’s Hospital with expertise in severe respiratory failure and infection in newborns, is a hot commodity when he visits Colombia. After all, with subspecialty training at Yale and a position at a top level pediatric hospital in the U.S., his level of expertise is highly appreciated in this South American country. But Rojas says people in the U.S. would be surprised by how much benefit can be reaped by conducting studies in developing countries.

Mario Rojas, M.D. in the NICU photo by Dana Johnson

"Doing research in developing countries actually opens doors that are harder to open here in the U.S.," Rojas said. "We tend to be so technology driven here, that it’s hard to study less invasive techniques that might actually be better for babies."

Rojas co-founded the Colombian Neonatal Research Network (CNRN). Through collaboration with a local university and the support of the International Clinical Epidemiology Network (INCLEN), CNRN selects epidemiologic studies designed to improve the care of sick infants. The group is uniquely positioned to study techniques and regimens that cannot be studied easily in the United States. It’s hoped the results of the studies could be of immeasurable benefit in developing countries, but also be of benefit in the U.S. and other developed countries.

Rojas has been the primary investigator for three multi-center studies, two of which have already been completed in Colombia. In one study, a new type of ventilator, called a high-frequency oscillator, was studied to see if it could be a better option than conventional ventilators in the treatment of severe respiratory failure in newborns. But there was a problem; typically, many of the babies that were candidates for this new technology would also be put on a device called ECMO (extracorporeal membrane oxygenation). That could make it hard to figure out which device was having what effect, so it was best to find a location where ECMO was not an option.

But doing studies like these long distance is quite a challenge. Three things are essential to make this happen: a high degree of trust in those carrying out the research in the developing country, a lot of telephone calls and Rojas’ ability to get a lot done in a very short amount of time during visits abroad.

"I go to Columbia only two or three times a year for between six and ten days per visit," Rojas said. "So we use our time together very wisely, we hold conferences with collaborators from all over, we have written copies of all our work that we review on the spot and make changes to."

All this drafting redrafting and polishing academic studies gets done, often within the space of a week. Work that in a typical academic context can take months.

"We get a lot done," he smiles.

And the information that comes out of this type of research may show how some sensible, perhaps lower technology, or at least lower cost solutions might benefit babies.

As Rojas says, Colombia and other developing nations get a definite benefit from their close work with Vanderbilt Children’s, but we may find there is a lot we can learn from research that is produced in those countries as well.