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Global Scholar: Dr. Juan Pablo Rodriguez Auad

Rodriguez-Auad focuses on infection prevention in Bolivia

Since his days studying pediatrics in Mexico, Dr. Juan Pablo Rodriguez Auad has known at least two things for certain in his professional life: He had a passion for studying infectious diseases, and he wanted, someday, to return to Bolivia to help the children in his home country.

Those certainties have helped shape the past decade for Dr. Rodriguez-Auad. He did in fact return to Bolivia, becoming one of the few pediatric infectious disease specialists in his country. He now heads the Infectious Diseases Unit and the Infection Control Committee at Hospital del Niño “Dr. Ovidio Aliaga Uria” in the capital city of La Paz. There, he also manages the hospital’s pediatric infectious diseases residents.

Now another realization — gleaned from his daily rounds through the pediatric oncology ward — is helping to shape the doctor’s next chapter.

“We see a lot of children with cancer in my hospital,” he says. “And … we see how these children die because of infections. … That was the most important thing I learned in these years. I realized that children with cancer sometimes don’t die because of the cancer; they die because of infections.

“And these types of infections can be prevented.”

Dr. Rodriguez-Auad has set out to address this problem, applying for the Global Scholars Program and then focusing his Scholars Project on central line-associated bloodstream infections (CLABSI). He has seen these infections arising both from the installation of a catheter and, even more commonly, from the ensuing manipulation of the catheter to take samples, administer medications, or perform other actions for a patient’s treatment.

Dr. Juan Pablo Rodriguez Auad

“The first thing I learned is you cannot do a change alone. So it’s very important to have alignment with key stakeholders, to try to influence other people, motivate other people." — Dr. Juan Pablo Rodriguez Auad

Dr. Rodriguez-Auad’s project will be deployed in two phases. First, he will use surveys and interviews to assess the hospital’s readiness for new infection prevention strategies. Then he will seek to implement the strategies themselves, with an eye toward establishing new protocols for hand hygiene, the use of antiseptics, and dressing changes, among others.

 “Many studies have shown that if you don’t do a good preparation before any implementation of a quality improvement project, you are going to fail,” Dr. Rodriguez-Auad says. “You are going to fail in your objective to improve something. So … you need to know how prepared that unit is, in many ways. In knowledge. In attitudes. Motivation. Many things.”

 Interestingly, he says, there hasn’t been much information published addressing this topic: the readiness for addressing CLABSI in institutions around the world. Particularly in low- and middle-income countries, he says, there can be challenges in implementing changes like this. A lack of resources, for one.

 “Trying to do this project, I’ve learned a lot,” he says. “The first thing I learned is you cannot do a change alone. So it’s very important to have alignment with key stakeholders, to try to influence other people, motivate other people.

 “Sometimes, we don’t want to bring people in who are opposed to the things we want to do. But I’ve learned that these people are very important if you want to do a change. You have to hear the people. The other thing I’ve learned in this project is to have allies. And these allies sometimes are people who think different than you.”

 These new approaches to change management and leadership were key things that Dr. Rodriguez-Auad took away from his time in the program.

And the Scholars Project has not been the first time he’s put those skills to use.

 As head of the Infectious Diseases Unit, he was on the front line of treating children with COVID-19, particularly in the early stages of the pandemic. That meant addressing shortages in resources, implementing new guidelines, and even appearing on television to answer COVID-19 questions related to children and their diagnosis and treatment.

 The master’s, he says, provided tools to meet that challenge.

 “We tried to put some skills we learned about leadership into practice,” he says. “We needed a lot of leadership in COVID to organize the hospital, organize people, organize many things. And to write a protocol, guidelines, about COVID in my hospital.”

 Beyond COVID-19, Dr. Rodriguez-Auad sees patients with a wide range of infectious ailments. The most common of these diseases are HIV, tuberculosis, upper respiratory infections, gastroenteritis, and hepatitis A. And with tropical locations less than two hours away from the elevated city of La Paz, he can also see patients with dengue, malaria, and fungal infections.

 It is the HIV cases, in particular, that have stayed with him.

 The majority of children with HIV in Bolivia contract it from their mother during pregnancy. Treating them, Dr. Rodriguez-Auad says, can be an emotional experience. He remembers one such patient who had lost both parents. While there have been advances in HIV medications, socioeconomic factors can still make it a challenge to get daily treatments to patients.

 “There are many, many challenges in my country, and in many low- and middle-income countries,” he says. “I know that doing this master’s, and this program, I will improve my skills. I will have more tools to do my work better. And not only me. Through me, I’m going to empower other people — nurses, physicians. …

 “I did this master’s for the children, to try to see more success in the treatment of these children — [so that] these children never die again from infections.”