Global health researcher helps US military and rural communities
January/February 2025 | Volume 24 Number 1
Dr. Barclay Stewart, a trauma and burn surgeon, credits his time as a Fogarty fellow with shaping his career: “It changed my life!”
Stewart’s career interests were originally in environmental health and focused on environmental impact analysis and how things like dams and wastewater treatment affect population health. He ended up in medical school and pursued a master's degree in public health at the London School of Hygiene and Tropical Medicine. Next, he took his first job in what was then southern Sudan, where he did tropical disease control work for the
Malaria Consortium at the tail end of the war there, just before their independence in 2011. There, he witnessed hundreds of patients with war injuries and no emergency care or trauma system to help people with life and limb threatening problems. “It was a gap that I wanted to spend my career filling,” said Stewart.
This realization led him to train in general surgery at the University of Washington (UW) and Harborview Medical Center, which focuses on adult and pediatric trauma and burn care and also healthcare for the Pacific Northwest’s most vulnerable people regardless of ability to pay. He began collaborating with the UW Department of Global Health and Drs. Charles Mock, Judd Walson, and Joe Zunt, a principal investigator in
Fogarty’s LAUNCH Fellows and Scholars program.
Stewart’s first Fogarty fellowship, 2008–09, brought him to Kenya, where he assisted with clinical trials addressing HIV co-infections (e.g., soil transmitted helminthiasis, tuberculosis, malaria). “That experience cemented my interest in global health and conducting interventional studies in low-resource settings while training the next generation of global health practitioners focused on injury prevention and control and trauma care.”
Stewart is one of a few Fogarty alumni who went on to do a second fellowship. In 2015-17, he worked with Fogarty investigators, Drs. Adam Gyedu and Peter Donkor, in Ghana, performing observational and interventional studies related to trauma care capacity building. After finishing that project, he completed a doctoral degree at Stellenbosch University in South Africa focused on health services research. Yet, he remained close to mentors and collaborators in Ghana with whom he continues to work on several projects and training programs for U.S. and Ghanian master’s and doctoral degree students. Student projects include NIH- and Department of Defense- funded grants for trials that advance real-time decision support tools for trauma care at first-level hospitals and a nationwide cluster randomized trial studying enteral versus intravenous resuscitation for children and adults with major burn injuries.
“We're excited to see the results of the enteral resuscitation trial and how the protocol might be implemented at a broader scale, particularly at first-level hospitals where access to burn resuscitation is critically limited.” He and his colleagues also developed additional Fogarty training sites in Nepal and Burkina Faso with projects in Ethiopia, Rwanda and Ukraine. Stewart, who is now director of the Dr. Dana C. Lynge Program for Global and Rural Surgery at UW and associate chief of trauma and burns at Harborview Medical Center, notes parallels between his work abroad and challenges faced by American and allied soldiers and civilians living in conflict.
Photo courtesy of Pariwesh Bista, UW Program for Global and Rural Surgery
Dr. Barclay Stewart currently conducts research at the National Burn Center in Nepal.
“There are many similarities between working in low-resource settings globally and those encountered by warfighters during prolonged field care scenarios in settings where we don’t necessarily have air superiority and therefore can’t evacuate the wounded quickly,” he explains. In the Pacific Northwest, he adds, “caring for injured and burned adults and children from Washington, Alaska, Idaho, and western Montana—across nearly 2,000 miles of pre-hospital transport—is synonymous in many ways with what warfighters experience as they’re being evacuated over hours or days across multiple echelons of military care.” The work with lay first responders—paramedics embedded with demining organizations—and first-level hospital providers in conflict zones and humanitarian emergency settings has parallels with the lower echelons of military trauma care and critical access hospitals in the U.S.
While the horizon looks bright for this field of research, the biggest challenge is that the hardest places to do this work is where it's most important and where funding is limited (despite how much injury contributes to the overall level of disease and disability).
“However, Fogarty has ensured that there's funding for those who want to change the way injured people can access higher quality trauma and burn care in a variety of settings, including areas of conflict,” says Stewart.
“We want to honor that commitment by doing high-quality work, even where it’s hard.”
More information
Updated February 12, 2025
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