Arnold Noyek

Ashoka Fellow
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Canada
Fellow since 2009
Ashoka commemorates and celebrates the life and work of this deceased Ashoka Fellow.
Ashoka commemorates and celebrates the life and work of this deceased Ashoka Fellow.

My work is a pioneering, Canadian-led team effort of more than three decades that strengthens healthcare systems worldwide, using health as a bridge to peace. I am working today with my colleagues on the same global projects and programs as we have done almost constantly for the past many years, demonstrating the unique global value of the Canada International Scientific Exchange Program (CISEPO). CISEPO’s strength is in the meaningful projects and high-impact programs created for our partners abroad and the societies and cultures that they represent. These include telehealth initiatives, exchanges here in Canada, and CISEPO’s on-the-ground activities in the health sector. We bring together the public sector and schools of medicine and public health across the globe.

Our work is consistent with and elevates the Ashoka mission through the creation of a large cadre of changemakers in Canada and abroad. We empower these young health professionals to grow the network and build a better world through education and professional development within our social contract.

This description of Arnold Noyek's work was prepared when Arnold Noyek was elected to the Ashoka Fellowship in 2009 .

Introduction

For the past 30 years Dr. Arnold Noyek has identified health issues common to Israelis, Jordanians, and Palestinians, and fostered cross-border cooperation to build lasting solutions to high-priority health concerns. By building such bridges, he is contributing to the type of cooperation needed to underpin the viability of future peace agreements. Dr. Noyek has created a collaborative network of more than 2,000 students and professionals, created the first cross-border professional association in the Middle East, and led the Jordanian government to make early hearing deficiency detection a public policy—an approach that has been replicated by other health organizations in the Middle East.

The New Idea

To change the way doctors approach health problems in the Middle East, Dr. Noyek has devised an incremental and personal mentoring approach to cooperation. The approach starts with training fellowships, progresses to student exchanges, and leads to the implementation of regional research projects, the establishment of a cross-border network of peaceful professional cooperation, organizational interactions, and the adoption of critical public policy changes at the national level. His organization, the Canada International Scientific Exchange Program (CISEPO) invites collaboration among health professionals from Israel, Palestine, Jordan, and Canada to solve pressing health issues in the Middle East. In part, Dr. Noyek achieves this through CISEPO initiatives that include: Educational programs such as student exchanges, training fellowships, on-the-ground conferences, and international eHealth and needs-based cooperative professional development and research. The participants in these initiatives then become lifetime members of the CISEPO network.Through the Canadian student-exchange program, CISEPO is building the capacity of medical students in Israel, Palestine, Jordan, and Canada for greater cooperation among health professionals in the future. To produce further change, Dr. Noyek also created a network of established health professionals from the same countries to spearhead initiatives that not only resolve pressing health problems, but also foster cooperation and lead to policy changes.Dr. Noyek’s organization is unique as a health-focused entity nurturing cross-border cooperation across the Arab and Israeli frontier in the Middle East, persistently achieving an impressive impact over the last 16 years in the context of a highly divisive conflict. He has advanced the field of health in Israel, Palestine, and Jordan by working on mother-child health, nutrition, infectious diseases, hearing health, youth health, other clinical and public health disciplines, thus strengthening health systems. This diversity is important as it has enabled CISEPO to have a greater impact, as well as facilitate relationships among a diversity of actors in the region.

The Problem

Through CISEPO, Dr. Noyek strives to respond to two systemic problems. The first is the prevalence of unaddressed essential common-ground regional public health issues; and the second, the added challenge of fostering cooperation between the countries of Israel, Jordan, and Palestine, which have been in conflict with one another for decades. These issues have lead to the unnecessary replication of efforts and to missed opportunities for peace-building.The Middle East, in particular, presents immense challenges for improving regional disparities in health and fostering peaceful coexistence. The history of conflict between Israel, Palestine, and Jordan limits the potential for schools, medical institutions, students, and professionals to exchange knowledge around strategic medical problems which affects all of them. Due to a lack of collaboration and interaction among these groups, there is also a lack of exchange of new technologies in the field, and medical students and professionals do not have an opportunity to learn tolerance and acceptance of one another in the health care context.Yet, there is excellent potential for doctors to play a role in the solution. For example, in the mid 1990s, Dr. Noyek’s continuing education programs through CISEPO and the University of Toronto identified a special cross-border need in the region: The detection of and assistance to infants and children with impaired hearing on a genetic basis. This public health challenge has arisen in the main from consanguinity in Arab society, estimated near 35 to 50 percent across various countries and communities. Hereditary sensorineural hearing loss is the most common form of congenital hearing impairment. Undetected hearing loss has serious social and economic consequences for children, families, and the community. For many years, the response to such shared problems in the region was slow due to the lack of access to appropriate treatment and technology as well as the lack of cooperation to respond in a concerted manner to a regional public health need. Thus, the lack of opportunities for students and professionals to work together across cultural, religious, and ethnic differences has impeded attempts to solve these problems.

The Strategy

Dr. Noyek seeks to address these issues by identifying apolitical, health-related issues and creating opportunities for professionals to collaboratively address these public health concerns. He began his work by addressing the issue of congenital hearing loss, common to Israelis, Jordanians, and Palestinians alike. Through these shared concerns Dr. Noyek began to build bridges among health professionals in the region.Dr. Noyek founded CISEPO in 1984 out of his deep conviction that bridge-building international relationships was necessary to advance the state of medicine. He began to develop these relationships in the early 1970s with his involvement in medical educational programming in Israel. As Dr. Noyek saw the need to foster the growth of otolaryngology, he began to accept invitations to speak at Israeli institutions, encouraging all the other medical schools in the country be invited to attend as well. As a result, he began building an intricate network of medical organizations in Israel. Dr. Noyek’s accomplishments within the field of otolaryngology later brought him to build similar relationships in Egypt, Jordan, and Palestine, among others. He brought these national networks together through CISEPO, but only in 1995 did its main focus become cooperation through health among Israel and the Arab World.Through a combination of cooperative education, training, research, and service for the network of medical students and professionals, CISEPO has built partnerships and impacted curriculum development between 30 medical institutions and more than 3,000 members in Israel, Palestine, Jordan, Canada, and the U.S. Each CISEPO activity serves two purposes: Enhancing scientific and medical advances by cooperation to respond to specific regional public health needs; and, building bridges and understanding to contribute to the greater goal of creating trust and confidence through new relationships in the region. To achieve the desired impact in each of his programs, Dr. Noyek works tirelessly to initially build a strong network of medical students, professionals, and institutions. He then identifies common health needs and synergies in the region and responds to them through knowledge and technology transfer between the four participating countries.Over the years, CISEPO learned to begin its work with smaller initiatives to create the necessary structure to support large-scale/high impact projects. For example, CISEPO will often start with continuing education workshops, scientific exchanges, and its fellowship program, to create a significant project on the ground in Israel, Palestine, and Jordan (with support from Canada) that will truly impact the state of public health in the region while putting a strong emphasis on building relationships among all health professionals. In one such initiative, CISEPO tested 130,000 infants in the Middle East and linked deaf children and their families with community-based aid services that fostered cooperation among health professionals, their patients, and social organizations. As a result, the first cross-border professional association in the region, the Middle East Association for Managing Hearing Loss (MEHA) was created and Jordan adopted the early detection of hearing loss through universal newborn hearing screening, habilitation, and family support as a public policy in 2007. The founding of MEHA has ensured that cooperation among health professionals was not a sporadic or ad-hoc occurrence, but rather a formalized, long-term initiative which set a precedent for cooperation and health as a bridge for peace in the region.To make the greatest impact and increase other organizations successes, CISEPO has systematized its methodology and shares it with the medical community. A significant gap identified by the public health community working in conflict areas is the lack of information on lessons learned, prerequisites, and practical steps to take. Therefore, CISEPO always begins with a high priority health concern for the region. It then sustains this health-driven strategy by spearheading collaborations of cross-border professional activities.Since CISEPO’s goal is to foster cross-border cooperation in the field of health, it began by creating partnerships with the ministries of health in Palestine, Israel, and with the Jordanian Royal Medical Services. These partnerships were instrumental to guarantee support from all the respective governments and to secure the necessary cross-border clearances. At the same time, as a Canadian organization, CISEPO keeps the work from being politically influenced by using the Canadian program to coordinate activities. The involvement of a trusted third party coordinator (CISEPO Canada) has been vital to attract colleagues and manage cooperation in periods of conflict. CISEPO has built active partnerships with more than 20 hospitals in the Middle East (12 Israeli, 8 Jordanian, and 1 Palestinian); 10 universities (5 Israeli, 4 Jordanian, and 3 Palestinian); the Royal Medical Service of Jordan; and dozens of Arab and Israeli mother and child health centers and citizen organizations.The organization runs successfully by receiving a variety of pro bono services, which helps to keep costs low. The operating expenses of CISEPO range from US$300k to US$500k. To operate the student exchange program for one year costs US$150k, most of which is received through in-kind donations, as well as US$30k in individual donations. Dr. Noyek also managed to secure in-kind electronic access to medical journals for the students in Israel, Palestine, and Jordan.CISEPO is ready to bring its work to the next level. It has generated many activities on the ground in the health sector and seeks to bring these initiatives into the economic sector as well. Recognizing that addressing economic inequalities, offering economic opportunities, and decreasing unemployment rates are vital to fostering peace, Dr. Noyek is collaborating with Ashoka Fellows Howard Weinstein (Brazil) and Ola Abu Ghaib (Palestine). This collaboration will offer disabled Palestinian women from Ola’s organization access to jobs and professional training to manufacture and distribute solar powered hearing aids. This work will be done in collaboration with Al-Quds University, Abu Dis, West Bank, a partner brought to the table through CISEPO. The hearing aids will be distributed throughout the Middle East. Not only will women gain access to decent jobs which will heighten their economic status and their self-esteem, but the community as a whole will be responsible for distributing essential hearing aids to populations in Palestine, Israel, and Jordan.

The Person

Dr. Noyek was born in Dublin and immigrated with his family to Canada when he was three-years-old. He knew he wanted to be a doctor since the age of ten. As a teenager, Dr. Noyek worked as a camp counselor and became passionate about bringing people together. After medical school he specialized in otolaryngology and went on to build an academic practice as a professor at the University of Toronto. He chose to specialize in ear, nose, and throat surgery because it was a field lacking resources and research at the time. After World War II, antibiotics transformed the discipline, and he saw a way to make the specialty more meaningful by “building bridges” with radiology. Dr. Noyek’s accomplishments within the field of otolaryngology later brought him to build similar bridges in Israel, Egypt, Jordan, and Palestine. CISEPO found a great supporter in King Hussein of Jordan who sought ways to facilitate the type of cross-border collaboration that would underpin the 1994 Peace Accords.Dr. Noyek firmly believes in the need to involve health agents as players in the search for peace as they have a duty to respect people beyond politics: “When elephants fight, the grass dies. We’re caring for the grass.”Dr. Noyek has been a leader in his field at Mount Sinai Hospital since 1966 and served as its otolaryngologist-in-chief from 1989 to 2002. He was a pioneer in cross-fertilizing specialties and brought radiology to the area of otolaryngology. Dr. Noyek was also recently awarded the University of Toronto’s prestigious Ludwik and Estelle Jus Memorial Human Rights Prize.Dr. Noyek believes CISEPO’s success is the result of a long-term cooperative team effort. The CISEPO board and all engaged in CISEPO operations at home and abroad volunteer their time and expertise generously based on their own sense of humanity and Dr. Noyek’s vision.