Why They Lead: Drs. Ngaruiya and Acker on Global EM, Innovation, and What Drives Them

Christine Ngaruiya, MD, MSc, DTM&H and Peter Acker, MD, MPH, have been appointed director and associate director of Stanford Emergency Medicine International (SEMI), which works to improve global emergency care through education, research, and health systems development. 

They recently offered a compelling look into the current challenges and emerging opportunities in global emergency medicine—while also sharing the personal motivations and memorable moments that continue to fuel their work.

What are some of the biggest areas of opportunity for innovation and advancement in global emergency medicine?

Dr. Ngaruiya: What immediately comes to mind is the potential for digital technology, including AI, to transform global health in many ways, including data collection. Rather than door-to-door surveys, why not mobilize mobile phones for data collection? Digital health tools like mobile phones, computers, and iPads can also be utilized for health education and delivering health interventions. Even in the most marginalized populations, people oftentimes still have a mobile phone. These phones create an opportunity to increase awareness, preparedness, and education on different health issues. And when it comes to clinical care, AI can guide more precise and efficient care for a range of needs.

Dr. Acker: I agree—the rapid expansion of technology, especially AI-enhanced tools, has the potential to dramatically improve access to quality, timely emergency care for patients who previously lacked it. I’m excited to see this continue to grow as we become more skilled and confident in using these tools, particularly in low-resource settings.

What are your primary areas of concern or roadblocks in global EM?

Dr. Acker: Work in this area does require resources, and the funding landscape is currently shifting in rapid and often unpredictable ways—affecting projects, implementers, and stakeholders alike. One of the key challenges moving forward will be finding sustainable ways for the global community to continue delivering services, advancing work, and conducting essential research despite the uncertainty around funding.

Dr. Ngaruiya: Yes, if I could wave a magic wand, I would increase access to equitable sources of funding globally. We do not lack ideas or the political will to see change effected. Rather, it’s a lack of stable and continued resources to see those ideas or policies implemented and enforced. Especially now, those of us working in global health need to be innovative, creative, and collaborative in exploring unique funding sources and ensuring that we are partnering with the right people.

What unique advantages does Stanford offer in the academic global EM space?

Dr. Ngaruiya: Our team of educators has a long history of developing effective educational programs—from Africa to Asia, within the U.S., and around the globe. We excel at developing and designing curricula, partnering with teams on the ground, being available and accessible to these teams, and creating measurable change. We have one of the strongest academicians in health systems development, Dr. Peter Acker. I also think we have unique research expertise that spans the research spectrum, including digital health and AI. And we focus heavily on community-engaged research, ensuring that partnership is at the core of our work.

Dr. Acker: Building on what Dr. Ngaruiya has said, our group is large and brings an incredibly deep and diverse set of talents. Our colleagues have been working across a wide range of global emergency medicine areas for years, developing expertise that’s truly rare. They’ve consistently shown a strong commitment to creating innovative and sustainable solutions for some of the world’s toughest emergency care challenges. Also, we’re based on an exceptional campus filled with brilliant minds working across education, research, clinical medicine, and technology. This environment creates rich opportunities for collaboration, which has helped us expand our networks and amplify our impact.

Why were you drawn to working in global EM?

Dr. Ngaruiya: I grew up in Kenya, which is a low- and middle-income country. I always knew I wanted to work in global health to improve equity and care for populations there, and more broadly, for African populations in general. When I became exposed to the process of research, and what research can contribute to improving equity, I realized the power of that to impact health globally—even beyond Africa. That’s what continues to drive me: this passion to ensure justice for all populations everywhere.

Dr. Acker: I was drawn to global emergency medicine because it’s such a meaningful way to exchange our knowledge and experience with colleagues and collaborators around the world, in hopes of having a tangible and lasting impact on the well-being and livelihoods of communities both locally and globally.

What does it mean to you personally to lead SEMI?

Dr. Acker: Stanford Emergency Medicine International has truly been my core community within the Department of Emergency Medicine. The group has provided nearly all of my career opportunities, and I’ve deeply benefited from the mentorship and friendship offered by both the team and its leadership. Being part of that leadership group—and having the chance to share the same kind of support, community, and guidance that I’ve received—is incredibly meaningful. It’s an honor to have this opportunity.

Dr. Ngaruiya: Hopefully, this role will enable me to impart lessons I’ve learned from both the opportunities I’ve had and the challenges I’ve faced during my own career. We have amazing faculty and fellows who are all motivated and already doing incredible projects. I feel our job will be to encourage that continued commitment. We can also introduce new processes to increase effectiveness and efficiency and ensure that people know who we are, what we're doing, and how to engage with us. The whole point of global health is to be able to tap shared resources and collaborate—to be able to move forward effectively, together.

Favorite global EM experience to date?

Dr. Ngaruiya: I've been a global non-communicable disease researcher for more than a decade now, and some of this work includes focusing on reducing tobacco use in countries in Africa. My most recent favorite relates to a research project I’m working on that leverages a mobile health texting tool to reduce tobacco use in Kenyan emergency department patients. We had a study participant who was just so overjoyed at the education and opportunity this tobacco cessation tool provided. They had never experienced education or received tools to help them work through tobacco cessation. The tool is as simple as a nudge, but we see that simple tools can have big impacts at the public health level.

Dr. Acker: There are few things I enjoy more than making connections and finding common ground with new people. Sharing meals, experiences, laughter, and learning together creates memories I truly treasure. Having had the chance to do that with so many friends and colleagues—both here at Stanford and around the world—has given me some of my most meaningful and lasting memories.

Dr. Ngaruiya and Dr. Acker are both associate professors at Stanford University’s Department of Emergency Medicine. Dr. Ngaruiya completed a fellowship in Global Health from Yale and a Master’s in Tropical Medicine from the London School of Hygiene and Tropical Medicine. Her work focuses on global noncommunicable diseases. Dr. Acker earned his MD and MPH at Tufts, completed a fellowship in International EM at Stanford, and specializes in strengthening emergency referral systems.