The Global Emergency Medicine Initiative (GEMINI) is a Rotary International service project, that began in 1998. The mission of GEMINI is to establish or improve the level of Emergency Medicine worldwide and to improve the health of patients and communities through programs of global distinction in healthcare and education. This endeavor symbolizes the collaborative efforts of a successful alliance that has 2 primary contributors:

    • Westborough, Massachusetts, Rotary Club, District 7910
    • University of Massachusetts Medical School, Worcester, MA.

In addition, GEMINI’s partners include:

    • Quetzaltenango, Guatemala, Rotary Club, District 4250
    • FUNDASALUD, Quetzaltenango, Guatemala
    • University of San Carlos de Guatemala’s Schools of Medicine in Quetzaltenango and Guatemala.

GEMINI has concentrated its efforts in Quetzaltenango.  Though this is the second largest city in Guatemala, through the years, Quetzaltenango’s needs have been ignored, making the city vulnerable to man-made and natural disasters. The vast majority of the population in Quetzaltenango is of Mayan origin. A volcanic earthquake destroyed the city at the beginning of the 20th Century due to the eruption of the nearby Santa María volcano. Since then, the daily activity of this volcano serves as a reminder of the impending danger of another eruption.

Furthermore, the uncontrolled urbanization and growth has resulted in an increased number of adverse events. Homes have been built in unsecured areas making residents vulnerable to mudslides, at the same time the number of motor vehicle accidents, most of them fatal, has increased. The occurrence of these disasters, natural as well as man-made, is in accord with the development of the theory of epidemiological transition. This theory states that while infectious and communicable diseases are being brought under control, chronic diseases and disasters are emerging as the number one killers. Unfortunately, the lack of adequate emergency medicine facilities accompanies this transition, particularly in the city of Quetzaltenango.

Paul Gallagher, a member of the Westborough Rotary Club, while on a needs assessment trip to Quetzaltenango, identified the necessity for an optimal standard of Emergency Medicine in the city. It has been through his vision that the collaboration between the Westborough Rotary Club and the University of Massachusetts Medical School evolved into GEMINI, a Global Emergency Medicine Initiative.


Soon after returning from Quetzaltenango, Paul contacted Dr. Richard Aghababian, Chairman of the Department of Emergency Medicine at the University of Massachusetts Medical School (UMMS), a pioneer in the development of Emergency Medicine as a specialty in the United States; and Dr. Jorge Yarzebski, a clinical research professor of UMMS and a native of Guatemala with strong professional, societal, religious and political ties to his homeland, particularly in the city of Quetzaltenango. An initial meeting was held in January 1999 at the UMMS. At that meeting, Paul expressed his desire to develop a program to bring the basics of emergency care to a group of 5 firemen (first responders) from Quetzaltenango, since firemen there also function as paramedics. Though they struggle to do the best they can, their efforts are restricted by the limited training in lifesaving maneuvers as well as by the lack of the necessary equipment to carry out their duties during emergency situations.

During that initial gathering, the seeds for the project were sown, and a few days later the GEMINI project was initiated. Through the shared vision of improving emergency medicine in developing countries, the partners of GEMINI formed a collaboration. The Westborough Rotary Club, in a leadership role, in conjunction with the Rotary Club of Quetzaltenango and Rotary International, works closely with expert medical education teams assembled by the University of Massachusetts Medical School.

Since then, several trips to Quetzaltenango have taken place. During these trips, several thousand health care personal and laypeople have been educated in basic as well as advanced life saving maneuvers. Medical education topics have included: disaster preparedness and management of disasters, triage, cardiopulmonary resuscitation, introduction and principles of advanced pediatric and adult life support, management of the multiple trauma victim, and update of recent guidelines in emergency medicine.

Education has been provided in a multilevel, cross-cultural scenario. Medical education has been provided to firemen (paramedics), nursing students and nurses, medical students and medical residents, and physicians from the city of Quetzaltenango. In addition, similar education has been provided to rural health care workers (community outreach workers), rural nurses and physicians.

Partners and Benefits

Dr. Jorge Yarzebski accepted the invitation from Paul Gallagher, a past president of the Westborough Rotary Club, to become an active member of the Club. Thereafter, Dr. Yarzebski invited several of his colleagues to join Rotary. Dr. Mick Godkin, Director of International Education at UMMS became a Rotarian; in addition, Dr. Richard Aghababian of the UMMS became honorary member of the Westborough Rotary Club. The participation of these key people as Rotarians has been a worthwhile strategy employed in the development of GEMINI.

The support and collaboration of the Westborough and Quetzaltenango Rotary Clubs has been outstanding. While the Westborough Rotary Club covers the cost of transportation for the medical teams between the United States and Guatemala, the club in Quetzaltenango provides local transportation, room and board. All Westborough Rotarians participate actively in fundraising activities to continue the support of this important international service project. Rotarians from Quetzaltenango, past and current presidents, and their international service director serve as strong supporters of this project.


Several mechanisms of support exist through Rotary International. Rotary grants (exploratory, need assessment, transportation, matching, Global Grants) provide the necessary funds to initiate this kind of project in a larger scale.

At the Westborough Rotary Club, all members support the GEMINI International Service project. Several local U.S. Rotary Clubs have joined our effort and others have expressed their desire to participate in support of the Rotary vision of service above self. We continue to have the support of the Quetzaltenango Rotary Club.

Several additional projects that are related to GEMINI are being developed.


As described, this project can be replicated elsewhere. 

GEMINI has replicated this project in Honduras, Nicaragua, Dominican Republic, and Guyana.