[Article] A Lot Can Be Done, and They Can Be Part of It

Paul Farmer has been described by Pulitzer Prize-winning author Tracy Kidder as "a man who would cure the world." Founder of the Boston-based nonprofit group Partners In Health, Paul Farmer is known worldwide for his pioneering work in global health. Farmer grew up as the second of six children in an unconventional family that moved frequently, living at times in a trailer park, in a bus, and on a boat without running water. Making friends easily and possessing a "photographic memory" for facts, he graduated from high school as valedictorian and went to Duke University on full scholarship.

It was there he began reading about the German physician Rudolf Virchow. Virchow, sometimes called "the father of public health," wrote: "Medicine is a social science, and politics is nothing but medicine on a large scale. The physicians are the natural attorneys of the poor, and the social problems should largely be solved by them." Of his inspiration, Farmer explains, "Virchow had a comprehensive vision: pathology, social medicine, politics, anthropology — my model."

Farmer splits his time between Boston's renowned Brigham and Women's Hospital and a small hospital built by Partners In Health in the tiny village of Cange, Haiti, called Zanmi Lasante (Creole for Partners In Health). Since beginning his medical career in the 1980s, he has devoted his life to improving the health and lives of the world's neediest people — building a health care center in central Haiti; helping prison officials fight epidemic tuberculosis in the former Soviet Union; and working with his colleague Jim Kim to fight multidrug-resistant tuberculosis (MDR TB) in the shantytowns of Lima, Peru. Most recently, Partners In Health has expanded its work into the African nation of Rwanda.

Trained as a medical anthropologist as well a physician, Farmer never stops asking the sometimes uncomfortable question "Why?": Why shouldn't poor people have access to medical care and drugs when they are sick? He has taken this message around the world and said it enough times that he now believes the world is beginning to listen.

"Finally people are starting to notice that a lot can be done, and they can be part of it," says Farmer. "The essence of global health equity is the idea that something so precious as health might be viewed as a right."

In true Robin Hood fashion, Farmer has begged, borrowed, and stolen AIDS drugs from virtually any source he could find, carrying the pills back to Haiti in his suitcase. He goes to the same lengths to secure medical supplies. Much of his time on planes, he says, is spent writing thank-you notes.

His dedication is paying off. When Farmer recently took some donors to visit the project in Haiti, they asked why they hadn't seen any AIDS orphans as they had in Africa. Farmer replied, "It's because we've been taking care of their mothers." Mothers who are HIV-positive are treated with AIDS drugs so they can raise their own children. Farmer and his team pioneered a system that showed that with the help of community health workers called accompagnateurs, rural people could follow even a complex regimen of antiretroviral therapy. The antiretroviral drug program began in 1999, when such efforts were almost unknown. "We didn't do it to be a model program; we did it because people were croaking," says Farmer, with characteristic deadpan outspokenness.

Farmer believes it's his responsibility to be outspoken, and he lectures widely on global health. "I feel it's part of my job to make the problems of the poor compelling," he says. "It's only through a failure of imagination that people turn away. The poor are doing their job — they're shouting as loud as they can. It's we who can't hear them. What the American public thinks is very important to the future of global health. Many people are moved by the idea that there is unnecessary suffering in the world, and we could do a lot to stop it. We have the technologies necessary to stop most of the suffering."

* Paul Farmer and Jim Kim are changing the way the world combats multi-drug resistant tuberculosis. http://www.pbs.org/wgbh/rxforsurvival/series/champions/paul_farmer.html

• Part I: Poverty and the Rise of MDR TB in Peru (3:49)
• Part II: Everyone Around Her is at Risk (8:20)
• Part III: Facing TB Head-On (4:56)
• Part IV: Reason to Endure (3:40)

[Article] Sons of Lwala

When residents of a tiny Kenyan village sold their chickens and cattle to buy Milton Ochieng a $900 plane ticket to Dartmouth College, they told him they wanted something in return. Eight years later, he's a Vanderbilt University Medical School graduate preparing for his residency. In his home village of Lwala, a clinic he and younger brother Fred established serves about 100 patients a day.

A documentary about their struggles to raise $150,000 to build the clinic — while attending school full-time and coping with their parents' deaths — will soon be screened at universities across the country.

"It's not common to have a couple of village boys come to the U.S. and advocate for a clinic to be built in their country," said Barak Bruerd, program director of Blood:Water Mission, a Nashville-based nonprofit that has contributed to the clinic. "The fact that they were able to bring so much support to their community is amazing."

Before the clinic, Mr. Ochieng says, sick villagers often had to be carried for miles just to get to a paved road. As a child, he remembers seeing a friend's mother taken away in a wheelbarrow during a difficult labor. Neighbors pushed her for 45 minutes before she died. The image stuck with him. His father, high school chemistry teacher Erastus Ochieng, emphasized the need for health care closer to the community. It was his dream to see a clinic in Lwala, a village of about 1,500 people in southwestern Kenya. It wasn't until a college service trip to Nicaragua, where students worked alongside villagers to build such a facility, that Mr. Ochieng started to think his father's dream could become reality. The elder Mr. Ochieng would not live to see the project completed. He died in 2005 of AIDS, which had killed Mr. Ochieng's mother the year before.

For several years, Mr. Ochieng made plans. Fred Ochieng followed him to Dartmouth and then on to medical school at Vanderbilt. By 2005, Milton Ochieng was ready to build, except he had no money. So he put Fred Ochieng in charge of fundraising. That weekend, Fred Ochieng raised $9,000 at a conference for a Christian ministry group. But it took another two years to raise the $150,000 they needed. They were finally able to open the clinic in April 2007, helped by a $45,000 donation from Blood:Water Mission, which was founded by Christian rockers Jars of Clay to reduce the impact of HIV and AIDS in Africa. In its first year, the clinic saw 20,000 patients at a cost of about $100,000.

"It's important for people to get a sense of how far the U.S. dollar can go," Milton Ochieng says, noting that one woman had emergency surgery for an ectopic pregnancy at a cost of only $250. A similar procedure could cost at least $10,000 in the U.S. The clinic is also getting help from former TV reporter Barry Simmons, who quit his job after interviewing the Ochieng brothers to work full time on a documentary about their struggles to build the clinic. "Sons of Lwala" has so far raised about $230,000.

"It was always the plan to give them a platform to raise money and spread their story," Mr. Simmons said. The volume of patients is growing, Mr. Ochieng says, because of the high standard of care the clinic provides, even without running water or a consistent electrical supply.

The Washington Times Sunday, July 6, 2008

[Article] Korean Doctor, Anthropologist Selected to be Dartmouth’s Next President

Doctor and anthropologist Jim Yong Kim will become the first Asian-American president of an Ivy League school this summer when he begins his term as the 17th president of Dartmouth College on 1st July 2009. The college announced the appointment on Monday, 2 March 2009.

A native of Seoul, South Korea, Kim moved to the United States when he was 5 years old and grew up in Iowa in one of only a handful of Asian-American families in the area. Kim has said that his father, who advised him to be a doctor, also counseled him on issues relating to race.

“What he said to me was, ‘Look, you’re Asian-American. As a Korean you will have a skill no one can take away from you.’ And that’s still what people felt at that time,” Kim told The Dartmouth, the college’s newspaper. “No one would have said an African-American could be president of the United States. I mean, that was not in the realm of possibility in 1980.”

Kim currently serves as chair of the Department of Global Health and Social Medicine at Harvard Medical School, as well as chief of the Division of Global Health Equity at Brigham and Women’s Hospital. He has never held a position at Dartmouth.

Kim was awarded a MacArthur “genius” fellowship in 2003, and U.S. News and World Report ranked him in 2005 as one of America’s 25 best leaders. In 2006, he was named one of Time magazine’s 100 most influential people. As a trained physician and anthropologist — he holds both an M.D. from Harvard Medical School and a Ph.D. in anthropology, also from Harvard — Kim has worked to improve the health of residents of many developing countries, serving as director for the Department of HIV/AIDS at the World Health Organization from 2004 to 2005. As Dartmouth’s next president, Kim will face significant challenges as the college is pressured to cut costs. Last month, Dartmouth announced that it would cut 60 non-faculty employees after the value of the endowment fell by $700 million, or 18 percent.

Noting that he has tracked Dartmouth’s financial situation since the global economic crisis hit in November 2008, Kim said that he has few concerns about the budget cuts and is optimistic about Dartmouth’s finances. “I think there’s a way for us to take advantage of this climate where everyone is just thinking about cutbacks and low-downs and scaling back on what they are going to do,” Kim said. He added that he has no plans to “impose any research agenda” during his time at Dartmouth despite concern that he will be overly focused on bolstering research. “I don’t want to argue with my faculty about content and curriculum — they’re the experts,” he said. “My job is trying to find ways of supporting them in delivering the content and curriculum in the most innovative way.”

As Kim prepares to take office in the coming months, he will also have to adjust to life with a second child in the house. Kim’s wife, Younsook Lim, gave birth to a baby boy on Feb. 27.

Kim will replace James Wright, who has served as Dartmouth’s president since 1998. Under Wright’s tenure, Dartmouth changed its financial aid policy to offer free tuition for all students from families earning less than $75,000 a year. Wright also oversaw the construction of new dormitories, gymnasium renovations and the creation of the Student Life Initiative in 1998, which banned the formation of new single-sex Greek organizations.

Kim said he has “no particular bias against [fraternities and sororities]” and pledged to keep an “open mind” about the college’s Greek organizations. “I want them to be institutions that actually enhance peoples’ experience and don’t detract from them.”

The Daily Princetonian By Marissa Lee and Aaron Hosios

Published: Tuesday, March 3rd, 2009

Be Diplomatic for Life

(back row) Eric Rubin, Seemoon Choi, Hyuna Lee, Stephen Linton, Youngjeon Shin, Woojin Lew, Matthew Carroll, Nackmoon Sung, Edward Nardell, Sonya Shin, Jim Kim (front row) Heejin Choi, Jason Ahn, David Kim, Christie Jeon, Eugene Yim, Ted Cohen on Tuesday 25th November 2008, @Busch Hall, Harvard University

Harvard Medical School, Harvard Korea Institute, Harvard Asia Center, and the EugeneBell Foundation organized a conference entitled: "Tuberculosis in the Korean Peninsula and Global Health" in Cambridge on November 24th and 25th, 2008. As a new grant writer of EugeneBell, I went to the conference with Dr. Stephen Linton, the Founder and Chair of EugeneBell. This conference was for seeking for new collaborations that will improve the future health of the North Korean people. A small number of dedicated scientists, clinicians and donors shared their experience on preventing and treating drug-resistant tuberculosis in the Korean peninsula.

In 1997, EugeneBell was officially invited to expand EugeneBell’s work to treating tuberculosis by the Ministry of Public Health in North Korea. Since then, EugeneBell started assisting programs for tuberculosis, however, physicians found many patients suspected of having multi-drug resistant strains. So EugeneBell has tried to expand organization’s program to include multi-drug resistant tuberculosis patients, who do not respond to primary medications.

The problem is now North Korea does not have an operating MDR laboratory, so Eugenbell has collected samples from patients in North Korea, had them analyzed at Masan National Tuberculosis Hospital and returned with individual prescriptions. Patients’ sputum samples are transported from Pyongyang to Masan via China and Seoul. It takes 5-20 days. It is indeed totally crazy process. That is why in the States EugeneBell is seeking for collaborations to build a laboratory and medical facilities; and to develop strict treatment programs for MDR-TB in Pyongyang. As well-known, North Koreans are highly suspicious of South Koreans’ intentions so North Korea government dislikes any Koreans or Korean-Americans’ helps. It means no Koreans and Korean-Americans can go to North Korea so only non-Koreans can access the laboratory and facilities.

Fortunately, productive conclusions were made at the conference in spite of highly complexed situations. Currently the Chair of Department of Global Health and Social Medicine at Harvard Medical School is a Korean-American, Jim Young Kim, MD, PhD. At the end of the conference, he said his father was from North Korea so there are still so many family members in North Korea. Then he asked Dr. Linton directly, “How Harvard Medical School can help North Korea with EugeneBell?” and mentioned he has known some people of Gates Foundation, and now the Foundation is preparing to build MDR-TB facilities in China. He is sure that Bill Gates will be quite interested in interrupting North Korea with medical aids. And he added he would like to call a conference with Bill Gates soon. If once a consensus is reached among the Gates foundation, American scientists and clinicians and EugeneBell, it is really amazing progress!

Global health has become a core political and economical reality of our time. Will improvements in health spur improvements in economic development? Or will economic development drive improvements in health? This argument is still ongoing. Anyway our response to NK is urgent to save life and from now on we must think seriously how we can use the possible grant and the chance diplomatically to open up the closed society.