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The Neighborhood 8,000 Miles Away Continue...
Sunanda Gaur, MBBS, professor of pediatrics and director of the RWJMS AIDS program, has always had a global mind-set when it comes to the treatment of infectious diseases.
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Sunanda Gaur, MBBS, professor of pediatrics and director of the RWJMS AIDS program, has always had a global mind-set when it comes to the treatment of infectious diseases. Dr. Gaur has worked extensively with HIV-infected youngsters, so when she had an opportunity to travel to South Africa, through a program sponsored by the Columbia University Mailman School of Public Health, she eagerly packed her bags.
“The program was designed to train physicians and nurses in South Africa in the use of anti-retroviral-class medications to treat HIV infection,” Dr. Gaur reports. Subsequently, she traveled to southern India, where she worked in a program to prevent mother-to-child transmission of the virus.
“In this program, one dose of an inexpensive anti-HIV drug taken by a pregnant woman, and another dose given to her infant at birth, was enough to reduce the probability of transmission of HIV to the child by 50 percent,” she says.
She adds the group was there to evaluate what the local medical authorities were doing, and to help them improve their methods. She reports being impressed by what had already been accomplished with minimal resources. Part of her work involved testing and counseling patients, while educating local clinic staff about the importance of counseling.
“There is such an enormous stigma attached to AIDS in India,” she says. “The number of suicides by people diagnosed with the disease is tragic. There have been instances of entire families jumping into the river and drowning to escape the shame.”
Asked about her motivation for such global involvement, Dr. Gaur says simply, “It’s just one way of giving back.”
How Her Garden Grows
When she describes her work in the rural Kenyan clinic she founded, her enthusiasm is as contagious as laughter. The animation in her eyes says what it’s “We call them Tropical Clinics,” says Margaret Kilibwa, PhD, clinical assistant professor of obstetrics, gynecology, and reproductive sciences, and clinical nutritionist at the Women’s Health Institute. “There’s only one now, but there will be more soon.” Never doubt it. Dr. Kilibwa radiates aresolvethat impresses even Bill Gates, whose foundation is donating vaccines so she can reach a goal of immunizing 80 percent of area children withinfive years. Dr.Kilibwa participatedina Johnson & Johnson program several years ago in which individuals could apply for medical supplies to send to underdeveloped countries. She personally took the drugs to Nairobi, Kenya, and recalls that it was a fulfilling adventure — just not fulfilling enough. “The medications were being disbursed all over the country,” she says. “I decided I could do better, and provide more direct help, from a central location.” Not only did she do better, she has done a great deal more. The clinic she directs opened in 2003 in the heavily populated village of Kakamega, 250 miles northwest of Nairobi. Staffed by year-round health workers, and volunteer physicians from the United States who travel there for three weeks to three months each year, the clinic focuses its care on women and children. Education and prevention are objectives that begin with teaching women the importance of boiling water, eating vegetables, and drinking milk. Care extends to the availability of screening mammograms and Pap smears, programs to reduce pregnancy- related fatalities, and, most critically, education to combat mother-to-child transmission of HIV, the AIDS virus. “In Africa, when you treat women, you are really treating the country,” Dr. Kilibwa ex- Dr. Kilibwa’s program benefits from her successful efforts, not only in recruiting physicians and other health care workers to volunteer at the clinic, but in getting donations of refurbished equipment, including an MRI scanner. She succeeded in raising $250,000 last year, directed toward medications and salaries for year-round staff. On weekends, she can be found campaigning for funds to reach the 2006 goal of $950,000. Her own participation, including the cost of her yearly travel to Africa, remains a volunteer commitment. What does she get out of all this? The answer lies in small rewards that pay big dividends. “I once gave a group of women money so they could grow vegetables for their families,” Dr. Kilibwa says. “When I went back the following year, they had learned to irrigate the area, and had grown more than they needed.” She adds that the women sold what was left over and expanded the vegetable garden, creating a micro-credit program in which they loan money to other women to plant their own gardens. In a year’s time, the original group of five women had become 18 and was still growing. Her eyes open wide with delight as she explains, “The creativity of these village In 2007, a group of RWJMS physicians will travel to Kakamega with Dr. Kilibwa. By then, her new clinic will be treating 500 patients a day. Qualified African doctors will begin work there as a result of the equipment she has been able to secure. Fees from paying patients will help supplement the cost of care for the poor. American physicians will provide refresher courses for local doctors, adding proof that sometimes a global project with far-flung implications begins on a modest scale, when one person cares enough. |
