In a World of Hurt Local Doctors Work to Change Lives Around the Globe
The challenges of the U.S. health care system are so significant that it’s easy to lose perspective and forget that, compared to most of the world, quality care is remarkably accessible stateside. Fortunately, a great number of doctors volunteer their time overseas in an effort to improve the lives of children and adults who would otherwise lack for the most basic care. Inside are some of their stories.
Dr. Omar Faruk: Bangladesh
 Dr. Omar Faruk distributes medicine and other supplies at the opening of the Begum Sajeda Free Clinic in Bangladesh. |
Dr. Omar Faruk ventured to his homeland of Bangladesh recently, intending to purchase some property for himself in the capital area.
That plan changed in a hurry.
“When you reach a certain point in your life, you think about giving back to society wherever you can,” said Faruk, a hospitalist at Mercy Medical Center. “Last December, I went back to Bangladesh, where I grew up. When I went to the village area, I had never imagined how disadvantaged and poor the people are.
“After seeing a 6-month-old baby who hadn’t had food for three days, suffering from a fever for seven days with no medicine and no doctor’s visits, that was just heartbreaking to me,” he continued. “So I asked some people if I could help them.”
The help that wanted most, it turned out, was an ambulatory health clinic, which Faruk opened and staffed at his own expense, redirecting the money he had intended to invest in real estate.
He named the Begum Sajeda Free Clinic after his mother, and on the first day, about 100 patients showed up. Faruk and his team, to put it mildly, did what they could.
“Many of those patients should have been in an emergency room,” he told The Healthcare News. “We saw respiratory failure, problems with rickets due to vitamin D deficiency, skin problems, malnutrition. At some point, I felt like I had opened a floodgate that I couldn’t control.”
So Faruk opened his wallet at a local market to buy as much medication as he could, but he knew it wouldn’t be enough, particularly in an area rife with poverty and unsanitary conditions. That’s when he began pondering how he could continue the medical care flowing in a village that previously had none.
“I wanted to bring this experience back to the people here,” he said. “Americans are the most generous people on earth, so I started thinking about forming a corporation to bring people together and show compassion.”
He dubbed that endeavor HAPI World (short for Humanity for All People in the World), and has spent the past several months building a donor base to permanently fund the clinic in Bangladesh — as well as look for locations for more such clinics.
For example, Dylan Ramirez, a physician assistant at Mercy, would like to establish one in his homeland of Ecuador, which also suffers from widespread poverty.
“I was inspired by Dr. Faruk’s work,” he said. “I can relate to his story, because I come from an impoverished country, so I know what it means when he talks about child labor, child disease, people drinking dirty water and looking for food in the garbage. I haven’t been in the medical field for very long, but I want to take full advantage of the opportunities I have to give something back. Just to know you can make a big change in someone’s life and future, that’s the greatest thing.”
HAPI World has been raising money by word of mouth and kicking around ideas such as T-shirt sales and a road race, all the while spreading the message that it doesn’t take much of a sacrifice to change lives for the better.
“A few pennies can help prevent rickets, or prevent blindness in children,” he said, referring to the affordability — by American standards — of the most basic medicines and and vitamins.
Yet, he’s dismayed at how little the quality of life in his native land has changed since George Harrison and Ravi Shankar assembled the awareness-building Concert for Bangladesh in 1971. “There are still many problems,” he said. “The infrastructure is suffering because of the cyclones, and the quality of life is poor for villagers. In fact, it’s lower than that of a domestic animal in the U.S. Think about it — a pet has food, shelter, and comfort.”
To maximize his efforts, Faruk wants to take HAPI World national and even has a goal of organizing a 30-year anniversary Concert for Bangladesh in New York City.
In the meantime, he’s focused on keeping his first clinic staffed and supplied with medicine, as well as items such as water-purification equipment and an ambulance-type vehicle to transport the sickest residents to the nearest hospital until they’re stabilized enough to return to the village.
“They’re scared to get out of there, and the district hospital is miles away,” said Faruk. “They can’t walk that far, and they don’t know the culture of the city.”
No doubt many Americans would experience a similar culture shock leaving a nation of plenty and landing in a place with so much need. But Faruk found great satisfaction in his journey back home, and hopes he can urge others to give of their time — and money, too.
“This work gives me so much comfort in a complex world, and every day, I feel like I need to talk to someone about this cause,” he said. “I feel like I should be giving something back to society, to those who don’t have anything. It was difficult to watch how a child can go to bed without food, how children live without medicine, how a person cannot breathe, and you know that simple oxygen or a simple breathing treatment could make a world of difference for them.”
“I believe,” he concluded “that every great thing begins with a small idea.”
And a humble goal of making the world a little bit happier — and healthier.
Dr. Naomi London: Cambodia
 Dr. Naomi London wound up taking care of children with HIV in Cambodia, one of the world’s unfortunate hotspots for the disease. |
“Collective post-traumatic stress disorder.”
That’s the descriptive phrase Dr. Naomi London summoned to describe what she sensed among the people of Cambodia nearly 30 years after the North Vietnamese invaded the country, in what was the beginning of the end of the murderous, despotic Khmer Rouge regime, but also the start of a decade of violent occupation and warfare.
Reconstruction and a sense of stability have come slowly and painfully, and the process is still very much ongoing, said London, a pediatrician at Baystate Health’s Brightwood Health Center who spent seven eye-opening, professionally fulfilling months in that Southeast Asian nation in 2007 at the behest of Doctors Without Borders, or Medecins Sans Frontieres (MSF).
“This country has a lot to heal,” said London, who went to Cambodia as a “pediatric HIV consultant,” noting that it took decades to rebuild a health care system decimated by the Khmer Rouge’s systematic mass murder of doctors and other professionals, and the work is still ongoing. “People there have a lot of issues to deal with.”
One of them is HIV.
In fact, Cambodia is at what experts consider a crossroads with that disease, said London, who told The Healthcare News that this disturbing state explains her trip to that country, which was part of a large effort aimed at stemming the tide with regard to the spread of HIV. The virus, which now affects roughly 2{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of the population (the highest rate in Southeast Asia), has spread throughout the country, an alarming trend facilitated by the proliferation of prostitution following the North Vietnamese invasion.
“If there’s not a big push to contain HIV in Cambodia,” she continued, “there will be a huge outbreak.”
As she recalled the sequence of events that led to her assignment in Cambodia, London told The Healthcare News that, late in 2006, she accepted an invitation to attend what she thought was going to a conference on infectious diseases hosted by Doctors Without Borders, the humanitarian group founded in 1971 that is currently providing aid to more than 60 countries worldwide.
Instead, this turned out to be a recruiting conference, and London, intrigued by what she saw and heard, signed on for duty, not knowing what her assignment would involve, where it would take her, or even if she could get a leave of absence to take part (she did).
Cambodia eventually became the destination, something she learned about a month before she left, and the assignment, well, it was supposed to be mostly of a consulting nature, with London reviewing work that has been done to date — the country has been battling to curb HIV for several years now — and making suggestions on what can be improved. But much of that changed with an outbreak of something called Dengue Fever, a mosquito-borne disease, that coincided with London’s trip and absorbed much of the other doctors’ time and energy.
So London, who split her time between two cities — Siem Reap, a popular tourist spot (the Angkor Wat temple is nearby) that is six hours north of Phnom Penh and Takeo, two hours to the south of the capital city — provided much more direct primary care to patients than she anticipated.
“Each of the hospitals had about 25 beds for pediatric patients, and they had between 100 and 125 patients hospitalized with Dengue Fever,” she explained. “So the physicians were very busy with those patients, and I ended up taking care of most of the children with HIV.”
Each site had roughly 400 to 500 children who were HIV-positive, she continued, noting that the care administered to these patients consisted of evaluation, treatment with medication supplied by Doctors Without Borders, and follow-up.
It was not uncommon to see several children in the same family infected, said London, adding that treatment started with monitoring the patients to gauge their immune functions. “And when the various tests that you do show that the amount of the virus is high or immuno-suppressed, then you want to start anti-viral medications, “ she continued. “It’s important to start with what’s called heart therapy — highly active anti-retro virals, which means you’re using several different anti-virals at the same time.”
Such work was made more difficult by sparse conditions — health care spending in Cambodia is the lowest per capita among all nations in Southeast Asia, said London — and also by that “post-traumatic stress disorder,” as she called it.
“There is still a strong level of mistrust among the people of Cambodia,” she explained. “They won’t trust their next-door neighbor, so they’re certainly not going to trust someone who comes from overseas to ostensibly help them.”
This was one of many observations she made about the people and the country as a whole, which is still very poverty-stricken, with average income of about $100 per month.
While London said she isn’t in any position to say how Cambodia is faring in its battle against the spread of HIV in that country, she believes Doctors Without Borders is firmly committed to help win that fight.
“The organization is used to responding to crisis situations,” she explained. “HIV is something new — it’s not an acute problem, it’s a chronic problem. They know they can’t just go in and out; there needs to be a long-term commitment.”
She told The Healthcare News that her experiences in Southeast Asia were rewarding professionally, and have left her looking to do more work with MSF.
“It was an intense experience, one that was very educational for me,” she said, adding that she exchanged ideas and observations with other MSF participants from Sweden, France, Greece, Ethiopia, Brazil, and other countries, and she still keeps in touch with many of these colleagues via E-mail.
“Some of them are still there, others are in Africa or other places,” she said, noting that news of their work only fuels her desire for additional work overseas — the prospects for which depend on how much leave she can obtain.
Joking, London says she probably knows more Khmer, the official language of Cambodia, than she does Spanish, versions of which are spoken by the vast majority of patients at the Brightwood Health Center. This was no doubt an exaggeration, but it spoke volumes about her short but intense visit to Cambodia and the impact it had on her.
“It was a learning experience on a number of levels,” she explained, “and something I’ll never forget.”
Dr. Rich Lawlor: Brazil
 Dr. Rich Lawlor has been struck by how little time and effort it really takes to make a difference that can last a lifetime. |
Children born with cleft lips and cleft palates have trouble speaking and even eating. In America, all that is usually solved with a quick operation. In many foreign countries, where care is less accessible, it sometimes leads to a life of isolation.
It’s a lesson anesthesiologist Dr. Rich Lawlor learned when he traveled to Brazil last year with an organization called Operation Smile, which sends teams of doctors and other medical professionals around the world to help children born with cleft lips or cleft palates — conditions which, in many cultures, result in not only discomfort, but outright ostracization.
“Many kids in third-world countries are born with these defects, they’re often shunned from society,” said Lawlor, who works at Cooley Dickinson Hospital. “With a cleft lip, the area between the nose and upper lip is not completely fused. There’s a gap, and you can see the gums, and they often talk funny. And kids with a cleft palate are often malnourished and sickly, and in a third-world country, that’s a double whammy.”
Operation Smile’s standard international medical mission is comprised of a team of credentialed medical professionals from around the world who travel to partner countries (there are 26 of them) to treat children over a two-week period. On a typical mission, 300 to 500 children receive full medical evaluations, and 100 to 150 children are surgically treated. With donor support, about 25 trips are planned annually.
In addition, the organization cultivates local foundations dedicated to treating the children year-round — not just post-operative care, but ongoing consultations in dental health, speech therapy, nutrition, and psychology, to further ease their adjustment to society.
And that’s the most profound part of the process for Lawlor — the fact that the traveling medical professionals not only fix faces, but lives. Considering how little time it takes to perform corrective surgery, the visit tends to put life in perspective.
“We’re donating our time to take care of these kids, and it takes only an hour or so to correct a cleft palate or cleft lip,” he said. “But that one or two hours of time can change a kid’s life. Now they can go to school, be accepted in the community, get married, and develop a normal life.”
Lawlor became involved in Operation Smile through his sister, a nurse anesthetist who has joined about six missions over the past decade. It didn’t take him long to appreciate the spirit of giving a little to make a huge difference.
“I didn’t anticipate how many people were donating their time — from nurses to techs to surgeons,” he said. “All these people have similar ideals, and it reaffirms why I went to medical school — just being able to help people.”
“There was one boy in Brazil, 8 years old, whose mother wanted to send him off to school, but he was different from the other kid. So, to save him the ridicule and embarrassment, he worked in the fields of his family’s farm instead. Now he has an opportunity to go to school.”
Everyone on the Operation Smile teams gets to experience stories like that, and it’s reward enough. But another benefit is being able to interact with medical professionals from other countries, which leads to interesting cultural exchanges.
“You’re exposed not only to kids from different parts of the world, but colleagues as well, and that makes the world a much smaller place,” he said.
Operation Smile contributes to that exchange by offering educational opportunities to in-country health professionals during the missions. That outreach may take the shape of a formal medical conference or an informal workshop on a specific skill or technique, all intended to improve the quality of care in that country after the American team leaves.
In speaking with The Healthcare News, Lawlor appreciated the opportunity not only to talk about his own experience, but to let people know that such volunteerism is not uncommon among doctors, even though the work doesn’t always get much attention.
“I was talking to one of my colleagues in my department and found out she had gone on many missions in the past. I’ve worked with her for 12 years, and I had no idea,” he said. “I can think of several people in my department off the top of my head who have gone on missions — a couple of surgeons and internists and a nurse. There are a lot of people in the Valley who do this.”
And why not? It makes them smile right along with their patients.
