It is with great pleasure that today we announce Global Health Service Corps (GHSC) is changing its name to Seed Global Health. As many of you know, we have been considering a name change over this past year to better capture the full scope and mission of our work and to better distinguish our cause. We believe this new name better represents our efforts to cultivate stronger, sustainable health systems through training new generations of physicians and nurses in countries where they are needed most.

Originally published in Roll Call.

A decade ago, as I was beginning my time as Senate majority leader, bipartisan consensus in Washington helped launch a new era of progress in global health just when it was sorely needed. Twenty years had passed since I first saw AIDS patients in Boston, though at the time we didn’t even have a name for this savage disease. Advances in treatment and technology were helping control HIV in the United States, but AIDS was decimating communities worldwide. There were tens of millions of infections, yet only 400,000 people in low- and middle-income countries had access to lifesaving antiretroviral therapy, meaning only a tiny fraction were able to escape death.

World leaders united to tackle AIDS and other scourges through an innovative financing tool — the Global Fund to Fight AIDS, Tuberculosis and Malaria. President George W. Bush and Congress made a founding pledge of $300 million to the international initiative. Bush, with bipartisan support from both chambers of Congress, also established the President’s Emergency Plan for AIDS Relief, the largest program ever to combat a single disease. President Barack Obama has similarly embraced this program and America’s role in eradicating this disease.

U.S. leadership at the Global Fund, and bilateral health programs such as PEPFAR and the President’s Malaria Initiative, signaled a renewed commitment to a core facet of our country’s greatness: compassion for those most in need. Understanding that improving global health is good for national security, economically prudent and — most importantly — the right thing to do, the U.S. taxpayers made an unprecedented investment in the world’s future.

That investment is paying off.

As we mark the 10th anniversary of PEPFAR this year, the number of people on lifesaving treatment has increased more than twentyfold. HIV infection rates are down. The number of malaria cases has plummeted by more than 50 percent. Tuberculosis mortality rates are falling steadily. The Global Fund alone saves an estimated 100,000 lives each and every month, working in more than 150 countries. These health gains were once unimaginable.

A new chapter in global health begins this month as visionary leader Dr. Mark Dybul takes the helm as executive director of the Global Fund. With so much gridlock in Washington, Dybul’s appointment is a reminder of what we can accomplish by reaching across party lines.

Dybul, who began as a physician treating AIDS patients in the early years of the pandemic, helped transform the fight against the disease as the architect and leader of PEPFAR. Now at the Global Fund, he will lead the charge to defeat AIDS, malaria and tuberculosis. Armed with scientific expertise and dedicated to a mission that goes beyond political ideology, there may be no one better suited for the job.

Today there is real hope in this fight — but it’s far from over. We have the science to help people with HIV live healthy lives, but millions still lack access to the treatment they need. We can detect and treat TB, but drug-resistant strains represent a growing threat, and disease respects no borders. And malaria still takes countless lives each year, though it can be stopped with basic, incredibly cheap prevention.

The next two weeks I found myself much better able to engage in the hospital system. Now I had learned the names of Benson, Mugo, Humphries all clinical officer or medical officer interns. It became my pleasure on night and weekend call to lead them through surgical triage or procedures. On subsequent calls I was able to help one of the medical officer interns through two chest tube placements. These patients had spontaneous pneumothoraces, but were not in extremis, thus I could take my time and coach the intern through the procedure. By the second placement, Mugo was able to anesthetize the patient appropriately, make the incision, and perform this life saving procedure. He remained a bit tentative, but I had seen vast improvement by this second time. These guys and gals are the front line of the Kenyan medical system, and are seeing patients in isolated places with no surgeons, or even residency trained physicians available. Teaching Mugo to place a chest tube well could benefit multiple Kenyan patients in the future.

FGHL Blog: Jason Axt - Extreme Medical Issues in the Field

Warning: This post contains graphic medical images.

Feb 28 2013

Warning: This post contains graphic medical images.

This week started with an orientation to the hospital. I learned where the theatres were, where the clinic patients were and the location of the wards. Patients were housed in common sleeping rooms with 4 – 20 patients per ward, with men and women housed separately. I was introduced to Dr. Irungu, the Kenyan consultant whose service I would join.
Spoiled. That’s the only way to describe how I feel heading back to the states. I feel that I had the opportunity to practice medicine the way my 6-year-old-self imagined it while in Guyana and I couldn’t be more thankful for the experience.
January 13

I can’t believe my time here in Haiti is over—but it is. I’m
writing this from my guesthouse in Port-au-Prince, in preparation for
my flight home tomorrow.

I would like to thank Senator Frist for forming the Frist Global
Health Leadership Program, and for allowing me to have come to Haiti
to work at HIC. I’d also like to thank the many people at Vanderbilt,
Dartmouth, and HIC who helped me make the needed connections and
organize the details of my trip. Last but not least, I’d like to give
a special shout-out to my boyfriend, for supporting and encouraging me
to leave him—and the U.S.—for three months and go work in Haiti.
Thank you.
Happy New Year!

Apart from working at the maternity this week—and getting to celebrate the arrival of 2013 with laboring women and their new babies—I’ve been busy completing the list of HIV+ women who have been lost to follow-up. From March of 2009 until November of 2012 there were 240 women who started receiving HIV care at HIC, but now no longer are doing so. I really hope that the social worker and the community health workers will make use of this list and that some of them will be found and restarted with their HIV care. I am however, not incredibly optimistic that many women will be located. The social worker and community health workers are already very busy and to try to track down 240 women—with little more than their names, dates of birth, and possible addresses—seems very ambitious. But I feel that if even one or two women are found and are restarted in care that my work on the list was worth it.
I returned to Samaria with a Clinical Officer, Waweru, in tow to staff Samaria for the week in Susan’s absence. Susan has an obligation to attend training and program review for her participation in Tunza the family planning program supported in part by USAID. If Susan is not able to find a substitute during her absence, then she must close her clinic. In this case it would have been for 4 ½ days, difficult on the patients and Susan’s income. Even so, engaging a substitute adds costs to clinic expenditures, that may or may not be recouped from leaving the clinic open. This underscores the difficulty that private clinic nurses have in taking time away from their practice if they are the sole practitioner. It is difficult to engage in continuing education, a must for any clinical practitioner, if the economics and finding a trusted substitute are onerous.
As I mentioned in my last post I’ve struggled with practicing as I’ve been taught and believe is best while also trying to respect how my Haitian counterparts were taught and what they believe is best practice.

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