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Summer 2005

Making a difference one person at a time

by Alyssa Allen

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Every year, a Christmas card from a Pakistani man named Abid arrives at the home of William Moore, M.D., ’63.

He and Moore met in Karachi in 1988, when Abid, then 19, was considering suicide rather than living another day with the bone infection that had plagued him for 10 years. Moore, an orthopaedic surgeon, performed a relatively simple operation that healed Abid’s chronically draining leg.

One year later, after a day of performing surgery in an International Medical Corps clinic in Peshawar, Pakistan, Moore was told a young man was waiting to see him. Abid and his father had made a nine-hour bus trip in sweltering heat to visit Moore. Abid proudly showed him the range of motion in his knee and then delivered the message that had brought him so far: “Thank you.”

Moore encouraged them to stay, but they had to return to Lahore to open the women’s shoe factory where they worked in the morning. After a 30-minute visit, they boarded the bus for the nine-hour return trip.

“When you get that kind of feedback, you can understand why I love to do this kind of stuff,” Moore said. “This has made me a better human being. The fact that you can leave something behind is the main thing that has helped me over the years, and it will keep me doing this until it’s time to go in the box.”

Moore is among several Franklin & Marshall alumni who are using their medical training in all corners of the globe. Some are retired or practicing medical doctors, and some are public health professionals. They have traveled to countries including Afghanistan, Cambodia, Haiti, Indonesia, Kenya, Kosovo, Nigeria, Somalia, and Sudan. And they don’t consider themselves heroes, just people trying to do their part to alleviate suffering.

Moore, an orthopaedic surgeon who worked in private practice in Salisbury, Md., for 30 years before retiring last year to Santa Fe, N.M., has been volunteering for International Medical Corps (IMC) since 1987. Introduced to IMC, a global humanitarian organization, through a colleague, he now serves on its board of directors. In his travels, Moore trained Afghan medics and doctors during the Soviet occupation, improved medical facilities and training programs in the Cambodian war theater in 1990, and performed surgery while under daily fire in the Somali capital of Mogadishu in 1992. Only his service in the Vietnam War prepared him for that experience.

“I was the only orthopaedic surgeon in a city the size of Baltimore with a war going on,” he said. “The only other was a French orthopaedic surgeon who couldn’t stand the shelling and flew back to Paris after two whole days, leaving it to me.”

When the devastating tsunamis hit the Indian Ocean’s coastal regions on Dec. 26, 2004, killing more than 250,000 people across South Asia, Moore knew IMC would call.

Moore speaking with the locals affected by the tsunami in Lamno

“It didn’t take long,” Moore said. “I had just finished taking a shower after a great day of skiing, and my wife handed me the phone.”

Within 72 hours he was on a plane to Sumatra, leading a 26-person team of surgeons, physicians, and nurses. Moore and three other members of the team headed to Banda Aceh, and the next day he and a doctor from Hawaii began the next part of their journey along the coast.

“We got on a boat that looked like the African Queen, minus Humphrey Bogart and Katharine Hepburn, and went down the coast about 70 miles. A tropical storm came up, with 10-foot seas, so the captain put in to the village of Lamno. We were supposed to go another 50 miles south to Calang, but this provincial capital no longer existed, we found out. There were only 500 survivors out of about 40,000 people.”

The devastation in the wake of the Dec. 26 tsunami

So the team stayed in Lamno, where there was plenty to do. They set up a clinic, where they vaccinated 2,700 children for measles and treated many people for diarrhea, malaria, tuberculosis, and what became known as “Tsunami Lung.” Doctors named the condition after they began noticing a pattern of symptoms—a combination of aspiration pneumonia and a ruptured eardrum, usually on the right side.

Moore and his IMC colleagues preparing for a day’s work

There was little need for surgery at this point. Tragically, people were either dead or they had survived, Moore said. “You go in and you do what you can do. You’re not going to be a hero. The real heroes are the public health people.”

They are people like Mary Kay Smith Fawzi, Sc.D., ’87, who earned a doctorate in epidemiology from the Harvard School of Public Health. In 1997 she joined Partners In Health (PIH)—a nonprofit organization that collaborates with Harvard Medical School and several other partners to improve health care in Haiti, Peru, Russia, and Boston. The group has been on the forefront of the treatment of diseases such as multidrug-resistant tuberculosis and HIV.

Smith Fawzi has been involved in PIH’s efforts at Zanmi Lasante (or “Partners In Health” in Haitian Creole), which provides health care and related services in the Central Department of Haiti. Programs include a full-service hospital, rural Haiti’s only HIV/ TB treatment facilities, a women’s health center, a dozen schools, and several cottage industries.

Smith Fawzi and Haitian children

During her first visit to Haiti in 1999, Smith Fawzi was struck by the devastating conditions, contrasted with the high quality of the hospital. “I think it was very reassuring to see that they offer a high standard of care in such an impoverished area,” she said.

Smith Fawzi travels to Haiti about twice a year for a week at a time and plays a key role in training local hospital staff in research methods, as well as setting up systems for data collection. Her research centers on HIV and other sexually transmitted diseases.

“This excellent facility is largely there due to the good will of people in Haiti and the U.S.,” she said. “Collectively, it really has made a huge difference in saving people’s lives.”

One such person, Marie (name changed), a young woman in her 20s, was so close to death from HIV disease that her father was asking for money for a casket. She weighed 79 pounds and could not get out of bed. Through PIH efforts she was treated with antiretroviral medications. As a result, she gained 26 pounds and regained enough strength to later became a community health worker herself.

Smith Fawzi feels fortunate to be able to work closely with local doctors to conduct research and translate those findings into improvement in people’s health. In the process, her own view of the world has changed.

“I think I am acutely aware on a day-to-day basis of the poor health conditions that people are enduring because of the lack of access to basic services,” she said. “I guess it’s a raised consciousness that drives me to work harder to ameliorate that suffering in whatever capacity I can.”

Barbara Marston, M.D., ’82 also chose a career in public health, first doing her medical residency in internal medicine, then joining the Epidemic Intelligence Service at the Centers for Disease Control (CDC) in Atlanta. Marston attended Emory University for an Infectious Diseases Fellowship and then joined the faculty there. For the last four years, she has been working with the CDC in Kenya, along with her husband Larry Slutsker, M.D., M.P.H., director of CDC’s research field station in Kisumu in western Kenya.

Marston explaining antiretroviral drugs to a client at the New Nyanza Provincial General Hospital in Kisumu

Marston has been involved in HIV prevention and treatment efforts made possible in part by the President’s Emergency Plan for AIDS Relief. Her role includes national coordination of CDC’s treatment programs: predicting, ordering, and ensuring a steady supply of antiretroviral treatment drugs that are used to treat HIV; developing training materials; working on monitoring systems; and supporting sites that are providing treatment.

Many of these supported sites are in Nyanza Province—by far the hardest hit in Kenya. The CDC, through people like Marston, is supporting about 30 treatment sites in the province and working with community groups to improve access to safe drinking water, provide home support to people with AIDS, and assist families who are supporting orphans.

Kenyan women learning how to make pots for safe storage of drinking water

It’s demanding work, but it’s having a major impact—the number of people on antiretroviral treatment in Kenya has grown from an estimated 2,000 people in 2001 to more than 40,000 now.

“Although it is disheartening to see the impact this awful disease is having here, this is very fulfilling work, a wonderful opportunity to see the world (including different cultures and the rich natural resources here),” she wrote from Kenya. “My kids can find Kenya and many other countries on the map, are comfortable with people of all races, and have developed an understanding of the vast inequities in the world.”

 The thriving coffin industry in Kenya due to the enormous impact of HIV/AIDS

Marston, her husband, and their 4- and 6-year-old daughters are looking forward to their return to the U.S. in December, but Marston thinks the return will be tough. She’ll miss the deep relationships she has developed with both American and Kenyan colleagues and predicts that “it will be tough to match this job for impact.”

Time overseas helped Patrick O’Connor, M.D., M.P.H., ’93 see that he wanted to integrate his medical degree with public health work. After graduating from F&M with a ROTC scholarship, O’Connor joined the U.S. Army, serving in Germany during the Balkans War. He later was assigned to work for the United Nations High Commissioner for Refugees field office in Sarajevo, where he was first exposed to humanitarian work.

In 1999, he enrolled in a unique medical school that prepares future doctors with specialized skills in global health and population-based medicine—the Ben-Gurion University of the Negev Faculty of Health Sciences Medical School for International Health. The Israel-based program is affiliated with Columbia University Medical School in New York.

As part of his training, O’Connor spent two months in Tamil Nadu, India, working on rural health care for women and children. His experience there prompted him to take a detour from medical school to earn a master’s degree in public health from the Johns Hopkins Bloomberg School of Public Health.

With that degree completed, it came time for O’Connor to complete his residency, and he thought another project overseas would help him decide on a specialty.

In August 2004, he accepted an assignment in South Darfur, Sudan, with the International Rescue Committee, a nonprofit organization that provides aid to refugees and other victims of violence around the world. He and other workers set up primary health care clinics in two refugee camps. As the clinic manager in Nyala, O’Connor ensured that the clinics were prepared for possible disease outbreaks, conducted public health surveillance, and supervised health care workers.

The patients they saw had been displaced by the genocide for months, O’Connor said. They saw many cases of infectious diseases such as measles, meningitis, and malaria, as well as diarrhea, respiratory problems, malnutrition, and dehydration.

A large part of O’Connor’s work was training Sudanese medical professionals. “There was a real dedication and understanding (among the Sudanese) that this is our country and this is our problem and we want to be involved in helping to fix that,” he said.

After nine months, O’Connor returned to the U.S. and is now completing his residency in family medicine at Drexel University in Philadelphia.

Though O’Connor was overwhelmed by the need in Darfur and frustrated that he could not help everyone, he focused on the difference he was able to make. “If you can treat 35 people in a day for malaria that probably won’t die from malaria, you think ‘OK, this is good,’” he said. “If all the agencies that are there are able to do a little bit, then perhaps we will be able to make a small difference.”

One “small difference” after another has amounted to a world of change for the Jos University Teaching Hospital, located in Jos, Nigeria, thanks to Robert Ford, M.D., ’58. In 1988, Ford knew he was interested in using his medical training to help overseas; he just didn’t know where. A Nigerian colleague at the University of Pittsburgh Medical Center where Ford worked as an obstetrician/gynecologist said, “Why don’t you go to my country?”

A year later the two had founded the World Health Mission (WHM), with the goal of providing medical services, training for medical professionals, and equipment to Jos University Teaching Hospital.

In November 1990, Ford made his first trip to Jos. Since then he has been back 12 times, each time bringing a team of medical professionals. He made trips while working in private practice at North Hills Obstetrical and Gynecological Association near Pittsburgh for 35 years, and continues his involvement since his retirement in 2002. His wife, Karen, is also integral to the whole operation as the one who organizes the group’s transportation and its huge amounts of cargo.

“A couple of people have said the greatest thing we have provided them is hope,” Ford said.

Over the years WHM has donated seven ultrasound machines and provided imaging training to the hospital staff, which led to the founding of the first ultrasound technical school in 2002. WHM established the hospital’s first medical library with Internet access, began the first cytology course to train technicians to screen for cervical cancer, and conducted large screening programs for hypertension and diabetes, two conditions that are under-diagnosed in West Africa. WHM also supported the World Health Organization’s Safe Motherhood Initiatives concentrating on diagnosis and treatment of hypertension, infection, and hemorrhage in pregnancy.

Ford feels that WHM has successfully carried out the four founding principles of the organization: Serving Others, Working Together, Sharing Ideas and Knowledge, and Giving Hope. As the hospital has been transformed, so too has Ford: “The people overseas have energized me as much as I have energized them.”

When Adrian Morrison, D.V.M., Ph.D., ’57 met Robert Ford at a Phi Sigma Kappa reunion in 2001, he jokingly asked whether he needed a veterinarian to come along for a trip to Nigeria. A few months later, Ford called Morrison and said he needed a basic scientist—Morrison fit the bill perfectly.

After earning his doctorate in veterinary medicine from Cornell University, Morrison earned a Ph.D. in anatomy from the University of Pennsylvania, with a specialization in the nervous system. For 45 years, he has studied the brain and basic sleep mechanisms at Penn. Now an emeritus professor, he continues to teach and do his research in the veterinary school. A new five-year grant from NIH will keep the latter going.

Morrison walks with local children in the Nigerian countryside

In November 2002, Morrison joined one of Ford’s teams on a two-week trip to Jos to teach comparative anatomy to students who are considering medical school. He has been back twice since then.

During his trips, Morrison befriended the chief of the Butura region, who honored Morrison by designating him as a war chief. Morrison responded by providing the funds to refurbish a decrepit school there. “I felt like it would be an empty honor if I did not help my people,” he said.

“I guess it grabs you,” Morrison said of his service overseas. “You just see natural, nice people who can use your help.