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The Global Heath Residency Program

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Setting up community health programs in Rwanda
Howard Hiatt Physician
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I indicated that... that Paul and Jim started in Haiti, that the Haitian program has grown greatly. In Peru, the goal of the program, as the goal of the program in Haiti, is ultimately, after training local people, to leave and in Peru Jaime Bayona, Dr Jaime Bayona, the head of the program there, has a group of people who are every bit as skilled now as the people in the program in Boston, and we are really remaining in a collegial relationship with Dr Bayona and his group, but there's very little, much, much less in the way of traffic between our program here and the program in Peru.

In Haiti, too, Haitian doctors, Haitian nurses and community health workers are trained and they're taking over more and more of the responsibility as the program grows there. Indeed, just over a year ago we were invited to set up a program in Rwanda, and Paul started the program there with Michael Rich, one of the young physicians who has been with Partners in Health for some years, and the first step that Paul took was to persuade some of his Haitian colleagues, doctors and nurses and community health workers, to come to Rwanda to help train local people, and what was a hospital that had been abandoned during the genocide 20 years earlier, has, within... within two months, was restored to function, and now is the base from which a second hospital is in the process of being outfitted and a major program in management of HIV/AIDS is underway.

The program that Paul and Jim began using community health workers for, the management of AIDS, is one that more and more people are turning to as the way in which AIDS should be treated with community health workers ensuring that there's no interruption of treatment, that patients who need help are identified at once and that help is recruited for them, and that program has become well known. We're working in Rwanda with the Clinton Foundation and when President Clinton visited the program a couple of months ago, he said to Paul that he hoped that he, the President, could persuade Paul and Partners in Health and our division, to work with the Clinton Foundation in the several places where they propose to go in Africa.

Born in 1925, American Howard Hiatt set up one of the first medical oncology research and training units in the US and has headed up some of America's most prestigious medical institutions. Hiatt attended Harvard College and received his MD from the Harvard Medical School in 1948. He was a member of the team at the Pasteur Institute, Paris, that first identified and described mRNA, and he was among the first to demonstrate mRNA in mammalian cells. From 1991 to 1997, he was Secretary of the American Academy of Arts and Sciences, where he began and directs the Academy's Initiatives For Children program. He is also committed to helping disadvantaged people access decent health care.

Listeners: Milton C. Weinstein

Milton C. Weinstein, Ph.D., is the Henry J. Kaiser Professor of Health Policy and Management at the Harvard School of Public Health and Professor of Medicine at the Harvard Medical School. At the Harvard School of Public Health he is Academic Director of the Program in Health Decision Science, and Director of the Program on Economic Evaluation of Medical Technology . He is best known for his research on cost-effectiveness of medical practices and for developing methods of economic evaluation and decision analysis in health care. He is a co-developer of the CEPAC (Cost-Effectiveness of Preventing AIDS Complications) computer simulation model, and has conducted studies on prevention and treatment of HIV infections. He is the co-developer of the Coronary Heart Disease Policy Model, which has been used to evaluate the cost-effectiveness of cardiovascular prevention and treatment. He is an author of four books: Decision Making in Health and Medicine: Integrating Evidence and Values; Cost-Effectiveness in Health and Medicine,the report of the Panel of Cost Effectiveness in Health and Medicine; Clinical Decision Analysis; and Hypertension: A Policy Perspective.He has also published more than 200 papers in peer-reviewed medical, public health, and economics journals. He is an elected member of the Institute of Medicine of the National Academy of Sciences, and a recipient of the Award for Career Achievement from the Society for Medical Decision Making. Dr. Weinstein received his A.B. and A.M. in Applied Mathematics (1970), his M.P.P. (1972), and his Ph.D. in Public Policy (1973) from Harvard University.

Tags: Haiti, Peru, Rwanda, Clinton Foundation, Partners in Health, Jaime Bayona, Paul Farmer, Jim Yong Kim, Michael Rich

Duration: 3 minutes, 48 seconds

Date story recorded: September 2006

Date story went live: 24 January 2008