NASHVILLE, Tennessee — Last week, Nashville joined Washington, New York and Seattle as an American capital of global health, at least for a day, when the Vanderbilt Institute for Global Health (VIGH) held the third Tennessee Global Health Forum. VIGH is a member of the Global Health Council, and three of us from GHC were here to speak to the student session and participate in the forum.
Sten H. Vermund, the director of VIGH, told us that the first year this event was called the Middle Tennessee Global Health Forum, but it attracted so many people from beyond Middle Tennessee that they had to change its name.
The day-long forum consisted of plenary and smaller sessions featuring a combination of Vanderbilt faculty and international speakers talking about their global health programs in Cambodia, Guatemala, Haiti, Kenya and Malawi.
One of our favorites was Dr. Jean Pape, founder and director of GHESKIO, which we knew well as the 2010 winner of the Gates Award for Global Health, which is managed by GHC. We selected GHESKIO for its ground-breaking clinical service, research and training to treat and prevent the spread of the HIV/AIDS and other related illnesses in Haiti, as well as its response to treat the sick and injured in the aftermath of the 2010 earthquake.
Dr. Pape’s keynote address, entitled “Redesigning Haiti: A vision for integrative development,” was a rapid-fire, fact-filled overview of Haiti, including its history, its complicated relationship with the U.S. (“It wasn’t always a love affair”) and, of course, its health status (worst health indicators in the Americas, only 4% of GNP spent on health, only two doctors per 10,000 people).
But Haiti has also had notable health successes, namely when childhood mortality plummeted from >40% to less than 1% in one year with the introduction of oral rehydration therapy in 1980 and its success in reducing HIV prevalence to such an extent that it is considered an HIV success story.
But then the earthquake of Jan. 12, 2010 hit, resulting in:
- 316,000 dead
- 240,000 injured
- 80% of Port-au-Prince destroyed
- Damage estimated at 120% of 2009 GDP
Then, with Haiti on its knees, came a cholera epidemic late last year that caused 231,070 cases and 4,352 deaths and riots rocked Port-au-Prince after November election results.
Dr. Pape said the urgent priorities are to prevent and monitor disease in displaced populations and to extend care to hard-to-reach populations in rural areas and slums.
Other priorities cited by Dr. Pape include screening for cervical cancer at all major points of care (prenatal, HIV centers, family planning clinics, etc.) and increasing child immunization rates (Dr. Pape said he is “ashamed” that Haiti has never been able to crack the 50% level).
Despite the depressing history and deplorable situation today in Haiti, Dr. Pape’s main message was optimistic. He said Haiti’s new vision is to “Build Back Better,” and he continues to call for a Global Health Model Village that addresses the major remaining challenge of relocating the 800,000-1,000,000 people still living in tent cities, a number that is only slightly less than the 1.2 million that Dr. Pape cited last July at the Vienna International AIDS Conference.
Dr. Pape already has a consortium of partners signed on, including the international partners of Cornell University, the MAC AIDS Fund, the Fondation Mérieux and the Principality of Monaco).
GHESKIO has had a relationship with the Vanderbilt University Medical Center since the early 1990s. Vanderbilt provides medical expertise and helps train Haitian physicians, and young U.S. physicians gain experience at GHESKIO treating HIV and other illnesses.