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Health Care Heroes
Ethan Zuckerman, 6 Jun 07

“Health and Heroism” is the theme of the second session this morning. Chris Anderson introduces the session by framing some of the difficult health issues, using maps from WorldMapper.com, cartograms that distort the world map to show statistical factors. Maps that show HIV prevalence and malaria prevalence inflate Africa to a huge size; maps that show public and private health spending and working physicians shrink Africa almost to invisibility.

Lisa Goldman, in a three minute talk, reminds us that we’ve got tools that are effective against malaria: artemisinin, interior spraying with DDT and insecticide impregnated nets. The nets cost roughly $10 each and last 5 years - the problem is distribution, as they’re bulky and hard to transport.

Ernest Chijioke Madu picks up an earlier theme: HIV and malaria are huge problems for Africa, but we need to address more “conventional” healthcare issues as well. More people in Africa die from heart disease and stroke than in the US. Cardiovascular disease kills 17 million people a year. 85% of global mortality is in developing nations, but 90% of medical spending and resources are in the North.

“What will happen if you have a heart attack in your hospital room?”, Dr. Madu asks us. Fly to the US? You’ll die - half of people die within 24 hours without treatment. You’ve got to have local care in developing nations. “If you cannot secure the parents, you cannot secure the health of the African child.” The local statistics are worrying: 30% of Tanzanians have hypertension, and less than 20% of them are getting treatment for it.

It’s possible to do world-class healthcare in the developing world. Dr. Madu introduces us to his work with the Heart Institute of the Caribbean in Jamaica. It looks like a remarkable facility, providing state of the art imaging, using a central imaging server to share diagnostic data and an electronic record system. Technology systems are easily repairable and multimodal - many are built on site, and the center has developed a strong technical staff which can repair equipment and generators. There are now three centers in the Caribbean, expanding to a fourth. The project is so successful that the next frontier is a center in Nigeria.

The most remarkable thing about the HIC is that no patients are turned away for inability to pay. The center provides about $85,000 a month in indigent care in Jamaica, taking in patients the government can’t pay for. Wealthier Jamaican patients have stopped traveling to Miami for care - instead, they pay less at HIC for similar quality care, and their payments subsidize indigent care.

The center is also focusing on prevention, leading pro-exercise campaigns, including group walks and exercise competitions, that give rewards for group weight loss and total miles walked.

New frontiers go beyond Nigeria, and include other medical focus areas, including dialysis. What’s most impressive about Dr. Madu’s talk is how matter of fact it is - he’s going to build as many centers as he can, and he’s got a model that works. It’s very impressive.

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