Amid the buffoonish Obamacare posturing in Washington, it’s easy to forget that Americans universally, if even through the emergency room, have access to the best medical treatment in the world. If you want to see a real healthcare crisis, then head to the developing world, where 1 billion people don’t have physical access to a hospital, clinic or doctor of any kind. Some 400 million of them live in sub-Saharan Africa. Rural villagers there know that if a child comes down with a fever, the two-day walk for medical treatment can turn a minor ailment into a death sentence.
In West Africa, Dr. Raj Panjabi is testing something that might solve this problem. His non-profit, Last Mile Health, recognizes that putting a hospital or a doctor into every remote settlement isn’t feasible. But training a local villager to perform basic medical tasks and arming him or her with essential medicines can both save lives and create jobs.
So that’s what Panjabi has been doing in Liberia since 2005. This year, 300 “frontline healthcare workers” from Last Mile Health will treat more than 30,000 Liberians, saving a few hundreds lives in the process.
“If you got sick the city in the city, you had a chance,” says Panjabi. “If you were in a rural area, you died anonymously.”
Panjabi knew this first-hand. Born in Liberia, he watched a brutal Civil War swarm across his country; his father disappeared for a month at one point. “Within a few weeks, we’d lost everything,” he remembers. At age 9, his family jumped on a rescue helicopter, and flew towards a new life. Resettled in North Carolina, he went to Chapel Hill, became a doctor and joined the faculty of Harvard Medical School – a ticket to a life of fat salaries and high prestige.
But he never forgot where he’d grown up, and those poor souls he’d left behind. As the Civil War wound down a decade ago, Liberia had just 51 doctors left in a country of almost 4 million. (For a rough equivalent, think about 10 doctors treating the entire city of San Francisco.) In the Liberian rainforest, the densest in West Africa, that number pretty much stood at zero.
Panjabi found the right mentor at Harvard, Paul Farmer, whose Partners in Health has famously tackled the state of Third World medical care. “The numbers are pretty daunting,” says Farmer. “One billion people will go to their graves, often prematurely,” without meeting a healthcare worker.”
Panjabi’s model changes that. Last Mile Health’s village nurses screen for tuberculosis, hydrate those with diarrhea and provide nutritional supplements to newborns. Those with AIDS get anti-retroviral drugs, those with malaria get anti-malarials, those with pneumonia get antibiotics. Basic stuff for Americans – revolutionary stuff in the rainforest.
On Saturday, I had the honor of presenting Panjabi a Global Citizen Movement Award in front of 60,000 people in Central Park (and another 15 million via screens) at the Global Citizen Festival. If he can make this model work so that it scales globally, it will be the first of many more.
By Randall Lane, Editor of Forbes Magazine
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