On August 7, 2013 UCSF Global Health – Hospital Medicine Fellows and the Fellowship Directors joined the Harvard Global Health Equity Residents and select leaders of Partners in Health in Cange, Haiti for an informal evening discussion as part of our training “bootcamp.”

As a student of global health it was surreal to hear some of the most experienced members of Partners in Health (PIH) talking sincerely about their experiences in Haiti, Mexico and Rwanda. Thanks to popular media, their dedication and commitment to serving the most neglected populations around the world is well known. However, I truly believe it takes a face-to-face interaction to realize the passionate flames for social justice still burning bright in eyes that have been staring down such problems for decades. It is this undying grit that gives us inspiration, but also models the kind of uncompromising action needed to address seemingly infinite maladies.

I had first heard Dr. Paul Farmer speak on a projector in an overflow-auditorium at the NIH in 2007 (after my third year of medical school). Embarrassingly I didn’t know who he was at that time, and can’t remember exactly what he spoke about – but his unlimited enthusiasm and explicit commitment to social justice for the poor had reverberated in my conscience.  Tonight he warned of the potential mistake in attempting to pursue our mission in global health alone. He reminded us that there now exists a vast community interested in, and expert in, the delivery of quality healthcare to neglected populations. He urged us not to let this cadre go to waste.  His poignant request to work together rather than attempt to tackle problems alone was supported by his reflections on the adversity faced by original PIH staff thirty years ago. In addition to violence, politics, and very little personnel engaged in global health work, he joked how the lack of literature, cell phones, and internet added further challenges to an increasingly desperate situation.

I found the words of PIH Chief Medical Officer Dr. Joia Mukherjee particularly touching when she mentioned that working for Partners in Health “was my first, and will be my last job.” Her comments throughout the evening underlined her upmost belief in the need for collaboration with local communities, physicians and healthcare providers.  She emphasized the word ‘local’ – and beseeched us to try harder to ask earnestly what the community wanted. Furthermore, she outlined the need to cooperate rather than undermine healthcare ministries in the places we aspire to work. Her words held particular significance for me – on previous volunteer trips to Haiti I witnessed the ill effects of well meaning NGOs following their own notions of what was needed rather than seeking the opinion of who they aimed to serve.

Both Dr. Farmer and Dr. Mukherjee acknowledged the importance of the name of Partners in Health by recognizing a vital Haitian team-member Dr. Fernet Leandre who started his social service year after medical school in Cange, and has been working with them ever since (for the last seventeen years). Dr Leandre related his work with PIH frankly stating: “I was watching children die, because parents could not afford the prescriptions… and I was looking for a way to increase my patient’s access to care.”

Ultimately the collective knowledge of the experienced physicians present at the discussion reminded me that global health must be grounded on a local level – and partnerships are always more important than single persons.

Varun Verma, MD – UCSF Global Health – Hospital Medicine Fellow

The Global Health Hospitalist Medicine Fellows (left to right): Alexandra Stanculescu, MD, Varun Verma, MD and Robin Tittle, MD.

Haiti