Einterz ’77 Visit Highlights Global Healthby Steve Charles • October 18, 2012
“Do those of us here in the U.S. have any responsibility or obligation to address issues of infant mortality, maternal mortality, and disease in sub-Saharan Africa?”
That was the question posed by Dr. Robert Einterz ’77 when he spoke Tuesday to students in the College’s Global Health Class about the Indiana University/Moi University-Kenya Nobel Peace Prize-nominated partnership that in many ways has taught the world how to do public health—a partnership Einterz co-founded more than 20 years ago.
“In sub-Saharan Africa, in many countries, infant mortality is 10 to 20 times higher than in the U.S, maternal mortality significantly higher than in the U.S., and there’s a tremendous amount of poverty and infectious disease.
“I’m not going to address the question of our obligation or responsibility at all: That’s for you to decide.
“But let’s assume for a moment that the answer is, ‘Yes.’”
It certainly was for Einterz and his colleagues when they began the partnership between IU and Moi that would later become AMPATH (Academic Model for the Prevention and Treatment of HIV/AIDS, now the Academic Model Providing Access to Health Care).
What began as an organization in Eldoret, Kenya built on face-to-face, one-on-one relationships with a foundation of mutual trust and mutual respect—Americans and Africans working together for mutual benefit—now has treated more than 150,000 patients and serves a large portion of Western Kenya. Its benefactors now include the National Institutes of Health, the World Health Organization and the Bill and Melinda Gates and Rockefeller Foundation, and collaborating universities include Brown, Duke, Purdue, and the University of Toronto, among many others.
AMPATH’s Kenyan-led programs working with the Kenyan government address issues of food security and distribution, communicable disease prevention, clinical and public health services, medical eduction and training, social health, family preservation, and primary care.
In the process AMPATH has reduced the transmission of HIV/AIDS from mothers to their babies from more than 50% to less than 5%.
Yet for all the good effort and news, Einterz says, “It’s not enough.”
"We’re failing despite our progress because there are so many pregnant women out in the community who never come in for care, or do so so late that the antiretroviral drugs we administer do not prevent the transmission from mother to child,” Einterz said. "If we wait for them to come to us for services, even if we do a perfect job in the clinic, we fail. If you want to really address this epidemic, you have to go out into the community. You have to go door-to-door.”
And that’s what AMPATH is now doing in collaboration with Kenya’s Ministries of Health—even in the most rural areas—with its Home-based Counseling and Testing Teams.
“It’s a model that holds promise, for the first time, of diminishing the incidence of HIV.”
Following the presentation, a student asked Einterz about the emotional and physical obstacles Americans encounter when working with the program in Kenya.
“The biggest challenge is being face to face with abject poverty, working in hospitals that could run better, yet knowing you can’t force it to run better,” Einterz said. “When faced with that, how do you respond in ways that maintain your hope and inner drive?
“It all gets back to why you’re here.”
And, as students and Wabash consider their responsibility in all this through the College’s fledgling Global Health Initiative, it also gets back to what a college means when it declares part of its mission is to teach students to “live humanely.” Einterz’s talk was the second event in 10 days for the College’s fledgling Global Health Initiative. He walked into a Hays Science Hall lined with posters from last week’s presentations by students who spent two weeks last summer in Peru led by Professor of Biology Eric Wetzel and Professors Frank Howland and Cheryl Hughes participating in projects focusing on water quality, sanitation and some of the parasitic disease issues that face people in the area. They also worked with an environmental NGO and a local medical clinic to gather information on disease problems in this area.
“I hope this trip will challenge these Wabash men to wrestle with their role in addressing global health issues and how they might use their education, skills, and talents to that end,” Wetzel wrote after the second Global Health Immersion project last August. Several students who remained to talk with Dr. Einterz after his talk on Tuesday were clearly still remembering the people they met in Peru last summer, and were wrestling with, and considering, that challenge.