By September 2000, the Indiana University Medical School and the Moi University College of Health and Sciences in Eldoret, Kenya, had already been collaborating for a decade. Hundreds of IU medical students, residents and faculty members had traveled to Kenya. Dozens of Kenyan faculty members and students had come to Indianapolis. Cross-cultural lessons had been learned while thousands of impoverished Africans received free medical treatment.
By most appearances, the IU doctors should have been satisfied with the success of the program. But their young Kenyan patients were dying from AIDS by the score, and the anti-retroviral drugs that could save them were not available in Africa. “We were all aware of the AIDS crisis, but like so many others we saw it as such an overwhelming problem, we didn’t know what we could do about it,” says Dr. Robert Einterz, an IU assistant dean and the program’s Indianapolis-based director. “Some of us had the same defeatist attitudes we are fighting against now.”
That September, however, Dr. Joe Mamlin refused to stand by and watch Daniel Ochieng die. When Mamlin first saw the Kenyan medical student, Ochieng was in an advanced stage of AIDS. He was hospitalized, grossly underweight and unable to eat. “A skeleton,” Mamlin says. The Indiana doctor scraped together the money to purchase the medicine he had not been able to provide his Kenyan patients. The anti-retroviral drugs worked their legendary “Lazarus effect” on Ochieng, stealing him from death’s door and guiding him to good health.
Prevention is the watchword for many programs fighting the raging African AIDS pandemic, with scarce funds seen as too precious to be spent treating the millions who are already ill. Ochieng’s resurrection was “the turning point for us,” Einterz says, convincing the IU doctors that treatment has to be a component of the global AIDS struggle.
The IU doctors began to aggressively seek funding for treatment. This past summer, a coalition of foundations awarded the IU-Moi program one of just 12 international grants given to confront mother-to-child HIV transmission in the developing world. The grant provides for HIV care and treatment for mothers, children and other family members, and includes a commitment to lifetime treatment of enrolled patients. Along with other private and institutional donations, the IU-Moi team has created a program that treats nearly 1,000 Kenyans for life. With half of their hospitalized Eldoret patients still dying from HIV, the IU doctors’ goal is to increase the number treated to 10,000.
Even more important, the IU-Moi University collaboration may provide the model for HIV care that can be replicated throughout the developing world. Many observers think simply pouring millions of dollars into anti-AIDS efforts in Africa will not work. Instead, those dollars should be used in careful imitation of a culturally sensitive and time-tested treatment and prevention model. A model, as it happens, like the one being created by the IU program.
One Indiana doctor refused to accept the inevitable, and Ochieng’s life was saved. Now, Mamlin and his colleagues are refusing to accept the death sentences handed to all their African AIDS patients. With a little help, they may end up saving a continent.
To contribute to the IU-Moi partnership, call the program”s offices at 630-6770.