SPH Student Demonstrates Compassion Without Borders

[an error occurred while processing this directive]

November 11, 1999

SEARCH THE GAZETTE

HARVARD GAZETTE ARCHIVES

By William J. Cromie
Gazette Staff

A local worker from Uzbekistan sits in Uzbekistan near Nukus, where the shrinking of the Aral Sea has left boats high and dry, contributing to high incidences of tuberculosis.

A doctor never wants to see a patient die, particularly when he or she knows it’s possible to save the patient. The 16-year-old girl suffered from multidrug-resistant tuberculosis – the same malady that killed her mother and father. Dr. Michael Rich knew that drugs used in the United States probably could cure her. But at the time he was working in a small town in Uzbekistan, a former Soviet republic in Asia, where such drugs aren’t available.

"We treated her for a number of months with the medicines we had," said Rich. "But it wasn’t enough."

Rich, now a student at the School of Public Health, was working earlier this year with Doctors Without Borders, the organization that recently won the Nobel Peace Prize. This group treats wounded, sick, and starving victims of natural disasters, wars, and political upheavals no matter what their political or religious affiliations. The organization also speaks out against governments who oppress or neglect people.

Rich, 37, decided he wanted this kind of life while serving in the Peace Corps in Cameroon, West Africa, after graduating from college.

"I worked as a high school teacher in Cameroon," he recalls. "I was sick a lot, ending up with malaria and a couple of other parasites. But I was also amazed at the power of medicine to relieve such infections."

Rich rows across the Amudar River with two Uzbeks from Nukus, the town where he worked with tuberculosis patients.

Rich earned an M.D. from the University of Massachusetts at Worcester, then worked as an internist in a community health center in Lynn, Mass. But his true interest has always been international health.

"Many people are motivated by money, power, and sensual pleasure," Rich notes. "That’s not necessarily bad, but these things do not always lead to happiness. For me, what’s most important is understanding others and having compassion for them."

In short, he was an ideal recruit for Doctors Without Borders.

Victories And Defeats
The group was organized in Paris in 1971 as Médecins Sans Frontieres. The founders, young doctors working for the Red Cross, felt stifled by rules that prevented them from speaking out against political injustices that contributed to the suffering they saw. Since then, Doctors Without Borders has been expelled from several nations for publicly denouncing mistreatment and neglect by authorities.

This combination of humanitarian aid and calling attention to iniquities made them an ideal candidate for the Nobel Peace Prize.

At first, the organization was small and ill-equipped. Today, it supports 2,000 volunteers working in 80 countries, 20 of them in areas of armed conflict. The Peace Prize includes a cash award of $960,000, which will help the organization meet annual operating expenses of about $280 million.

When Rich applied to Doctors Without Borders, they offered him the opportunity to go to Uzbekistan. The job involved control of tuberculosis and of infectious diseases in children. "Both of these things interested me, so, after reading up on the place, I took the job," said Rich.

Watching a young girl die whom he had grown close to saddened him. But his experiences, like those of other volunteers, involved victories as well as defeats.

"Most of the TB patients we treated got better, and that’s a great source of satisfaction," Rich notes.

A pa rticular victory he remembers involved correctly diagnosing a patient as having a collapsed lung caused by TB. With no X-ray equipment available, Rich made the diagnosis by listening to the man’s breathing. An Uzbek surgeon then corrected the problem.

Rich was also able to assist in the treatment of children with diarrheal diseases and acute respiratory infections, two of the common killers of young people in that area.

Much of Rich’s work concerned setting up new programs for TB control. "Their method of treating the disease is cumbersome and expensive," he says. "Doctors Without Borders is trying to introduce more low-cost and effective programs. Also, not having the proper medicines for multi-drug-resistant TB is very frustrating. The disease amounts to a death sentence there. We hope to change that."

A Harvard report, released Oct. 28, says that multi-drug- resistant TB is spreading faster than anticipated, especially in the former Soviet Union, and threatens to become a global epidemic that eventually will reach the United States.

Pursuing A Passion
Rich was impressed by the camaraderie among the medical volunteers, doctors, and nurses in the Uzbek hospital, and national and local administrative staffs. "We got together to celebrate every conceivable occasion from the birth of a baby to a guest arriving in the area," he recalls. "We attended many lunches and dinners where everyone at the table would get up and offer a vodka toast."

Before going to Asia, Rich had decided to attend the Harvard School of Public Health to specialize in international health.

"My experience with Doctors Without Borders firms up that decision," Rich comments. "I get a great deal more out my classes now after six months in the field dealing with both patients and administrative problems."

After he graduates in June 2000, Rich will look for a career "that allows me to kee p learning and to relieve the suffering of others in different places around the globe. I feel lucky that this is my passion and that I can pursue it."