Saturday 11 July 2009

Moving into high places


About a decade ago we were setting up what was then a small TB programme at Nav Jivan Hospital in Jharkhand.

Sheba had just joined us and brought with her the rigorous approach to TB treatment that Dr. Raj her mentor at the Christian Fellowship Hospital Oddanchataram had drilled into her. I had the data from a previous study that showed only 20% of patients completed their treatment at Nav Jivan. Repeating the study with a group of medical interns from Ireland showed even less - only 17% documented completing their treatment.

One day we were visited by an old friend of Sheba. Dr. Raj Singh was the older brother of a school friend. Raj had since medical studies and was appointed to the Revised National TB Control Project. He came to visit us along with an American advisor to the government on TB issues - Dr. Tom Friedman.

I just found out that Dr. Friedman has been appointed by Barack Obama to be the head of the Centres for Disease Control and Prevention (usually called the CDC). It seems a long way from a small hospital in Jharkhand to being a shaper of US public health policy. Through its first rate epidemiological research and various links with international agencies, scientists at CDC continue to be a formidable force in shaping public health policy. Our Indian Council for Medical Research is a pale shadow in many ways - barely able to make its voice heard - and often drowned in bureaucratic dullness as it plods along with uninteresting and barely relevant research.

Tom Friedman has played a high profile role in between his stint advising the Government of India on TB policy and the current position at CDC - he was the health commissioner for the city of New York - a city which continues to have a far greater effect on world affairs than many countries.

What I remember him for in the short visit there in Jharkhand was Tom's earnest and positive questions about our work on TB control - and the total enthusiasm he was able to evoke in Dr. Singh and the others in government TB control work at the time. If Tom Friedman able to enthuse others like he did Dr. Singh, then his legacy in public health will last a long time.

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Post script: the small TB control programme we started in response to the poor patient completion data at Nav Jivan has grown by leaps and bounds since we left. Thanks to the hard work of Dr. Arpit Matthew, Dr. Jeevan Kuruvilla and Dr. Chering Tenzing, the hospital has now been designated as a TB unit - coordinating all the TB work in the Latehar district. Hundreds of patients have successfully completed their TB treatment - lives have been changed - communities helped. We are greatful to God for what he has done through modest beginnings - and hard work of so many!

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