Published in the March 2008 issue of Today’s Hospitalist
AS MEDICAL DIRECTOR for the hospitalist program at Nash General Hospital in Rocky Mount, N.C., William Harden, MD, says he sees too many AIDS patients who suffer needlessly because they refuse to take their antiretrovirals.
While noncompliance with lifesaving medications would irk any physician, it’s particularly frustrating for Dr. Harden. That’s because in areas like Africa, where he leads medical missions every year, those medications are unavailable or too costly for most patients to afford. Dr. Harden helped build an AIDS clinic in Uganda in 2002, one that he continues to visit and help maintain. This May, he’ll lead his third mission to Zambia, where he estimates that the prevalence of AIDS is 20%.
His 12-member teams, which include physicians, physician assistants, nurses and pharmacists, spend between seven and 10 days on each trip. “We can see an average of 5,000 to 8,000 patients,” says the 61-year-old hospitalist.
Logistically, each trip is a nightmare, he notes. The team travels with more than 1,000 pounds of baggage, which includes surgical and medical supplies.
Teams also bring flip flops, hats, clothing, soap, over-the-counter medications like calamine lotion and antifungals “and drugs. “We buy some medicine in-country,” Dr. Harden says, “such as scabies medications and mebendazole, when they’re too expensive in the U.S.”
He tries to coax pharmaceutical companies into donating drugs, particularly ones that are expired. Dr. Harden estimates that the retail value of the drugs that each mission brings is around $175,000.
That’s a drop in the bucket in countries with epidemics of AIDS, malaria, measles and meningitis. At his clinic in Northern Uganda, 500 patients are on a waiting list for antiretrovirals. The nearby 200-bed hospital where mission surgeons operate serves a half-million people, has electricity four hours a day and typically stocks only 20 vials of ceftriaxone.
Team members, who come from throughout the U.S., pay their own way. But Dr. Harden says that it’s impossible to put a price tag on what they receive in return.
“I tell them that if you think you are going to go for 10 days and change something in Africa, you are wrong,” he explains. “It’s going to change something in you.”
Go online to www.westminstermedicalmissions.com for more information on Dr. Harden’s work.