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In This Issue:
At the bedside of a 7-year-old girl dying of kidney failure in rural Rwanda, Amy Sievers, MD, MPH, faced a dilemma: the government had agreed to pay for the girl’s transplant, but there was no funding available to cover pre and post-operative care. For guidance, Sievers quickly e-mailed Paul Farmer, MD, PhD, co-founder of Partners In Health and associate chief of the Division of Social Medicine and Health Inequalities at BWH.
“Paul told me to start dialysis, and we’d find money to pay for it,” said Sievers. “That’s what this is all about. No child should die because there is no money.”
Sievers, Claire Farel, MD, MPH, and Daniel Palazuelos, MD, MPH, graduated last Friday from the Doris and Howard Hiatt Residency in Global Health Equity and Internal Medicine in the Division of Social Medicine and Health Inequalities. The residency program honors Howard Hiatt, MD, associate chief of the Division of Social Medicine and Health Inequalities, who spoke at the ceremony, and his wife, Doris. The program was established to give residents the training needed to manage the range of clinical, social and administrative factors that affect health care in poor settings.
“These residents get the best training there is, and the opportunity to work closely with the poorest and sickest people on earth,” said Jim Yong Kim, MD, PhD, co-founder of Partners In Health and chief of the Division of Social Medicine and Health Inequalities.
Farmer emphasized the challenges residents face. “You have a whole set of issues that you are just not prepared to take on as a physician in America, such as whether your patients have access to food or to medicine and care that would be routine here,” he said.
Joel Katz, MD, program director of the Internal Medicine Residency, read from the graduates’ applications. “Watching the trajectory from applicants to graduates, these three inspiring physicians have stayed true to their calling,” he said.
During her residency, Sievers completed field work in Rwanda with the national malaria control program, designing community-based prevention and early treatment programs. She also designed and implemented treatment protocols for cancer patients. She plans to seek dual fellowship training in oncology and in infectious diseases at BWH and MGH, preparing her to address the dreadful challenge of cancer in developing countries.
Palazuelos could not attend the ceremony because he was in Chiapas, Mexico, working to open a new clinic and community health centers. His classmate Michael Herce, MD, MPH, a fellow Global Health Equity resident, read his comments. “This opportunity does not exist anywhere else. I have found my calling in life, which has taken me back to my native Mexico.” Palazuelos will become a member of the faculty of the Division of Social Medicine and Health Inequalities as a hospitalist.
Farel focused her residency on the Prevention and Access to Care and Treatment project (PACT) in Boston and worked to improve assessments of adherence to HIV medications. She begins a fellowship in infectious diseases at BWH and MGH, aiming to provide HIV care in underserved areas. “This residency helped me feel that medicine is the right career for me,” she said.
This year’s ceremony included the first annual Marshall Wolf Award in Social Medicine and Health Equity, named in honor of Wolf, who is program director emeritus for the Department of Medicine. Michael Rich, MD, MPH, the BWH physician who is country director for PIH in Rwanda, received the award. “Marshall says there’s always time to be a mentor, to help your trainees become great doctors and teachers. Michael is a remarkable physician/teacher who shares this belief,” Farmer said.
Wolf thanked donors who help make the program possible. “Once in a great while, you meet a resident with giant dreams like Jim and Paul, who can change the world. Your generosity helped Jim and Paul make their dreams come true. Your continuing generosity will provide this opportunity to the next generation of Jims and Pauls: the graduates of this program,” he said.