Designed to saves lives: Cholera, Haiti and the MASS Design Group’s latest clinic

The New York Times reports on the latest effort by the Boston-based MASS Design Group,  a cholera clinic in Haiti designed to so that natural ventilation — sea breezes — will lower transmission. Cholera reportedly arrived with aid workers after the island’s devastating earthquake. The story appears in the “Well Design” column, which reports on architecture and health care.

The clinics here are simple, even handsome. Instead of constructing hermetic shields in the form of airtight, inflexible hospital buildings, the architects took advantage of Haiti’s Caribbean environment, exploiting island cross breezes to heal patients and aid caregivers.

It’s not clear yet how well the clinics will work. They open soon. If they turn out right, they could serve as relatively light-footed models for other struggling countries that lack resources for high-end Western-style hospitals.

Building Better Builders from MASS Design Group on Vimeo.

How to feel a little bit better about ordering a $42 steak

Some need the excuse of a birthday or anniversary to splurge at celeb chef Jody Adams’ Rialto. Entrees at the Harvard Square restaurant run from $26 for roasted eggplant agrodolce (golden raisins, pine nuts, mozzarella, saffron tomatoes, chickpea arancini ) to $43 for grilled Tuscan sirloin steak (portabella, arugula, Parmigiano Reggiano, truffle oil).

For those interested in global health, here’s another. Louinique Occean, Rialto’s hePHIad baker, and Adams, James Beard Award-winning chef, are working with Partners in Health to create healthy meals with local ingredients at University Hospital in Mirebalais.

“Occean, who is Haitian-American, and Adams, a PIH trustee, have come at the request of the medical team to help the kitchen staff make healthier meals for patients, using locally sourced ingredients.

In Haiti, lack of access to nourishing food is at the root of many health problems. About 22 percent of young Haitian children show signs of chronic malnutrition. Doctors and nurses often see poor nutrition exacerbating the effects of other health problems, including tuberculosis, HIV, and diabetes. Malnutrition puts women at greater risk of dying in pregnancy and childbirth.”

Link here to her recipes.

Here is another tip for PHI supporters. For everyone who takes PIH’s 3-question, online quiz, a donor will contribute 50 cents to PIH’s maternal health efforts.


Harvard event: Can mobile apps improve health care in South Asia?

harvard event

Here’s how Wired describes HealthTap “A network of patients and doctors where patients can find doctors, and ask medical questions of specific physicians (for a fee) or to entire network. HealthTap already rates the doctors in its system based on how often they use the site to answer patient questions, and if other doctors agree with those answers. Now it’s adding information about which doctors get referred to the most so patients can find the most trusted MDs.”

Founder Ron Gutman will be at Harvard today to talk about  using the technology to improve health in India.

At 4 p.m.  in room K262, 1737 Cambridge Street, Cambridge. Free and open to the public.

For more health events this week, check out the BHN calendar.

Also, check out the story from “Daily Dose” blogger Deborah Kotz for the latest on good fat v. bad fat. 

What’s…clear is that Americans often received bad advice to eat as little fat as possible when it was first discovered that reducing saturated fats could reduce cholesterol, and especially after researchers demonstrated that the practice could prevent heart attacks. Too many of us embraced fat-free cakes and cookies after swearing off cheddar cheese and steak — and often gained weight as a result of the excess sugar and calories.

Partners in Health patron Tom White dies at 90

There would probably be no Partners in Health without Tom White, the Boston builder turned philanthropist who died yesterday.  He not only seeded the bold medical aid group, White believed in them when no in public health did. In today’s Globe obit, Dartmouth president and PIH founder Jim Kim called White “the real patron saint of hopeless causes. “He allowed us to tackle what are quite literally the most difficult health problems in the world,’’ including drug-resistant TB and untreated HIV. (Kim named his son after White.)

White in Haiti © PIH

In addition to the Globe story, see PIH’s own tributes, including one from Tracy Kidder, who followed PIH doc Paul Farmer around for a year for the book “Mountains Beyond Mountain.”

Recalling his first meetings with Paul Farmer, Tom said, “Paul was a lot younger than me, but he was way ahead of me, on service to the poor.” He smiled and went on, with a trace of wistfulness in his voice: “Sometimes I think how much money I used to have, before I met Paul Farmer.” Then he added, “But that’s all right. They give me a big steak now, and I can only eat half of it.” 

More here, including pictures.

Boston conference on technology and global health.

The World Health Medical Technology Conference, was a “workshop dedicated to exploring the opportunities and challenges of designing, building and funding medical technologies for the developing world.”

In other words, trying to find inexpensive tests and treatments that are simple to use and don’t require a lot of infrastructure, like labs and clean water.  

BHN sat in on the morning sessions at BU, which features presentations from local groups, including Cambridge’s “Diagnostics for All.”  Una Ryan, the group’s CEO, said: “We have all this advanced and innovative technology and we don’t know how to get it to the people who need it the most.”

So, the non-profit has created a tiny, paper diagnostic tool that works like a home pregnancy test.  Imagine a miniature game of Twister. Instead of a foot, health care worker can put a drop of blood on one of the dots. The dot then changes color based on, say, how well the patient’s liver is functioning.

 Since hepatitis and drugs for HIV and TB can cause liver damage, this simple, inexpensive test will allow docs to monitor patients even if in remote villages with no roads and a couple of generators for electricity.  The costs – ten cents. The group plans to use the technology to give rural health workers tools to test for and monitor TB, malaria, HIV/AIDS, and diabetes.

The session also featured a presentation on a Seattle group called PATH, which describes itself as an international nonprofit organization that creates sustainable, culturally relevant solutions, enabling communities worldwide to break longstanding cycles of poor health.” Among other projects, PATH is   working with a Cambridge start up called Daktari on an inexpensive hand-held device that can perform key blood tests on patients with HIV/AID.

Daktari was founded in 2008 by Bill Rodriguez, who has worked at both Harvard and at the Clinton Foundation, and Mehmet Toner, a Harvard/MIT engineer.

Innovation was the theme, as the morning speakers said many existing devices simply can’t be adapted to work in communities without water, doctors, or electricity.

“The technologies we use to diagnose diseases are way too complex,” Rodriguez said. “They were never designed to work in these settings.”

So for details, check out the Mass Device blog.


Infectious disease and Bostonians from Africa

Passing this along from the Running a Hospital blog, which is run by BIDMC chief Paul Levy. 

According to World Health Organization reports, nearly half of deaths due to infectious diseases globally, occur in the Sub-
Saharan Africa. Particularly, of all the people infected globally
by various diseases, 89% of those infected by malaria, 77%
of HIV/AIDS patients and 31% of Tuberculosis patients, in Sub-Saharan Africa die of these diseases.

There is a large population of Sub-Saharan Africans domiciled
here in Massachusetts.
The African Community Health Initiatives
(ACHI) has stepped up to help, not only to provide appropriate
education, but has increasingly become a conduit through which
people of African descent are sought after, screened for health
insurance, health/social service needs, and assisted with application/referral to appropriate health/social service providers.
ACHI also assists in the enrollment of clients in the Massachusetts state health insurance plans, namely, MassHealth and Commonwealth Care.

Gates Foundation under the spotlight

Aid groups built this well and supplied the bicycle to a child disabled by polio

Aid groups in Cambodia built this well and supplied the bicycle to a child disabled by polio. Photo by Tinker Ready, 1996

One saying about international aid goes something like this – Give a man a fish and you feed him for one day; teach him how to fish and you feed him forever.

Then there is another point of view – Give the guy the goddamn fish — he’s starving! Then worry about fishing lessons.

Having spent a year covering dysfunctional Cambodia, I learned a bit about international aid. These folks mean well, do a lot of good and face a lot of complicated issues. For example, do you want to hand a new hospital over to the government if you know they are going to turn it into another corrupt fiefdom?

The British journal The Lancet has a piece this week on one of the world’s biggest aid donors – The Bill and Melinda Gates Foundation.

Here’s what AP had to say about it.

 SEATTLE (AP) — A new study of the Bill and Melinda Gates Foundation illustrates its global reach with spending on health issues, but notes a need for accountability on whether the money is being spent in the most effective way.

The world’s largest philanthropic foundation focuses its global health giving on eradicating diseases such as malaria and AIDS. It also works to aid agricultural development in Africa and Asia and improve education in the United States.

”What we have is a private actor with a huge degree of influence, but not really a mechanism by which that influence is held to public account,” said Dr. David McCoy, the primary author of the study.

The Gates foundation was also the subject of a story from the journal Foreign Policy, which I read in the UTNE reader. The title says is all – “The New Colonialists.”

In much the same way European empires once dictated policies across their colonial holdings, the new colonialists—among them international development groups such as Oxfam, humanitarian nongovernmental organizations (NGOs) like Doctors Without Borders and Mercy Corps, and mega-philanthropies like the Bill & Melinda Gates Foundation—direct development strategies and craft government policies for their hosts. But though the new colonialists are the glue holding society together in many weak states, their presence often deepens the dependency of these states on outsiders. They unquestionably fill vital roles, providing lifesaving health care, educating children, and distributing food in countries where the government can’t or won’t. But, as a consequence, many of these states are failing to develop the skills necessary to run their countries effectively, while others fall back on a global safety net to escape accountability.

The issues are well-worth debating. But, I do know that some of the issues the Gates Foundation is dealing with — like malaria — were virtually ignored for years. Plus, they help fund one of the most thoughtful health aid groups around – Boston-based Partners in Health

(Windows Vista turned my computer into an evil demon, but that’s another story.)

So, choose your cliché – 1) The road to hell is paved with good intentions or 2) No good deed goes unpunished.


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