Engaging in a world without borders

The importance of global health

Sten H. Vermund, M.D., Ph.D.
Amos Christie Chair and Professor, Department of Pediatrics
Director, Vanderbilt University School of Medicine Institute for Global Health
Published: July, 2006

Sten H. Vermund, M.D., Ph.D.
Photo by Anne Rayner
Global health is a vibrant component of today’s Vanderbilt. It is evident in the growing number of research partnerships with other nations that, for example, are providing AIDS treatment in Haiti, improving the care of premature babies in Colombia, and screening for diabetic retinopathy in remote areas of Peru and Bolivia.

It was evident in last year’s creation of a new Institute for Global Health by medical school Dean Steven Gabbe, M.D. During a visit to Niger, where their son was posted in a remote rural village for his Peace Corps service, Gabbe and his wife, Patricia Temple, M.D., professor of Pediatrics, became convinced that Vanderbilt needed to be even more active in promoting health on a global scale.

It is evident in the international health component of the innovative “Emphasis Program,” which allows first- and second-year medical students to pursue research and scholarship outside the classroom. Under the guidance of Peter Wright, M.D., director of the Division of Pediatric Infectious Diseases, more than 20 students are tackling projects in a dozen countries this summer.

Second-year medical student India Fox Landrigan has just published a manuscript about her experience in polio eradication in northern India. The remarkable odyssey of Milton Ochieng’—who also has just finished his second year of medical school—is reported elsewhere in this issue of Lens.

Why do we highlight a global health agenda when the problems in Tennessee are so acute and the need is so obvious? One reason is that the lessons learned in health care abroad apply here at home, and vice versa.

Each year several of our faculty members in Emergency Medicine provide medical services and training for local health care providers all over the globe, from Peru and Zambia to the Ukraine. Their international expertise was put to good use last year in New Orleans following the devastation of Hurricane Katrina.

International health care also is provided by Vanderbilt faculty, staff and students through Nashville’s Siloam Family Health Center, which serves refugees from war-torn Southern Sudan, Kurds from Turkey, Iraq, and Iran, and immigrants from several Latin American countries.

About a decade ago, Wei Zheng, M.D., Ph.D., MPH, and Xiao Ou Shu, M.D., MPH, Ph.D., a husband-and-wife research team, initiated several large cohort studies among women and men in Shanghai. These studies—which Zheng and Shu have continued since joining the Department of Medicine—are teaching us about dietary risk factors for cancer and heart disease in this country.

A second reason for Vanderbilt’s engagement in global health is that American industry and commerce is now operating in a global marketplace, surely a permanent shift. On a December 2005 flight to Beijing, I sat next to an employee of a Tennessee firm whose technical-support business to assist steel-making in China now rivals business done within the United States.

A symbol of global health: insecticide-treated bed nets, like the one opened over this child's bed in Tanzania.  "It's a marvelous appropriate technology for resource-limited settings," Sten Vermund, M.D., Ph.D., who directs the Institute for Global Health at Vanderbilt.
Photo by Hugo Jaeggi for the Swiss Tropical Institude in Basel, Switzerland
The Vanderbilt Traveler’s Clinic serves hundreds of travelers going to developing countries for mission work, business, research, adoption, humanitarian relief or tourism. A global awareness of malaria, yellow fever, influenza, and many other diseases helps keep American travelers and military personnel healthy.

A third reason for us to care about the global health agenda is the fact that we rely on our tropical and global health experts to address local emergencies and those of expatriate Americans, including diplomats, missionaries, business persons, military employees and many others.

West Nile virus, avian influenza (“bird flu”), HIV/AIDS, imported malaria near airports, the threat of dengue fever, and other emerging infectious diseases threaten U.S. citizens who may never leave their home towns. We need our global health experts to anticipate, prevent, and confront these threats.

The U.S. military has been a fount of tropical disease expertise; I have just spent a year on an Institute of Medicine committee studying the infectious disease problems of returning troops and veterans of the Gulf War (Kuwait), Operation Enduring Freedom (Afghanistan), and Operation Iraqi Freedom (current war). Bullets and bombs are not the only threats to American servicemen and women overseas and veterans returning home.

Global health experiences also can be transformative for the next generation of American physicians. Some of my former medical students returned from abroad to take up similar challenges in this country: delivering health services to remote Inuit communities in Alaska; practicing in a rural hospital in the mountains of Puerto Rico; joining the Indian Health Service Corps in the Four Corners area of the Southwest; and working in Appalachia, Alabama’s Black Belt region and the Mississippi Delta.

Several Vanderbilt alumni and faculty of both the School of Medicine and School of Nursing have served or are serving as medical missionaries. An example is Carol Etherington, M.S.N., assistant professor of Nursing, who is past president of the USA board of Médecins Sans Frontières (Doctors Without Borders).

Other alumni work as military physicians or as public health experts in the U.S. Centers for Disease Control and Prevention. Former Senate Majority Leader William Frist, M.D., on leave from his Vanderbilt faculty position, has been instrumental in spearheading HIV/AIDS treatment programs in Africa.

Enjoy this special issue of Lens. It shares the stories of faculty members at Vanderbilt and Nashville’s Meharry Medical College who are leaders in the global health arena. Many of us have been inspired by the research and training partnerships in neonatology with Sweden and South Africa that were established by Mildred Stahlman, M.D., nearly half a century ago.

These commitments and contributions reflect Vanderbilt’s broader vision: to prepare our students and engage our staff and faculty in research and service that is of vital importance to the future of our world in the 21st Century.

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