Interview with Dean Glimcher: Healing Haiti

Today I'm speaking with Dr. Dan Fitzgerald, associate professor of medicine and co-director of our Center for Global Health. Dr. Fitzgerald works primarily in Haiti, providing medical care to people in one of the poorest places in the Western Hemisphere. I have recently returned from my first trip to Haiti and I saw first-hand the inspiring work Dr. Fitzgerald does, not just to boost health, but also to boost the spirits of those in the greatest need.

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Interview tranScript below:  LAURIE H. GLIMCHER: It's really a pleasure to be speaking with you today, Dan.  DAN FITZGERALD: Thank you.  GLIMCHER: You co-direct the Center for Global Health with Dr. Warren Johnson. Can you tell us what the center does and what the mission of GHESKIO is?  FITZGERALD: Our center coordinates international programs from Weill Cornell. There are three main programs. There's a program in Brazil Warren Johnson started in the 1960s, which focuses on tropical diseases. There's a Weill Cornell program in Tanzania really focused on medical education. The third program is the GHESKIO program in Port-au-Prince, Haiti. And that's the program I've worked most closely with. GHESKIO was founded in 1982 by Weill Cornell faculty member and, actually, alumnus Bill Pape with a focus on conducting research, service and training in HIV/AIDS.  GLIMCHER: What are the biggest obstacles as you see in Haiti today that makes it difficult for Haitians to receive medical care?  FITZGERALD: The number one obstacle is money. Seventy percent of Haitians are living on less than $1 a day. Every day for them is a struggle. Our role is how do we help people who are earning less than $1 a day.  GLIMCHER: Since GHESKIO started, the number of new HIV cases, HIV/AIDS incidents, has really fallen dramatically. What part has GHESKIO had in facilitating that?  FITZGERALD: Haiti was one of the first countries affected by HIV early in the 1980s. The prevalence of HIV rose to about 6, 7 percent in the early 1990s and really the international experts really felt this is going to be a disaster; it's going to go to 25, 30 percent. Fortunately, there was a team of great Haitian doctors, led by Bill Pape, who were there, and Warren Johnson also from Weill Cornell, who worked hand-in-hand with the Haitian government to investigate how was the virus spreading, who was catching the disease. That openness on the part of the government, and then having the expertise, allowed some key early interventions. So it's been a team effort, but Weill Cornell and GHESKIO and Bill Pape really played a critical role very early in the epidemic.  GLIMCHER: When I visited, you took me to the site in the northeast of Port-au-Prince, which is going to be the site of a new TB (tuberculosis) hospital. I was excited to see the beginnings of the hospital when I visited the site. It's amazing to think that all those tents, those isolation tents, are going to be replaced by 35 hospital beds, right?  FITZGERALD: Right. There were five TB hospitals in Port-au-Prince and all five of them collapsed. After the earthquake, the GHESKIO team just marshaled the troops and set up a field hospital for tuberculosis patients.  GLIMCHER: When the earthquake struck and the magnitude of the disaster was apparent, the world jumped in to help. GHESKIO was a big part of that help. Tell me a little bit about what GHESKIO did.  FITZGERALD: The earthquake struck on an afternoon, about 5 o' clock. Even though about more than half of the buildings were destroyed, a team of GHESKIO doctors and nurses and pharmacists, they were able to get the center up and running, started seeing patients and opening the doors. So that by the next morning, they had started providing care to not only our patients that we routinely see with HIV and tuberculosis, but also trauma patients started to come in. GHESKIO is right downtown, was really in the center of the most severely affected area, so they were really, truly the first responders. As word got out that GHESKIO was open, that doctors were there, they were just inundated with hundreds the first day and then, quickly, thousands of patients.  GLIMCHER: Well, my long-awaited trip to Haiti coincided with the three-year anniversary of the earthquake. It didn't seem to me that the country had fully recovered. What's your sense of that?  FITZGERALD: There's been some debate recently, with some people saying, 'Well, look, where are the buildings?' I think there has been great progress. I don't think it's progress that's going to be measured in bricks and mortars. It's about community organization, about people working together.  GLIMCHER: What brought you to Weill Cornell?  FITZGERALD: Haiti. I was working at the Albert Schweitzer Hospital as a primary care physician. This was in the mid-1990s. At that time, rural Haiti was seeing a lot of HIV/AIDS. I would have questions about how do I treat something or I wasn't sure what the diagnosis was. I had heard about this doctor in Port-au-Prince who was an expert on HIV/AIDS, and so I would drive down to Port-au-Prince and then met with Dr. Pape and run cases by him. And increasingly, I found I kept going down about once every two weeks. And then, finally, Bill suggested I join the Weill Cornell team down in Port-au-Prince.  GLIMCHER: Dr. Pape is such an inspirational force in both New York and Haiti. It's really been a pleasure talking with you. I'm a huge admirer of what you and the other faculty in our Center for Global Health are doing. You're bringing so much help to people who ask for so little but really need so much. So thank you very much.  FITZGERALD: Thank you for visiting.  GLIMCHER: I'll come back when the hospital is built.  FITZGERALD: Yes!  GLIMCHER: And we'll cut the ribbon.  FITZGERALD: That would be great. [Glimcher laughs] That would be great. Thank you.