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The Tiny Faces of AIDSPediatric AIDS Corps brings cutting edge care to Africaby Ruth SoRelle, M.P.H. 
Children sat in the grass at dedication ceremonies for the Baylor/Bristol-Myers Squibb Children's Clinical Center of Excellence—Lesotho. Tiny faces—thousands upon thousands of them—fill Dr. Mark Kline's dreams. They are children with HIV/AIDS from around the globe. Most of them have no access to the potent drugs that can stave off death and the other ill effects of the disease that has infected most of them since birth. Their plight keeps Kline, professor of pediatrics at Baylor College of Medicine and president of the Baylor International Pediatric AIDS Initiative, on the telephone, at the computer, at the conference and board table and in the air, marshalling forces to bring care and treatment to as many as possible. Harkening back to the genesis of this phenomenal effort, Kline said that no one child sparked his concern when he visited resource-poor Romania in 1996 as an advisor on their pediatric AIDS problem. It was the enormity of the problem. In a way, it was all the children. At the time, half of all children with HIV/AIDS in Europe lived in Romania. 
A woman uses a small flag bearing the message "Know Your Status" to shield her self from the sun during ceremonies dedicating the Baylor/ Bristol-Myers Squibb Children's Clinical Center of Excellence—Lesotho in Maseru, Lesotho, World AIDS Day, Dec. 1, 2005. The event also served as a nationwide launch of a campaign encouraging people living in the kingdom to be tested for HIV. "It was the totality of the situation in Romania," he said. "It was not an individual face. It was the realization that there were hundreds and thousands of children who could benefit from the kinds of treatment available in the United States but who would not because those medications were not available. This situation led me to do something. Children across the developing world, in every resource-poor setting around the globe, were dying needlessly." In the plane, on the way back from frozen Romania in February 1996, Kline began to draw up his plan to bring care for HIV to children around the world. Since that time, the program best known by its acronym, BIPAI, has grown exponentially, funded by foundations established by pharmaceutical companies such as Bristol-Myers Squibb and Abbott Laboratories. It treats more children with highly active anti-HIV therapy than any other program in the world. It has expanded from treating children with drugs to building Clinical Centers of Excellence for children and their families. Now, it has established the Pediatric AIDS Corps to make up for the "brain drain" that has bled medical professionals from the African continent. 
A group of children perform a traditional dance during ceremonies dedicating the Baylor/Bristol-Myers Squibb Children’s Clinical Center of Excellence—Lesotho. Funded by Bristol-Myers Squibb's Secure the Future campaign, designed to fight AIDS in sub-Saharan Africa, the Pediatric AIDS Corps will, at first, field 50 pediatricians, internal medicine/pediatric specialists and family practitioners to provide care in Botswana, Burkina Faso, Lesotho, Malawi Swaziland and Uganda, all now or soon-to-be homes to Centers of Excellence associated with the Baylor International Pediatric AIDS Initiative. These physicians will also provide training to other doctors and health care professionals on the continent. The Corps' numbers are anticipated to grow, and the 50 slots are already filled. When Kline, a 1981 BCM alumnus, issued his call for physicians to join the Corps, he anticipated a strong response. 
The Baylor/Bristol-Myers Squibb Children's Clinical Center of Excellence - Lesotho seen at twilight in Maseru, Lesotho, World AIDS Day, Dec. 1, 2005. The center is the newest addition in a network of pediatric HIV outpatient clinics and is expected to serve more than 1,000 patients in the southern African nation. "As I travel and give presentations at various medical schools, I often ask residents and students if they would be interested. Invariably, I have found young physicians who have said yes. I was not surprised at the numbers, but the quality has surprised me. The pool of talent is amazing. The caliber of the applicants we have attracted represents a group that any residency program in any specialty in the United States would be thrilled to have." Corps members commit to at least one year in one of the African nations. In return, they receive an annual stipend, housing and some student loan debt relief. Kline knows, however, that they will receive much more. David Jones, BIPAI vice president in charge of the Corps, anticipates that the plan will be "transformational" for the HIV/AIDS situation in Africa. 
Using umbrellas and cowboy hats to shield themselves from the summer sun, local residents attend ceremonies dedicating the Baylor/Bristol-Myers Squibb Children's Clinical Center of Excellence - Lesotho, World AIDS Day, Dec. 1, 2005. "I believe passionately that the way we will stop AIDS in Africa is to start fighting it, and as we learned in programs to prevent mother-to-child transmission for the disease, people will move the world for their children." As children and their families get treatment for the disease, Jones sees the end of stigma, a major "Within two or three years, Africa will look different," he predicted. "The Pediatric AIDS Corps and the Clinical Centers of Excellence will make that happen." "We want them to go to Africa to treats tens of thousands of children with HIV," said Kline. 
Dr. Peter G. Traber, president and CEO of Baylor College of Medicine, visits with Jennifer, a young patient served at the Botswana-Baylor Children's Clinical Center of Excellence in Gaborone, Botswana, Nov. 20, 2005. Jennifer, who likes to be called "J-Lo," is one of 1,400 children and their family members treated at the center that opened in 2003. The center, the first of its kind in Africa for the treatment of HIV-infected children, serves as a model for five more centers opening in a few years across the continent. "As that happens, these doctors will change too. They will never be the same," he said. "Many will return to the United States with skills and compassion that will prove crucial to the medicine of the future. Those who stay—and many will—will provide the bedrock upon which the future health of the world will rest." "I will be amazed if we don't 'hook' a substantial portion of them," he said. He understands the tug. "That's what I enjoy most—caring for patients," he said. "I would just park myself in the clinic in Romania and Botswana, and I'd just see patients." That, however, would not fill the needs of those tens of thousands of tiny faces. In 10 to 15 years, Kline anticipates more clinics and more doctors working with BIPAI. "HIV will still be with us, and children in impoverished countries will still bear the brunt of it, as well as malaria, TB, diarrhea and respiratory disease," he said. |
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BIPAIAdrian Hazbun, M.D.
It was not his first encounter with Africa. Before going to medical school, he spent more than two years in Tanzania as a teacher. While there, he saw two of his students die—one in an auto accident and the other of an infection. The knowledge that better medical care might have saved both of them propelled him into his medical studies. The loss of those two students brought home to him not only the personal effect that the problems with medical care had on their families but also the loss to the nation. The parents scraped to pay school fees, he said. If their children are likely to die, why bother to send them to school. "It has a far reaching impact on the nation as well," he said. A telephone call from a friend alerted him to the BIPAI program. He talked first to Dr. Meg Gwynne Ferris, vice president for international fellowships, and then to BIPAI president Dr. Mark Kline. "I am really excited about all of this," he said. "There is so much potential." Lineo Thahane, M.D.For Dr. Lineo Thahane, the posting in the newly opened Lesotho clinic is like going home. A pediatrician educated at Washington University in St. Louis and who did her residency at Children's Hospital of Philadelphia, she joins her mother Dr. Edith Mohapi, a native of Lesotho who worked in the United States until recently. Now she heads the Baylor-Bristol-Myers Squibb Children's Clinical Center of Excellence—Lesotho. Even though Thahane grew up in northern Virginia, her summers were spent with family in Lesotho. She always planned to practice there at some point in her career. "I've committed to the (pediatric) AIDS corps for at least two years," she said. She has spent a year working on a research project in Zambia, and she is comfortable in an African setting. She looks forward to working with her mother and the rest of the BIPAI network. The collegiality and enthusiasm energizes and motivates her. Kebba Jobarteh, M.D.
Educated in the Ivy League—Princeton, Yale and Harvard, Jobarteh has an M.D. and a master's in public health along with his pediatrician credentials. Asked about how he feels about his posting in Malawi, Jobarteh, who was born in Kenya and whose family immigrated to the United States when he was only seven years old, answered simply: "It is what I became a doctor for," he said. "I have always wanted to be involved in international health." He has already spent time in Botswana, where his help was sorely needed when the numbers of doctors in the Baylor-Botswana Clinical Center of Excellence dwindled as the government had to reallocate staff. It is clear that he has developed affection for his mentors and colleagues there. He is young and eager, but his strength and obvious enthusiasm endear him to his colleagues, who have come to expect him to go beyond what is required as demonstrated during a recent team-building exercise at a Texas Hill Country camp that included tightrope walking. "Who is that up on the wires?" asked one. "Oh, of course. It's Kebba." |
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Volume 2, Issue 1, Spring 2006 |
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| Last modified: April 11, 2006 |
His Baylor College of Medicine badge was barely two weeks old when Dr. Adrian Hazbun left Houston for Kampala, Uganda, where he plans to join the BIPAI team there in the battle against AIDS.
Given the choice of scaling a climbing wall, walking the high ropes or jumping from the top of a telephone pole to a trapeze, Dr. Kebba Jobarteh opts for them all.