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One in a Million, Literally

You know things are really bad if there isn’t someone for miles around to even document how bad it is. That’s how it is in the developing world; it’s a real healthcare crisis, where 1 billion people don’t have physical access to a hospital, clinic, doctor or medical care of any kind, no matter how basic. Some 400 million of them live in sub-Saharan Africa. Rural villagers there know that if a child falls ill, the 48 hour long walk for medical treatment can turn the common cold into a one way ticket to hell.

Thankfully for West Africa and in turn, the whole wide world, a fantastic man called Dr. Raj Panjabi is testing something that might solve this problem. His non-profit organisation Last Mile Health recognizes that putting a hospital or a doctor into every remote settlement isn’t feasible, but training a local villager to perform basic medical tasks and arming him or her with essential medicines can both save lives and create jobs.

So that’s what Panjabi has been doing in Liberia since 2005. This year, 300 frontline healthcare workers from Last Mile Health will treat more than 30,000 Liberians, saving a few hundreds lives in the process.

“If you got sick the city in the city, you had a chance,” says Dr. Panjabi. “If you were in a rural area, you died anonymously.”

Panjabi knew this first-hand. Born in Liberia itself, he watched a ruthless Civil War swarm across his country and brutally rip his family apart. Resettled in North Carolina, he became a doctor and joined the faculty of Harvard Medical School – a ticket to a life of fat salaries and high prestige.

But he never forgot where he’d grown up, and the death an decay he’d left behind. As the Civil War wound down a decade ago, Liberia had just 51 doctors left in a country of almost 4 million. (For a rough equivalent, think about 10 doctors treating the entire city of San Francisco.) In the Liberian rainforest, the densest in West Africa and undoubtedly the most inaccesible, that number pretty much stood at zero.

Panjabi found the right mentor at Harvard, Paul Farmer, whose Partners in Health had famously tackled the state of Third World medical care. Farmer admitted that the numbers in Liberia made any positive change seem more implausible than challenging; “One billion people will go to their graves, often prematurely, without meeting a healthcare worker.”

Panjabi’s model changes that. Last Mile Health’s village nurses screen for Tuberculosis, hydrate those with Diarrhea and provide nutritional supplements to newborns. Those with AIDS get anti-retroviral drugs, those with malaria get anti-malarials, and those with pneumonia get antibiotics. Basic stuff for the developed word – revolutionary stuff in the rainforest.

It’s hard to imagine how bad things can get in the world, but Dr. Panjabi’s unbelievable spirit of humanity and brilliance makes it a slightly less frightening picture to paint.

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cloudchowk is a healthcare software company based out of Delhi. Its software help medical labs, clinics and patients share information and collaborate seamlessly.

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