Happy Valentine’s Day: Healthy Hearts for all - A reflection on 5 years of public service in Tanzania

In the Fall of 2005, while attending ward rounds one day at the National Hospital in Tanzania I met a 9 year old girl named 'Rosie' being treated for rheumatic heart disease (RHD). Some of you reading this might be wondering how a 9 year old girl acquires heart disease. Rosie is one of millions of children living in low income countries with RHD, a condition that was mostly eradicated in the US in the 1950s and 1960s through the widespread availability and use of antibiotics to treat streptococcal infections (more commonly known as strep throat). RHD follows a neglected strep infection which can cause severe damage to the heart. Once severely damaged, the only course of treatment is expensive valve-replacement surgery, something Rosie is not even a candidate for, as her condition is too severe.

Inspired by Rosie, I joined my colleagues in Tanzania and at Harvard/MIT to launch a US 501 c(3) foundation called Bienmoyo. Bienmoyo in French and Swahili translates to ‘Good Heart’ or ‘Good Soul’. Through the generous support of colleagues, friends, and acquaintances almost five years later we have managed pilot programs to find ways to help prevent rheumatic heart disease in children living in Tanzania and accomplished so much more. During this time we have had over 50 volunteers join us in the field working closely with our dedicated colleagues from the public and private health sectors to support programs ranging from developing a business plan to expand cardiac care services at the national hospital, strategic planning workshops to help provide micro financing to over 600 physician practices, and most recently ways to use emerging mobile health (mHealth) technologies to improve maternal and child health by reducing infant death from obstructed airways after birth.

Ms. J.K. Rowling of Harry Potter fame stated at the 2008 Harvard Commencement Address, “We do not need magic to change the world, we carry all the power we need inside ourselves already: we have the power to imagine better.” The Bienmoyo philosophy stresses how by working together and using our collective imaginations as a global community we can create new approaches and innovations to improve quality of life for the world’s most vulnerable populations.

The journey for my colleagues and me began anew in 2005, with the knowledge that through hard work and great perseverance a difference can be made to help those most in need. We have learned so much over the past five years through our successes and the challenges we have overcome. We now more than ever sincerely believe that answers to global health delivery problems are best found locally to provide high quality and affordable health services.

So thank you Bienmoyo family and friends for all for the wonderful support over the years and we look forward to an amazing 2010 and beyond.

Jeffrey Blander
President
Bienmoyo Foundation
Sunday February 14th, 2010

Happy Mothers day and Reflection

We wish you a very happy, wonderful, and happy mothers day.

Appropriately Mr. Nicholas Kristof from the NYT has given us a gift of reporting on a condition that effects both mothers and children, yet remains largely under funded with few direct advocates. Mr. Kristof reports that childhood pneumonia is an illness that is easy to treat, yet more than two million children die each year in developing countries. Thanks again to the herculean advocacy efforts of Lance Laifer the world is becoming better acquainted with a condition that Mr. Kristof states will kill almost twenty children in the five minutes it will take to read his column or my blog.

Though we are reminded that part of the challenge of advocating for childhood pneumonia is typically the condition can be a secondary infection caused by a primary underlying condition such as upper respiratory disease, HIV, malaria and malnutrition. Actually many scientists and health officials will argue that malnutrition or under nutrition and health illiteracy by parents are the biggest root causes of disease.

This highlights the challenge of advocating for a disease versus channeling the energy and funding dollars to strengthen health systems and increase health literacy to improve primary health care services and tackle root causes of disease. Otherwise, if we target a specific disease, yet do not thoughtfully look to apply needed attention to strengthen the health delivery system, we may get a disproportionate investment in treating one disease versus improving overall health services for mothers and children.

For example I’ve worked with local health workers in Tanzania to help develop primary prevention programs to eradicate rheumatic heart disease (RHD) over the last 5 years. RHD is thought to be an entirely treatable and preventable condition (it was a leading primary and secondary cause of cardiovascular death in the US prior to the discovery of penicillin), yet we have millions of children and adults in the developing world suffering from this disease. However, my colleagues and I have learned that the root cause and treatment for RHD goes beyond screening for streptococcus A and handing out penicillin. The inability to eradicate RHD in the developing world also has also been effected by traditional focusing on disease specific programs versus strategic strengthening of systems to detect and prevent diseases among infants and children.

Lance and Bill; We know your reporting and advocacy work are making an amazing difference for mothers and children the world over. The world needs more people like you bringing attention to these conditions. Lets hope that the tremendous advocacy and resulting funding dollars are spent wisely to also focus on root causes of disease and strengthening primary care and prevention services. Otherwise, the world will continue to follow the treatment of one disease at a time strategy versus creating a system that promotes wellness and health for an entire community and village.

Happy Mothers Day to all!