The late Dr. Margaret Brand, a pioneering leprosy expert and eye surgeon, and a friend, once shared with me a story from when she took part in a India-wide health campaign to distribute vitamin A.
She told me that one day, a young mother came into the outpatient clinic carrying a toddler and a six-month-old baby. The baby, who received sufficient vitamin A through breast-feeding, looked fine. But the toddler showed signs of extreme vitamin A deficiency. The child’s eyes confirmed the diagnosis.
Without vitamin A, the cornea of the eye dries out with no resistance against even mild infection. Ulceration follows, and within a day or two the whole cornea melts. If a child receives vitamin A during the dry stage, followed by a good diet with supplementary vitamin A, this condition generally can be stopped. If not, the consequences are dire, including loss of sight and possibly of life.
When Dr. Brand examined the child, with his tired young mother at her side, she knew the window for treatment had closed, that it was too late to do anything for him.
Initially, Dr. Brand couldn’t understand why the mother had waited more than a week to get her son the treatment that could have saved him from going blind. But then Dr. Brand noticed the mother’s tears, and heard her quietly say, “I’ve been walking seven days to get here.”
Dr. Brand confessed to me how her focus on vitamin A deficiency had made her blind to the broader human experience this woman represented. That too many people do not have access to basic health care that can improve or save a life.
As CEO of an organization dedicated for more than a century to ensuring people affected by leprosy receive the treatment they need, Dr. Brand’s story helped me see a bigger picture.
What if our organization’s singular focus on providing high-quality leprosy care caused us to miss seeing patients as human beings with other health needs. What if our focus on single disease interventions were a way of denying people access to other health services they also desperately needed.
I often try to put myself in the shoes of the people we treat. I admit that if I were offered either the option of receiving high quality leprosy services, but unreliable access to services for other diseases for which I am at risk – or the reverse – I would pick reliable health services.
To me, this choice is at the heart of the sustainable development goals for Universal Health Coverage. It’s also at the heart of the Accelerating Integrated Management (AIM) Initiative, a recently-launched collaboration that works to connect one billion people suffering from or at risk of neglected tropical diseases (NTDs), such as leprosy and lymphatic filaraisis, to quality health care services.
The AIM Initiative, of which my organization is a proud founding member, brings together non-profit organizations, country governments and the London School of Hygiene and Tropical Medicine to focus on three critical elements:
First, is “making the invisible, visible,” by mapping where people with NTDs live in relation to local health clinics and each other. Second, is working with ministries of health and using the maps to better target limited resources and increase access to essential care. Third, is supporting national health programs to deliver integrated NTD case management services through resilient health systems around the world.
This work has started in countries including Liberia, Cameroon, Mozambique, Ghana and Nigeria, where ministries of health and partners are working together to identify how to best deploy limited health care resources in closest proximity to where NTD impacted communities are concentrated.
In the bigger picture that Dr. Brand helped me see, achieving individual goals such as a world free of leprosy depends on supporting the broader vision of Universal Health Coverage and building resilient health systems. By ensuring the one billion people who suffer from or are at risk of the ongoing consequences of NTDs have access to the quality health care they and their families deserve, I’m confident the AIM Initiative can help make this vision a reality.
By Bill Simmons, president and CEO of American Leprosy Missions, a founding partner of the Accelerating Integrated Management (AIM) Initiative.