In celebration of this week’s UN MDG Summit, the Millennium Cities Initiative interviewed a number of “MDG Heroes” – individuals working hard to advance the Millennium Development Goals in our Millennium Cities. The following is an interview with Brigadier General Ron Sconyers, President and CEO of Physicians for Peace, about his organization’s outreach.
Since 2006, Physicians for Peace (PfP), a U.S. based non-profit focused on providing health care training and education to developing countries, has been working with the Millennium Cities Initiative to help the Millennium Cities in their efforts to attain the Millennium Development Goals. Under the leadership of Brig.-Gen. Ron Sconyers, PfP has shipped containers of life-saving medicines and medical equipment to the Millennium Cities in Mali and Senegal; has led several missions to research the most acute medical training needs in Millennium Cities in both east and west Africa; and has dispatched multiple surgical teams to perform fistula repair surgeries that have transformed the lives of many women and girls in Kaduna, Nigeria, and Segou, Mali. PfP has also been instrumental in advocating for a blood bank in Segou, Mali, which will bring millions of people access to safe blood transfers. MCI recently asked this MDG Hero about his work and that of Physicians for Peace; his responses are printed here below.
How was PfP founded?
Dr. Charles Horton, a plastic surgeon, began pursuing humanitarian work 50 years ago. Through this, he realized that not enough organizations were focused on long-term sustainable education. He also noticed a particular need to help countries increase access to health care, so he mobilized volunteers to take their teaching skills and put them to work to help address unmet needs and scarce resources in developing countries. Physicians for Peace uses a “train the trainer” model, teaching health care providers in areas like diabetes, dental care, maternal and child health, and support for the disabled, who can then train more local professionals, ultimately offering care to hundreds of patients.
Your website indicates that PfP works with hundreds of medical volunteers. How do you identify and recruit volunteers? Do you have a number of volunteers who continue to serve with PfP?
PfP does very little recruiting, only actively recruiting when we need specialists who can support distinct needs, such as vesico-vaginal fistula (VVF)(1) repair. We have many more volunteers than we can send out on missions, because of a lack of resources. Most of our volunteers are from the United States, but many of them are expatriates who want to give back to their home countries.
How many volunteers typically go on a mission? How many non-medical professionals accompany the mission?
The average mission includes 5-7 volunteers. We create a small footprint and don’t want to be disruptive to in-country medical professionals. There might be one non-medical volunteer who accompanies the team – maybe a marketing or operations person. Ninety percent of our volunteers are medical professionals, including physicians, dentists, physical therapists and nurses.
PfP’s missions typically vary in length. What is the average stay?
The typical length is 7-14 days. Most of our volunteers are practicing professionals so they can only spend a few weeks on a mission. We do have one volunteer, a nurse, working in an area near the Millennium City of Blantyre, Malawi, for 16 weeks.
When a mission is planned, how do you identify the patients? Are public service announcements made in advance of your arrival? Do you work with local hospitals to spread the word?
We typically try to fit our work into the average day of the practicing physicians in the country where the mission is located, especially since we’re focused on training medical professionals, so we don’t do much to promote our missions. Yet we recently sponsored an optometry mission to the Philippines that served more than 1700 people. Our approach is to work with NGOs, teaching hospitals and clinics who invite us to train; we then design a curriculum.
How has PfP selected the 60 countries where you currently work?
Countries generally come to PfP for support. We recently met with a delegation from Niger which knew of the work we had done for the Millennium Cities Initiative. We then began preparing a strategy to work with them. Sometimes we get involved in a country because of a relationship. Through our work with MCI in Mali and Nigeria, and through our work with the International Society of Ultrasound Obstetrics in Gynecology (ISUOG) in Eritrea, we realized the two should partner to introduce an ultrasound outreach program in some of the Millennium Cities.
Given PfP’s focus on providing education and training to medical professionals in developing countries, could you please describe in more detail the type of training you provide? How many local medical professionals are typically trained during a mission?
Our signature model is our “Walking Free” program, which started in Turkey in response to amputees on the Kurdish border with Iraq. We focused on training prosthetists and physical therapists. We also provided all the prostheses and equipment to go along with it. We were able to bring the program in Turkey close to 21st-century standards with our equipment and training. It flourished, and we realized it had potential, so we started replicating it. We took it to the Dominican Republic, then to Manila in the Philippines, which now serves as the state-of-the-art center of excellence in prostheses for Asia.
In January, when the Haiti earthquake occurred, we were not the first responders, but we developed a program to support a number of organizations in Haiti, eventually serving 500-600 amputees. Our work there has been more hands-on, clinical in nature. We’re now working with the Ministry of Health to develop a longer-term program.
What do you see as the greatest health care needs in Africa?
There is an incredibly high rate of childhood morbidity and maternal mortality. Many of these cases could have been preventable with basic health care. A dramatic difference could be made just by ensuring greater access to basic health care. Compared to what we have in the United States, very few people have this kind of access. That’s why the work that the Millennium Cities Initiative and the Millennium Villages project are doing is so important – demonstrating how to improve the quality of life by paying attention to things like water, sanitation, nutrition, etc. Another issue is getting the population to understand they need to take care of their health.
How did you come to work with the Millennium Cities Initiative?
Four years ago, I met with Jeff and Sonia Sachs (Earth Institute director and the health coordinator for the Millennium Villages project), who later introduced me to Susan Blaustein (MCI’s co-director). We recognized there were some synergies in our organizations’ work, and we began by sending medications, medical supplies and medical reconnaissance missions; in time, we started the project in Kaduna, Nigeria, focused on fistula repair. Eventually our work evolved to support several VVF missions, and now we’re working together to bring a blood bank to Segou, Mali. I’m confident our relationship will continue to grow.
PfP has now conducted several VVF missions in the Millennium Cities, not only in Kaduna, Nigeria, but also in Segou, Mali. How did PfP come to support missions to repair fistulas? Was this something your organization identified as a need during one of your earlier reconnaissance missions?
VVF is not an issue in the United States, but unfortunately it is rampant in some developing countries. It is a complex surgery, so not many surgeons in the U.S. are familiar with the process. This was a situation in which our medical professionals needed to be trained. A friend of PfP’s in Nigeria offered to introduce us to a VVF surgeon, which led to our first mission in Kaduna, during which many of our volunteers were trained. We came back two more times. Simultaneously, we were invited to do the same in Segou, so we put a team of professionals together, including one from Houston and one from Washington state who had a lot of experience in this area.
Please describe a typical VVF mission. What’s involved in the planning, what happens when you arrive and how many women and girls typically receive surgeries? In your opinion, how will this type of surgery impact the women and girls?
The key to this type of surgery is selecting the team. Very few surgeons or obstetricians know how to do this, so they would need to be motivated to learn how and make a difference. Generally this isn’t an issue for our volunteers since most of them are not interested in managing an office and would rather work with patients. Next, we select a team leader and make sure the right equipment is in place. Volunteers will fill their suitcases with extra supplies like medicine, masks and gloves, which are in short supply (in these settings). Finally, we make sure the right post-operative care is available for patients receiving the surgery. While we have made some progress with VVF repair, there are so many women waiting for this type of surgery.
Your organization has been instrumental in generating support to establish a blood bank in Segou. In your opinion, why is this a critical need? Would you please describe PfP’s efforts in more detail?
Two to three years ago, Susan Blaustein and Sonia Sachs mentioned that the most urgent medical need in Segou was a blood bank. In Bamako, Mali, they have the ability to match (blood type), but in Segou, this wasn’t the case. It has been a long, slow process, but I feel very positive about our efforts. American Red Cross is now involved, and they have been very resourceful and helpful in meeting needs.
You recently introduced MCI to the International Society of Ultrasound Obstetricians Gynecologists. What role can ultrasounds play in improving maternal health? Why is it so important that African medical professionals receive this training?
Having a diagnostic capability can really change the shape of maternal health. Ultrasounds will allow medical professionals to be corrective and take precautions, enabling the best possible outcome for pregnancies. We take ultrasounds for granted in the U.S., but they are life-changing for mothers and babies and obstetricians in developing countries. They also offer new avenues for training.
Is there an area where you feel PfP can have the greatest impact in terms of helping the Millennium Cities achieve the MDGs?
Maternal and child health. There is such a desperate need in this area, yet there is a lack of capacity to meet it. If we can get these under control, it will have a positive impact on families, women’s roles in the community and economic development. They need access to prenatal care, health and nutrition, clean drinking water … it’s amazing what can happen if the resources are there.
What is your favorite aspect of your work?
Hearing volunteers come back from their missions and tell stories about the impacts they have made. Each life makes a difference for us.
(1) Vesico-vaginal fistula can result from prolonged or obstructed labor, typically in younger girls, and can cause incontinence.