When she was only four and living in Nigeria, Ose Okoye saw photos of a starving boy before and after being cared for by UNICEF, and decided on the spot that she wanted to be a physician. One of 10 children whose parents encouraged all of them to graduate from college, Okoye received her MD degree from the University of Benin in 1995 – one of about 15 women in a class of 127.
Although she initially thought of pediatrics, she selflessly decided to go into public health, a field in which Nigerian doctors go to the poorest, least educated patients in the field rather than sitting in pleasant offices and having well-off patients come to them. Then, in 2008, she was invited to be a Pears Foundation fellow and study with other Africans at the Hebrew University-Hadassah Braun School of Public Health and Community Medicine. Its special international program leading to a master’s degree (in public health, plant sciences or nutritional sciences) and headed by the Braun School’s Dr. Yehuda Neumark requires a year of study.
The Braun School’s international MPH program, established in 1971, now has more than 700 graduates from 90 countries in developing and transition regions, as well as from developed countries in North America and Western Europe. All Pears scholars study with top experts in the field of public health in the developing world, live on the Jerusalem Ein Kerem campus and tour all over Israel. Okoye went home last September but was invited back last month for a special Pears Foundation symposium at the school of public health, along with other former fellows from countries such as Kenya, Ethiopia, Cameroon and Uganda.
Okoye said that when she saw TV broadcasts about the Israel Defense Forces’ field hospital in Haiti’s capital after the devastating January earthquake, she was “so proud of Israel. I want to come to here again and again.” She added that she feels a real attraction to “spiritual, quiet Jerusalem and its historical and biblical background, rather than to the bustle and noise of Tel Aviv.” She marvelled that Israel and Israelis are “very concerned about health; from what I read about Israeli medical advances, I learn that they are very interested in promoting basic medical knowledge and applied research.”
Although Nigeria is one of the world’s eight largest producers of oil, its national wealth is not fairly distributed among the half-Christian and half-Muslim population, who are not entitled even to national health insurance. Influential businessmen and other powerful people siphon off most of the assets, she said. As a result, the poor – mostly in rural areas – have little access to medical care.
Okoye now works in a faith-based organization in the southern part of the country whose physicians set up tents in such poverty-stricken areas and treat patients who flock to them. Some 300,000 Nigerians have benefited from the program over the past decade. More than 50% of women now give birth in hospital, and vaccination programs have taken off.
The tall, striking-looking physician, who is married to a Nigerian engineer, told The Jerusalem Post
during the symposium that she learned a great deal at the Braun School. One of the most important things was “how to characterize a community, learn its medical needs and problems before you start to offer services. I learned to partner with other organizations and make sure my tools are used. The level of teaching was very high,” she said. The one-day symposium – part of a week-long conference for graduates – was a bonus, “enabling all of us Pears Foundation scholars over the years to exchange notes.”
The London-based foundation, which announced it is expanding the number of African scholars from six to eight annually, sponsored the symposium because it thought it was important for the faculty and MPH graduates to discuss critical issues impacting health in Africa today, and look at Israel’s role in helping out. Nearly all the graduates who return to Africa take senior positions as physicians and specialists; due to their close exposure to Israel’s innovations in medicine and its society, they become informal ambassadors. Sixty scholars have taken part in the project since it was established five years ago, and thanks to the foundation, a strong network of alumni has been established.
Foundation executive chairman and British businessman Trevor Pears sent a message stating that the aim of the scholarship program was to build a network of scholars in the developing world who benefit from academic expertise in Israel, and transfer that expertise to development efforts in their home countries. “A subsidiary objective is to help strengthen relationships between Israel and Africa,” he declared.
At the symposium, foundation director Charles Keidan said the Braun School scholarships were “a flagship program for us, as we aim to promote the developing world and Israel’s integration into the world community in this field.”
During the early days of statehood, Israel, through the Foreign Ministry’s MASHAV (International Cooperation Department), invested relatively large sums sponsoring health, agriculture, water supplies and other fields in Africa. After the Yom Kippur War, African countries cut off diplomatic relations, thus ending such assistance, even though individual beneficiaries begged that it continue. In recent years, the ministry realized that the technical aid created positive memories of Israelis in Africa, and decided to restore such projects. MASHAV director Haim Divon told participants that his ministry now spends $20 million annually on direct aid to the continent, excluding salaries, and that Africa is regarded as the “number-one beneficiary” for Israeli knowhow. He added that there is a clear correlation between friendly relations with African countries – including Muslim ones – and technical support Israel has provided. “The prime minister of Senegal, who is head of the African Union, is a Muslim but praises our activity,” he said.
Braun School Prof. Jeremy Kark lectured at the symposium on what his parents, Dr. Sidney and Dr. Emily Kark, contributed to public health and social medicine (the practice of medicine concerned with health and disease as a function of group living). Graduates of Witwatersrand University Medical
School in Johannesburg, they spent much time in rural Natal Province during the 1940s and early 1950s.
“I was born there,” said Jeremy, himself a graduate of the Braun School. “My parents’ mission in South Africa was to prevent disease and provide high-quality primary care.” He said medical teams carried out health assessments at various levels and reached conclusions on what treatments as well as preventive medicine and health promotion services were needed. Thus they spent much time supervising pregnancies and developing sanitation, improving water quality, diet and nutrition, health education, epidemiology and other topics that weren’t even considered at that time.
The Karks also moved to Durban, where Sidney directed the new Institute of Family and Community Health; the couple returned to Jerusalem in 1959. Jeremy’s lecture was accompanied by a large collection of black-and-white photos of his parents and their African patients some six decades ago. Here, the Karks established the department of social medicine in Ein Kerem, and Sidney was one of the founders of the Braun School. He died in 1998 and his wife in 2006.
“They pioneered the holistic approach. They identified serious malnutrition in 80% of the Pholela population, as well as high childhood mortality, stunted growth, inadequate milk consumption by children and consumption of meat, fresh fruit and vegetables. They also taught local residents how to make compost and grow vegetables.” As a result, health improved significantly, and their work prepared the country for South Africa’s universal health care system, Jeremy recalled. But the rise of apartheid led to the dismantling of the public health team, leading to the emigration of many members.
Prof. Steve Tollman of the University of Witwatersrand lectured on how the serious decline in the global economy has affected Africa. “There has been a dramatic fall in capital inflows, in commodity prices [but not gold] and less demand for good and services. Agricultural costs and food prices are up. Companies cut back or go out of business. There are more public works projects, but a million jobs were lost in sub-Sarahan Africa,” he said. This holds 12% of world’s population but contributed only 1.5% to its economy. The declining economies, as well as the devastating loss of life due to HIV and AIDS, have had a significant impact on health, he said. “About 15% of our life expectancy has been lost since 1990 due to HIV, and the disease has also increased maternal mortality. At the same time, in addition to acute diseases, older teens are increasingly getting overweight, leading to chronic illness.
Dr. Norbert Rakiro, responsible for the East African Zone of the
International Red Cross and Red Crescent Federation, was in the first
Peers Foundation Program in Jerusalem in 2004/5, and said that then
there were only three surgeons in Southern Sudan, and in some areas one
doctor for every 500,000 people.
Braun School and Hadassah University Medical Center nutrition expert
Prof. Elliot Berry said many people lack basic food security. Some 165
million children under five in developing countries suffer from stunted
growth. They lack iron, vitamin A and iodine, Berry said. Many pregnant
women are anemic and lack iodine, thus leading to more disease and
reduced cognition, and productivity. “There is enough food in the world
to feed everybody,” he noted, “but it is not well distributed.”
Surely as the number of Pear Foundation scholars increase and they take
up key positions, they will practice the principles of social medicine
and other fields they studied in Jerusalem.