From AIDS to Population Health

James D. Kelly

Description

From AIDS to Population Health explores the thirty-year history of a unique collaboration between the medical schools of Indiana University and Moi University in Kenya, as it progressed from combating the HIV/AIDS epidemic in East Africa to the building of a national plan to provide universal healthcare to all. The Academic Model Providing Access to Healthcare (AMPATH) program focuses on the medical education of healthcare professionals who are building communities that can take care of themselves.

The overwhelming success of the AMPATH program and its continuing vibrant legacy today are showcased through dozens of striking photographs, telling interviews, and revealing anecdotes and encounters. It focuses on four of the most innovative projects among the fifty that AMPATH oversees: a microfinance officer who organizes villagers, an oncology nurse who runs outreach clinics, a farm extension agent working in partnership with a multinational agriculture corporation to improve farm output, and a special healthcare clinic exclusively for adolescents.

Over its thirty-year history, AMPATH has served more than a million clients and trained 2,600 medical professionals and community health workers, always guided by its motto "Leading with Care." From AIDS to Population Health presents their compelling stories and explores the program's continuing legacy for the first time.

Part 1: Introduction
1. My African Experience
2. History and AMPATH
3. AMPATH Re-envisioned
Part 2: Photographic Essays of Workers
4. Population Health through Economic Empowerment
5. Public-Private Partnerships
6. Managing Chronic Diseases
7. Rafiki Centre for Adolescent Health
Part 3: Leadership Profiles
8. The Leadership
Part 4: Research
9. Methodology
10. Staff Responses to the Survey
11. Discussion and Conclusions
Epilogue
References

Sujets

• Santé et bien-être
• Santé du quotidien
• African Studies
• Ethnic Studies
• Health Issues
• Social Science
• Sociologie, société et politique
• Universidad de Indiana
• VIH
• Kenia
• AIDS
• Moi University
• Indiana University (Bloomington)
• Disease
• Health
• Université d'Indiana
• Syndrome d'immunodéficience acquise
• Kenya
• HIV

Informations

• Publié par: Indiana University Press
• Date de parution: 22 novembre 2022
• Nombre de lectures: 0
• EAN13: 9780253062772
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

From AIDS to POPULATION HEALTH
The IU House family celebrated 20 years with Joe and Sarah Ellen Mamlin in the garden of Hilltop House with food and dance on March 16, 2019. The staff gave the Mamlins a portrait that now hangs on the wall of the dining room.

This book is a publication of
Indiana University Press
Office of Scholarly Publishing
Herman B Wells Library 350
1320 East 10th Street
Bloomington, Indiana 47405 USA
iupress.org
2022 by James D. Kelly
All rights reserved
No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying and recording, or by any information storage and retrieval system, without permission in writing from the publisher.
This book is printed on acid-free paper.
Manufactured in Korea
First printing 2022
Library of Congress Cataloging-in-Publication Data
Names: Kelly, James D., [date] author.
Title: From AIDS to population health : how an American university and a Kenyan medical school transformed healthcare in East Africa / James D. Kelly.
Identifiers: LCCN 2022024169 (print) | LCCN 2022024170 (ebook) | ISBN 9780253062758 (cloth) | ISBN 9780253062765 (pdf)
Subjects: LCSH: AMPATH. | Health services administration-Kenya. | Medical care-Kenya.
Classification: LCC RA971 .K439135 2022 (print) | LCC RA971 (ebook) | DDC 362.1068-dc23/eng/20220523
LC record available at https://lccn.loc.gov/2022024169
LC ebook record available at https://lccn.loc.gov/2022024170
Dedicated to the staff members who each day give life and meaning to the Academic Model Providing Access to Healthcare (AMPATH) by leading with care for the people of Kenya.
CONTENTS
Preface
Acknowledgments
Note on Language
List of Abbreviations

PART ONE
INTRODUCTION
1. My African Experience
2. History and AMPATH
3. AMPATH Reenvisioned

PART TWO
PHOTOGRAPHIC ESSAYS OF WORKERS
4. Population Health through Economic Empowerment
5. Public-Private Partnerships
6. Managing Chronic Diseases
7. Rafiki Centre for Adolescent Health

PART THREE
LEADERSHIP PROFILES
8. The Leadership

PART FOUR
RESEARCH
9. Methodology
10. Staff Responses to the Survey
11. Discussion and Conclusions
Epilogue
References
Index
PREFACE
I AM TRYING TO PAY A debt. I have been privileged to visit with the people of Eldoret, Kenya, for nearly a dozen years now. I say privileged because it has been an honor and pleasure to know the people of AMPATH but also because I have taken advantage of an entitlement that white people enjoy. I do not know why I was born white in the United States instead of Black in Africa, but I do recognize that the circumstances of my birth have afforded me opportunity I have not earned and that I need to pay for it if the world is to be made right.
My privilege derives from a long history of people who trace their ancestry to Europe subjugating the people who trace their ancestry to Africa. As an American, I enjoy a life purchased with the labor stolen from enslaved people whose ancestors were stolen from Africa. As a professor at Indiana University, I teach my students on land stolen from Indigenous people recognized now as Miami, Delaware, Potawatomi, and Shawnee. We call our state Indiana, a tacit if largely unrealized acknowledgment that our home was someone else s home before us. This theft by my ancestors provided great economic gains that I continue to benefit from.
Shortly after graduating from Indiana University with my doctoral degree, I had the great personal fortune to wander into a meeting room in a hotel I was staying at in Chicago. The Reverend Jesse Jackson was addressing a crowd with an oratory style that now reminds me of the great speakers I have since listened to in Kenya, Uganda, Tanzania, and Ethiopia. At the time, though, I thought of him as simply a Black American. Sure, he had just run for president, but I was not thinking of him as a son of Africa. I had not yet deeply considered the relationship he and all Black Americans have to a continent on the other side of the ocean that few will ever see but that is a part of them nevertheless. At the time, I had never visited Africa and didn t know any Africans. But what Reverend Jackson said that afternoon in 1991 changed my way of thinking and has continued to resonate as I have photographed and written this book.
He explained that white people living today did not own slaves, did not colonize Africa, and did not displace the Native Americans. He nevertheless said that reparations ought to be paid, not just to American Blacks but also to the African nations from which they were stolen. The voices that cry out for reparations have been seen as marginal or radical, but they cry for justice, he said. What is America willing to do to repair the damage done? He said the government ought to make the payments and acknowledged that such a day might never come, but at the very least, white people can acknowledge that they owe a debt. Since that day I have tried to do a wee bit more than what Jackson said was the very least.
I do acknowledge the debt my European ancestors owe to the people of Africa and America. I myself cannot pay it back. It is too large. No amount of money is sufficient to compensate for the millions of lives lived in shackles and without their loved ones and their land. I cannot undo what has been done. None of us can. But I can use my privilege to help tell the story that Reverend Jackson taught me about in Chicago.
I am still faced with an impossible task. The story you need to hear, need to know, and need to understand-well, it is not my story. It is a Kenyan story. It is a story about Kenyans building a healthcare system in the wake of generations of colonial exploitation. It is a story about those Kenyans fighting the HIV virus, and it is a story about those Kenyans expanding upon the lessons they learned from that great nation-building effort so that all Kenyans can live healthy, sustainable lives. It is a story surely better told by a Kenyan voice than by mine, but here I am, using my privilege to tell someone else s story.
This is what journalists do. They find a story that isn t being told loudly enough and try to tell it themselves. It is an imperfect attempt every time. We listen, we watch, and we do what we can to understand, but in the end, we are telling stories that others have lived and that they understand in ways we never will. I get to try because I have been given opportunity to try. Instead of paying those reparations, my government paid me to go to Africa to teach Kenyan students about journalism and to create a truthful story that describes a thirty-year partnership between people in Kenya and people in Indiana. It is the very least my government could do, and it is the very least I could do.
This book is an imperfect, inadequate attempt to pay a monstrous debt. I believe real monetary reparations are owed, and I hope the story I tell in these pages lets Kenyans know we are trying and lets Americans know we need to do more.
What is good and right and just is that ever since that day I stood in the back of the room listening to Jesse Jackson, Hoosiers have been working with Kenyans as if they were brothers and sisters. Hoosiers have used their privilege to live in the Great Rift Valley, and they have used their privilege to bring Kenyans to the homes they have made on Native American land. Every time I have looked at AMPATH since first going to Eldoret in 2009, I have seen friendship, respect, admiration, and love.
I cannot let this story go. It must be told. If I have done anything right, it is because my Kenyan friends have helped me see, helped me understand, and helped me tell their story back to them. If it rings at all true to their ears, it is because I have been a good student. Their ability and willingness to teach me has only added to the debt I owe Black people who trace their ancestors to Africa.
ACKNOWLEDGMENTS
I OWE THIS BOOK TO THESE fine folks. I had help writing this book. A lot of help from a lot of people living in a lot of different places. This is where I acknowledge their kind assistance. I m going to miss someone and likely get the order of importance wrong too, so bear with me.
Carol Ann Kelly helped the most. For all of our thirty-three years together, she has cared for my children and me as I took off for overseas places about one month of every year. She tells wonderful stories, and many of them begin with, Well, Jim was out of the country when . . . There were sick babies, broken cars, ice storms, smoke alarms, snow days, and bumps in the night. Her stories were always funny, but they were about what happened when I was away. This book is about what happened when she was away with me in Africa. She retired early from a job she loved so she could live in servants quarters in a small city on the other side of the planet. Eldoret was very familiar to me, but it was literally a world away from what she knew. Every day while we were in the IU House, she listened to me tell tales about who I had met and what I had seen. She calmed me down every time I decided nothing was going to work, and she celebrated every time something did, in fact, work. It was our big adventure. Since then she has read drafts of proposals, letters, budgets, chapters, and more chapters. She s the best proofreader I know. In other words, she has kept me focused and accurate.
Those children Carol cared for while I was away also helped me with this book. Both Anna and Megan read early drafts and provided insightful feedback that helped me land the Fulbright award and the book contract. They visited us in Eldoret and reminded me all over again just how special the Great Rift Valley is by their constant joy over being there with their parents and meeting my friends, and they told me how nice it was to see me in the place they had long imagined me in before.
Now the order of importance becomes