Day 17 and 18: And today we worked: Bringing Bednets to Badakhshan

Latte: Don't try class without it

Class is in session

“You have 2 years and 1 million US dollars, to design and implement a disease control program for the treatment of endemic and Neglected Tropical Diseases (NTD) in the resource limited setting of 6 rural provinces in post-war Northern Afghanistan with a focus on the morbidity of social ostracism related to cutaneous lesihmaniasis. Submit a proposal for consideration to the country’s Ministry of Health, potential donors, relevant non-government organizations (NGOs) and stakeholders in 5 weeks. Begin.”

More lecture

Vector control of a giant gerbil? Huh?

What?! That was one tall order and not a lot of time or money to serve it up in! I was going to have to learn everything about leishmaniasis and Afghanistan and fast. The class of 120 was divided into multiple groups of 6 members each, our task, as stated above, was to bring some relief and public health expertise to a post-war torn Northern Afghanistan. My group was an international mix of chaos and talent. We hailed from Sweden, Calgary, the Middle East, Germany, California and Illinois. The scope of our backgrounds ranged from masters student, to pharmacist to laboratory researcher to physician. 

Yes, there is no running water for your hygiene campaign.

We got along well and agreed on nothing, but we shared a common goal, and that was to learn how to develop sustainable programs, in resource limited settings. Essentially we were learning how to save the world on a budget.

Veggie burger break time in the cafeteria

The questions we were confronted with on a daily basis were unlike any questions I have had to answer as a physician in the “modern” world. Questions such as accessibility to health care in a war torn environment, getting medical care for women whose husbands wouldn't allow it, distributing bed nets to homes in hard terrain areas, finding literate and educated health care workers to help translate interventions and using donkeys where vehicles couldn't travel. The class materials were intense, the lectures dense and the group work demanding. I was loving every bit of it.

It costs how much to rent a donkey?

Are we sure about the shuras?

But these were not just theoretical questions for the sake of argument and of class material. These were questions that were being asked every day on the ground in these countries right now. The current events of the time with revolution and retaliation in the Middle East, made the assignment all the more timely and relevant. What would we do if we had the chance and how would we do it? The possibilities endless, the suggestions for intervention strategies creative (and comical at times), point of views diverse, but regardless of where we stood,we embraced the task and dove right in.

What do you mean we're already over budget??

We spent days on end drafting tables, doing literature searches, creating scenarios, finding maps and generating ideas. We looked at systems we could integrate into existing models already in the field and worked on developing new ones that hadn't been tested yet. 
It seemed dysynchronous talking about rare tropical diseases across the street from the stoic halls of the British Museum in a modern, London city classroom, but I couldn’t imagine where else in the world such an eclectic group of diverse talent could come together to fulfill an assignment with such cohesiveness.
The international appeal of the London School drew students from all over the world seeking the chance to learn from professors who had actually rolled out these proposals on the ground and worked in the true trenches of public health.

Leishmaniasis and a latte

And back to class. . .

The sun had been out for two days now, and although it was still crisp in the shade, being in class was difficult when all I wanted to do was catch some rays and shoot some film along the Thames. But I didn’t. I was just as engrossed in the work at hand as I was in sights left unseen. Lectures on behavior change, policy reform and cultural sensitivity were as interesting as they were invaluable. I wasn’t quite sure how I was going to use or integrate these new skills and knowledge when I got home, but I was pretty sure it was going to be indispensable in my arsenal of learning.

Our fearless leader

As we teemed over budget costs for bed nets in rural provinces in Northern Afghanistan, over unit doses of pentavalent antimonials and costs of health education campaigns, I imagined what it would be like to realize this project in Northern Afghanistan with my team. To actually go there on the ground and implement our strategy. 
As I dreamed about the hot desert sands and cities with names like Kandahar, Kunduz and Nuristan I made a hopeful wish that one day I would. But for now, I would get back to work in Bloomsbury looking for ways to bring bed nets to Badakhshan.