Category: Uncategorized

The ‘Boston-Benghazi’ Initiative

On February 12, Massachusetts General Hospital (MGH) hosted a dinner in Boston in honor of Dr. Anne Stevens, the sister of the late Ambassador Christopher Stevens, and a team of senior administrators from Benghazi Medical Center (BMC). There were separate meetings regarding a Memorandum of Understanding (MOU) that it is hoped will lead to progress on expanding trauma/emergency medicine capacity at Benghazi Medical Center, despite the dangerous situation prevailing in the city following the attack on the US compound, September 11, 2012.   The partnership between BMC and MGH was initiated, and intensively facilitated over the course of a year, by the Avicenna Group (Co-founders Ethan Chorin and Omar Benhalim), with generous support from the American public and the Libyan diaspora.  MGH was one of many US teaching hospitals Avicenna approached in the Summer of 2011, with respect to engagement with BMC. MGH’s leadership deserves significant credit for considering this possibility, and its continued engagement to assist the people of Benghazi.  The Avicenna Group is a 501(c)(3) organization committed to building medical capacity in post-conflict environments. — EDC

Djibouti Diary: The Story of Two Ports & A Clinic (Part I)

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February 8, 2013

Doesn’t look like much –a lean-to and some wooden pallets, along a bit of desolate highway near the ultra-modern Doraleh Container Terminal, built by Dubai Ports World in the Red Sea State of Djibouti in 2008/2009– but this photo appears to be evidence that a potentially important health initiative may finally have been unstuck after more than 2 years. During this time, parts for a new clinic, meant to serve more than 30,000 patients a year, were left sealed in three shipping containers. The project, linked to a broader initiative called ROADS, and billed as the first-ever “U.S.-Djibouti-Dubai Public Private Partnership” was designed with the hopes it would become a model for primary care service provision for some of the poorest and harshest environments in Africa.

A development economist, then working for Dubai Ports (which runs more than 30 ports globally),  I effectively managed the design and rollout this project for close to three years, with strong backing from USAID’s Mission director Stephanie Funk, colleagues at Dubai Ports, and USAID’s implementing partner, Family Health International (FHI).

ROADS, as originally conceived by  Jeff Ashley, a veteran USAID hand, and advocated by the inspirational Gail Goodrich, then with FHI, was meant to prevent HIV/AIDS infections among vulnerable populations along a couple of major African transport corridors, by providing shelter and recreational space for truckers, mobile/displaced populations and local villagers at manned, roadside outposts. At these “SafeTStops”, visitors received information about how HIV/AIDS is transmitted, contraceptives, and some basic health counseling.

Some of the main enhancements to the ROADS model included 1.) expanding the range of services provided, from HIV information to a more robust array of primary care (addressing nutritional deficiencies, obstetrics, TB , etc.) based out of a ‘hub’ , that would serve the “route”– a section of 600 miles of highway– and as well as a provisioning and administrative center for a series of health posts placed up and down the corridor  2.) Changing the architectural/design paradigm, by sequentially replacing the baking-hot shipping containers from which these structures were made, with more inviting, durable, easy to assemble, easily sanitizeable and secured materials, and for which there was a permanent source of power (solar, in this case) 3.) linking the hub facility to the radiating outposts via satellite Internet, so that a patient’s health records, as rudimentary as they might be, could follow them beyond any single facility. Direct internet access powered a series of health tutorials, to be provided by Dubai Ports’ suppliers and enabled Skype communication between truckers and their families often thousands of miles away. 4.) Feeding micro-economies in the shadow of the clinics and outposts — a canteen, or a souvenir shop, or a cell phone charging station, for example.

–EDC