People, Community, Commitment
Dr. Michael Schull, Dignitas International front man is devoted to improving and saving the lives of adults, children and families affected by HIV/AIDS in Malawi, The Warm Heart of Africa.
Dignitas International is a group of international health experts who have formed an allegiance to help strengthen developing countries such as Malawi, Africa by improving the quality of life for people living with HIV/AIDS, malaria and related illnesses. In Malawi, the medical humanitarian organization began to implement more community-based care programs in the Zomba District Malawi in 2004 with their vision to increase wide-ranging prevention and innovative treatment of HIV/AIDS.
Dr. Michael Schull is on the Board Chair and associate professor at the Department of Medicine at University of Toronto. He is an emergency room physician at Sunnybrook Health Sciences Centre in Toronto, and Senior Scientist at the Institute for Clinical Evaluative Sciences, where his research has included emergency health service utilization and quality care, emergency overcrowding and patient safety. Fueled by his compassion and solidarity for individuals and communities affected by HIV/AIDS, Dr. Schull is a saving grace for many, especially those severely affected in Malawi.
Dr. Schull, his wife, Dr. Josee Sarrazin, and their three children relocated to Malawi from Canada in July 2009 for one year. And in a country known as the Warm Heart of Africa, where the people are friendly, receptive and open, and the country’s spectacular scenery is marked by rich red clay-like soil, beautiful skies, lush vegetation and stunning mountains, no one could could begrudge him the move. However, is also one of the world’s most densely populated countries with one of the most under-resourced health systems on the planet.
The southeast Africa country has a high prevalence of HIV/AIDS resulting in low life expectancy; it has one of the highest infant mortality rates in Africa, as well as infectious diseases like hepatitis A, typhoid fever, malaria, Bubonic plague, diarrheal disease and tuberculosis that claims lives daily. A broken medical system with almost no doctors and nurses inadequately trained to provide proper health care services or good quality care to people living with HIV/AIDS, resulting in poor health care aid in most rural hospitals, makes it nearly impossible for people infected with the disease and a multitude of other medical needs to get proper health care. Catastrophic numbers of HIV/AIDS cases are on the rise with one million people (1 out of 15) infected with the disease. Malawi has since birthed a new nick name -The Orphan Nation- with more than 500, 000 children orphaned due to AIDS.
Dr. Schull’s focus remains on the integrity of good quality HIV care and better primary care in community-based rural health centres. It is about increasing access to life-saving HIV/AIDS-related prevention and treatment for thousands of adults and children. And this is exactly where Dignitas International stands taller than most. The organization was formed to help strengthen developing countires such as Malawi by improving the quality of life for people living with HIV/AIDS, malaria and related illnesses. In Malawi, the medical humanitarian organization began to implement more community-base care programs in Zomba District in 2004 with a vision to increase wide-ranging prevention and innovative treatment of HIV/AIDS.
In October 2004, Dignitas International formed an accord with the Ministry of Health in Zomba District, offering clinical support to help strengthen its medical system through innovative operations research, training and guidelines that will improve dignified quality care for those affected by HIV/AIDS. Dr. Schull is the senior fellow researcher leading the pilot project called PALM-PLUS designed to employ novel training and knowledge to healthcare workers by incorporating HIV/AIDS care into primary patient care. Dr. Schull says it will involve training about twelve people who will in turn train nearly 300 staffers working in small health centres in the Zomba District. Training will focus on simplifying the work of frontline clinicians making diagnoses.
PALM-PLUS is a modification of PALSA-PLUS, which was originally developed by the University of Cape Town in South Africa. Dr. Schull said it was rolled out there in a series of pragmatic, randomized controlled trials, which ultimately demonstrated that PALSA-PLUS provided higher job satisfaction for nurses and better care for patients.
The Dignitas International team of medical research experts, including researcher Sandy Thompson and research assistant Egnat Katengeza, has worked to improve PALSA-PLUS and now PALM-PLUS. With Malawi’s medical guidelines now incorporated into the system, the idea behind PALM-PLUS is to promote more effectual communication with patients by developing administration skills to run the health centres more smoothly. For example, it teaches stock-keeping to ensure that health centres will be less likely to run out of medicine, thereby increasing treatment and decreasing the patient care burden on Zomba Central Hospital workers.
Since Dignitas International has partnered with Malawi’s Ministry of Health the HIV/AIDS program has been very successful. Dalhousie University’s Global Health Office reported that the organization has helped to start over 11,500 adults and children on life-saving antiretroviral medications. Additionally, nearly 5,000 patients are now seeking care at decentralized health facilities in their own communities. For Zomba District, tremendous improvements have been made, as nearly 20,000 children and adults have started life-saving antiretroviral treatment and services. Schull explains that the “problem is people might take the success of the last few years to mean we don’t need to provide so much money anymore.” On the contrary, the reality is that thousands are affected by the disease and they will continue to be affected by HIV/AIDS.
Before Dignitas International’s innovative treatment of people living with HIV/AIDS, wide-ranging prevention of the disease and life-extending antiretroviral therapy, the average Malawian’s life expectancy was just 40 because of the high mortality rate due to HIV/AIDS, malaria, and malnutrition. Thankfully, with the help and commitment of Dignitas International’s visionaries, impartial access to HIV/AIDS-related prevention treatments and quality care are made readily accessible to everyone. Dr. Schull believes that Malawian life expectancy will increase with the intervention of PALM-PLUS, saying, “What we’ve also begun to see that is really quite remarkable is mortality or death rates across the population are starting to decline, and we think that’s a reflection of improved access to medication for AIDS.”
Dr. Schull’s goal for PALM-PLUS is to have the project running consistently and smoothly to help health care workers such as nurses and clinicians perform their jobs more easily. This will create a less stressful environment, thus provide good quality care and services to caregivers and patients alike. “I can feel that the project really has contributed to making the lives of nurses and clinicians who are working here easier and the care that they provide a bit better for patients,” Schull continues. The success of PALM-PLUS continues as it has established a deep-rooted core infrastructure. To put this into perspective, five years ago thousands of patients walked 40 kilometres or more to access treatment but now, with the new infrastructure, 5000 HIV/AIDS patients are receiving quality care in their local communities at decentralized health facilities.
The success of PALM-PLUS has established a deep-rooted core infrastructure. To put this into perspective, five years ago thousands of patients walked 40 kilometres or more to access treatment. With the new infrastructure, 5,000 HIV/AIDS patients are receiving quality care in their local communities at decentralized health facilities. The future and health of adults, children and families living with HIV/AIDS certainly looks bright with life expectancy sure to increase and infant mortality rates decreasing. Dignitas International has successfully established healthcare clinics in 42 rural healthcare facilities with HIV services. The implementation of innovative operations, research and training has kept hundreds of HIV patients alive and has improved their health considerably.
By Simone Da Costa
First published by Muud Magazine