Medical school expands Botswana program

Through the Penn Program in Botswana, physicians and School of Medicine students are traveling to the other side of the world to put their skills to use.

Botswana's adult population is nearly 40 percent HIV-positive, giving it what is possibly the world's highest concentration of the virus.

Penn has had researchers and physicians in Botswana since 2001, and is expanding its program there to include an inpatient care program to keep up with the rapidly spreading disease.

"I've been [at Penn] for 26 years now and... this is probably the most comprehensive program that we've developed," said Harvey Friedman, chief of the Division of Infectious Diseases and director of the Penn Program in Botswana.

"It's the first international treatment program of this magnitude at Penn," he added.

Medical Professor Stephen Gluckman -- the man in charge of the program's new treatment component -- recently left for Botswana to begin the inpatient care program at the Princess Marina Hospital in Gaborone, Botswana's capital city.

The University first received an invitation to do work in Botswana from the Merck Foundation, a private charity organization started by the pharmaceutical giant.

The program started with educating local health care providers.

"Usually you have three components to any program: clinical care, clinical education and research," Friedman said. "We try to get all three elements going eventually."

This comprehensive model, which is used at Penn's own hospitals, is now being exported to Botswana.

"We wanted to follow the same model that's worked so well in this country," Friedman said.

Clinical Medicine Professor Dan Baxter has been running the education component since 2002. The clinical research effort is headed by physician Greg Bisson.

As part of the research component, three first-year Medical students -- Richard Vidal, Hema Magge and Sanam Roder -- spent nine weeks in Botswana last summer working with a local hospice.

They worked to "develop a partnership with the hospice" and decide together what needed to be done, Vidal explained.

What the hospice wanted was an assessment of community needs. Working with volunteers from the University of Botswana, the Medical students conducted surveys and led focus groups among the patients.

The assessment process "empowered the clients and [gave] them a voice in guiding the direction of their care," Vidal said.

"It was the first time the patients got asked questions to assess their knowledge of AIDS."

This component of the program will be continued with three new students next summer.

"Every year, three first-year students will go to continue the work with the hospice and build upon the work we did the previous year," Vidal said.

With the new inpatient care program to begin in January, third- and fourth-year Medical students will now have a chance to work on their clinical skills.

"I definitely plan to go back," said Vidal, now a second-year student.

The program is going "extremely well," Friedman said.

Penn is one of three American universities working in Botswana. The others are the Baylor Medical School and the Harvard AIDS Institute.

Friedman said that for now, the universities are just trying to avoid "stepping on each other's toes," but mentioned possibilities for collaboration in the future.

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