The reach of work by Emory’s doctors, nurses, and public health practitioners extends throughout the globe.

The risk of HIV transmission due to blood transfusion approaches one in 500 in some developing countries (compared with one in 5 million in the United States). The World Health Organization estimates that 5% to 10% of HIV infections worldwide are caused by transfusion of unsafe blood and blood products and that the percentage is considerably higher in many African nations where blood products are seldom tested and the majority of hospitals have no transfusion policies or procedures to limit HIV transmission. More than half of all blood transfused in Africa is given to children. The dangers of transmitting AIDS in transfused blood may be changing, thanks in part to the efforts of Emory Healthcare’s Christopher Hillyer, director of the Emory Transfusion Medicine Program and President-Elect of the American Association of Blood Banks. Hillyer is the co-principal investigator of a five-year grant funded by the President’s Emergency Plan for AIDS relief to improve the safety of blood transfusion in Kenya, South Africa, Mozambique, and Guyana.

In Kenya, large numbers of young nurses are dying of AIDS. That’s one reason this and other countries hardest hit by poverty and disease have fewer and fewer nurses to hold together already fragile health care structures. Another reason is that richer countries regularly recruit Kenya’s nurses away in an effort to solve their own countries’ worsening nurse shortages. The Nell Hodgson Woodruff School of Nursing’s Lillian Carter Center for International Nursing—created precisely to strengthen the global capacity of nurses to improve the health of vulnerable people worldwide—works closely with governmental chief nursing officers in Kenya and more than 80 countries to help reverse the flow of nurses from the very countries that need them most.

Georgia—the one in the former Soviet Republic—has bestowed honorary citizenship on Kenneth Walker, the Emory medicine and neurology professor who heads the Atlanta-Tbilisi Health Care Partnership. Created by Emory 15 years ago to improve the education and health care systems in this struggling country, the partnership includes Emory’s schools of medicine, nursing, and public health, as well as Georgia State University, Morehouse School of Medicine, Grady Memorial Hospital, and Georgia Institute of Technology. Over the years, all these institutions have sent faculty back and forth to the other Georgia, but none have made the trip more often than Walker. He exemplifies Emory’s broad-scale commitment to bringing this and other developing nations the information, technology, and training they need to improve health care for their own citizens. Program areas range from providing training in emergency medical services and in maternal and child health to helping get prosthetics for an estimated 10,000 lower-limb amputees, half of whom were injured in land mine explosions.

Malnutrition during pregnancy and in childhood often has devastating long-term effects on physical and intellectual development of the individual and, if widespread, on the health and functioning of the nation. Even the failure to obtain sufficient amounts of specific minerals or vitamins during pregnancy—a nickel’s worth of iodine, easily packaged in iodized salt—can result in severe retardation and other birth defects. The Rollins School of Public Health has had a major impact on the nutrition and consequent health of children and adults. Rey Martorell’s research on the effects of improved nutrition during pregnancy and early childhood, conducted over three decades in Central America, has had a major influence on the policies of international organizations such as UNICEF, the World Bank, and the World Food Program. Glen Maberly, founder and director of the Program Against Micronutrient Malnutrition, has been given a share of the credit for the elimination of iodine deficiency in children in China, and Fritz van der Haar heads the network for Sustained Elimination of Iodine Deficiency, a global alliance of 10 international organizations working toward universal salt iodization. Work by other faculty in public health on a Flour Fortification Initiative, sponsored by UNICEF and the CDC, seeks to improve micronutrient status of global populations through fortification of wheat flour.

The Atlanta Rotary recently joined forces with the Rollins School of Public Health’s Center for Global Safe Water to build new wells and support safe water treatment and storage in Kenya. The joint effort was inspired by problems in many villages in the struggling country where lack of easy access to clean water means children must spend hours carrying water instead of going to school and poor sanitation causes life-threatening disease. The effort also was inspired by the success of an inexpensive but effective water purification program, sponsored by the CDC and CARE, in which poor Kenyan women borrow enough money to buy a purifying chlorine solution wholesale and sell it retail to their neighbors. The program works. It gives the women (sometimes called the Avon ladies of Kenya) unprecedented economic power and already has cut in half the number of cases of diarrhea in children under 5, those least likely to survive serious bouts of the disease.
Faculty in public health are also working to build better latrines in places like El Salvador to help conserve water, prevent pollution, and reduce childhood illness and death.


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