Dr. Fredrick Chite, director of oncology at the Moi Teaching and Referral Hospital, conducts clinical rounds on the wards of the Sori Lakeside Hospital as part of a remote cancer and sickle cell screening clinic. Here he examined 71-year-old Deborah Akeyo Acharo, who had been admitted to the hospital because of a failing heart but was additionally diagnosed with cancer. Photo by James D. Kelly, Indiana University
A longtime partnership between Indiana University and colleagues in Kenya to provide health care and train future medical professionals has become such a successful model of global health collaboration that it expanded to three more countries in 2022.
The growth and success of AMPATH — the Academic Model Providing Access to Healthcare —also has been captured in a new book by James D. Kelly, an associate professor and director of journalism in The Media School at IU Bloomington. IU Press published “From AIDS to Population Health: How an American University and a Kenyan Medical School Transformed Healthcare in East Africa” in November.
Indiana University School of Medicine has worked with Moi University and Moi Teaching and Referral Hospital in Eldoret, Kenya, and the Kenyan Ministry of Health for more than 30 years. In that time, AMPATH has grown to include a consortium of 15 institutions in North America and Europe, with expansion of the health care model to Mexico and Ghana in February and to Nepal in October.
“We all believe strongly that this model is replicable, and by adhering to AMPATH’s principles in these new sites, we are setting a new standard for global health partnerships,” said Dr. Adrian Gardner, director of the Center for Global Health at Indiana University and executive director of the AMPATH Consortium.
Watch interviews with Gardner and Kelly, and see photos from Kelly’s book
The new sites in Ghana, Mexico and Nepal were made possible by having the right people in the right place at the right time, and a little bit of serendipity, Gardner added.
“Former AMPATH Kenya leaders who helped implement this model in Kenya are now faculty at other AMPATH Consortium institutions and are providing leadership for this expansion,” he said. “There were leaders and institutions in these new host countries that were interested in the partnerships, and existing institutional and corporate relationships also made these new sites feasible.
“Both Ghana and Nepal were sites that the team from IU visited in 1988 before establishing the partnership in Kenya, so in many ways it feels like we are also fulfilling our original destiny as well.”
Model of success
The model is rooted in equity, as AMPATH is a co-creation of Kenyans and North Americans working together, Gardner said. They’ve collaborated to train medical students from both continents and community-level workers so that Kenyans could receive the health care they need. The bidirectional learning also has produced reciprocal innovation — creative solutions used by both Kenyans and partners in their home countries.
Dr. Adrian Gardner. Photo by James D. Kelly, Indiana University“We have been privileged to be a part of the health system there and to be welcomed as visitors into the Kenyan health system, and we have been able to embed our trainees, who have incredibly valuable experiences there, and bring those lessons back to Indiana,” said Gardner, himself a product of the AMPATH partnership.
He went to Kenya in 2001 as a fourth-year medical student from Brown University with thoughts of becoming an obstetrician.
“I was there at a time when the HIV pandemic was devastating western Kenya, and I began to appreciate the response that an academic health center could have,” he said. “And, really, that changed my career at that point and set down a new path. I wanted to be part of the global HIV response.”
One patient who stood out to Gardner was a young man from western Kenya who had pulmonary tuberculosis, Kaposi sarcoma — an HIV-related cancer in his mouth and oropharynx — and a new diagnosis of HIV. The man’s father had heard about AMPATH and drove several hours in the hope that his son would receive medical care.
“To see him one year on, 35 pounds heavier and doing really well, is incredibly motivating and rewarding for me as an individual and provider,” Gardner said.
The AMPATH community-based programming grew rapidly with a focus on the HIV and AIDS epidemic, but has evolved to focus on chronic diseases, nutrition and financial stability in the overall population so communities can take care of themselves.
“AMPATH is so holistic and comprehensive in its notions about how care is administered,” Kelly said. “It’s not just treating people’s bodies; it’s treating people’s entire lives, making sure that they have the means by which to live a healthy life.”
Important story to tell
Kelly, a photojournalist by profession, had experience with AIDS reporting in East Africa, but he didn’t learn about AMPATH until coming to IU in 2007 to teach.
James D. Kelly takes photographs in the Kibera slum in Nairobi, Kenya, in 2009 while a guest of his good friend Noor Khamis, a photographer for Reuters wire service who grew up and continues to live in Africa’s largest slum. Photo by Noor Khamis, courtesy of James. D. Kelly“I realized that people in Indiana needed to know more about this,” Kelly said.
He initially took journalism students to Eldoret over three summers to report on AMPATH’s work before using a Fulbright Award so he could personally tell its story, this time with a book.
Using 100 color photos and 70,000 words, he illustrated the success of the partnership by telling the stories of AMPATH leaders, including Gardner, and some of the hundreds of nurses, social workers, counselors, technicians and other workers who provide community-level help.
“I wanted to emphasize the role of what I call ‘worker bees,’ the regular folks who go out every day and perform the service that is AMPATH,” Kelly said.
One of his profiles is of Ebby Opisa, whose husband had died from AIDS and who was in danger of dying from AIDS herself. She survived because of AMPATH’s care and now teaches Kenyans about creating and sustaining group savings organizations that support small businesses and ensure financial independence.
“She’s gone from somebody who was on death’s door to somebody who is organizing communities to improve their living conditions,” Kelly said. “Her efforts decrease the likelihood that they’re going to need medical care.”
When readers finish the book, Kelly said, he hopes they understand how people who seem very different have worked together to create solutions, and that they themselves reach out to others in equal partnership to solve problems. He also hopes it motivates readers to help AMPATH.
“I hope that Hoosiers read this book and then provide some support for AMPATH financially and morally,” Kelly said.
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