Laura Warner, Medical Student, Rush Medical College
Dr. Marge Cohen came to global health relatively late in life. She did not have
aspirations to live and work abroad but was astute enough to seize an opportunity to enter the community of global health when the chance came. Since she had worked with HIV-
94 positive women in Chicago as a clinician and researcher for 20 years, it is surprising it took so long for her to combat HIV/AIDS in Africa -- a role she now sees as a “natural continuation” of her work.. Once she became involved with a group called Women’s Equity in Access to Care and Treatment (WE-ACTx), she admits being “bit by the bug” of global health work.
About 4 years ago, Dr. Cohen heard of the need for HIV medications for the women of Rwanda, many of whom became infected through rape during the genocide of 1994. Appallingly, many of these women were sick and dying while the men who raped them received anti-retroviral treatment in prison. This dire need for care led to the formation of WE-ACTx and Dr. Cohen’s first trip to Rwanda. The purpose was to establish a clinic where these women could receive the treatment they desperately needed. “That first trip, in April 2004, was when I became committed to the issue”, says Dr. Cohen. In the years since, she has returned to Rwanda for 3-4 weeks every few months. One of her main roles in the organization is to raise funds in the U.S.A. for the clinic. Her efforts are aimed at raising “grassroots” consciousness about the cause, as she focuses on reaching out to religious groups, friends, and students.
Through the past few years of developing the clinic in Rwanda, Dr. Cohen and her
colleagues have learned how vital it is to be in touch with what their patients need. Apart from HIV medications, they need food, education for their children, and economic
empowerment for themselves. The Rwandan people are clearly the best equipped to understand the needs of their own community, thus the WE-ATCx clinic is now staffed by locals. Dr. Cohen says that it took a long time to understand the events of the genocide and its impact on the country. The local people have been an incredible asset for those involved with the clinic, as many of the patients have no addresses or telephone numbers and follow-up can be difficult. According to Dr. Cohen, “it is nearly impossible to find anything unless you’ve been there before”. These lapses in infrastructure
contribute to the difficulty of many developing countries in providing all that their citizens need. Many problems stem from the historical exploitation of these countries by colonial powers, making it “impossible for the poor countries of Africa to solve these problems on their own.”
Being sensitive to the problems facing developing countries is something about which Dr. Cohen feels strongly. She stresses the importance of those of us in the U.S.A. being “global citizens and [of] feeling that it matters to us what is happening in Kigali as well as in the U.S.A.”. This sentiment is directed especially at those interested in global health work abroad. Her advice to those who would like to work in a foreign country is to “follow the lead of the people you know there.” Students shouldn’t go abroad simply to learn skills, but “to learn about how other people live and to grasp other cultures”. Building credibility and relationships with local groups was essential to the success of the WE-ACTx clinic, and simply taking the time to become familiar with local customs made the job easier. Dr. Cohen remembers she had to become accustomed to slowing her pace since “no one is in a rush in Rwanda”. Despite being relatively new to global health work, Dr. Cohen is thankful for the opportunity to be involved in such fulfilling work. She has found it hard not to let this project become her major focus now that it has “captured her imagination and desires”. She adds, “The friends and colleagues I have
95 met make me feel good all the time”, even during times when she is tired or
overwhelmed by the sheer amount and gravity of what needs to be done. Dr. Cohen feels privileged to be able to get to know the patients in Rwanda and gratifying to have the tools to help them.
“The desire to help,” says Dr. Cohen, “must be tied to understanding in order to produce an impact”. While keeping in mind the larger global context and working together with partners abroad to make an impact is the essence of global health. Dr. Cohen asserts that “there is enough money worldwide to have a healthy population in developing countries and we have to demand that”. If more of us can find her courage and the strength, perhaps we will someday reach that goal.