[Peace-discuss] Mississippi turns to Iran for advice on health care

[John W.]

Very nice.  we could learn a few lessons about health care from Cuba as
well.




On Mon, Mar 22, 2010 at 2:09 PM, Robert Naiman <naiman.uiuc at gmail.com>wrote:



> http://www.timesonline.co.uk/tol/news/world/middle_east/article6962844.ece
>
> Sunday Times
> December 20, 2009
> Deep South calls in Iran to cure its health blues
> In ground-breaking project, one of America’s poorest communities is
> turning to the Middle East to try to resolve its crisis
> Christina Lamb
>
> AS Marie Pryor shuffles along a Mississippi roadside collecting
> discarded drink cans to sell for a few cents, her breath comes in
> short puffs caused by a congenital heart defect. The same condition
> caused her granddaughter’s death earlier this year.
>
> The last place on earth she would look for help is Iran, a country
> widely regarded in America as the enemy. The US and Iran have not had
> diplomatic relations for 30 years and the two governments trade daily
> insults over Iran’s nuclear programme. Last week Tehran charged three
> American hikers with espionage after they apparently strayed across
> the border.
>
> But with Congress acrimoniously debating the reform of healthcare, it
> is to Iran that one of America’s poorest communities is turning to try
> to resolve its own health crisis.
>
> A US doctor and a development consultant visited Iran in May to study
> a primary healthcare system that has cut infant mortality by more than
> two-thirds since the Islamic revolution in 1979.
>
> Then, in October, five top Iranian doctors, including a senior
> official at the health ministry in Tehran, were quietly brought to
> Mississippi to advise on how the system could be implemented there.
>
> The Mississippi Delta has some of the worst health statistics in the
> country, including infant mortality rates for non-whites at Third
> World levels.
>
> “It’s time to look for a new model,” said Dr Aaron Shirley, one of the
> state’s leading health campaigners.
>
> “Forty years ago, when I was a resident at Jackson hospital, I was in
> charge of admitting sick babies and was astonished at all the children
> coming in from the delta with diarrhoea, meningitis, pneumonia.
>
> “After years of health research and expenditure of millions of
> dollars, nothing much has changed.”
>
> As the House of Representatives and Senate weigh the cost of President
> Barack Obama’s health reforms, Shirley points out that good primary
> care prevents people from ending up in hospital in the first place.
>
> Besides, nowhere is the need for reform more acute than in
> Mississippi. The southern state has the highest levels of child
> obesity, hypertension and teenage pregnancy in the US. More than 20%
> of its people have no health insurance.
>
> Baptist Town, where Pryor lives, is typical. A rundown suburb of
> Greenwood, the collapse of the cotton industry has led to massive
> unemployment. The local stores are a pawn shop, Juanita’s Beauty Salon
> and Bail Bonding, and an office offering “payday and title loans”.
>
> Pryor’s son Kenneth and daughter-in-law Lizzie, who live with her, are
> both out of work and their only daughter died from her heart condition
> at the age of 26. With no local clinics or transport, they go to the
> hospital’s accident and emergency department if they need a doctor.
>
> The idea of looking for solutions in Iran emerged when James Miller, a
> consultant based in Mississippi, was called in to advise a rural
> hospital in financial difficulty. He was shocked to find that the
> state had the third highest medical expenditure per capita, but came
> last in terms of outcome.
>
> Miller, managing director of Oxford International Development Group,
> remembered a conference in Europe where Iranian officials had
> explained how their country had revolutionised its healthcare system.
>
> Facing shortages of money and trained doctors at the start of the
> Iran-Iraq war in 1980, the new government launched a system based on
> community “health houses”, each serving about 1,500 people.
>
> Locals were trained as health workers known as behvarz, who would
> travel their area, dispensing advice about healthy eating, sanitation
> and contraception as well as monitoring blood pressure and conditions
> such as diabetes.
>
> It was a stunning success, reducing child mortality rates by 69% and
> maternal mortality in rural areas from 300 per 100,000 births to 30.
> There are now 17,000 health houses in Iran, covering more than 90% of
> its rural population of 23m.
>
> Miller contacted Shirley, who is seen as a community health pioneer in
> Mississippi and had recently converted a deserted shopping centre in
> Jackson into a “medical mall” for the poor.
>
> “I thought if the Iranians could do it with a fraction of resources we
> have, then why shouldn’t we?” said Shirley.
>
> An Iranian doctor helped them make contact with Shiraz University,
> which manages more than 1,000 health houses and trains healthcare
> workers.
>
> Shirley and Miller visited Iran in May and were astonished to be
> welcomed with open arms. When they went to remote villages to see the
> health houses, the Iranians were equally amazed.
>
> “They told us this is a miracle,” said Miller. “Not only were
> Americans coming here, but also they were learning from us rather than
> telling us what to do.”
>
> One villager exclaimed: “We always knew rain fell down but never knew
> it could fall up.”
>
> They signed an agreement with Shiraz University to form the
> Mississippi/Islamic Republic of Iran rural health project and applied
> to the US Treasury for a special licence for “Iranian transactions”.
>
> The next step was to win over communities in Mississippi. They started
> with Greenwood, where Shirley had already been in talks about setting
> up a local clinic.
>
> Community leaders were shocked when he advised using Iran as a model.
> “To be honest, I wasn’t overwhelmed with the idea of copying Iran,”
> said Larry Griggs, the local fire chief. “It’s not exactly one of the
> most favourable countries to the US.”
>
> They also had to overcome the legacy of distrust between blacks in the
> American south and public health officials after a series of scandals
> over medical experiments. The most notorious was the Tuskegee
> experiment between 1932 and 1972, in which 399 impoverished, black,
> illiterate farmers were left to suffer from syphilis even though
> penicillin was available. More than 100 died.
>
> To sell the Iranian idea, Miller promoted it as “a healthcare model
> just like the Beetle”, pointing out that the popular Volkswagen Beetle
> had been conceived by the Nazi regime to show “good things can come
> out of somewhere not very popular in the world right now”.
>
> The Iranian experts who came to Mississippi included two of the
> programme’s architects, Dr Hossein Malekafzali, a former minister who
> is professor of public health at Tehran University, and Dr Kamal
> Shadpour, the initiative’s co-ordinator in the health ministry.
>
> The Greenwood community was convinced and leased a defunct car
> showroom for $1 a month for the first Mississippi health house, which
> is due to open next month. Fifteen Delta communities have expressed
> interest and Harvard’s School of Public Health will monitor the
> project.
>
> Paula Gutlove, deputy director of the Institute for Resource and
> Security Studies, a US think tank, said there was a positive shock
> value to using an Iranian model. “The exotic nature of working with
> Iran makes it intriguing to potential funders and sponsors,” she said.
>
> The first candidates from the Mississippi Delta are expected to be
> trained as health assistants in Iran this spring. If it works, Shirley
> hopes to extend the programme to the rest of the US. “Just as
> Mississippi was ground zero in the civil rights movement, so it can be
> for health,” he said.
>
> Nonetheless, the Iranian connection poses a problem. Knowing that many
> Americans might be outraged, they have not spoken about the project.
> Even the governor of Mississippi is unaware of it. “We’ve been
> deliberately working under the radar,” said Shirley.
>
> The programme chimes with Obama’s policy of engagement and his support
> of so-called “smart diplomacy”, using links between scientists as a
> way of breaking down barriers between countries. Following his speech
> in Cairo last June, aimed at reaching out to the Islamic world, the
> president has appointed three science envoys who will head to the
> Middle East next month.
>
> “The Iranians are a proud people with 5,000 years of history and huge
> contributions to science and medicine,” said a State Department
> official.
>
> “A project like the Mississippi one is incredibly powerful as it
> appeals to that Iranian concept of history. It’s a great way to keep
> the door open between the two countries.”
>
> Gutlove points out that similar meetings between American and Soviet
> scientists in the 1980s helped pave the way for the end of the cold
> war. “What we did in the 1980s created lasting relationships which cut
> across the divide,” she said.
>
> “It’s a win-win project,” said Shirley. “Not only do we finally have a
> way of addressing disparities in Mississippi, but also building
> relations between peoples.”
>
>
>
> --
> Robert Naiman
> Policy Director
> Just Foreign Policy
> www.justforeignpolicy.org
> naiman at justforeignpolicy.org
>
> 6 minute video: highlights of the House Afghanistan debate
> http://www.justforeignpolicy.org/act/endthewar
>
>

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