From America to Africa: One doctor strives to make a difference
Not many American physicians would leave a suburban family practice in the U.S. to practice medicine at a clinic in Malawi, let alone transplant their spouse and family to make Africa a permanent home.
But that’s exactly what Perry Jansen, M.D. ‘91 did. He recounts the starfish story, which was part of his essay for medical school: Thousands of starfish have washed ashore, dry, and dying. A boy walks along throwing them back into the water. A man stops and says, “There are so many. What difference can one make?” The boy answers, “It makes a difference to this one,” and throws another starfish into the ocean.
As Jansen explains, there are millions of people with AIDS that he cannot reach. For eleven years, however, as founder and director of Partners in Hope (a local NGO focused on the HIV/AIDS epidemic in Malawi), Jansen has made a difference in the lives of the patients he has cared for. “I couldn’t say that about my practice in suburban America,” he says. “I would have just been another doctor.”
Not that anything is easy. “Many things about Africa make me want to run away screaming,” says Jansen. Yet he sees it as God’s calling for his life.
He traces his journey back to his third year of training at Penn State College of Medicine, where he had originally planned to be an orthopaedic surgeon. When his first-born daughter was born with a heart defect, Jansen “readjusted my thoughts about work and personal life and switched to family medicine."
He credits George Sims, M.D. and Penn State’s strong tradition in this field as major influences. “It’s about becoming a lifelong learner,” says Jansen. “It’s about looking at what you’re doing and how your work is impacting others.”
[Aside: In recognition of Jansen’s impact, Penn State recognized him as the youngest recipient of its Distinguished Alumnus Award, which is the highest award given by Penn State, in 2007.]
Following his daughter’s death in 1996, Jansen moved to Malawi in 1999 with his family (wife Brenda, son Nathan, now nineteen, and daughter Erin, now fourteen) initially to work at a clinic for two years – a welcome change from his life as one of fifty doctors in a large, Washington-based practice struggling for reimbursement from a local insurance provider.
While he continues to fight for funding, this time it’s for a greater cause – to provide care, training, research, and free or low-cost generic anti-retroviral medicine for his patients. “When I first arrived in Malawi, most people died within a year of diagnosis of HIV,” says Jansen. “Two years later, when we started prescribing [anti-retroviral medicine], the change was dramatic. I saw patients literally on death’s door get better. One-third of these patients would not be alive today without the care we provided.”
HIV treatment is particularly complex in Africa since half of all HIV patients suffer from TB at some point. “You have to diagnose and start TB treatment first,” explains Jansen. “If you start them on anti-retroviral medicine, they get worse.”
Early on, Jansen had a hard time picturing a return to America. “To never go back – that was quite an adjustment for my wife to make,” he says. “But she really came to see this not just as my calling, but her's as well.”
He adds, “There is a real sense of satisfaction of being on the cutting-edge, of offering life-saving medication to people who wouldn’t otherwise have access. It keeps me going day to day and asking ‘How can we do more? How can we extend our reach and impact?’”
Those questions have driven him to expand his practice, establish partnerships with other health centers, and pursue translational research projects with the goal of finding better ways to apply research findings to real-world situations in Africa.
Today, working in partnership with four major hospitals and nine health centers across Malawi, Partners in Hope (PIH) treats 11,000 HIV patients. PIH also trains Malawian health providers in advanced HIV/AIDS care in collaboration with the University of California, Los Angeles.
As director of EQUIP-Malawi (Extending QUality Improvement for HIV/AIDS in Malawi) , a $2 million U.S. Agency for International Development-funded research project, Jansen is training more health care providers and improving the infrastructure of labs and HIV clinics across central and northern Malawi. He also conducts operational research, testing new diagnostic technology for HIV patients with increased sensitivity to TB.
As a practicing physician, researcher, and health care administrator, Jansen has a broad perspective on HIV/AIDS, locally and globally. “We are pursuing ways to expand our impact to empower other people and organizations to do more to fight against HIV,” he says.
Malawi also has touched his family personally. Soon after arriving in Africa, Jansen started a ward for malnourished orphans, victims of drought and a severe food shortage.
Along came Olivia, a severely malnourished six-month-old weighing less than seven pounds. Her mother had died, and her grandmother struggled to care for five other siblings. “There was just something special about her,” says Jansen.
After regaining health, Olivia was transferred to a project seeking to place orphans. Missing her sorely, the Jansens became her foster parents and formally adopted her at age two. Jansen proudly gushes about his youngest daughter: “She’s musical, athletic, charming and smart as a whip. By the end of first grade, she was reading “The Chronicles of Narnia.’”
He recognizes that it’s not necessary for someone to literally move here or adopt a baby (which has become more difficult in Malawi since Madonna) to make a difference in Africa. “We encourage doctors to come and impart their knowledge, especially people in surgical or technical specialties,” says Jansen. “There are many opportunities for physicians to do something satisfying and contribute to international health.”
He stresses that this is “not about medical tourism” and urges anyone interested to contact him directly at firstname.lastname@example.org.
Jansen, his wife, and daughters are currently on sabbatical in the U.S. until June, spending precious time with family and getting Nathan settled at college. In addition to speaking engagements (UCLA grand rounds, NIH presentation in January, and at churches providing funding support), Jansen is studying at NIH and seeking part-time work.
“I have a whole different perspective of medicine,” says Jansen. “It’s thinking about how to improve health care beyond the patients I can see.”