Wednesday, October 31, 2012

A broad horizon | Minnesota Medical Foundation | University of ...

Tim Meade, M.D., and volunteer Molly Pederson screen young patients for HIV in the village of Lechwe near Lusaka, Zambia (Photo courtesy of Tim Meade, M.D.)

Looking ahead, Meade says he can envision the total elimination of mother-to-child HIV transmission. Of the 80,000 HIV-positive women who gave birth in Zambia last year, about 14,000 transmitted the virus to their child. It?s a huge improvement, he says. ?But we?ve still got a long way to go.?

?Internal medicine opened the most doors and allowed me to see the broadest horizon,? he says. ?And now that I?m in my early 50s, I realize this is exactly where I wanted to be. I?m in the right place at the right time, and along the way, I collected all the tools I need to be there.?

There is Tiny Tim & Friends, the charity he established to provide medical, educational, vocational, and nutritional support to HIV-positive orphans, vulnerable children, and pregnant women in Lusaka, the capital of Zambia. How did he get there? It?s an interesting story.

Outreach workers teach HIV basics in a village schoolroom in rural Zambia. (Photo courtesy of Tim Meade, M.D.)

The road to Zambia?and fatherhood

When Meade was in medical school, few international opportunities were available; nevertheless, he always knew he wanted to go overseas. Early in his career, while on a fellowship at the National Institutes of Health in Washington, he got his chance and moved to Russia to work as one of two doctors at the British Embassy there. He stayed 10 years. Toward the end of that time, he took off a year to set up a mother-to-child HIV/AIDS transmission prevention program for Doctors Without Borders in southern Ukraine.

That?s when Meade realized he?d found what he wanted to do.

?My special area of interest is tuberculosis and HIV co-infection in pregnancy, so I needed to find a place where the prevalence rate was 25 percent or higher,? he says. ?That gave me about five countries in sub-Saharan Africa.?

It was 2003, and he found a position as a general practitioner at Corpmed Medical Centre, a private clinic in Lusaka. Besides taking the full-time job, he immediately started volunteering at a local hospice and orphanage, Kasisi Children?s Home, which then had about 40 HIV-positive kids. Not long after, the sisters of Kasisi found a woman with AIDS, seven months pregnant and living in a bus station, and brought her to the hospice. The mother died soon after delivering her baby but not before asking ?Dr. Tim? to care for the boy, whom she named Tim as an expression of gratitude. Meade soon adopted baby Tim as his own son.

Aleda, one of 40 HIV-positive orphans in a day care located in an adult hospice in Lusaka. (Photo courtesy of Tim Meade, M.D.)

A small charity?s wide reach

In March 2004, Meade?s parents traveled to Zambia to visit and volunteer at the orphanage. The experience was both uplifting and heartbreaking for Tom and Betty Meade. When they returned home to Minnesota, they couldn?t stop thinking about the HIV-positive orphans who were dying at a rate of two per month. So they wrote to their family and friends, launched a website, and started raising money to support their son?s work, thus enabling him to establish Tiny Tim & Friends.

Today, the charity provides care for thousands of HIV-positive children. ?We have a rolling census of about 500 kids,? says Meade. ?We look for the ones in the public system who are doing poorly. We take them out of the public system, enroll them in Tiny Tim & Friends for six months, tune them up, and then transfer them back. The public system loves us. And being loved by the public system is really important for a small charity like ours.?

The reality is not all rosy. They lose 10, 15, sometimes 20 percent of the children they treat. The death of a child is always difficult, says Meade, but he and his team have learned they can still achieve a successful outcome in terms of the child?s comfort and the family?s understanding of the dying process.

Early in 2012, Tiny Tim & Friends opened Maluba House, the first pediatric hospice in Zambia. ?Pediatric palliative care is not something I envisioned doing five years ago,? says Meade. ?Now I can?t see how we did without it.?

Much of the financial support for Tiny Tim & Friends today comes from big international donors, including the Elizabeth Glazer Pediatric AIDS Foundation, the Elton John AIDS Foundation, and the Diana, Princess of Wales Memorial Fund, which tend to fund specific projects. ?But at the end of the day,? says Meade, ?it?s the grassroots Minnesota donors that keep us alive.?

Looking ahead, Meade says he can envision the total elimination of mother-to-child HIV transmission. Of the 80,000 HIV-positive women who gave birth in Zambia last year, about 14,000 transmitted the virus to their child. It?s a huge improvement, he says. ?But we?ve still got a long way to go.?

By Kristine Mortensen, associate director of donor relations at the Minnesota Medical Foundation.

Source: http://blog.lib.umn.edu/mmf/news/bulletin/2012/a-broad-horizon.html

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