Walking Together, Walking Far: How a U.S. and African Medical School Partnership Is Winning the Fight against HIV/AIDS

3. “We All Need to Be Doing More”

34 walking together, walking far 34 walking together, walking far 3 “We All Need to Be Doing More” After the Moi University and Indiana University medical schools formalized the decision to begin a partnership, Bob Einterz agreed to be the first Indiana faculty physician to spend a full year in Kenya . He was the first in an annual rotation of “team leaders” who practice medicine, teach at Moi University, and oversee Indiana students and residents. Bob, his wife Lea Anne, and their growing family of three boys arrived in Eldoret in July 1990, and soon settled into a house they rented from one Ibrahim Hussein, who happened to be a three-time winner of the Boston Marathon. They discovered that Eldoret’s temperate climate and 7,000-foot altitude formed the cradle of Kenya’s legendary running champions . In Eldoret, it was not unusual to bump into an Olympic gold medalist on the street or see a former world-record holder at the next table in a restaurant. By the time Einterz arrived, Mengech had hired a dozen faculty members, and the first-ever Moi University medical school class, forty students strong, began their studies that fall. Six Indiana University medical students and residents spent time in Kenya that first year. Einterz especially enjoyed the experience of working in the rural health clinic in the Kosirai district of Moso- “We All Need to Be Doing More” 35 riot, a community that would become a critical part of the program ’s HIV outreach nearly twenty years later. “I learned in Haiti that we could not make real change by confining ourselves to the four walls of the hospital or the examining room. The push toward the community began with the inception of the relationship with Moi,” Einterz says. “’Community-based’ was almost all that mattered to me.” So Einterz’s efforts that first year focused on championing the community-based education and service of COBES; for a full month he even lived without his family in spare quarters at the Mosoriot health center. After a year, Einterz was followed by Charlie Kelley and then Joe Mamlin as team leaders for Indiana. In 1991, Diana Meneya and Gabriel Anabwani became the first Moi physicians to travel to Indiana. The partnership moved forward during the 1990s, climbing over barriers of culture and financial constraints to train hundreds of Kenyans and Americans and provide care in both urban hospital and rural clinic settings. All the while, the partners helped build the Moi University Faculty of Health Sciences (it would eventually change its name to Moi University School of Medicine) into a solid institution. But each year, a shadow was lengthening over Kenya and the rest of the African continent. In the United States, the reported history of HIV/AIDS began in 1981 with a small notice in a Centers for Disease Control bulletin . The notice stated that a cluster of homosexual men in Los Angeles and New York had been diagnosed with Kaposi’s sarcoma , a rare skin cancer, and pneumocystis carinii pneumonia, known as PCP. Soon, hundreds of gay men began dying in the United States of what was being called GRID (Gay-Related Immune Deficiency). By 1982, the disease was linked to blood and discovered to be also affecting heterosexual intravenous drug users , hemophiliacs, and recent immigrants from Haiti. French researchers found the virus in 1983, and named it the human immunodeficiency virus, HIV. By 1985, the U.S. public began learning more about AIDS when thirteen-year-old HIVpositive hemophiliac Ryan White was barred from attending middle school in Kokomo, Indiana. That same year, actor Rock Hudson publicly acknowledged his AIDS diagnosis and died soon 36 walking together, walking far 36 walking together, walking far afterwards, making him one of over five thousand Americans to die of the disease in 1985 alone. It was not known at the time, but these U.S. incidents were not HIV’s debut. Later analysis of a blood sample of a man who had died in the Belgian Congo in 1959 showed the earliest confirmed case of HIV infection. Genomic records now reveal that the virus existed in humans in Africa as far back as the 1920s, when it was transferred from a chimpanzee, likely during butchering . Cases of “slim” had been observed in communities along the shores of Lake Victoria in Uganda, Tanzania, and Rwanda since the late 1970s. But the disease...