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Aid: From Alaska to Africa

Carolyn and George Brown, local doctors active in the Juneau community, have a long history of helping others, from the MatSu to Kenya.

Posted: January 15, 2012 - 1:00am
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The scholarship committee for the Kenyan Health Scholarship Program pose together at one of their meetings.  George Brown
George Brown
The scholarship committee for the Kenyan Health Scholarship Program pose together at one of their meetings.

This is kind of a love story, but it’s not a sappy romantic fable or steamy Harlequin paperback — it spans continents and communities.

Carolyn and George Brown met in medical school in North Carolina, where he’s from, in the 1960s. As she describes it “they met, romantically, in the cadaver lab.”

They were classmates, then friends, then they decided they really liked each other and got engaged. They were married just before graduating medical school and continued the romance, interning together in Richmond, Va.

With their internships complete and in the midst of the Vietnam War, the pair opted to apply to the National Health Service Corps, feeling they could serve the country better in that capacity.

They had two options, she said, serving in the Southwest — she’s from Texas and was not interested in going back — and Alaska.

“We sort of looked at each other like, ‘where’s Alaska, now?’ — this was way back in the 60s, you know,” carolyn said with the knowing laugh of a decades-long Alaska resident.

They moved to Anchorage in 1965 and, excluding a decade of carolyn teaching at the University of Vermont School of Medicine, training for specialties and some humanitarian work, the pair have been in Alaska since — Juneau for the last decade.

A condition of their service was that they practice in an underserved area. At the time, the entire Matanuska-Susitna Valley had a population of roughly 30,000, served by a 25-bed hospital with five general practitioners and no specialists.

“They had no specialists, no pediatrics, obstetrics, gynecology…” carolyn recounted.

George specializes in pediatrics, while carolyn specialized originally in public health and prevention, but now also specializes in gynecology and obstetrics — her second residency was completed in Hawaii in 1978.

Once finished serving with the National Health Service Corps, they felt there was still a need for their services and they started a 501(c)3 not-for-profit practice, Women and Children’s Health Associates (WCHA), keeping on the same board members who governed their NHSC practice.

“(The practice) was so successful in terms of outreach of the people — we went out to Talkeetna, we went up the river, we went all over,” said carolyn, explaining why they recreated the practice.

They continued not as the owners, but as staff of the practice run by the board, receiving salaries.

“We were so foolish in those days,” recalls carolyn, “Didn’t know anything about stocks, didn’t know anything about retirement, didn’t know anything about pensions — didn’t set up any of those. I didn’t know a stock from a — anything. I didn’t know anything. We were just doing good and helping people. Saving the world as we said.”

In 1988, the Browns sold the practice to a colleague in the area and gave the profits to the board, which ran the organization, she said.

During their time serving in the Mat-Su they had started a scholarship fund, providing scholarships of $500 or $1000 to Mat-Su students interested in the medical field — the board opted to keep the scholarship program going with the money.

With time, the scholarship fund management has evolved. While they once took out of the principle to provide, they now only use interest and dividends for the longevity of the endowment. And after a trip to Africa in 2004 to 2006, the Browns saw the need for assistance in accessing training in medical fields was far greater there than in the Mat-Su, which has boomed since its days of being sparsely populated and underserved.

The Browns spent nearly two years living in Kenya near Lake Victoria setting up an HIV clinic.

There is a 15 percent prevalence of HIV there.

There was a clinic set up for primary care, but there was no HIV facility and the nearest decent hospital was two hours away “on the god-awfulest, rockiest roads — your brains were rattled by the time you got there.”

HIV/AIDS carries with it a lot of stigma, convincing people to even get tested was a difficult first step.

“To even suggest that people got tested — it wasn’t going to happen. Because if you’re tested and you’re positive, you’re dead, because they didn’t have medicine yet.”

After the Browns’ arrival, a box of medicine came. One shoebox of anti-retrovirals (ARTs).

“It was literally a shoebox — that’s pissin’ up the Yukon! That’s nothing!” explained carolyn.

The Browns saw a number of challenges before them and, in the end, they consider their efforts there a success. During that time, they obtained a separate clinic for HIV/AIDS care, more ARTs and medicine for tuberculosis. More than that, they helped break the barrier that kept people from getting tested.

The first to submit to testing was a higher up in the lab at the existing clinic. He was ill and his condition only worsened.

“I (could) see he’s walking death — I didn’t need a test for that,” she said.

He allowed a laboratory technician to perform a blood test and the results were positive. They started him on ARTs but he was too far gone and died a few days later.

The first real success came a little later.

“We tested the librarian, we had a tiny little library, and we tested him and he had HIV and I said, ‘Moses — will you take the medicine?’ And damned if he didn’t get better.”

According to carolyn, once the people of the community started to see he was getting better — gaining weight, his eyes brightening — there was greater reception to testing and treatment. Men started coming in to get tested, though hesitantly, and women would come in, though secretly. According to carolyn, domestic violence is another prevalent issue in the area. Finally, she said, they were able to test pregnant women and eventually children.

Since the HIV clinic was set up, thousands have been served and, according to a contact of the Browns still in Kenya, 400 or 500 patients are taking ARTs.

During their time there, the Browns noticed one difficulty was keeping on medical staff. Clinical officers (physician’s assistants) and medical officers (doctors), nurses, lab techs and pharmacists cycled through the clinics, because government jobs were better paying.

There seemed to be no lack of potential health care workers, if people could afford it, though. The Browns worked with the board for their organization, WCHA, to start providing scholarships in Kenya, where the $500 or $1000 awards could provide a full year of training.

The board for the organization has members in Palmer, Wasilla, Anchorage, Juneau, Arvada, Colo. and Gorham, Maine. Many of the board are original members and since they are no longer staff, the Browns are members of the board as well. The board ultimately makes the decisions about the scholarship program, called the Kenyan Health Scholarship Program, but there is a scholarship committee in Kenya to help choose candidates.

The scholarship committee is made up of Kenyans — all but one have completed high school and many have further training and education. The man who doesn’t have a high school education is a farmer who grows cassava and corn, but who is known for his wisdom. Among the other committee members, there are educators, HIV/AIDS counselors, a dental care worker, a government employee who inspects schools and a former scholarship recipient who studies general medicine.

The committee helped create the scholarship forms and recently, during the Browns October 2011 visit, they worked on by-laws for the committee. The committee has ultimately chosen the 21 recipients, 17 of which have completed their studies, four of whom are still studying.

The students who qualify for the scholarship must have earned their high school degree, must speak English and must be accepted to a medical program, like nursing or medical school, which costs between $500 and $1,000 a year in Kenya, depending on the program.

“It really doesn’t take much, George and I were talking … about how much it really costs — depends on the course the kid is choosing — if it’s a two-year nursing (program) many of them choose, it can be as low as $500 a year, and that’s chickenfeed. And that’s room and board and school and books.”

They haven’t had any failures. Everyone who has entered the program has completed their education. They owe that to good choices on the committee’s part.

They did have one recipient die shortly after completing nursing school, due to complications from HIV.

The scholarship money comes from the interest and dividends from that original payment when the Browns sold their practice in Palmer. Those funds also cover some other costs for the committee, such as travel and per diem.

When the committee meets, it is customary, absolutely necessary, to supply food. And Fanta.

Another cost is getting committee members to attend some of the graduations. The scholarship recipients don’t generally have family, Carolyn said, sometimes they might be double orphans — both parents having died of HIV/AIDS — who managed to beat the odds and complete their education anyway.

Although each of these additional expenses doesn’t cost much — 50 to 200 schillings (up to $50) — it all adds up.

Mostly, when the committee makes requests, they are reasonable. They would like to have a laptop, especially now that wireless Internet is more available. They would like to have a space to keep the files, an office with a filing cabinet. Sometimes their requests are a little less realistic.

“So they want some simple things like that,” carolyn said, “they want some other things too, like ‘we want a motorcycle” — now everyone wants motorcycles. When we were there in ‘04 to ‘06, everybody had bicycles, a few people had cars, and they had the equivalent of taxis there… Since we left, bicycles are out, motorcycles are in and that’s what everybody wants.”

“Now those are wonderful things — those are fantasy things,” she continues, “ there’s still this simple, naive mentality that ‘the rich white doctors from Alaska can give us anything we want’ and, of course, we can’t. We can’t even afford to pay rent for a place. We can probably afford to buy a two drawer filing cabinet for the stuff.”

Unlike a number of not-for-profit organizations out there, WCHA is entirely volunteer run. Every cent is added to the principle toward scholarships, travel for the committee members, or helping with books a student didn’t initially include in their application. The Browns pay for their own plane tickets for their visits every year or so, right down to the stamps to send a letter.

They are very appreciative of any contribution they might receive, though they don’t actively seek donations. The Browns are good at being doctors and helping people it seems, but not at asking for money. Mostly, contributions come from board members, the occasional church, or friends of the Browns who support the program.

And so the love story continues, with the Browns and some other caring volunteers, from Alaska to Africa, working to save the world.

To learn more about WCHA and the Kenyan Health Scholarship Program, contact the Browns at 364-2726. To make a donation to help fund scholarships in Kenya, mail to 1640 Second Street, Douglas, AK 99824.

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