人妻少妇专区

In Review

Gretchen Birbeck鈥檚 first trip to Zambia came in 1994, when she was a University of Chicago medical student completing an elective at the remote Chikankata Mission Hospital, about 75 miles south of the capital city, Lusaka.

More than two decades later, she spends half her year in sub-Saharan Africa, working to improve care for people with seizure disorders.

The Edward A. and Alma Vollertsen Rykenboer Professor in Neurology at Rochester, Birbeck is the director for Chikankata鈥檚 Epilepsy Care Team. She鈥檚 also an adjunct faculty member at the University of Zambia.

Seizure disorders can be caused by many medical conditions, and they鈥檙e more common in the developing world. Neurological and psychological disorders account 鈥渇or about a quarter of the global burden of disease, and much of that is in developing countries,鈥� says Birbeck.

鈥淭here鈥檚 a disconnect between where disease is and where experts are,鈥� she says.

She works to redress that disconnection, providing clinical care and conducting research. As a result, more than 3,000 patients have received treatment they otherwise wouldn鈥檛 have. And she has helped make changes to Zambia鈥檚 national policy that could help many more.

She鈥檚 also working to build up the resources and networks necessary to conduct clinical trials in Africa, and to create education and training programs for health care providers and researchers. She鈥檚 involved in cerebral malaria research in Malawi and Uganda, and mentors postgraduates and junior faculty carrying out research in Zambia, Malawi, Kenya, and South Africa.

While creating access to specialty health care is critical, Birbeck finds that tackling stigma and misinformation is also key. The difficulties are complex. There aren鈥檛 only problems procuring a diagnosis, finding treatment options, and getting access to medication. Open flames from fires and bodies of water also pose significant threats. 鈥淏urns and drowning,鈥� she says, 鈥渁re two of the most common causes of death of people with epilepsy in developing countries.鈥�

In the years that Birbeck has been traveling to Africa, she has seen 鈥渟low inroads鈥� in Zambia for treating epilepsy, with improvements in general services and better access to information about the disease. Meanwhile, a 鈥渞oll back malaria鈥� campaign has transformed the incidence of malaria seizures in Zambia, though Malawi hasn鈥檛 seen such progress. Efforts to deal with malaria haven鈥檛 kept pace with those for epilepsy, but there have been advances. 鈥淚鈥檓 not convinced malaria eradication is likely, but there are improvements in infection rates,鈥� she says.

Overall, though, Birbeck sees reasons for optimism. 鈥淭here鈥檚 much more expertise in-country,鈥� she says. 鈥淛unior people are coming back as senior people, and staying.鈥�

Their efforts are an amalgam of teaching people about seizures and making care available to them. Both are essential, she says, and her research and clinical care are different but interrelated efforts to improve the lives of people with epilepsy and other seizure disorders. 鈥淲e鈥檙e educating the public, but we also work with the health care structure to ensure there are providers and treatment,鈥� she says.

鈥擪athleen McGarvey