Zimbabweans have the unusual custom of naming their children after important events or emotions they experienced at the time of the child’s birth. In 2004, for example, when the swimmer Kirsty Leigh Coventry represented Zimbabwe in the Athens Olympic Games, a great many newborns were named Backstroke, denoting the event which won her a gold medal. A young waitress I met at the Victoria Falls Hotel explained that her name was “Happiness” because that is what her parents had felt when, after many years of trying to have children, she was born. Things were decidedly different when her youngest brother – the last of seven children – was born unexpectedly many years later. His name was Hardship.
I met Everlasting Hope while rounding on the general medical wards of Parirenyatwa Hospital during the two weeks I spent in Harare, Zimbabwe in August 2016 as part of Western Connecticut Health Network’s Global Health Program. I remember being immediately captivated by the biblical proportions of the name, eager to hear the story behind it. Regrettably, I never got the chance. Everlasting Hope, a thirty-four-year-old woman, had been admitted the day before after suffering a massive stroke that left her unable to speak, unable to swallow, and unable to move her entire right side. Her communication was limited to a series of desperate blinks and hand gestures which frustrated both of us.
Everlasting Hope’s hospital care consisted of one liter of intravenous fluid per day, and oral blood pressure medications and aspirin, neither of which she could swallow. Not surprisingly, her condition progressively deteriorated and she died four days after being admitted. I remember explaining to the American medical students in the program with me that her care would have been very different had she been admitted to a modern, multidisciplinary stroke unit. She would have received nutrition through a feeding tube, medicines to prevent blood clots, telemetry monitoring to assess for life threatening cardiac arrhythmias and daily speech and physical therapy. More importantly, I explained, in a less resource-constrained medical environment, Everlasting Hope may never have had the stroke because her high blood pressure and high cholesterol would, hopefully, have been diagnosed and treated early.
I returned to Connecticut a few days later, preoccupied. As Chairman of the Department of Medicine at Danbury and New Milford Hospitals, much of my job involves finding ways to continuously improve the prevailing systems and processes in place to care for patients. Since my return from Zimbabwe, whilst considering these issues, I find myself no longer thinking just about the patients in the hospitals and communities that my organization serves in Northwestern Connecticut. I think about Everlasting Hope and the countless other patients like her at Parirenyatwa Hospital. How, I constantly wonder, do we build better systems and processes that could be implemented there, so that patients like Everlasting Hope have a chance for a better outcome?
And this, perhaps, is the greatest value of global health: it expands the boundaries of what we, as physicians, consider to be “our” medical community. After witnessing, firsthand, the devastating impact that globalization can have on vulnerable populations in a cost-constrained medical environment, the mission of global health has become personal for me. It is no longer about bringing healthcare equity to nameless, faceless people on a distant continent across the sea. It is about dear colleagues and patients with whimsical names and warm, toothy smiles, whose stories I know and suffering I have, however briefly, shared. For me, it will also always be about Everlasting Hope. Wherever my future adventures in global health take me, I know that her story and her name, with its latent promise that better times must lie ahead, will guide me.