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Doctor trains in SC to improve care in Tanzania

CHARLESTON, S.C. (AP) — Dr. Mohamed Janabi remembers that when he was a child in Tanzania, stores carried only one kind of chocolate.

Now, when he enters a store in the east African nation with his children, he sees more brands than he can count.

The increasing availability of less than healthy foods, combined with more sedentary lifestyles, has led to an increase in heart disease, said Janabi, who is President Jakaya Kikwete's personal physician. He also is a high-ranking faculty member at the Muhimbili University of Health and Allied Sciences in Dar Es Salaam, the country's largest city, and is guiding the medical direction of a new Cardiovascular Care Center at the Muhimbili National Hospital.

Janabi is at the Medical University of South Carolina this month, where he is receiving training in cardiac care and sharing information with MUSC personnel.

Dr. Peter Zwerner, a professor in MUSC's Division of Cardiology, said that when people think about health problems in Africa, diseases such as AIDS often come to mind. But infectious disease rates have been declining, and cardiac disease is on the rise.

MUSC is working with Janabi and others in Tanzania to put in place a "train forward" model for improving heart health, Zwerner said.

Janabi said the new cardiac center will train not only doctors but also nurses, biomedical engineers and technicians to perform certain cardiac procedures.

Some of the people trained at the new center will then work with and train others in the rural parts of the country, he said. "Once you have such a center, you can teach the basics in the villages."

And people living in Tanzania's rural areas are in desperate need of medical care. Fewer than 6 million of the country's 40 million people will see a doctor in their lifetimes, MUSC officials said.

Zwerner said the "train forward" model was pioneered by MUSC neurosurgeon Dilan Ellegala, who trained people in rural Tanzania to do brain surgery.

Many well-meaning people and groups send equipment to the developing world that sits unused because nobody is trained to use it, MUSC leaders said. And some doctors go abroad to help on a short-term basis, but problems persist after they leave. By training people in the developing world to help each other, the overall health in those regions is likely improved in the long run, they said.

Zwerner said providing opportunities to learn about and work on global health issues is essential for those pursuing medical careers. "They expect opportunities in global health," he said. "That's a part of being a top-tier university."

It's simply the right thing to do, he said. And professionals and students working abroad on health care issues bring back knowledge to their own countries.

Eric Powers, medical director of MUSC's Heart and Vascular Center, said many trainees "aren't trained and don't think about serving underserved populations." But after they return from working abroad, they can use what they learned to help people in rural South Carolina, he said.

And the lack of resources in the developing world often prompts the development of, and creates new markets for, new medical devices and procedures, he said. So working on global health issues also is valuable economically, he said. "It's a win-win from anybody's perspective."

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