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Slug: In the Field Enawgaw Mehari, MD, Founder of People to People – Tackling the Spread of HIV/AIDS in Africa By Elizabeth

Stump Ethiopian-born Enawgaw Mehari, MD, came to the US in 1995 to fulfill his dreams of becoming a neurologist, enrolling in the University of Kentucky for a neurology residency. But he never forgot the medical turmoil in Ethiopia after moving to the US. In 1999, while wrapping up his residency, he founded People to People USA (P2P), a nonprofit organization that aims to improve health care and reduce AIDS in Africa, particularly in Ethiopia. After graduating, he began practicing neurology with specialties in pain management and neuro-AIDS at the Morehead Clinic and St. Claire Regional Medical Center in Kentucky, where he is now chief of the neurology department. Meanwhile he has been expanding the services of P2P, including opening the People’s Free Clinic in Morehead, KY, in 2005 for the working poor who have no health insurance — Kentucky has more than 500,000 uninsured people — and a clinic online for anyone anywhere in the world. In 2006 Dr. Mehari won a distinguished services award from the Society of Ethiopians Established in the Diaspora, and in 2007 he was nominated as a CNN Hero, awarded by the cable network to everyday people around the globe who have made a major impact on the world. In 2008, P2P and Dr. Mehari were officially honored and presented with a Certificate of Recognition by the Senate of the Commonwealth of Kentucky for their impact on local Morehead, KY, and work in Ethiopia.

Dr. Mehari spoke with Neurology Today about his dedication to P2P and the organization’s strong outreach programs. Tell us about the origins of P2P. P2P USA was founded as a non-governmental, nonprofit organization to improve health care and reduce the spread of HIV/AIDS in Africa, particularly in Ethiopia, as well as the diaspora communities in the USA. There are currently about five thousand members worldwide. The membership is free and open to anybody — doctors, nonprofessionals — who want to make a difference in the lives of the people. You can go to www.peoplepeople.org and become a member. So I understand P2P has offices around the world? P2P has now become international, with headquarters in the US and operating in Ethiopia (the office in Ethiopia is the focal point of all the satellites in the world), Canada, Sweden, Finland, Tanzania, Sudan, Somaliland, and Australia. In 1999, the same year P2P USA was founded, chapters were formed in Sweden and Canada, followed by Ethiopia and Finland. In 2002, P2P established an international discussion forum on health matters, and currently there are about 2,500 active members from all over the globe who participate in the discussion every day, sharing their viewpoints and posing questions. Our free, Web site-based Virtual Clinic can also be accessed by anyone from anywhere in the world. Our staff monitor the site, and anonymously-posted questions are usually answered by volunteer medical professionals within a few days. Most questions are HIV/AIDS-related, such as “Does exercise help a patient with AIDS or will it trigger some complications?”

Who has been your greatest support and inspiration? I was inspired by the challenges of medical care in Ethiopia I witnessed firsthand, particularly families torn apart and children orphaned by AIDS. My wife and my kids have been my greatest support, and Dr. Joseph Berger, the chair of neurology at University of Kentucky, has been an immense source of energy and helped me to believe nothing is impossible. Where does your funding come from? Funding is always a challenge, and our resources don’t match our needs. Sources of our funding include Pfizer, the NIH, the National HIV/AIDS Prevention and Control Office), the Stephen Lewis Foundation, Ethiopian Air Lines, Canadian Embassy in Ethiopia, World Bank, and the Packard Foundation. We also survive by public donations and individual support. We’re both a nonprofit and a volunteer-based organization, and only the administrative people who implement the activities are paid. How do you specifically work towards reducing the spread of HIV/AIDS and rectifying the stigma of AIDS through your organization? We work with anti-AIDS clubs in communities that organize students to perform AIDS awareness dramas that educate and amuse schoolchildren, and develop education programs for high school students about HIV transmission and prevention by addressing behavioral change and life values. These projects are well received by both teachers and students. P2P emphasizes that it is wrong to discriminate against people based on their diseases, and that we cannot close our ears and eyes to the challenges of patients with HIV/AIDS, especially in Africa where the epidemic is so prevalent.

In 2005, Pfizer Foundation graciously responded to P2P’s request to freely supply fluconazole, a potent antifungal drug, to the Ministry of Health in Ethiopia to distribute to AIDS patients for an unlimited amount and time. This drug is not easy to acquire in poor countries where AIDS and complicating infections often occur. Tell us about the P2P sponsorship program for Ethiopian children orphaned by HIV/AIDS. More than a million children have been orphaned by HIV/AIDS, and that number is growing. In collaboration with the Dawn of Hope and the Association of People with HIV/AIDS in Ethiopia, P2P USA and P2P Canada have helped over 400 orphans in Ethiopia through a sponsorship program that covers the immediate needs of a child, including schooling, and supervision by Ethiopian organization staff and volunteers. Sponsors fill out a form on the Web site and send a monthly $20 (US dollars) money order or check per orphan to the Orphans Sponsor Program at the P2P US headquarters, which is wired to the Addis Ababa, Ethiopia P2P branch account. They withdraw funds to make payments to guardians of selected orphans after they sign a payment voucher for the month. As an extension of this program, we established a boarding school for girls (AIDS orphans) who are in very good academic standing in Amanuel, in eastern Gojjam, Ethiopia. Every year we organize a luncheon for AIDS orphans in Addis Abeba around a major holiday and provide gifts to the children. This special occasion is attended by top governmental and non-governmental agencies, United Nations representatives, and diplomats, which helps to attract more attention to HIV/AIDS and the orphans. What other services do you offer?

P2P has served as a bridge between the West and Ethiopia to transfer knowledge and technology to improve health care education, training in hospice and palliative care, and medical research in Africa. In 2006, P2P was instrumental in establishing a neurology fellowship training program, and we continue to review curricula for post graduate training. Our Horn of Africa Journal of AIDS is the first regional, scientific, peer-reviewed journal devoted to HIV/AIDS, published biannually and distributed free of charge to the medical community in Ethiopia and in East Africa. P2P also believes that patients with terminal illnesses, regardless to place of residence, deserve high-quality, compassionate care. Based on this principle, our organization designed a training workshop for physicians in Africa on the basic concepts of hospice and palliative care philosophy. I led a group of physicians and nurses from Morread, experienced in hospice care, to participate as trainers in Addis-Abeba, Ethiopia. Your project to establish a youth and diaspora center in Addis-Abeba, Ethiopia, was begun last September. How is this contributing to the well-being of the residents? P2P USA’s and P2P Canada’s three-year project, “Mobilizing the Diaspora through a Youth Center in Addis Abeba,” was funded by the Packard Foundation Population Program to provide youth with education on reproductive heath, family planning, prevention of sexually transmitted diseases, and HIV/AIDS. For example, the center trains peer educators, and offers education sessions by partnering with local and diaspora expert individuals and organizations. The center trains youth and other individuals in life skills such as CPR training and computer training, and it serves as a resource center by providing Internet access, books, and a 24-hour hotline to identify a center for HIV testing or counseling. Lastly, the project mobilizes expertise from the diaspora and

facilitates visiting lectureships and internships, such as visiting diaspora experts offering university students a week of training in program management. -30[set as box] For more information on People to People, please visit www.peoplepeople.org. The P2P discussion forum can be accessed at http://health.groups.yahoo.com/group/People_to_Peopl e_Forum/.