Saturday, Oct 20, 2018
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Jack Lessenberry

Michigan doctor's efforts in Nepal a model for health care


BLOOMFIELD HILLS, Mich. -- For nine months of each year, Dr. Richard Keidan is an elite physician in an upscale Detroit suburb who specializes in treating cancer.

But every three months or so, he flies to Nepal, lands in Kathmandu, and trudges into the interior. He climbs mountains, endures high altitudes and stiff winds, and pitches a tent among the primitive huts of villagers.

For the next month, he will try to do what he can to improve public health, medicine, and hygiene in rural Nepal through the organization he began three years ago, the Miles Levin Nepal Foundation for Health and Education. "This is really my life's work," Dr. Keidan, head of William Beaumont Hospital's multidisciplinary melanoma clinic, told me over lunch a few days ago.

He has written dozens of scientific articles, and is a professor of surgery at the medical schools of Wayne State University and Oakland University.

But his heart is more than 7,500 miles away, with his Nepalese foundation partner, Namgyal Sherpa, who has led many an expedition up Mt. Everest, and then gone back to retrieve the bodies and gear of those who didn't survive.

Though he was trained to perform some of the most sophisticated surgery, Dr. Keidan has come to believe that those in charge of practicing medicine in this country might learn something from the situation in Nepal. For one thing, he believes, the best thing any society can do is invest in basic medical care.

"Maybe I should say public health even before medical care," said Dr. Keidan, a 56-year-old graduate of the University of Michigan.

If you've watched the GOP presidential debates this year, you might have the impression that physicians unanimously hate what the candidates sneeringly call ObamaCare.

Not so. "I may be in a minority among my colleagues at Beaumont, but I am a strong supporter of President Obama," Dr. Keidan said. "It is absolutely indefensible that people don't automatically have access to primary health care in this country."

If he has a criticism of the Patient Protection and Affordable Care Act, it is that there is too little understanding of what it does.

He does understand what Nepal needs. "You get a far bigger bang for your buck by putting money into primary care and, especially, public health services," he said.

What Dr. Keidan doesn't do in Nepal, surprisingly, is surgery. Doctors have often traveled to developing countries to provide medical services for a few days or weeks at a time.

He thinks that's wrong: "You help a few people, yes. But when you leave, nothing really changes."

Instead, he and his foundation are helping rural Nepalese to help themselves. They are building a school in a town called Dipru, and helping kids pay to attend it.

Dr. Keidan and his allies are working at having toilets installed in every home and school in a town called Dipsung, and are promoting a hydroelectric project in a town called Rakha.

Most important, the foundation is working with a new medical school called the Patan Academy for Health Sciences, which is designed to train doctors in rural settings. These doctors then promise to spend at least four years in rural areas. Interestingly, there's been some talk in Michigan of the need to launch a similar project to bring family practitioners to rural areas here.

Dr. Keidan has been in love with Nepal, a nation of 30 million in an area slightly larger than Michigan, ever since he took a year off as a young doctor to find himself. He made the trek with Betsy, who is now his wife.

He got the idea for his foundation gradually, after he noticed that "the vast majority of people live in rural areas, don't have access to a physician, and may never see one." Instead, the government provides a network of rural health stations, staffed by workers who may have from two to eight years of rudimentary medical training.

The foundation was named after a young Detroit boy who became famous nationwide after he was diagnosed with terminal cancer at age 15, and wrote a plucky blog about his battle with the disease.

The night he died in 2007, just weeks before his 19th birthday, CNN's Anderson Cooper told the nation: "Miles Levin was a friend of mine." Dr. Keidan knew Miles, and named the foundation in tribute.

He also knows that most people in Michigan think they have medical care vastly superior to that of Nepal's.

What they don't know is that the emergency room of his hospital is frequently filled with people who have no money, no medical insurance, and no other way to see a doctor. Nor do they know that parts of Detroit and the Upper Peninsula would benefit from a few Nepalese-style health stations, and even more so from better standards of public health.

Thousands of villagers and officials in Nepal are learning from their new sherpa, this tall doctor from Detroit. Few of them may know that medicine in the doctor's own country has a way to go as well.

Jack Lessenberry, a member of the journalism faculty at Wayne State University in Detroit and The Blade's ombudsman, writes on issues and people in Michigan.

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