Human rights and universal access to treatment

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In many ways, Dr. Jan Hajek personifies VPSA’s values: connect; collaborate; and care. As an infectious diseases specialist, he provides inpatient consultations at VGH and works in its tropical medicine clinic. He also cares for clients who inject drugs and have severe infections at the Community Transitional Care Team on the Downtown Eastside. In addition, Dr. Hajek lends his expertise part-time to medical staff in Gulu, Uganda—providing clinical care in the hospital and teaching at the medical school. One of his true passions is his work with Doctors Without Borders/ Médecins Sans Frontières (MSF); he is a clinical coordinator and infectious diseases specialist for its telemedicine platform. Dr. Hajek spoke of these multiple roles at a recent VPSA Unique Lives in Medicine presentation.

“I found the clinical electives during my residencies to be real eye openers,” said Dr. Hajek. “I struggled against accepting the poverty and racism I came across in Northern Ontario, as well as the social injustice and health inequities I encountered in Haiti, India and Uganda.”

Dr. Hajek later spent time in Guyana doing malaria research, in Malawi providing HIV care, and in Ottawa working with Citizenship and Immigration Canada as a senior policy advisor specializing in TB and infectious diseases. He came to Vancouver in 2010, joining the TB clinic at the BC Centre for Disease Control and the Infectious Diseases Division at VGH. A year later, he was on the ground in Uzbekistan for his first mission with MSF. His work there was with patients with multi-drug-resistant tuberculosis (MDR-TB). The rates of MDR-TB globally were rising; effective treatment was available, but it was not being provided to people in low- and middle-income countries because it was felt to be too expensive and too difficult to administer. In addition to the need to prevent the spread of MDR-TB, Dr. Hajek believes that there is a human right to health and a moral imperative to treat all patients, especially those who live in poverty and face huge barriers in accessing health care.

“I felt I had to do something,” said Dr. Hajek. “MSF’s advocacy work, its support for health equity, and its calls to lower the price of MDR-TB treatment resonated with me. My role with MSF was to help support local doctors in Uzbekistan to rollout treatment for MDR-TB in an area of Uzbekistan called Karakalpakstan.”

Watch this video to learn more about Dr. Hajek’s work in Uzbekistan.

Dr. Hajek’s next work with MSF was in South Sudan in response to an outbreak of hepatitis E in refugee camps and then in Ethiopia to help treat patients, mostly rural farmers, with visceral leishmaniasis. He followed this with missions to West Africa to treat patients with Ebola, first providing clinical care at an Ebola Treatment Unit with MSF in August 2014 in Guinea and then from November of that year until January 2015 worked with WHO as a clinical trainer and mentor in Sierra Leone.

“I really enjoyed the work in West Africa, and was privileged to be in a position to help,” recalled Dr. Hajek, “but it was an emotionally taxing job. It made me realize how important it is to support the infrastructure to provide access to good health care for everyone, everywhere. While some temporary Ebola Treatment Units were built with running taps of water, one per cent and five per cent chlorine, there were government hospitals and maternity wards in Guinea and Sierra Leone that ran short of running water, electricity and gloves.”

Today Dr. Hajek continues to work with MSF as a coordinator of its telemedicine platform. Up to now, MSF doctors around the world have submitted over 10,000 cases; coordinators allocate the cases to volunteer specialists. Drs. Mark Cresswell and Eric Yoshida are Vancouver specialists on the platform.

“In the future, the use of telemedicine—practicing health care at a distance—will become a norm,” said Dr. Hajek. “Indeed, we expect that it will become so common as to be unremarkable, that the prefix tele- will disappear, and that all telemedicine work will be considered as part of usual practice.”

Physicians attending the presentation appreciated learning about opportunities to volunteer with MSF and to extend the VPSA’s connect-collaborate-care model beyond our own community of care.

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