Last Thursday, The Albert Schweitzer Fellowship (ASF) President Lachlan Forrow, MD met with Flavien Nziengui-Nzoundou (the Minister of Health for Gabon, Africa) to discuss current
and future collaborationâand lay groundwork for the 2013 Centennial
celebration of Albert Schweitzerâs founding of his iconic hospital in
LambarÃ©nÃ© , Gabon, Africa.
In addition to supporting 250 Schweitzer Fellows annually at 13 program sites across the U.S., ASF has sent over 100 senior U.S. medical students
to serve clinical rotations at the Schweitzer Hospital in LambarÃ©nÃ©
since 1979. Forrow himself was one of those LambarÃ©nÃ© Â Schweitzer
Fellowsâand now, in addition to serving as ASFâs president, he is the
president of the Schweitzer Hospital.
In that role, Forrow is forging collaborations with Gabonâs new
government and other partners in order to advance the health and
well-being of the countryâs citizens, and serve as a replicable model
elsewhere in Africa.
Read on for our interview with Nziengui-Nzoundou â who met Albert Schweitzer in 1963 when his father was a patient in LambarÃ©nÃ©.
ASF: What is the most pressing health-related issue facing Gabon today?
Nziengui-Nzoundou: In our country, there are two
particular health problems: malaria and AIDS. We are a tropical country
near the equator â very humid. The population is concentrated in the big
cities without any real urban organization, and thereâs a real problem
of sanitation. There are a lot of places with stagnant water, which is
the perfect breeding ground for mosquitoes. We have a public-private
partnership with the Global Fund to address the high incidence of
Additionally, we allocate 3 billion CFA [$6 million dollars] of our
national public budget to engage Gabon in the fight against malaria. We
particularly prioritize pregnant women and children under fiveâwhich is
one of the main objectives of the Millennium Development Goals. Weâve
had some successes, but thereâs much, much more to do.
The second major pathology is the HIV/AIDS epidemic. Gabon has
approximately 5.2% seroprevalence, which is enormous for a population of
only 1.5 million people. Four months ago, Gabon President Ali Bongo
Ondimba tripled the national budget against HIV/AIDS, implemented free
testing and the distribution of free medications, and started
construction throughout the entire country for ambulatory treatment
centers. We also have a public-private partnership with the Global Fund
with a budget of 10 billion CFA [$20 million dollars]. AIDS is something
you have to tackle at multiple levelsâeducation, prevention, and
And of course we canât forget tuberculosis, and also other diseases
like leprosy. We have programs that are in the process of tackling these
ASF: I know Lachlan has been working to gather
support for a new tuberculosis [TB] initiative based out of the
Schweitzer Hospital as the first major project of the planned Centre Hospitalier Universitaire Albert Schweitzer a LambarÃ©nÃ©âbut
has not yet been able to procure a stream of medications and a vehicle
to check on follow-up. Where does progress on that stand, and what other
efforts to address TB has the Ministry of Health undertaken?
Nziengui-Nzoundou: This CHU in LambarÃ©nÃ© will attack
the problem of tuberculosis as a top priority, but we have had
difficulty securing the distribution of tuberculosis medications. The
Global Fund is the secondary partner in this, and there is a United
Nations Program that we are also working with. So when money arrives, it
first goes to the local UN program, which orders the TB medications.
There are often interruptions in the flow of medications, so we have
revised the procedures. So now, itâs the country itself that orders the
medications. The goal is to ensure that there will never again be an
ASF: Is there a recent public health success that you and your team at the Ministry of Health are particularly proud of?
Nziengui-Nzoundou: Something weâre really proud of
is the creation of a master plan for public health by the president that
offers medical care at the curative level. Since we have 70 percent of
the entire population living in large cities that have problems with
primary careâespecially Libreville, the capitalâwe are in the process of
creating three CHUs in Libreville. One is in North Libreville, one is
in Central Libreville (linked to a center focusing on maternal health),
and one is in South Libreville.
The North Libreville CHU will open on December 15, and the cancer
center affiliated with it will open in April. The Central Libreville CHU
will also have two modules. The first, a technical block with operating
rooms and emergency medicine, will open on December 15. Construction
will start on the second module â which will offer the enhanced maternal
health services â in January, and it will take a year and a half to
build. This is in addition to eight regional hospital centers that have
already been constructed in recent yearsâand then of course we have CHU
The vision of the president is to figure out how to ensure that every
citizen of the country is provided with health care of high qualityâand
that when we have finished developing all of these aspects of the
system, we will become a medical resource for all of Africa, not just
for our own country. We are building the infrastructure, and we intend
to complete that as soon as possible, and then we will be using that
infrastructure to put operationally into place systems of education and
ASF: For the past 30 years, ASF has sent senior
U.S. medical students to the Schweitzer Hospital to help provide care
(and more recently, public health students as well). What message do you
hope these students will bring back to the U.S. after their time in
Nziengui-Nzoundou: We are a young country, and we
need partnerships to work on improving health professional training. I
hope that the American students who have come to Gabon â like Lachlan â
can think together about the vision they have based on their experience
of our country, and become partners with us in making actual results
happen. But of course, a real partnership works in both directions.
We really hope that we can also involve young doctors in training,
researchers, and others from Gabon in coming to the United States and
understanding research and training there, that they can then bring back
to our country.
We hope that over time, we will have Gabonese and American partners
in medicine, research, and public health who can work together to make
sure that our ambitious health, science, and other goals in Gabon are
accomplished. The centennial celebrations in April 2013 provide a
perfect focal point for this. We hope that many of the Americans who
worked in LambarÃ©nÃ© as students will come back for those celebrationsâas
well as engage in serious discussions with Gabonese about how they can
work together as partners to achieve important health goals.
ASF: As youâve mentioned, 2013 marks the
centennial of Albert Schweitzerâs founding of the Schweitzer Hospital.
What does Albert Schweitzerâs legacy mean to the people of Gabon?
Nziengui-Nzoundou: Let me speak very personally.
When I was very young, I had the chance to shake the hand of Dr.
Schweitzer. My father worked in LambarÃ©nÃ©. In 1963, he fell from a palm
tree. He was brought to the Albert Schweitzer Hospital, and I was with
him because I was very young.
When Dr. Schweitzer came and made rounds to see the patients, he was
so close, at a human level with the patientsâand also with all of their
family members, because at the Schweitzer hospital, itâs not just the
patient. The patient is there with the family. So he reached out to
touch with his hands, to connect at a deep and personal human level, not
only my father, but also me. I will never forget this direct experience
of his humanity.
So for us in Gabon, from my own direct experience, Dr. Schweitzer
came to be with people who suffered and to help them. He gave his life
to the service of my people, the Gaboneseâso the people of Gabon are
waiting with great excitement for the centennial in 2013.