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Beyond Plugging the Dam: Building a Sustainable Solution to Health in Resource Limited Settings

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Two weeks ago I stood in the Indian Treaty room of the Old Executive Office Building of the White House. In front of me stood 30 doctors and nurses reciting their oaths to become Global Health Service Partnership Volunteers and embarking on a life-changing experience in Africa. They were smiling -- or at least I think they were. I was fairly misty-eyed seeing this moment truly come to fruition. With their own stories and personal motivations, these individuals shared a common goal of making systemic change in healthcare globally.

Natalie Sloan is one of the volunteers. A passionate 31-year-old public health nurse, she has made the remarkable decision to leave her job in Seattle to work in rural Uganda as Global Health Service Partnership (GHSP) Volunteer. A former Peace Corps Volunteer, she will now serve as faculty at the Lira University College, a new nursing school in the northern part of the country, a region once besieged by conflict. Today the region is relatively peaceful and trying to rebuild. Lira University College would not be able to open its doors without Natalie and a fellow GHSP volunteer -- Jacki Tindall. They will welcome the first class of Lira nursing students with a promise of stability and development for the region.

Natalie and Jacki and 28 other men and women make up the inaugural class of the Peace Corps Global Health Service Partnership -- the first-ever program to address the urgent need for medical and nursing educators in resource limited countries. A program designed to create a pipeline of new doctors and nurses in the countries that need it most. Faculty shortages are endemic in many parts of the world and that means students go untrained. It also means that a cycle of poor care is perpetuated. There are not enough doctors and nurses to take care of patients, nor to train the next generation of healthcare providers and educators.

These volunteers represent an initiative that has been more than 25 years in the making. Efforts to create a program to send American doctors and nurses to serve alongside local medical and nursing school faculty had repeatedly been hindered for one reason or another. Building the Global Health Service Partnership has indeed been a process of diplomacy, unsparing perseverance, humility, humor, and at times, outright boldness.

This day in the Indian Treaty Room happened in large part because of a catalytic moment at a public forum in Boston in 2010 when I stood up and asked then Peace Corps Director Aaron Williams if he thought sending doctors and nurses abroad as educators was a good idea (he said yes!) The next months were filled with creative problem solving, negotiation, planning and all the other heavy lifting of program design made only more complex by building a public-private partnership to work in some of the neediest countries in the world. To move our work forward would also require maintaining a veil between my Dad -- now Secretary of State -- and the all-consuming living, eating, and breathing efforts of my day-to-day work. I did not want to compromise him or more importantly -- (and with apologies, Dad) -- this absolutely critical program. But on that day in the Indian Treaty Room, the careful construction, the hours logged and miles accrued between Africa, Washington and our base in Boston has all been worth it.

Today, this program, GHSP, is a truly unique partnership between the nonprofit I helped found called Seed Global Health, the Peace Corps and the President's Emergency Plan for AIDS Relief (PEPFAR). Remarkably, such a program has never existed in the Peace Corps before.

Family Medicine doctors, OB/GYN's, anesthesiologists, and nurse practitioners among other specialties, serve as Peace Corps volunteers for one year in Malawi, Tanzania, and Uganda and will cultivate the next generation of doctors and nurses - not just plugging the dam of need for the short term.

The program succeeds though multiple partnerships with ministries of health and education and with local hospitals and nursing and medical schools to match the needs of each site. Our in-country colleagues have shared with us their belief that just 10-12 GHSP volunteers -- six doctors and six nurses in each country -- will not only make an immediate difference but will have an exponential impact on generations of doctors and nurses in there.

Starting in these three African countries, we hope to expand globally helping to create stronger, sustainable health systems where the need is greatest.

The GHSP makes history not only because of the commitment of these health professionals to the program, but also because of the commitment the program is making to them. To help remove a very real barrier of service and to encourage the best and brightest to serve, Seed Global Health helps repay our volunteers' educational loans or other major forms of debt. This year, through the support of philanthropy and grants, we will help eliminate nearly $700,000 worth of debt for 27 of our volunteers who would not be able to serve without our support.

So, yes, I stood with tears in my eyes watching these 30 individuals pledge to sacrifice, serve and represent our country, to invest in our global neighbors, and to help redefine what a strong health system can look like. We will be following them closely through their blogs, video and photos. We invite you to follow with us, to share their stories, and to inspire others to join us.