Global Health as a Night Job

Thomas Stossel, MD, conducts a fluoride treatment on a Zambian patient.

In this month’s Clinical & Research News profile, hematologist Thomas P. Stossel, MD, details the twists and turns that brought him to Zambia on a public health mission with a group of dentists—and how the unique experience has enriched his life and career.

Dr. Thomas P. Stossel’s career path includes a series of unexpected turns that led him to new family, friends and an appreciation for fluoride toothpaste.

The first of many fortunate accidents for Stossel, a BWH hematologist, occurred in 1996 when he met his wife, Kerry Maguire. She was many things Stossel was not – a college dropout who became a self-described hippie, then a park ranger and ultimately a dentist and a passionate public health advocate. With Maguire’s influence, Stossel found himself globetrotting to Zambia in 2004 with a handful of dentists, dental students and other volunteers ready to provide oral health relief.

The team of eight packed their own equipment and set out to the Kasisi Childrens’ Home, a large orphanage in the capital city of Lusaka. They saw 90 patients, 21 percent of whom required surgery for advanced dental decay. On Stossel’s next trip to Zambia two years later, that number fell to 4 percent as a result of fluoride treatments, education, sealants, restorative treatment and extractions. Every few years, Stossel’s team returns to continue to the work of admitting, diagnosing and providing oral health treatment for patients at Kasisi. For these activities, Stossel and Maguire have obtained permanent Zambian medical and dental licenses.

For Stossel, an acclaimed cell mobility researcher, the approach to health care in a developing country was far removed from his familiar Brigham clinic and lab environments. He never predicted someday to be performing hundreds of fluoride treatments on children halfway around the world or gain the name ‘Mulenga,’ a common Bemba name he received from his patients.

“My career in research forced me to be rigorous,” said Stossel. “But I’ve learned that the practical applications of research rarely work the way you want them to. Someone may have an idea for how to do something and I say, ‘Try doing it and expect it to fail – then try again or try something else!’”

In 2006, Stossel and Maguire’s project in Lusaka expanded to the remote rural village of Muchila within a chiefdom of the same name (meaning “the end of the ox’s tail”). By then, they had established a nonprofit organization named Options for Children in Zambia. They hired an outfitter to set up a camp in the village where they sleep in tents. Stossel and the oral health crew had to overcome fractured infrastructure, limited resources, language barriers, infectious diseases and dangers of the dry and wet seasons.

Initially, their dental screening and treatment was limited to what could be accomplished by the American visiting team. By this year, however, the addition of community volunteers and dental therapists from a dental training school in Lusaka has doubled the number of screened patients (more than 700 seen in two and a half days this past August) and increased the number of treatments five-fold.

The group also added other beneficial activities for the community – they organized construction of a bore hole to provide clean water and, because one of Options’ board members is a master beader, created a microfinance beading project for the village’s women’s group. Currently, they are raising funds for constructing a birthing center.

Stossel poses for a picture with children from the Kasisi orphanage.

As Stossel and Maguire returned to Zambia each year, they saw a boost in their patients’ oral health that could be attributed to such simple solutions as providing fluoride toothpaste donated by manufacturers. Stossel also began to notice other changes. As oral health began to flourish, so did his Zambian relationships.

When Stossel touched down in the airport, he would recognize friendly faces. The village women sing their group a welcome song upon their arrival, and the village volunteers began taking an interest in learning dentistry as a career option instead of subsistence farming. Options for Children has subsidized their education, and this contribution to the Zambian health care workforce will make its efforts sustainable.

“Going abroad has made me more aware of the importance of relationships,” he said. “The people need to trust you and know that you will deliver for them.”

Stossel has worked with Zambian medical colleagues to try and jump start research and prevention efforts resembling the dental project in sickle cell disease, which is highly prevalent in Zambia.

“I am lucky to be a part of an organization like BWH that lets me do this kind of work,” he said. “I have a dedicated team here, and it allows me to have global health as a night job.”

One other relationship – and another unexpected event – also evolved through Stossel’s connection to Zambia. In 2010, Stossel and Maguire adopted a daughter, Tamara Sakala, from the Kasisi orphanage.

Tamara became a part of the family when she turned 18, and currently is a junior at Pine Manor College. She calls Stossel “Tata,” the Bemba word for Dad. The family keeps its Zambian roots strong and plans to continue visiting the country to work. Stossel remains humble when asked about his experience:

“I’m not a public health hero. It gives me perspective, something to talk about, and even a daughter.”

Tamara Sakala and Kerry Maguire