‘Collective humanity’ is their rallying cry, both here and abroad

Harvard has significantly contributed to transforming Greater Boston into an international biomedical center, featuring interconnected schools, hospitals, and organizations that provide cutting-edge facilities and life-saving medical research.

Yet, for numerous decades, many of these same institutions have also sent hundreds of physicians, researchers, and students to the most impoverished regions around the globe — where what may be considered routine care in Longwood often becomes a gamble.

Despite hundreds of grants being ended or suspended, these initiatives persist. However, the effort feels uneasy during a time when U.S.-backed foreign aid has fallen out of favor.

Serving as the faculty director of the Harvard Global Health Institute, Louise Ivers has been contemplating how to advocate for some of the University’s most humanitarian endeavors in an atmosphere filled with skepticism.

This type of discourse does not come naturally to Ivers. “I don’t engage in global health because I believe it benefits Americans or due to the ‘return on investment’ — not in those terms whatsoever,” she remarked. “I pursue it because I have faith in a collective humanity, and in global unity, and because I consider it our duty.”

Nonetheless, she stated, a case can be made — one she associates with the late Paul Farmer, her friend and mentor who was an icon at Harvard and in global health.

“Paul [Farmer] believed that Harvard’s doctors, who operate in the best-equipped institutes in the nation, should also serve in the most under-resourced communities worldwide. Engaging in that balance between those two experiences can enhance both of them.”

Louise Ivers, faculty director of the Harvard Global Health Institute

Beginning around 2003, Ivers established a connection with Farmer in central Haiti, at clinics managed by Partners In Health, the organization he co-founded. There, Ivers — an infectious-disease expert born and educated in Ireland — encountered surges of HIV and tuberculosis while also addressing the everyday care demanded by malnutrition and extreme deprivation.

“Paul insisted that Harvard’s doctors, who engage in the best-equipped institutes in the nation, should also work in the most under-resourced communities globally,” she mentioned. “Engaging in that balance between those two experiences can enhance both of them.”

The recent experiences in the nation with COVID-19 have validated that claim.

In the initial months of the pandemic, Massachusetts turned to Partners In Health to conduct contact tracing, drawing from “what the organization had learned from working in places such as Haiti, during the cholera outbreak, or facing illnesses like Ebola in West Africa,” Ivers explained.

Furthermore, doctors who have volunteered in minimal facilities across the Global South learn to maximize limited resources — as they had to do in 2020, amid worldwide shortages of ventilators, masks, and diagnostic tests. The experience reveals insights in various aspects.

“In Haiti, I discovered how essential it was not to impose ideas on the community that they had not been involved in developing,” Ivers remarked. She acquired Haitian Creole, visited patients’ residences, and offered solace to families mourning the loss of children due to malnutrition or illness.

Consequently, as American healthcare evolves to become more inclusive, she suggested, we all owe a debt of gratitude to Haiti.

Today, Ivers occupies a multifaceted position akin to that held by Farmer prior to his passing in 2022: She is a clinician and researcher in Haiti and Africa, a pivotal link in a network of Harvard-affiliated physicians and their collaborators worldwide, and a promoter for their initiatives at home.

Each month, HGHI hosts virtual discussions aimed at elucidating what global health entails — and what it does not. For instance, they highlight, foreign aid constitutes roughly 1 percent of U.S. annual expenditures, rather than the 20 or 30 percent some people might estimate.

Even in the face of challenges to American health initiatives like USAID and PEPFAR, global health remains the most favored secondary field among Harvard students, according to Ivers.

And many medical students and emerging faculty in medicine are advancing the mission.

Similar to Ivers, Amir Mohareb is an infectious disease expert. He splits his time between rotations at Mass General Hospital and distant areas of global need. The “engagement” can be challenging, Mohareb shared. “When we’re
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abroad, caring for individuals, we’ll consider, ‘I could manage this at home, we could preserve this individual’s life. Here we cannot.’”

However, it is also constructive. Over the last five years, alongside his frontline assistance, Mohareb has authored numerous research papers on topics such as oil spills, prison outbreaks, and the hazardous dangers of migration through Central and South America.

Recently, his efforts took him to the Darién Gap, located on the Panama-Colombia frontier.

“It’s a region of thick rainforest, and it’s incredibly perilous,” Mohareb mentioned, referencing mosquito-borne diseases, cartel violence, and erratic weather conditions. “But up until this year, likely, people have been migrating through it, in the hundreds of thousands” each year heading towards the United States.”

In a 2023 publication for The Lancet, Mohareb and his Panamanian associates evaluated the ramifications. They utilized 138 autopsies — a limited sample, Mohareb stated — to piece together the stories of migrants lost in the gap. They uncovered many young adults — as well as children and the elderly; Haitian and Ecuadorian migrants were accompanied by others from distant Africa.

Through his studies, Mohareb aims to bring forth narratives that many in the West are not informed about — or would prefer to ignore.

Being a physician has always resonated with him as a “sacred honor,” he expressed. But he views research as a privilege too, providing another form of solace to its subjects.

“Individuals are sharing delicate, personal information, and — when the projects are executed correctly — they feel recognized and validated in their beliefs: that this is occurring, not just affecting me.”

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