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Darn, Fresh Out of Penicillin

By Jennifer L. Mnookin

Harvard's efforts to help developing countries improve their medical facilities may at times worsen the country's health problems, Professor of Medicine Howard H. Hiatt '44 told members of a symposium yesterday.

Hiatt, former dean of the School of Public Health, said primary health care in developing countries is often terribly inadequate, but that "despite this, many of the countries spend most of their money on high-tech medical facilities."

When Harvard helps such countries to develop modern, high-technology medical schools, it may often be doing the countries a disservice, Hiatt said during the symposium "International Education in a Changing World: Is Harvard Doing its Part?"

To illustrate his argument, Hiatt described a visit he made to one African country. Upon visiting a medical outpost, he saw many women with infections easily treatable with antibiotics, but found that the entire antibiotic supply for that month had been distributed. Then, he visited a major hospital in the country, and the director proudly showed him the facilities for heart surgery and told him that this hospital received 70 percent of the country's medical budget.

But even though Harvard may sometimes aggravate this situation, it can also do much to help, panelists emphasized. Yamil H. Kouri, research coordinator of the Institute for International Development's Latin America and Caribbean Health Program, said that the principle problem in developing countries is not a lack of doctors or medical personnel, but rather a problem of management and efficiency.

Programs in public health, such as the one Harvard offers, he said, can help train foreign nationals to manage a country's medical resources more efficiently, he said, although such programs must find the proper balance between covering the medical problems of the United States and the very different ones of developing countries.

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