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Overseas experiences inspire doc to push for change

Dr. James Orbinski was working at a Doctors Without Borders clinic in South Africa in January 2000, when a 20-year-old man dying of AIDS asked him a few simple, yet powerful, questions.
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Dr. James Orbinski (centre) was presented with the Sudbury Medal for Leadership in Community Health after speaking at Laurentian University Jan. 19. He is seen here with Laurentian president Dominic Giroux and the city's medical officer of health, Dr. Penny Sutcliffe. Photo by Heidi Ulrichsen.

Dr. James Orbinski was working at a Doctors Without Borders clinic in South Africa in January 2000, when a 20-year-old man dying of AIDS asked him a few simple, yet powerful, questions.

“He told me, and I quote, 'Why do you come here with all of your kindness, when what I need is medicine to stop this AIDS?” Orbinski, who gave a speech at Laurentian University's Fraser Auditorium Jan. 19, said.

“'Your kindness is good. But it will not help this AIDS. They have such medicine in your countries. Why not here in South Africa for people like me?'”

The young man's questions addressed the “heart of inequity of the HIV/AIDS epidemic,” Orbinski, the former international president of Doctors Without Borders, said.

Doctors Without Borders, also known as Médecins Sans Frontières, is one of the world's leading independent international medical relief organizations.
At the time, effective drugs were available to treat HIV/AIDS, but it cost about $15,000 a year to treat one patient.

“There wasn't a hope in hell that this young man, or millions more like him in the developing world, would gain access to that treatment,” Orbinski said.

In response to the young man's story, and many more like it, Doctors Without Borders launched its Access to Essential Medicines Campaign.

The organization first explored the issues surrounding the high cost of HIV/AIDS drugs, bringing together “the best scientific, political and legal scholars in the world,” he said.

Through a coalition of citizens groups, they then “publicly shamed governments and pharmaceutical companies that supported profit over people's right to exist.”

“We then pooled our purchasing power and bought generic versions of AIDS drugs,” Orbinski said. “By 2001, we had brought the market price for the treatment of AIDS from $13,000 US for patented antiretrovirals to less than $200 for generic versions of exactly the same medicines.”

Today, these same treatments cost less than $64, and “against all odds,” there are at least six million people being treated for HIV in the developing world, up from just 40,000 before the campaign started, he said.

Orbinski, who in 2004 co-founded Dignitas International, a medical humanitarian organization working with communities to increase access to life-saving treatment and prevention in areas overwhelmed by HIV/AIDS, insists “the right kind of change is, in fact, possible.”

“It does not lie in naive, utopian theories,” he said.

“It lies in what we actually do. The most innovative and politically transformative ideas ... over the last 200 years have been driven by engaged citizens who acted, however imperfectly, to explore and create alternatives.”

Orbinski is the first speaker in the Dr. Dan Andreae Distinguished Presidential Lecture Series on Living in Healthy Communities.

Andreae, a social worker who teaches at the University of Waterloo, donated $100,000 to establish the once-a-year Laurentian University lecture series.

He said he decided to do so after hearing about Laurentian through James Grassby, a well-known Sudbury social activist who passed away last year.

Andreae said it's important for society to “increase our body of knowledge around elements comprising healthy communities.”

He said he couldn't think of a better person than Orbinski to present the inaugural lecture.

“In my view, (Orbinski) really exemplifies the splendid virtues upon which the lecture series is based,” he said. “These are compassion, caring and commitment, juxtaposed with a can-do, action-oriented perspective.”

Along with the lecture series, Andreae is also sponsoring an annual $2,500 scholarship for a Laurentian University student. First year Northern Ontario School of Medicine student Jessica Chan is this year's recipient.

Chan, who hopes to work with Doctors Without Borders one day, said the scholarship will help her to continue research she's been conducting in Africa for the past two years.

“I'm truly honoured to be the first recipient of the scholarship founded by Dr. Dan Andreae,” she said. “I'd like to take this opportunity to thank him for his generosity and vision.”

Orbinski told those gathered at the lecture about his experiences as the Doctors Without Borders head of mission in Rwanda during the genocide in 1994.
“The gutters alongside the hospital we managed to keep open literally ran red with human blood,” he said.

He treated one little girl who hid in a latrine while her family was murdered.
Through an interpreter, she told him “I saw through the hole. I watched them hit (my mother) with machetes. I watched my mother's arm fall into my father's blood on the floor, and I cried without noise in the toilet.”

While this little girl “had no voice,” the same wasn't true of the doctors working at the clinic where she was treated, Orbinski said.

“We had a responsibility to speak out against what we knew was happening in Rwanda, and we did speak, and we spoke with a clear intent to arouse outrage of public consciousness around the world,” he said. “We did so with a view to pursuing a politics that puts dignity and equity at the core of its pursuit of justice.”

One of the outcomes of the outrage against the Rwandan genocide was the creation of the international criminal court, something which Orbinski describes as a “seminal human achievement.”

“Now, for the first time in human history, those individuals who violate the laws of war can be held to account if their own governments fail to do so.”
After the lecture, Orbinski was presented with the Sudbury Medal for Leadership in Community Health.

The award was jointly created by the Sudbury and District Health Unit and Laurentian University, and recognizes outstanding leadership in contributing to the health of communities.

“This medal is about inspiring us to do our best, be at our best,” Sudbury's medical officer of health, Dr. Penny Sutcliffe, said, before she presented Orbinski with the award.

“Your work in humanitarian assistance — a great personal sacrifice — is a beacon by which we can steer our own individual efforts to make a difference in the health of our own communities. You are such a well-deserving recipient of this medal.”

Posted by Arron Pickard 


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Heidi Ulrichsen

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