Even with all this up-to-date technology, which includes a telemedicine platform that enables HIC staff to consult electronically with medical experts abroad, there’s an agreeably relaxed atmosphere to the place. The waiting room is furnished with cushy sofas from which patients and their families cheer on the Nigerian team in a soccer match with Germany on TV. Madu is not bashful about walking into another physician’s office with just a perfunctory knock in order to show me a new device (“This technology never existed before in the Caribbean. Look at it!”) or to introduce me to colleague’s (“Meet Dr. Aldo Furlani, an electrophysiologist trained at the Montreal Heart Institute, who is from Argentina”). As we pass one anxious-looking woman hooked up to a monitor, Madu carefully studies the screen and then reassures her in a deep, soft voice, “ Your heart looks really good to me.”
A social movement
More than a hospital, HIC is also an education and research facility that conducts medical studies on health factors in the developing world, trains professionals from public hospitals and sponsors public campaigns about healthy lifestyles. While HIC is run as a private business so the staff can be free of interference from bureaucrats or shareholders, a nonprofit foundation supports its research and training programs as well as raises money to honor Madu’s and Baugh’s pledge that no sick person will be turned away.
“This is not a business, this is a social movement,” notes Dr. Edwin Tulloch-Reid, director of clinical services, a Jamaican who came home after working in Montreal and Pittsburgh. “We make money, but that is not our mission. We must be economically self-sustaining to show that this can be done other places around the world.”
One HIC research study that particularly excites Madu is a project measuring the average size of the heart among people in the Caribbean. It’s known that heart measurements can vary among cultures, but there is no firm data from the Caribbean. “They use simply the heart dimensions that are normative in the US and Europe,” he says. “The average ventricle size is set at 4.2 centimeters, but what if 3.8 is the average in the Caribbean, and 4.0 is actually enlarged? We need to know that.”
Madu himself is investigating the incidence of high blood pressure among Africans who migrate to other countries, compared to those who stay at home. “We already know there is more hypertension among Africans who immigrate and with an earlier onset. Someone who left Africa at 30 has a greater chance of developing hypertension at 40 than someone who stayed in Africa, but we don’t know why. We are pursuing research to measure the effects of stress in the new environment, and the loss of family and community support systems.”
HIC researchers are creating a medical profile of top Jamaican athletes, hoping to explain their exceptional performances and find clues that can boost overall health. With a population of less than 3 million, the island has produced many world-class runners, including Asafa Powell, dubbed “the fastest man in the world” for breaking his own world record in the 100-meter dash in September with a time of 9.74 seconds. “The world wants to know what makes us great athletes,” says HICs staff nutritionist Dr. Garth Officer, who once served as reggae star Peter Tosh’s personal physician. “We don’t have the best equipment, the best coaches, the best training facilities. But it may be that we eat a better diet—a poor man’s diet of complex carbohydrates, not the refined carbohydrates of the American diet.”
Western development/Western disease
Madu and his staff are worried the advance of Western-style development means Jamaicans and other people of the global south are losing the few health advantages they enjoy compared to wealthier nations—a way of life with fewer processed foods, lower stress, more exercise, and a richer sense of community, all of which have been proven to affect wellness. “Obesity is becoming a problem in Jamaica and it’s rising in Africa,” Madu reports. “And smoking is rising, too, as tobacco companies intensify marketing efforts there.”
In developing nations, where a desk job seems like a dream come true after generations of back-breaking labor, where cigarettes still appear glamorous, and where an overflowing plate of food represents a triumph over malnutrition, people are not naturally inclined to worry about exercise, smoking, or overeating. But as Western-style development slowly transforms these societies, unhealthy lifestyles have become a growing health problem. The first sight I saw coming into Kingston from the airport was a huge banner strung across the highway advertising Kentucky Fried Chicken, and, later, when walking back to my hotel from the clinic, I asked directions from a well-dressed young woman on the street. She was shocked that I wanted to go that far on foot. It turned out to be only three blocks, but along a particularly grim stretch of road full of speeding vehicles and exhaust fumes that made me wish I had taken a taxi.
