DMU alumni put passion in action

DMU leaders like to say the University is “doing a world of good.” A big way it does that is through its alumni, many of whom apply their health care and leadership skills to making the world – or at least a piece of it – a better place.

Taking a Toms Shoes tack to save lives

Karl “Fritz” Disque, D.O.’07, R.Ph., is driven to make money, but not for the reasons one might think. He got his first taste of managerial leadership at age 10, when his parents made him the coordinator of a team of people at least twice his age in their Brownstown, IN, carpet installation and cleaning business.

Unsure in high school of what he wanted to do career-wise, he found a comparison of starting salaries by profession and picked the highest-paying, pharmacy.

When his eventual dislike of that job led him to medical school at DMU, Disque worked full-time as a pharmacist and got into real estate, flipping houses and renting apartments.
His night shift at the local Walgreen’s allowed him to read incessantly, always about entrepreneurship when he wasn’t studying medicine. Whenever DMU brought a financial adviser to campus to counsel students individually about managing tuition debt, Disque booked the adviser for hours at a time to talk instead about taxes and finance.

At the same time, he observed physicians whose practices, he felt, were stymied by insurance companies and medical reimbursement policies.

“They didn’t really want to practice the way they were, but they had to or they would have lost their jobs,” he says. “I began to wonder, how can you decouple money and medicine?”

Disque found his answer in part through global health service. As a resident at Rush Hospital in Chicago, he served as an instructor for Ethiopia’s first nurse anesthetist master’s program. He also joined a team of volunteers to provide relief in Haiti after its catastrophic earthquake in 2010.

“When you go to underserved countries, you’re just clinical,” he says. “It’s like a rebirth – it’s why we wanted to do medicine.”

A near-tragedy in Haiti inspired him to combine his medical and entrepreneurial interests: When a pregnant woman digging her family out of the post-quake rubble went into labor, Disque’s team delivered the baby by C-section. The local nurse was unaware the blue baby in her arms was in danger.

“She didn’t know the baby needed help because she didn’t have the basic training,” he says. “We were able to resuscitate the infant. That was an extremely preventable death, but she just didn’t know because of a gap in knowledge.

“That changed everything. That was a turning point for me,” he adds.

Disque and his cousin, John Lustig, have since co-founded National Health Care Provider Solutions (NHCPS), an online medical education company that provides health care professionals with basic life support, pediatric advanced life support and advanced cardiac life support courses, certified by the American Emergency Medical Advisory Association. All proceeds support medical care and education in underserved countries through the Disque Foundation. It’s a concept similar to that behind Toms, the shoe company that gives a free pair to a person in need for every pair it sells.

“With Toms, it’s not about the shoes for the buyers; it’s a statement about themselves that they like to give to other people,” explains Disque, foundation executive director, NHCPS chief medical officer and a full-time anesthesiologist in Chicago, Las Vegas and Racine, WI. “Everyone wants a little more meaning in their lives. You need shoes. You can just buy shoes, or you can buy Toms and contribute. When you’re in health care, you’ve got to have basic life support training. If you get it through our company, you’re giving to someone else and saving a life.”

That includes the more than 250 patients treated by a Disque Foundation team that partnered with the Floating Doctors organization to bring medical relief to remote communities in Panama last September. “All of the villages we visited had been without medical care for at least three months, often longer,” he stated in a recap of the trip. “Poor health care scenarios like these are what the Disque Foundation is fighting to improve.”

Disque’s do-good entrepreneurial approach works in large part because of the increasing popularity of online education and the explosion in technology worldwide. During a service trip in Panama, he and his team worked in a village that had constructed its first classrooms with wireless Internet at the same time it obtained its first bank of flushing toilets.

“The people cook by open fire and were doing laundry in the stream, and they have Wi-Fi,” he marvels. “Technology is moving faster than it ever has, and the number of people online is growing. The beautiful thing about technology is that it doesn’t take a lot to start something big.”

“Find your ‘why’ – the purpose that drives you, that causes you to dig deep when energy fades,” he said. “An uninspired life is just not one to lead.”

That “something big” for NHCPS, in addition to funding medical service trips, may soon include offering its educational programs to people in underserved nations possibly for free. Disque relies on his team of programmers and other technology experts to make such ideas happen.

“The median age on my team is 24. They’re not money-motivated,” he says. “We’re very purpose-driven. The way we can impact the most people is by offering excellent education in multiple languages and making it accessible.”

Disque considers defining that purpose as his top job. “An entrepreneur is the kind of crazy one to be driven and be willing to go where there isn’t a clear roadmap. An entrepreneur takes direct responsibility for turning an idea into a profitable finished product through assertive risk-taking and innovation,” he says. “Social entrepreneurism is the same, with an imperative to drive social change and benefit society.”

When Disque was the inaugural speaker in DMU’s Innovative Leadership Series last October, he advised students to define their own imperative.

“Find your ‘why’ – the purpose that drives you, that causes you to dig deep when energy fades,” he said. “An uninspired life is just not one to lead.”

Following fate to fill needs in Haiti

Not long ago, Sarah McCool, M.P.H.’13, observed to her DMU academic adviser, MPH Program Chair/Director Mary Mincer Hansen, Ph.D., R.N., “The best things in my life have happened when I haven’t planned them.”

Much of her journey bears that out: After at least a decade of planning to become a lawyer, she didn’t score well on the LSAT. Devastated, she took a secretarial position at a hospital, “fell in love with health care” and then accepted an administrative position there. After earning her master’s degree in health care administration, she enrolled in DMU’s public health program. A course on global health policy was her “aha moment,” leading her to land an internship with the World Health Organization in summer 2011.

“All of these amazing things kept happening,”

McCool says. “Thanks to DMU, I found my passion and profession.”

In one way, they found her: In 2010, she joined a group of Iowans to volunteer with Visitation Health Foundation (VHF), a Nashville-based health and health education organization that operates a clinic in rural Haiti. Later, when McCool had finished her DMU master’s degree and had begun working on her doctorate in public health at Arizona State University, she got a call from VHF founder and board Vice President Theresa Patterson: The organization needed a new executive director.

“She was very supportive of me in finishing my Ph.D. It was a win-win situation,” says McCool, who took on the role last fall. “It’s the perfect alignment of everything I’ve wanted to do – global health, applying my public health degrees and coming up with culturally appropriate interventions in a country I’ve fallen in love with. I can’t believe I have a position that actually pays me to go to Haiti.”

She is rightfully proud of the VHF clinic, which sits approximately three and a half hours southwest of Port-au-Prince in the town of Petite Riviere de Nippes. Located in an architecturally innovative, energy-efficient building with an all-Haitian staff, a variety of laboratory and pharmacy services and satellite Internet access, it also features flexible interior space to tackle the uncertainties of providing health care in the impoverished nation. For example, when more than 70 critically ill patients arrived one morning during a cholera outbreak, they received care in every corner of the clinic; not one life was lost.

“When I first visited the clinic, I was blown away. While everything in Haiti can be sort of chaotic, the clinic is clean, efficient and competent,” McCool says. “Our guest house is beautiful. We host medical teams there.”

The clinic, which has treated more than 90,000 patients since it opened in January 2008, also has become a base for public health outreach.

“To date, we have provided approximately 2,500 families with purified drinking water. We have almost eliminated child malnutrition in the area, though we are still working with mothers of infants in breastfeeding and providing formula when necessary,” McCool says. “We offer an array of classes from basic hygiene to diabetes to hypertension classes, and more.”

Still, she adds, “Haiti has a long way to go” in recovering from the massively destructive 2010 earthquake. “It’s hard to get doctors and nurses out into the rural areas. Access to clean water and the incidence of cholera are issues. A huge percentage of the population are illiterate. Education is a big issue. There are not huge numbers of job opportunities,” she notes.

Another issue for VHF is the fact its clinic has no surgical capabilities. The closest option is a substandard facility about 30 miles away – a near-impossibility in a place where transportation is limited for many people. McCool and the organization are engaged in a $2 million fundraising effort to change that.

“The hospital we want to build already has received approval by the ministry of health. We hope to have clinics, and we hope to create jobs with the health system,” she says. “Another hope, once we get the surgery center, is to get medical students to do rotations there and visiting medical teams to volunteer.

“We have the blueprints, the engineer, and we will use local workers,” she adds. “Now we just need the money.”

A September breakfast event raised $250,000 toward the project, which also will include expansion of the existing clinic. McCool and her colleagues hope another event in February will raise even more. In the meantime, she’s working to increase awareness of VHF’s impact and boost support to multiply it. She’s working on her doctoral dissertation analyzing the level of collaboration and cooperation among health care and nongovernmental organizations (NGOs) in Haiti. She continues to teach an online course on global health for a community college in Arizona.

McCool also has recruited three current students in DMU’s public health program to design their capstone projects in Haiti. Margaret Galvez, a nurse in Fort Worth, TX, who’s been active in global health service for almost a decade, plans to focus her capstone on training Haitian women to become birth attendants in their communities.

“Having been a nurse and working in global health in very poor areas of the world, I understand that people need medical help – but what can they do after that medical help leaves?” Galvez says. “They need infrastructure, training and strategies that embrace their cultural systems. Having local birth attendants is a right choice.”

In addition to engaging MPH students, McCool hopes other DMU alumni will consider bringing teams of health care volunteers to VHF’s Haiti clinic and, when it’s up and running, its new hospital. Whatever the future may bring, she’s fairly certain about one thing.

“I’m so passionate about global health,” she says. “I think I’ll always be able to incorporate it into my career.”

Moved by faith, informed by reality in Uganda

Charles Holt, D.O.’94, has treated children with advanced hepatitis and “livers the size of basketballs.” He once referred a severely malnourished 14-month-old girl from his mobile medical camp to a hospital, only to learn later she died when her parents decided they couldn’t afford to get her there. He’s cared for patients with multiple strains of HIV in the nation where experts believe the virus originated.

Charles Holt’s work in Uganda, one might say, truly takes a leap of faith. He believes his faith keeps him balanced and his work,
arduous though it often is, keeps him young.

Such is the sometimes soul-crushing nature of delivering health care in Uganda. The East African nation, slightly smaller than the state of Oregon, is home to nearly 35 million people, incredible scenery and wildlife, the world’s third-highest birth rate and an average life expectancy of 54 years. According to the CIA, Uganda has one-half a hospital bed and 0.117 physicians per every 1,000 people. Holt first visited the country six years ago on a stipend from Yale University, thanks to his training in tropical medicine.

“I sensed God leading me to go there and I have never looked back,” he says. “You can’t go there and see all the destitution and not do something about it.”

An emergency medical physician at Covenant Hospital in Waterloo, IA, Holt is founder and president of Caring Hands Foundation Ltd., a faith-based, nonprofit organization that since 2010 has provided medical, social and financial support to people in Uganda free of charge. He travels to the country two or three times per year, working as an attending physician at Mulago Hospital in northern Kampala, Uganda’s capital. It’s the nation’s only tertiary care hospital.

“Caring Hands is an accepted organization at the hospital. We’ve got good people there year-round,” Holt says. “It’s tough to get in, but now we actually have an office on the hospital grounds. I consider that answered prayer because there’s so much bureaucracy.”

Holt doesn’t hide his faith, but it doesn’t make him naïvely view the world through rose-tinted glasses. Rather, he leans on his trust in God to provide care, with his team, to patients who come to Mulago Hospital with advanced diseases and no family to help them.

“Admission to Mulago means the patient has to provide his or her own bedding, food and transportation for labs and x-rays,” Holt explains. “Otherwise, a patient may end up lying on the floor being ignored by everyone. We encourage our team to get to know the patient physically, emotionally and spiritually.”

Charles Holt, Karl Disque and Sarah McCool all invite other alumni to join their global health efforts. “I know they would have a very rewarding experience,” Holt says.

For the past six years, Holt and CHF also have worked in Kasensero, a small fishing village that, according to a recent CHF report, “has had the profound misfortunate of being the epicenter in the 1980s of social upheaval, poverty, mass migration, smuggling, warfare, disease, and sex trade that led to the HIV crisis in East Africa and ultimately the rest of the world.”

“The hygiene is terrible. The water table is really low there. The people can’t build latrines because they can’t afford to build them high enough,” says Holt, who notes the government once built functional toilets in the area but, because it charged three shillings per person per visit, they went unused. “There’s a lot of hopelessness and suspicion. The people don’t have the concept that a rising tide lifts all boats.”

In 2012, CHF organized a two-day mobile medical camp in the community at which nearly 1,300 patients received care. Last June, CHF partnered with other organizations, the local government, individuals and pharmaceutical companies for another two-day camp that served more than 1,850 patients, many of whom also received clothes, personal hygiene products and other basics.

Holt and his organization have purchased and leveled fives acres of land in Kasensero for the construction of a school. Caring Hands has worked with other nonprofit organizations to help build five other facilities in Uganda, but the Kasensero Hope of Life Primary School, with an estimated total cost of $600,000, is the organization’s biggest undertaking to date.

The school project and Holt’s continued work at Mulago Hospital seem to define the phrase “a leap of faith”: He and his colleagues are working to fill a 40-foot overseas shipping container with 2,000 wall-mounted hand sanitizer dispensers, sanitizer and furniture donated by Covenant Hospital as well as donated medical equipment, clothing and cloth diapers.

They also plan to stuff in a mile of chain link fence – acquired at a donated discount – to enclose the school grounds as protection against wandering cows, goats and pigs. Holt says a U.S. team already has committed to travel to Uganda in June, at their own expense, to erect it.

“Try to imagine how many customs officers are going to have to sign off on this delivery en route, and you can start to get the picture of how tricky this shipping process can get,” he admitted in an e-mail message to friends about the undertaking last November. “However, as [Saint] Paul so well said, ‘I can do all things with Christ who strengthens me.’”
A DMU adjunct faculty member in global health, Holt wants more volunteers, including DMU alumni and students, to join his medical service activities. “We want to be in Uganda for the long haul and are trying to get more people involved,” he says. “If we could engage retired physicians and those winding down in their careers and get a facility where they can stay, I know they would have a very rewarding experience.”

That’s in part because of the Ugandans themselves. Despite the nation’s troubles, Holt deeply values many of the people he’s met there, particularly his fellow hard-working health care providers.

“I have a lot of good friends there. They really commit to you as a person; friendship really means a lot to them,” he says. “Uganda could be a paradise if they could get people in government who don’t think of corruption as a way of life.

“A lot of time it’s two steps forward, three steps back, but my faith in Christ keeps me balanced,” he adds. “I work with others with like minds. It’s worth the effort; it keeps me young. I’m 60 but I feel 35. When you see Scripture come to life, you rest in it.”

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