America had long ago acknowledged the impact Dr Jacob Eapen had on its society. Now, his alma mater, Trivandrum Medical College, too has. On February 16, Dr Jacob Eapen was awarded the Trivandrum Medical College Distinguished Alumnus Award.
“I was informed of the award after I had returned to California after a vacation 10 days ago,” Dr Jacob Eapen said, casually seated in the sunny sit-out of his ancestral house at Kuravankonam in Thiruvananthapuram. “But this is a special honour so I did not mind the extra flying hours,” Dr Eapen said, two days after he received the award from Governor P Sathasivam.
Here is a man who had received honours that were bestowed on American presidents and great athletes. In 1999-2000, when the prestigious Stanford University marked the 40th anniversary of its shift to Palo Alto from San Francisco, it celebrated '40 Careers in Medicine'. Dr Eapen was one of them, and the only foreigner in the 40.
Dr Eapen has a unique career graph. After passing out of the Trivandrum Medical College, he did his post-graduation in paediatrics at Christian Medical College, Ludhiana in Punjab. “There was not much access to post-graduate training in Trivandrum those days,” Dr Eapen said.
Dr Eapen's Buddha moment
From there he flew straight to Africa, first working in Tanzania's Aga Khan Hospital as consultant paediatrician, and then in Nigeria. It is the children dying of malnutrition he saw in these African nations that told him that public health was his calling. “I found that preventive medicine was the best way to tackle health issues,” Dr Eapen said.
In poor African countries, with poor access to healthcare, vaccine-preventable illnesses were high. There would be 200-250 patients waiting to see him a day at his clinic in poor African countries. “I still recall moments when I could spot a child seated on the hip of her mother standing long back, say 50th or 60th in the queue, and thinking that the child will not survive an hour,” he said.
His work in Africa made the United Nation High Commissioner for Refugees appoint Dr Eapen as health advisor in Philippines in 1990. During this period, he was in charge of 40,000-odd Indo-Chinese refugees at the Philippines Refugee Processing Center, Battan. Shashi Tharoor was his contemporary in the UN. When he left Philippines he was paid a glowing tribute by Herman T Laurel, the administrator at the Refugee Processing Center. “No other medical advisor before him has figured as positively in Health Services group affairs, nor shown as much commitment to its mission, for which he has earned our respect and high esteem,” he wrote.
Berkeley and Stanford
This was long after Dr Eapen earned a master's degree in public health from the University of California, Berkeley, in 1984. Later, he also served in its advisory board. When Berkeley later invited him as an advisor, he was the first Asian to be given the honour. After Berkeley, Dr Eapen went to Stanford University as resident for higher studies on paediatric public health. It was this residency that qualified him for the '40 Careers in Medicine' honour. “I was the only doctor among the 40 who had studied in Stanford only as a resident. Others had done their graduation too at Stanford,” Dr Eapen said.
Currently Dr Eapen serves as the medical director for Alameda Health System (AHS), one of the largest public health system in California. 'Washington on Wheels', a mobile health clinic stationed at Tri-City area schools and churches in the San Francisco Bay area that offers vaccination and basic medical care, is one of the successful outreach programmes run by the Alameda Health System. He also helped set up the first school-based clinic at James Logan High School in Union City, a programme that was adopted by other Californian high schools.
Honour reserved for legends
Such public health activism had won him the Ellis Island Medal of Honour in 2007, a honour won earlier by American presidents Ronald Reagan, Bill Clinton, George Bush, and Jimmy Carter, civil rights activist Rosa Parks, pop icons like Frank Sinatra, legendary sportsmen like Muhammad Ali and Arthur Ashe, and the American-Romanian writer Ellie Wiesel. The medal is given to outstanding individuals who have dedicated themselves to community service.
“The world has advanced tremendously technologically but advanced very little in terms of compassion,” is how Dr Eapen explains his philosophy. His celebrated health activism has led him to hold an elected position in the board of directors of Washington Hospital Healthcare System, Freemont, California. Over 600 doctors work under this system.
Dr Eapen's unique record
Last November, he was elected for the fifth consecutive time to the board. Dr Eapen had secured 35,000-odd votes, good enough to win a seat in the Senate. Even the Indian-born Bobby Jindal (former Louisiana governor) had won only three public elections. Last February, Washington Hospital Healthcare System received the America’s 100 Best Hospitals Award from Healthgrades, placing it among the top two per cent of hospitals in the United States for clinical excellence.
America's health issues
Though it is definitely not Africa, Alameda county too has severe disparities in health indices. African Americans, for instance, have infant mortality rates that are two to three times higher than average. Like in Kerala, immunisation too is an issue. “There is a lobby working overtime against immunisation in America,” he said, and added: “Only 73 per cent of Alameda County children were up to date on their immunisation by age 2, well below the the objective of at least 90 per cent.”
According to him, the high spending in healthcare is not proportionate to the quality in healthcare. “The US spends 20 per cent of its income on healthcare compared to 11 per cent in Canada and Switzerland. Yet the US ranks 25 or less in the quality of healthcare. Also, the US has a life expectancy that is very close to Kerala even though I am told Kerala spends less than one per cent of its GSDP on health,” Dr Eapen said.
Insure against skyrocketing medical bills
He agrees that healthcare costs are on the up in the state. “One of the reason for escalating cost per patient is the adoption of newer technologies and its excessive usage,” he said. According to him, the only panacea to neutralise rising healthcare costs was universal insurance coverage. Insurance coverage can bring in accountability.
“Now there is a situation where a patient is made to do an MRI scan even for a running nose. This will not happen if insurance companies take over the payment. They will question the hospital on such equipment choices. They will also compare costs and bring the price down,” he said.
Dr Eapen also sounds a note of caution. “There is no quick fix to the rising cost in health care and if we don't take pre-emptive measures like controlling the cost of pharmaceuticals and administrative costs, the country's healthcare system can go bankrupt.”
