By Peta Owens

A day at work is hardly routine for Dr. Nadeem Anwar MPH'97. First, he must decide whether to commute by land, river, or air. If there are no roads to the remote Papua New Guinea villages he is headed to that day, he scrambles on board a boat or helicopter with his health staff and supplies.

"When we arrive, the whole village is assembled to meet us; the people are in a festive mood and they seem to know that we are going to make a difference in their lives," says Dr. Anwar, who regularly visits 84 villages in one of the most remote regions of Papua New Guinea; an island located just north of Australia. The country has health standards that compare with some of the world's poorest. It has a high rate of infant and maternal mortality and rampant infectious diseases such as malaria, dysentery, typhoid, tuberculosis, and skin infections.

Most of the villagers Dr. Anwar attends to have never seen a Band-Aidólet alone a doctor. Dr. Anwar brings both in his traveling health clinic, often hopping from one village to the next. The health workers bring vaccines, educational posters, videos on healthcare, a television to show them on, and an electrical generator for power. Before the videos, Dr. Anwar addresses the entire village: "We are here today to teach you about prevention of diarrhea, malaria, measlesówe will show you a movie about each sickness and then we will explain to you how we can work together to fight, prevent, and control them in our villages."

After showing the video, nurses examine the women and children and give immunizations. On return visits, other educational sessions are offered on topics ranging from personal hygiene, to nutrition and sanitation awareness. All sessions are combined with "Save na Mekim" (know it and do it) workshops to encourage self-sufficiency in attending to the villagers' health. These workshops may be held under the shade of a tree or in one of the bamboo community huts. Techniques used to teach the villagers about prevention of disease may involve role playing, group discussions, case studies, and lectures with visual aids.

"In the villages, you must present modern ideas within the framework of their cultureóa marriage of modern ideas with traditional beliefsóso whatever we teach must be culturally acceptable," says Dr. Anwar. "We must be knowledgeable about the culture and show great respect for the people and their traditions."

For the past four years, Dr. Anwar has overseen Chevron Niugini's Kutubu Project to set up a public healthcare program and teach preventive health measures like maintaining clean drinking water, improving sanitation, and proper nutrition, to name a few. "When we first started, there was no effective healthcare program, now we have helped establish two hospital health centers and 14 aid posts or clinics," says Dr. Anwar. He revived an immunization program that had dissipated ever since Papua New Guinea gained independence from Australia in 1974.

It is obvious that Dr. Anwar deeply values the intangible rewards of his work. "Imagine a feeling that your contribution saved lives, reduced suffering, and improved the quality of life of many men, women and children," he says.

The Kutubu Project is sponsored by Chevron Petroleum Corporation, which has agreed to work with the country's government to help improve socio-economic development in villages within its petroleum licensing area. Besides basic healthcare, the project has helped with, among other things, the installation of water tanks for drinking water, improvments in sewage disposal and sanitation methods, the introduction of chemically-treated mosquito nets to help prevent malaria, and the instigation of training programs to improve villagers' skills.

Aside from providing material for his master's project, Dr. Anwar's work in Papua New Guinea is a learning experience that has cultivated his interest and skill in international health. "This has been a rich professional experience for me. The culture, the people, and working in this environment is in itself a universityóa very unique one," reflects Dr. Anwar. "I learned the principles at the University of Utah, but now I'm learning the application of those principles in Papua New Guinea."

Service is an integral part of the "principles" he's applying. "This is a place where my presence makes a big difference. So few people bring their skills to such a remote area that when you do, you can make big changes." For example, the program has helped raise immunization rates in the project's villages from 5 to over 70 percent, provide vision-restoring surgeries to six blind villagers, and saved the lives of children in the grips of malaria.

"There are certain feelings and memories that will be with me forever," says Dr. Anwar. "The feeling of knowing that if you or your staff had not been there this woman or this newborn baby or this child would have definitely died. The satisfaction derived from saving lives and reducing suffering is very difficult for me to express."

The Mother Child Health Program (part of the Kutubu Project) is Dr. Anwar's "baby" so to speak. "I think this is the area that I am making the biggest difference," says Dr. Anwar. The program has made phenomenal improvements in the health of thousands of native mothers and children. Sixty percent of Papua New Guinea's population is women and children under fiveóthe group with the highest mortality rate. Most of these deaths and suffering can be prevented by immunization and prenatal and postnatal care.

When Dr. Anwar and his staff return to villages he is reminded of what his work has accomplished. "They'll say, ëDoctor, do you remember this baby? This is the one that was born when you took care of me.' They want to all gather around us and hug us and say, `Do you remember me?' "

Dr. Anwar's experience in international healthcare is extensive; before attending the U to earn a master of science in public health degree through the Department of Family and Preventive Medicine, he earned a medical degree in Pakistan. He worked in seven countries as a physician before coming to the United States. "I returned to school because I wanted to be more specialized in my field [international healthcare], and a colleague of mine spoke highly of the program at the University," says Dr. Anwar.

His wife, Shama John MPH'95, graduated with a master of public health degree from the University in 1995. When Dr. Anwar is not trekking through the Papua New Guinea countryside, he is at home in Salt Lake City with her and their two children, son Zeeshan and daughter Hina. Dr. Anwar plans to continue the kind of work he is doing, but in many other countries. "My goal is to go to different countries and train the local people so they can provide healthcare on their own," he explains.

Perhaps what tempers the jet lag, homesickness, and heavy workload is Dr. Anwar's commitment and belief in what he does. "Working in developing countries is a worthy cause. You are a walking ambassador for your state, country, and your own culture. You are not only giving but you are bringing back these experiences and knowledge to your own country and culture."