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Crossing the country to promote global health

Yale Medicine Magazine, 2006 - Autumn


A 1997 alumna bicycles through 13 states to raise awareness of the links between poverty and disease.

Karen Kiang, M.D. ’97, approached the podium at the public library in Telluride, Colo., with an enthusiasm and none of the weariness you might expect from someone who had pedaled her bike 77 miles over a 10,000-foot mountain pass the previous day. Slim, with a luminous smile that dominates her round face, Kiang came to Telluride with a single goal—to awaken others to the urgency of world health issues she has seen firsthand.

Kiang has no desire to lecture—she designed her presentation, dubbed Global Health 101, as a conversation starter. “What do you know about malaria?” she asked a high school student in the audience. When he replied that it’s a blood disease, she nodded her head. Like so many other diseases facing the developing world, malaria is largely preventable with low-cost interventions, she told the audience. Kiang has seen malaria’s damage with her own eyes, and it’s the senselessness of it that bothers her most. “These are treatable diseases, but it takes money to get things done,” she said.

Just 18 days earlier, she had left San Francisco with 20 other bicyclists to begin the Ride for World Health, a 3,700-mile journey across the United States to raise awareness and money for global health issues. Along the way, Kiang and the other riders, most of them medical students, slept in school gyms, in churches and in the homes of gracious local hosts. In the evenings the riders led lectures and discussions about issues like malaria, HIV, tuberculosis and the poverty that drives these diseases in the developing world. Kiang and her companions sought to raise $250,000 for Partners in Health, a nonprofit global health program aimed at providing basic health care to underserved people in Haiti, Rwanda, Guatemala, Mexico, Russia, the United States and other parts of the world. “Just $50 can provide testing and treatment for seven tuberculosis patients,” said Kiang. “You also prevent each patient from spreading it to 10 to 15 other people.”

Kiang signed up for the ride after receiving a notice about it via e-mail. “I couldn’t resist,” she said. Already an avid bicyclist, she owns no car and bikes about 10 miles each day to her job at The Northern Hospital in Melbourne, Australia. “I loved the idea that such a humble vehicle could carry such an important message,” she said. The ride also appealed to her sense of adventure.

But Kiang is not just on a ride—she’s on a mission. “I grew up in a safe, well-to-do suburb of Minneapolis. I never worried about whether I could eat or not,” she said. Her parents, both physicians, fled China to escape Communism and never allowed her to take prosperity for granted. “My father lived for years on rice porridge,” said Kiang. “I understood from an early age how fortunate I was, and I felt I should pay something back.”

During medical school she teamed up with renowned medical parasitologist Peter J. Hotez, M.D., Ph.D., to study chronic hookworm in China and Thailand. She noticed that one village had fewer cases of parasitic disease than the others. “It was the richest village, and that realization was part of my public health awakening,” said Kiang. “Poverty is the root of disease.” She saw it on American Indian reservations and in the villages of China and Thailand—poverty leads to malnutrition, which boosts the probability of infection, in turn increasing the risk of early death.

Kiang has spent her career trying to stop the cycle. As a resident at Duke, she traveled to Tanzania to work with HIV patients. While there, she met her partner, Tim Fricke, M.Sc., a pediatric optometrist. After two years as an Epidemic Intelligence Service Officer at the Centers for Disease Control and Prevention in Atlanta, Kiang moved to Australia, where she is now the equivalent of a fellow in the emergency room at The Northern Hospital.

In November, she will embark on her next project, a stint with Doctors Without Borders, which will likely take her back to Africa. But in April she still had a ride to finish. By the time she reached Washington, on May 21, Kiang had crossed 11 states and given her Global Health 101 presentation to hundreds of people. “Once people realize these problems exist, they open themselves to doing something about it,” she said.