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International Health Initiatives in NC

The policy forum of this issue of the NCMJ highlights several North Carolina–based activities to improve health across the world. Elsewhere in the issue, representatives from 3 physician societies discuss the influence of health reform legislation on their stakeholders. Also, Action for Children and the NCIOM provide an update on the health of North Carolina children, and original articles examine smoking policies at fairs and drive-time proximity to stroke centers.


Anthony Charles, MD

Anna Bauer

N C Med J. 2010;71(5):404, 406.PDF | TABLE OF CONTENTS

Anthony Charles was practically born to be a great surgeon. His father, a pediatrician, operated a hospital in Lagos, Nigeria, and dreamed that all of his children would become physicians in different specialties and work at the hospital. Although this dream did not become reality, his son Anthony has become a first-rate surgeon who improves the health and well-being of people around the world.

Charles is an assistant professor in the Department of Surgery at the University of North Carolina (UNC) School of Medicine. He excels in this role and serves as a medical practitioner, mentor, and teacher to many people. “Dr. Charles is very dedicated to any project he’s involved in,” said Adesola Akinkuotu, a former student and co-investigator of Charles and current surgical resident at Johns Hopkins Hospital. “Dr. Charles is very passionate about education, which makes him a great person for his position.”

Charles is spreading his passion for education near and far. UNC has a long-standing partnership with Malawi. While getting his masters in public health at the UNC Gillings School of Global Public Health, Charles was invited to Malawi to see one of the projects involving human immunodeficiency virus. During his visit, Charles observed that the trauma burden was substantial, that the availability of surgical services could not keep up with demand, and, in particular, that there was a need for surgical education in Malawi. With 14 million people, Malawi has only 25 trained surgeons; few of the surgeons are Malawians, and none worked in the hospital he visited.

Since that first visit, Charles and a team of surgeons and students from UNC have periodically visited Kamuzu Central Hospital in Lilongwe, Malawi, to provide surgical services, conduct training, and perform research through the Malawi Surgical Initiative, a program affiliated with UNC Project–Malawi (available at: Although the initiative had a sustained presence in Lilongwe, the team realized that training Malawians as surgeons would be a more effective public health project. With that idea in mind, Charles spearheaded the effort to create the Malawi surgical residency program, with the intention that Malawian surgeons take over the program’s administrative and training responsibilities after 5 years. The program is now training 8 residents, and the first group will finish in 2014.

A man of many talents, Charles enjoys politics and interacting with local and international government officials, which enhances his effectiveness in persuading others to support his novel ideas. According to Clara Lee, director of research, assistant professor of surgery in the Division of Plastic and Reconstructive Surgery at UNC Hospital, and colleague of Charles on the Malawi Surgical Initiative, “Anthony is the person who holds the Malawi Surgical Initiative together and keeps pushing it forward.” Charles is not only a compelling communicator, he is also a very capable physician. Gift Mulima, one of the residents in the inaugural class of the Malawi Residency Program, reflected that Charles “is smart and gets things done and done the right way. He makes sound decisions. You should see him in the operating room!” Lee summarized Charles’ character by noting that “he has talents in so many areas, so he is able to keep many things going at once. He is the guy who comes out of the operating room after a trauma laparotomy, walks down the hall to smooth out some administrative issues with the hospital staff, turns the corner to teach the Malawi surgery residents, and then goes back to the office and analyzes our study data on his laptop. And somehow he does all of that with a smile, or even a laugh. He is always laughing, which is really telling. I think he finds great joy in helping people. It’s one of the best things about working with him. We are all energized by his joy.”

Charles was born in Germany, grew up in Nigeria, studied in England, and currently works in North Carolina and Malawi. If there is anyone who understands the complex relationship between global health and local health, it is he. When asked to compare these places, he noted that, in each setting, many professionals on the frontlines of medical care are overwhelmingly frustrated and that there is often a divide between administrators and direct care professionals. However, Charles recognizes that much can be done in the developing world, even with little funding, and he sees how much gratitude the patients and families express, particularly for surgical care that would otherwise have been unavailable.

One of Charles’ hobbies is to collect African proverbs, a favorite of which is “Sometimes in life, you must stoop to conquer.” He has taken this proverb to heart. By confronting challenges such as uncertain funding and frequent changes in government administration, he has helped Malawi move toward a solution to a seemingly unsolvable problem. He has also inspired a new generation of surgeons in Malawi. As Mulima stated, “We are the pioneers of this program. Being young blood, we have the future of the program in our hands.”

Contributed by Anna Bauer, graduate student, Department of Maternal and Child Health, UNC Gillings School of Global Public Health.