Jim Katzenstein: Management Expert Leads Mission of Health Care and Education

Through the efforts of doctors from around the world working and teaching at local village clinics and health education, Health Span International (HSI), led by executive director Jim Katzenstein, works to help communities as far away as Tanzania or Cameroon but also closer to home, in New Orleans, to improve local health care with a hybrid of hands-on medical treatment, the development and training of nurses, doctors and specialists, and the use of technology - what Katzenstein calls "telemedicine," to inform patients and practitioners in developing economies about basic health issues.

The adjunct faculty member in the management department at California State University, Dominguez Hills, draws upon 30 years of experience as senior management at companies such as Keebler Foods, the A&P Grocery Company and General Cinema to prepare his students to tackle real world business problems and to to help him lead the nonprofit in its mission to provide health care and education to underserved populations and prepare his students.

“It’s a partnership, with health care workers from here and there, collaborating,” he says.

Since its inception in 2001, HSI has been wholly dependent on donated funds, which for Katzenstein and his colleagues, including Barbara Chrispin, emerita professor of management, means thinking outside the box. Often, their clinical facilities are set up in less than orthodox venues ranging from vans and buses to a neighborhood bar. In these settings, the nonprofit provides free prenatal and maternal care, infant wellness exams, vaccinations, HIV/AIDS testing, and cervical cancer screening. Photographs and patient assessments are sent via email and responded to with diagnoses by doctors and pathologists – among them Katzenstein’s daughter, a pediatrician – from around the world. The training of doctors and nurses takes place at the Mission Mikocheni Hospital and Hubert Kairuki Memorial University, both in Dar Es Salaam, Tanzania. And patients themselves are educated on public health issues through weekly radio broadcasts on such topics as family planning, drug addiction, dental care and the importance of clean water.

Katzenstein says that the nonprofit seeks to educate local practitioners and their patients on modern medicine and health care while maintaining a respect for native healers and their traditions.

“The patient is in one world and the doctors and nurses are in another,” he says. “You’ve got to bridge that gap. Our nurses go into the villages and develop a relationship with traditional healers and let them know, ‘We are not here to replace you. We are here to work with you and improve health care.’”

Prevention as the best medicine is, according to Katzenstein, a key factor in HSI’s success. He says that the ultimate goal is to upgrade the skills of doctors and nurses in these regions in order to supplement the current health care system in more developed communities and extend its reach to the village level.

“Once you get [the system] set up, it’s theirs,” he says with satisfaction. “That gets them self-sufficient. It also addresses the millennium development goals [to end] the high maternal and infant mortality rate in these countries.”

Many children in developing countries are still orphaned by the HIV/AIDS epidemic. HSI oversees an orphanage on the outskirts of Dar es Salaam in Tanzania, providing food, milk, and school supplies to its residents. In addition, the organization subsidizes secondary school fees for local children.

Although HSI has concentrated its efforts in Africa, last year, the organization took on a project closer to home: reconnecting New Orleans residents with primary and pediatric care in underserved areas still neglected in the aftermath of Hurricane Katrina. Turning to its expertise with mobile health care clinics and telemedicine, the nonprofit is working toward establishing a fixed clinic to service the impoverished, multicultural population of central New Orleans. Katzenstein underscores the parallels between the third-world environment that HSI has experienced in Africa, and the irony of similar conditions for the poor in the United States.

“One of the major deliverers of health care [in New Orleans], Charity Hospital, was destroyed,” he says. “And you had health care workers that left and didn’t come back. So now you’ve got a population that has insurance, Medicare, and Medicaid —there are some private funds—but there is nowhere to get health care. There’s a shortage of fixed sites.”

Katzenstein says that a program that transports local residents to health care facilities in the city and brings them home is HSI’s version of a “reverse” mobile clinic for now, to supplement visits by other agencies that bring health fair-type mobile facilities to the neighborhoods. The organization has also been asked by the state government to examine possibilities for mental health care through telemedicine technology in rural areas. Whether in Africa or the United States, however, Katzenstein says that HSI’s mission of capacity and access is the same.

“There’s a man in Tanzania, who comes to one of our clinics,” says Katzenstein. “He’s blind, and his wife is blind. When she got pregnant, the hospital that I’m working with, delivered the baby for free.

“He shows up one day with his cane and the baby on his shoulder. The nurse picks the baby up, gives it a well-baby visit, vaccinates it, and changes its diaper. In the meantime, he sits there on a bench, waiting. When she’s done, she puts the baby on his shoulder, and he gets up and leaves. I cried. Without this, he and that baby would have no access to health care.”

- Joanie Harmon

Photo above: Health Span International's clinic in Mikocheni, a slum in Dar es Salaam. Servicing up to 120 patients on the one day per week that it is open, the clinic is located in the back of a bar.

Courtesy of Jim Katzenstein